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{"sheet":"Test Cases","index":0,"n_rows":1691,"n_cols":19,"rows_kept":1691,"cut":false,"hidden":false,"merged":[]}
["Test Case ID","Use Case ID","Edit ID","Element ID","Seq #","Bene Info","Provider Info","Intercase Dependancies","Prerequesites for Set-Up","Purpose of Test Case","Steps to Execute","Expected Results","Comments","Data File xRef","MAC & CEDI Exception","Exception Explanation","Exception Response","MAC & CEDI Pass/Fail","Date Completed"]
["DA92400.CR303...0003","DR92400","X222.371.2400.CR303.030","CR303",3,null,null,null,null,"\nTo verify a 999E is generated when 2400.CR303 is not = to numerics","Submit a claim with 2400.CR303=AA\n","IK403 = 6: \"Invalid Character in Data Element\""]
["DA92400.CR303...0011","DA92400","X222.371.2400.CR303.015","CR303",1,null,null,null,null,"To verify that 999E errors  is generated when 2400.CR303 is not 1 or 2 digits","Submit a claim with  2400.CR303 greater than 2 digits","999 accept with errors, data mapped correctly to flat file"]
["DA92400.SV501-04...0010","DA92400","X222.359.2400.SV501-4.010","SV501-04",1,null,null,null,null,"To verify that a 999 accept with errors is received when SV501-4 is present","Submit a claim with SV501-4 present","999 accept, not used data dropped, remaining data mapped correctly to flat file"]
["DA92400.SV501-06...0010","DA92400","X222.359.2400.SV501-6.010","SV501-06",1,null,null,null,null,"To verify that a 999 accept with errors is received when SV501-6 is present","Submit a claim with SV501-6 present","999 accept, not used data dropped, remaining data mapped correctly to flat file"]
["DA92400.SV501-08...0010","DA92400","X222.359.2400.SV501-8.010","SV501-08",1,null,null,null,null,"To verify that a 999 accept with errors is received when SV501-8 is present","Submit a claim with SV501-8 present","999 accept, not used data dropped, remaining data mapped correctly to flat file"]
["DA92400.SV504...0010","DA92400","X222.359.2400.SV504.010","SV504",1,null,null,null,null,"To verify that a 999 accept with errors is received when 2400.SV504 is > 99,999.99 ","Submit a claim with SV504=10199999999999999999999999.99","999 accept with errors, data mapped correctly to flat file"]
["DA92400.SV505...0035","DA92400","X222.359.2400.SV505.035","SV505",35,null,null,null,null,"To verify that a 999E is generated when 2400.SV505 is greater than 99,999.99","Submit claim with 2400.SV505=100,000.00","IK403 = 5: \"Data Element Too Long\""]
["DA92400.SV507...0010","DA92400","X222.359.2400.SV507.010","SV507",1,null,null,null,null,"To verify that a 999 accept with errors is received when SV507 is present","Submit a claim with SV507 present","999 accept, not used data dropped, remaining data mapped correctly to flat file"]
["DA92440.FRM03...0090","DA92400","X222.494.2440.FRM03.090","FRM03",2,null,null,null,null,"To verify a 999 accept with errors is received when 2440.FRM03 is not AN characters","Submit a claim where 2440.FRM03 is a special character (use TAB character by doing Shift Tab). In the data file it will be visible only as spaces","999 Accept with errors IK403=6 is received and data is mapped correctly to the flat file."]
["DAS2300.HI09-02.BF..0030","DAS2300","X222.226.2300.HI09-2.030","HI09-2",30,null,null,null,null,"To verify that a 277 accept is generated when 2400.SV107-1, \nSV107-2, \nSV107-3 OR SV107-4=9 and \n2300.HI09-1=BF but 2300.HI09-2 is a valid ICD-9 diagnosis code for the 2400.DTP03 date for 2400.DTP01=472\n","Submit claim with:\n2400.SV107-1=9 \n2300.HI09-1=BF\n2400.DTP01=472, DTP03=  and\n2300.HI09-2 is a valid ICD-9 diagnosis code for the that date","277 accept is generated and data is mapped correctly to the flat file"]
["DAS2300.HI09-02.BF..0031","DAS2300","X222.226.2300.HI09-2.030","HI09-2",31,null,null,null,null,"To verify that a 277 accept is generated when 2400.SV107-1, SV107-2, SV107-3 or SV107-4=9 and 2300.HI09-1=BF but 2300.HI09-2 is a valid ICD-9 diagnosis code for the 2400.DTP03 date for 2400.DTP01=472","Submit claim with: \n2400.SV107-2=9 \n2300.HI09-1=BF \n2400.DTP01=472, DTP03=  and\n2300.HI09-2 is a valid ICD-9 diagnosis code for the  date","277 accept is generated and data is mapped correctly to the flat file"]
["DAS2300.HI09-02.BF..0032","DAS2300","X222.226.2300.HI09-2.030","HI09-2",32,null,null,null,null,"To verify that a 277 accept is generated when 2400.SV107-1, SV107-2, SV107-3 or SV107-4=9 and 2300.HI09-1=BF but 2300.HI09-2 is a valid ICD-9 diagnosis code for the 2400.DTP03 date for 2400.DTP01=472","Submit claim with: \n2400.SV107-3=9 \n2300.HI09-1=BF \n2400.DTP01=472, DTP03=  and \n2300.HI09-2 is a valid ICD-9 diagnosis code for the that date","277 accept is generated and data is mapped correctly to the flat file"]
["DAS2300.HI09-02.BF..0033","DAS2300","X222.226.2300.HI09-2.030","HI09-2",33,null,null,null,null,"To verify that a 277 accept is generated when 2400.SV107-1, SV107-2, SV107-3 or SV107-4=9 and 2300.HI09-1=BF but 2300.HI09-2 is a valid ICD-9 diagnosis code for the 2400.DTP03 date for 2400.DTP01=472","Submit claim with: \n2400.SV107-4=9 \n2300.HI09-1=BF \n2400.DTP01=472, DTP03=  and \n2300.HI09-2 is a valid ICD-9 diagnosis code for the  date","277 accept is generated and data is mapped correctly to the flat file"]
["DAS2300.HI09-02.BF..0070","DAS2300","X222.226.2300.HI09-2.070","HI09-2",70,null,null,null,null,"To verify that a 277 accept is generated when 2400.SV107-1, SV107-2, SV107-3 and SV107-4 are not =9 and 2300.HI09-1=BF but 2300.HI09-2 is a valid ICD-9 principal diagnosis code for every date in the date of service range 2400.DTP03 date for 2400.DTP01=472","Submit claim with: \n2400.SV107-1, SV107-2, SV107-3 and SV107-4 NOT=  9\n2300.HI09-1=BF\n2300.HI09-2 is a valid ICD-9 principal diagnosis code for the date range","277 accept is generated and data is mapped correctly to the flat file"]
["DAS2300.HI10-02.BF..0030","DAS2300","X222.226.2300.HI10-2.030","HI10-2",30,null,null,null,null,"To verify that a 277 accept is generated when 2400.SV107-1, SV107-2, SV107-3 or SV107-4=10 and 2300.HI10-1=BF but 2300.HI10-2 is a valid ICD-9 diagnosis code for the 2400.DTP03 date for 2400.DTP01=472","Submit claim with:\n2400.SV107-1=10 \n2300.HI10-1=BF and 2400.DTP01=472, DTP03=  and \n2300.HI10-2 is a valid ICD-9 diagnosis code for the that date","277 accept is generated and data is mapped correctly to the flat file"]
["DAS2300.HI10-02.BF..0031","DAS2300","X222.226.2300.HI10-2.030","HI10-2",31,null,null,null,null,"To verify that a 277 accept is generated when 2400.SV107-1, SV107-2, SV107-3 or SV107-4=10 and 2300.HI10-1=BF but 2300.HI10-2 is a valid ICD-9 diagnosis code for the 2400.DTP03 date for 2400.DTP01=472","Submit claim with  2400.SV107-2=10 and 2300.HI10-1=BF and 2400.DTP01=472, DTP03=  and 2300.HI10-2 is a valid ICD-9 diagnosis code for the that date","277 accept is generated and data is mapped correctly to the flat file"]
["DAS2300.HI10-02.BF..0032","DAS2300","X222.226.2300.HI10-2.030","HI101-2",32,null,null,null,null,"To verify that a 277 accept is generated when 2400.SV107-1, SV107-2, SV107-3 or SV107-4=10 and 2300.HI10-1=BF but 2300.HI10-2 is a valid ICD-9 diagnosis code for the 2400.DTP03 date for 2400.DTP01=472","Submit claim with 2400.SV107-3=10 and 2300.HI10-1=BF and 2400.DTP01=472, DTP03=  and 2300.HI10-2 is a valid ICD-9 diagnosis code for the date","277 accept is generated and data is mapped correctly to the flat file"]
["DAS2300.HI10-02.BF..0033","DAS2300","X222.226.2300.HI10-2.030","HI10-2",33,null,null,null,null,"To verify that a 277 accept is generated when 2400.SV107-1, SV107-2, SV107-3 or SV107-4=10 and 2300.HI10-1=BF but 2300.HI10-2 is a valid ICD-9 diagnosis code for the 2400.DTP03 date for 2400.DTP01=472","Submit claim with 2400.SV107-4=10 and 2300.HI10-1=BF and 2400.DTP01=472, DTP03=  and 2300.HI10-2 is a valid ICD-9 diagnosis code for the  date","277 accept is generated and data is mapped correctly to the flat file"]
["DAS2300.HI10-02.BF..0070","DAS2300","X222.226.2300.HI10-2.070","HI10-2",70,null,null,null,null,"To verify that a 277 accept is generated when 2400.SV107-1, SV107-2, SV107-3 and SV107-4 are not =10 and 2300.HI10-1=BF but 2300.HI10-2 is not a valid ICD-9 principal diagnosis code for every date in the date of service range 2400.DTP03 date for 2400.DTP01=472","Submit claim with 2400.SV107-1, SV107-2, SV107-3 OR SV107-4 NOT = 10\n2300.HI10-1=BF  and 2300.HI10-2 is a valid ICD-9 principal diagnosis code for the date range","277 accept is generated and data is mapped correctly to the flat file"]
["DAS2300.HI11-02.BF..0030","DAS2300","X222.226.2300.HI11-2.030","HI11-2",30,null,null,null,null,"To verify that a 277 accept is generated when 2400.SV107-1, SV107-2, SV107-3 or SV107-4=11 and 2300.HI11-1=BF but 2300.HI11-2 is a valid ICD-9 diagnosis code for the 2400.DTP03 date for 2400.DTP01=472","Submit claim with 2400.SV107-1=11 and 2300.HI11-1=BF and 2400.DTP01=472, DTP03=  and 2300.HI11-2 is a valid ICD-9 diagnosis code for the that date","277 accept is generated and data is mapped correctly to the flat file"]
["DAS2300.HI11-02.BF..0031","DAS2300","X222.226.2300.HI11-2.030","HI11-2",31,null,null,null,null,"To verify that a 277 accept is generated when 2400.SV107-1, SV107-2, SV107-3 or SV107-4=11 and 2300.HI11-1=BF but 2300.HI11-2 is a valid ICD-9 diagnosis code for the 2400.DTP03 date for 2400.DTP01=472","Submit claim with 2400.SV107-2=11 and 2300.HI11-1=BF and 2400.DTP01=472, DTP03=  and 2300.HI11-2 is a valid ICD-9 diagnosis code for the that date","277 accept is generated and data is mapped correctly to the flat file"]
["DAS2300.HI11-02.BF..0032","DAS2300","X222.226.2300.HI11-2.030","HI11-2",32,null,null,null,null,"To verify that a 277 accept is generated when 2400.SV107-1, SV107-2, SV107-3 or SV107-4=11 and 2300.HI11-1=BF but 2300.HI11-2 is a valid ICD-9 diagnosis code for the 2400.DTP03 date for 2400.DTP01=472","Submit claim with 2400.SV107-3=11 and 2300.HI11-1=BF and 2400.DTP01=472, DTP03=  and 2300.HI11-2 is a valid ICD-9 diagnosis code for the that date","277 accept is generated and data is mapped correctly to the flat file"]
["DAS2300.HI11-02.BF..0033","DAS2300","X222.226.2300.HI11-2.030","HI11-2",33,null,null,null,null,"To verify that a 277 accept is generated when 2400.SV107-1, SV107-2, SV107-3 or SV107-4=11 and 2300.HI11-1=BF but 2300.HI11-2 is a valid ICD-9 diagnosis code for the 2400.DTP03 date for 2400.DTP01=472","Submit claim with 2400.SV107-4=11 and 2300.HI11-1=BF and 2400.DTP01=472, DTP03=  and 2300.HI11-2 is a valid ICD-9 diagnosis code for the that date","277 accept is generated and data is mapped correctly to the flat file"]
["DAS2300.HI11-02.BF..0070","DAS2300","X222.226.2300.HI11-2.070","HI11-2",70,null,null,null,null,"To verify that a 277accept is generated when 2400.SV107-1, SV107-2, SV107-3 and SV107-4 are not =11 and 2300.HI11-1=BF but 2300.HI11-2 is  a valid ICD-9 principal diagnosis code for every date in the date of service range 2400.DTP03 date for 2400.DTP01=472","Submit claim with 2400.SV107-1, SV107-2, SV107-3 and SV107-4 NOT = 11 and 2300.HI11-1=BF and 2300.HI11-2 is a valid ICD-9 diagnosis code for the date range\n","277 accept is generated and data is mapped correctly to the flat file"]
["DAS2300.HI12-02.BF..0030","DAS2300","X222.226.2300.HI12-2.030","HI12-2",30,null,null,null,null,"To verify that a 277 accept is generated when 2400.SV107-1, SV107-2, SV107-3 or SV107-4=12 and 2300.HI12-1=BF but 2300.HI12-2 is a valid ICD-9 diagnosis code for the 2400.DTP03 date for 2400.DTP01=472","Submit claim with 2400.SV107-1=12 and 2300.HI12-1=BF and 2400.DTP01=472, DTP03=  and 2300.HI12-2 is a valid ICD-9 diagnosis code for the that date","277 accept is generated and data is mapped correctly to the flat file"]
["DAS2300.HI12-02.BF..0031","DAS2300","X222.226.2300.HI12-2.030","HI12-2",31,null,null,null,null,"To verify that a 277 accept is generated when 2400.SV107-1, SV107-2, SV107-3 or SV107-4=12 and 2300.HI12-1=BF but 2300.HI12-2 is a valid ICD-9 diagnosis code for the 2400.DTP03 date for 2400.DTP01=472","Submit claim with 2400.SV107-2=12 and 2300.HI12-1=BF and 2400.DTP01=472, DTP03=  but 2300.HI12-2 is a valid ICD-9 diagnosis code for the that date","277 accept is generated and data is mapped correctly to the flat file"]
["DAS2300.HI12-02.BF..0032","DAS2300","X222.226.2300.HI12-2.030","HI12-2",32,null,null,null,null,"To verify that a 277 accept is generated when 2400.SV107-1, SV107-2, SV107-3 or SV107-4=12 and 2300.HI12-1=BF but 2300.HI12-2 is a valid ICD-9 diagnosis code for the 2400.DTP03 date for 2400.DTP01=472","Submit claim with 2400.SV107-3=12 and 2300.HI12-1=BF and 2400.DTP01=472, DTP03=  but 2300.HI12-2 is a valid ICD-9 diagnosis code for the that date","277 accept is generated and data is mapped correctly to the flat file"]
["DAS2300.HI12-02.BF..0033","DAS2300","X222.226.2300.HI12-2.030","HI12-2",33,null,null,null,null,"To verify that a 277 accept is generated when 2400.SV107-1, SV107-2, SV107-3 or SV107-4=12 and 2300.HI12-1=BF but 2300.HI12-2 is a valid ICD-9 diagnosis code for the 2400.DTP03 date for 2400.DTP01=472","Submit claim with 2400.SV107-4=12 and 2300.HI12-1=BF and 2400.DTP01=472, DTP03=  and 2300.HI12-2 is a valid ICD-9 diagnosis code for the that date","277 accept is generated and data is mapped correctly to the flat file"]
["DAS2300.HI12-02.BF..0070","DAS2300","X222.226.2300.HI12-2.070","HI12-2",70,null,null,null,null,"To verify that a 277 accept is generated when 2400.SV107-1, SV107-2, SV107-3 and SV107-4 are not =12 and 2300.HI12-1=BF but 2300.HI12-2 is a valid ICD-9 diagnosis code for every date in the date of service range 2400.DTP03 date for 2400.DTP01=472","\nSubmit claim with 2400.SV107-1, SV107-2, SV107-3 and SV107-4 NOT = 12 and 2300.HI12-1=BF  and 2300.HI12-2 is a valid ICD-9 principal diagnosis code for the date range\n","277 accept is generated and data is mapped correctly to the flat file"]
["DAS2400.CRC...0003","DAS2400","X222.376.2400.CRC.030","CRC",3,null,null,null,null,"To verify a 277CA accept is generated when 2400.CRC01=70 is not present","Submit a claim with  2400.CRC01=09","277CA accepted, and data is mapped correctly to flat file "]
["DAS2400.CRC...0004","DAS2400","X222.373.2400.CRC.040","CRC",4,null,null,null,null,"To verify a 277CA accept is generated when 2400.CRC01=07 is not  present","Submit a claim with  2400.CRC01=09","277CA accepted, and data is mapped correctly to flat file "]
["DAS2400.CRC04.09..0003","DAS2400","X222.378.2400.CRC04.030","CRC04",3,null,null,null,null,"To verify a 277C is generated when 2400.CRC01='09' and  2400.CRC04 is not =  to 38","Submit a claim with 2400.CRC01='09' and 2400.CRC04=83","\nCSCC A7: \"Acknowledgement /Rejected for Invalid Information...\"\nCSC 527: \"Certification Condition Indicator\"\n"]
["DAS2400.DTP.304..0002","DAS2400","X222.386.2400.DTP.020","DTP",2,null,null,null,null,"To verify that a 999 accept is received when 2400.DTP when DTP01 is not = 304","Submit a claim with 2400.DTP when DTP01=461","999 accept is received and data is mapped correctly to the flat file"]
["DAS2400.DTP.455..0002","DAS2400","X222.389.2400.DTP.020","DTP",2,null,null,null,null,"To verify that a 999 accept is received when 2400.DTP when DTP01 is not =455  ","Submit a claim with 2400.DTP when DTP01=461","999 accept is received and data is mapped correctly to the flat file"]
["DAS2400.DTP.461..0002","DAS2400","X222.385.2400.DTP.020","DTP",2,null,null,null,null,"To verify that a 999 accept is generated when 2400.DTP01=461 is present when 2400.CRC01=09 and CRC03 or CRC04=38 and CRC02=Y is present","Submit a claim with 2400.DTP01=461 is not present when 2400.CRC01=09 and CRC03 or CRC04=38 and CRC02=Y ","999 accept is received and data is correctly mapped to the flat file"]
["DAS2400.DTP.461..0003","DAS2400","X222.385.2400.DTP.030","DTP",3,null,null,null,null,"To verify that a 999 accept is generated when only one iteration of  2400.DTP01=461 is present  ","Submit a claim with 1 2400.CR301=461 segment","999 accept is received and data is correctly mapped to the flat file"]
["DAS2400.DTP.463..0001","DAS2400","X222.384.2400.DTP01.010\nX222.384.2400.DTP01.020","DTP01",1,null,null,null,null,"To verify that a 999 accept is generated when 2400.DTP is present with DPT01=463","Submit a claim with 2400.DTP is present with  DPT01=463","999 accept is received and data is correctly mapped to the flat file"]
["DAS2400.DTP.463..0002","DAS2400","X222.384.2400.DTP.020",null,2,null,null,null,null,"To verify that a 999 accept is generated when 2400.DTP01=463 is present when 2400.CR3 is present ","Submit a claim with 2400.CR3 and 2400.DTP01=463","999 accept is received and data is correctly mapped to the flat file"]
["DAS2400.DTP.463..0003","DAS2400","X222.384.2400.DTP.030","DTP",3,null,null,null,null,"To verify that a 999 accept is generated when multiple 2400.DTP01=463 segments are not present","Submit a claim with 1 iterations of 2400.DTP01=463","999 accept is received and data is correctly mapped to the flat file"]
["DAS2400.DTP01.461..0001","DAS2400","X222.385.2400.DTP01.010\nX222.385.2400.DTP01.020","DTP01",1,null,null,null,null,"To verify that a 999 accept is generated when 2400.DTP is present when DPT01=461","Submit a claim with 2400.DTP is present with DPT01=461","999 accept is received and data is correctly mapped to the flat file"]
["DAS2400.DTP01.607..0001","DAS2400","X222.383.2400.DTP01.010\nX222.383.2400.DTP01.020","DTP01",1,null,null,null,null,"To verify that a 999 accept is generated when 2400.DTP is present with a valid DPT01","Submit a claims with 2400.DTP is present with DPT01=607","999 accept is received and data is correctly mapped to the flat file"]
["DAS2400.DTP02.463.D8.0002","DAS2400","X222.384.2400.DTP02.020","DTP02",2,null,null,null,null,"To verify that a 999 accept is generated when 2400.DTP01=463 is present when DPT02 is= D8","Submit a claim with 2400.DTP01=463 is present with DPT02=D8 date range","999 accept is received and data is correctly mapped to the flat file"]
["DAS2400.DTP02.607..0001","DAS2400","X222.383.2400.DTP02.010\nX222.383.2400.DTP02.020","DTP02",1,null,null,null,null,"To verify that a 999 accept is generated when 2400.DTP01=607 is present with DPT02","Submit a claims with 2400.DTP01=607 is present with DPT02=D8 ","999 accept is received and data is correctly mapped to the flat file"]
["DAS2400.DTP03..D8.0070","DAS2400","X222.380.2400.DTP03.070","DTP03",70,null,null,null,null,"To verify a 277CA accept is generated when \n2400.DTP01=472 \n2400.DTP02= D8 and the CCYYMM of the 1st date is = to the CCYYMM and \nSV101-3 -4 -5 or -6 is = RR and SV104 is = 1","Submit a claim with  2400.DTP01=472, DTP02=D8 and the CCYYMM of the 1st date is = to the CCYYMM and SV101-3  is = RR and SV104 is  = 1","277 accept is received and data is correctly mapped to the flat file"]
["DAS2400.DTP03..D8.0071","DAS2400","X222.380.2400.DTP03.070","DTP03",71,null,null,null,null,"To verify a 277CA accept is generated when \n2400.DTP01=472 \n2400.DTP02= D8 and the CCYYMM of the 1st date is = to the CCYYMM and \nSV101-3 -4 -5 or -6 is = RR and SV104 is = 1","Submit a claim with  2400.DTP01=472, DTP02=D8 and the CCYYMM of the 1st date is = to the CCYYMM and SV101-4  is = RR and SV104 is  = 1","277 accept is received and data is correctly mapped to the flat file"]
["DAS2400.DTP03..D8.0072","DAS2400","X222.380.2400.DTP03.070","DTP03",72,null,null,null,null,"To verify a 277CA accept is generated when \n2400.DTP01=472 \n2400.DTP02= D8 and the CCYYMM of the 1st date is = to the CCYYMM and \nSV101-3 -4 -5 or -6 is = RR and SV104 is = 1","Submit a claim with  2400.DTP01=472, DTP02=D8 and the CCYYMM of the 1st date is = to the CCYYMM and SV101-5  is = RR and SV104 is  = 1","277 accept is received and data is correctly mapped to the flat file"]
["DAS2400.DTP03..D8.0073","DAS2400","X222.380.2400.DTP03.070","DTP03",73,null,null,null,null,"To verify a 277CA accept is generated when \n2400.DTP01=472 \n2400.DTP02= D8 and the CCYYMM of the 1st date is = to the CCYYMM and \nSV101-3 -4 -5 or -6 is = RR and SV104 is = 1","Submit a claim with  2400.DTP01=472, DTP02=D8 and the CCYYMM of the 1st date is = to the CCYYMM and SV101-6  is = RR and SV104 is  = 1","277 accept is received and data is correctly mapped to the flat file"]
["DAS2400.DTP03..IS.0008","DAS2400","X222.380.2400.DTP03.080","DTP",8,null,null,null,null,"To verify a 277CA accept is generated when 2400.DTP01=472, DTP02 RD8 and the second date is a future date and the proc option on the HCPCS file is = IS, PA, PE, PI, PK, PL, PP, PS or PX  ","Submit a claim with 2400.DTP01=472, DTP02=RD8 and the second date is a future date 20150321 and proc option on the HCPCs file is = IS","277 accept is received and data is correctly mapped to the flat file"]
["DAS2400.DTP03..PA.0008","DAS2400","X222.380.2400.DTP03.080","DTP",8,null,null,null,null,"To verify a 277CA accept is generated when 2400.DTP01=472, DTP02 RD8 and the second date is a future date and the proc option on the HCPCS file is = IS, PA, PE, PI, PK, PL, PP, PS or PX  ","Submit a claim with 2400.DTP01=472, DTP02=RD8 and the second date is a future date 20150321 and proc option on the HCPCs file is = PA","277 accept is received and data is correctly mapped to the flat file"]
["DAS2400.DTP03..PE.0008","DAS2400","X222.380.2400.DTP03.080","DTP",8,null,null,null,null,"To verify a 277CA accept is generated when 2400.DTP01=472, DTP02 RD8 and the second date is a future date and the proc option on the HCPCS file is = IS, PA, PE, PI, PK, PL, PP, PS or PX  ","Submit a claim with 2400.DTP01=472, DTP02=RD8 and the second date is a future date 20150321 and proc option on the HCPCs file is = PE","277 accept is received and data is correctly mapped to the flat file"]
["DAS2400.DTP03..PI.0008","DAS2400","X222.380.2400.DTP03.080","DTP",8,null,null,null,null,"To verify a 277CA accept is generated when 2400.DTP01=472, DTP02 RD8 and the second date is a future date and the proc option on the HCPCS file is = IS, PA, PE, PI, PK, PL, PP, PS or PX  ","Submit a claim with 2400.DTP01=472, DTP02=RD8 and the second date is a future date 20150321 and proc option on the HCPCs file is = PI","277 accept is received and data is correctly mapped to the flat file"]
["DAS2400.DTP03..PK.0008","DAS2400","X222.380.2400.DTP03.080","DTP",8,null,null,null,null,"To verify a 277CA accept is generated when 2400.DTP01=472, DTP02 RD8 and the second date is a future date and the proc option on the HCPCS file is = IS, PA, PE, PI, PK, PL, PP, PS or PX  ","Submit a claim with 2400.DTP01=472, DTP02=RD8 and the second date is a future date 20150321 and proc option on the HCPCs file is = PK","277 accept is received and data is correctly mapped to the flat file"]
["DAS2400.DTP03..PL.0008","DAS2400","X222.380.2400.DTP03.080","DTP",8,null,null,null,null,"To verify a 277CA accept is generated when 2400.DTP01=472, DTP02 RD8 and the second date is a future date and the proc option on the HCPCS file is = IS, PA, PE, PI, PK, PL, PP, PS or PX  ","Submit a claim with 2400.DTP01=472, DTP02=RD8 and the second date is a future date 20150321 and proc option on the HCPCs file is = PL","277 accept is received and data is correctly mapped to the flat file"]
["DAS2400.DTP03..PP.0008","DAS2400","X222.380.2400.DTP03.080","DTP",8,null,null,null,null,"To verify a 277CA accept is generated when 2400.DTP01=472, DTP02 RD8 and the second date is a future date and the proc option on the HCPCS file is = IS, PA, PE, PI, PK, PL, PP, PS or PX  ","Submit a claim with 2400.DTP01=472, DTP02=RD8 and the second date is a future date 20150321 and proc option on the HCPCs file is =PP","277 accept is received and data is correctly mapped to the flat file"]
["DAS2400.DTP03..PS.0008","DAS2400","X222.380.2400.DTP03.080","DTP",8,null,null,null,null,"To verify a 277CA accept is generated when 2400.DTP01=472, DTP02 RD8 and the second date is a future date and the proc option on the HCPCS file is = IS, PA, PE, PI, PK, PL, PP, PS or PX  ","Submit a claim with 2400.DTP01=472, DTP02=RD8 and the second date is a future date 20150321 and proc option on the HCPCs file is =PS","277 accept is received and data is correctly mapped to the flat file"]
["DAS2400.DTP03..PX.0008","DAS2400","X222.380.2400.DTP03.080","DTP",8,null,null,null,null,"To verify a 277CA accept is generated when 2400.DTP01=472, DTP02 RD8 and the second date is a future date and the proc option on the HCPCS file is = IS, PA, PE, PI, PK, PL, PP, PS or PX  ","Submit a claim with 2400.DTP01=472, DTP02=RD8 and the second date is a future date 20150321 and proc option on the HCPCs file is =PX","277 accept is received and data is correctly mapped to the flat file"]
["DAS2400.DTP03..RD8.0070","DAS2400","X222.380.2400.DTP03.070","DTP03",70,null,null,null,null,"To verify a 277CA accept is generated when \n2400.DTP01=472 \n2400.DTP02= RD8 and the CCYYMM of the 1st date is NOT = to the CCYYMM of the second date and \nSV101-3 -4 -5 or -6 is = RR and SV104 is = 1","Submit a claim with  2400.DTP01=472, DTP02=RD8 and the CCYYMM of the 1st date is = to the CCYYMM of the second date and SV101-3  is = RR and SV104 is  = 1","277 accept is received and data is correctly mapped to the flat file"]
["DAS2400.DTP03..RD8.0071","DAS2400","X222.380.2400.DTP03.070","DTP03",71,null,null,null,null,"To verify a 277CA accept is generated when \n2400.DTP01=472 \n2400.DTP02= RD8 and the CCYYMM of the 1st date is NOT = to the CCYYMM of the second date and \nSV101-3 -4 -5 or -6 is = RR and SV104 is = 1","Submit a claim with  2400.DTP01=472, DTP02=RD8 and the CCYYMM of the 1st date is = to the CCYYMM of the second date and SV101-4  is = RR and SV104 is  = 1","277 accept is received and data is correctly mapped to the flat file"]
["DAS2400.DTP03..RD8.0072","DAS2400","X222.380.2400.DTP03.070","DTP03",72,null,null,null,null,"To verify a 277CA accept is generated when \n2400.DTP01=472 \n2400.DTP02= RD8 and the CCYYMM of the 1st date is NOT = to the CCYYMM of the second date and \nSV101-3 -4 -5 or -6 is = RR and SV104 is = 1","Submit a claim with  2400.DTP01=472, DTP02=RD8 and the CCYYMM of the 1st date is = to the CCYYMM of the second date and SV101-5  is = RR and SV104 is  = 1","277 accept is received and data is correctly mapped to the flat file"]
["DAS2400.DTP03..RD8.0073","DAS2400","X222.380.2400.DTP03.070","DTP03",73,null,null,null,null,"To verify a 277CA accept is generated when \n2400.DTP01=472 \n2400.DTP02= RD8 and the CCYYMM of the 1st date is NOT = to the CCYYMM of the second date and \nSV101-3 -4 -5 or -6 is = RR and SV104 is = 1","Submit a claim with  2400.DTP01=472, DTP02=RD8 and the CCYYMM of the 1st date is = to the CCYYMM of the second date and SV101-6  is = RR and SV104 is  = 1","277 accept is received and data is correctly mapped to the flat file"]
["DAS2400.PWK.CT..0003","DAS2400","X222.366.2400.PWK.030","PWK",3,null,null,null,null,"To verify that a 999 accept is generated when there is not more than one iteration of 2400.PWK01=CT ","Submit a claim with 1 iterations of 2400.PWK01=CT ","999 accept is received and data is correctly mapped to the flat file"]
["DAS2400.PWK01.CT..0001","DAS2400","X222.366.2400.PWK01.010","PWK01",1,null,null,null,null,"To verify that a 999 accept is generated when 2400.PWK including PKW01  ","Submit a claim with 2400.PWK is present including PWK01  ","999 accept is received and data is correctly mapped to the flat file"]
["DAS2400.PWK01.CT..0002","DAS2400","X222.366.2400.PWK01.020","PWK01",2,null,null,null,null,"To verify that a 999 accept is generated when 2400.PWK01 is = CT","Submit a claim where 2400.PWK01 is = CT","999 accept is received and data is correctly mapped to the flat file"]
["DAS2400.PWK02...0001","DAS2400","X222.366.2400.PWK02.010","PWK02",1,null,null,null,null,"To verify that a 999 accept is generated when 2400.PWK is present including PKW02  ","Submit a claim with 2400.PWK and  PWK02 is present","999 accept is received and data is correctly mapped to the flat file"]
["DAS2400.PWK02..AB.0002","DAS2400","X222.366.2400.PWK02.020","PWK02",2,null,null,null,null,"To verify that a 999 accept is generated when 2400.PWK and PKW02 is a valid code (ab, ad, af, ag, ns)","Submit a claim with  PWK02 is = AB","999 accept is received and data is correctly mapped to the flat file"]
["DAS2400.PWK02..AD.0002","DAS2400","X222.366.2400.PWK02.020","PWK02",2,null,null,null,null,"To verify that a 999 accept is generated when 2400.PWK and PKW02 is a valid code (ab, ad, af, ag, ns)","Submit a claim with  PWK02 is = AD","999 accept is received and data is correctly mapped to the flat file"]
["DAS2400.PWK02..AF.0002","DAS2400","X222.366.2400.PWK02.020","PWK02",2,null,null,null,null,"To verify that a 999 accept is generated when 2400.PWK and PKW02 is a valid code (ab, ad, af, ag, ns)","Submit a claim with  PWK02 is = AF","999 accept is received and data is correctly mapped to the flat file"]
["DAS2400.PWK02..AG.0002","DAS2400","X222.366.2400.PWK02.020","PWK02",2,null,null,null,null,"To verify that a 999 accept is generated when 2400.PWK and PKW02 is a valid code (ab, ad, af, ag, ns)","Submit a claim with  PWK02 is = AG","999 accept is received and data is correctly mapped to the flat file"]
["DAS2400.PWK02..NS.0002","DAS2400","X222.366.2400.PWK02.020","PWK02",2,null,null,null,null,"To verify that a 999 accept is generated when 2400.PWK and PKW02 is a valid code (ab, ad, af, ag, ns)","Submit a claim with  PWK02 is = NS","999 accept is received and data is correctly mapped to the flat file"]
["DAS2400.REF.F4..0010","DAS2400","X222.405.2400.REF.010","REF ",10,null,null,null,null,"\nTo verify a 277C Accept is generated when 2400.REF01=F4 is present when 2400.SV101-3 -4 -5 or -6 is = 90\n","Submit a claim when 2400.SV101-3=90 is present AND 2400.REF01=F4 is present \n","277CA accepted, and data is mapped correctly to flat file "]
["DAS2400.REF.F4..0011","DAS2400","X222.405.2400.REF.010","REF ",11,null,null,null,null,"\nTo verify a 277C Accept is generated when 2400.REF01=F4 is present when 2400.SV101-3 -4 -5 or -6 is = 90\n","Submit a claim when 2400.SV101-4=90 is present AND 2400.REF01=F4 is present \n","277CA accepted, and data is mapped correctly to flat file "]
["DAS2400.REF.F4..0012","DAS2400","X222.405.2400.REF.010","REF ",12,null,null,null,null,"\nTo verify a 277CA accept is generated when 2400.REF01=F4 is present when 2400.SV101-3 -4 -5 or -6 is = 90\n","Submit a claim when 2400.SV101-5=90 is present AND 2400.REF01=F4 is present \n","277CA accepted, and data is mapped correctly to flat file "]
["DAS2400.REF.F4..0013","DAS2400","X222.405.2400.REF.010","REF ",13,null,null,null,null,"\nTo verify a 277CA accept is generated when 2400.REF01=F4 is present when 2400.SV101-3 -4 -5 or -6 is = 90\n","Submit claim with 2400.SV101-6=90  present and 2400.REF01=F4  present \n","277CA accepted, and data is mapped correctly to flat file "]
["DAS2400.SV101-03...0003","DAS2400","X222.351.2400.SV101-3.030","SV101-3",3,null,null,null,null,"\nTo verify a 277CA accept is generated when 2400.SV101-3=90 and 2400.REF01 is  = F4\n","Submit claim with 2400.SV101-3=90 and 2400.REF01=F4\n","277C accept is generated and data correctly mapped to flat file.\n"]
["DAS2400.SV101-04...0003","DAS2400","X222.351.2400.SV101-4.030","SV101-4",3,null,null,null,null,"\nTo verify a 277CA accept is generated when 2400.SV101-4=90 and 2400.REF01 is = F4\n","Submit claim with 2400.SV101-4=90 and 2400.REF01=F4\n","277C accept is generated and data correctly mapped to flat file.\n"]
["DAS2400.SV101-05...0003","DAS2400","X222.351.2400.SV101-5.030","SV101-5",3,null,null,null,null,"\nTo verify a 277CA accept is generated when 2400.SV101-5=90 and 2400.REF01 is  = F4\n","Submit claim with 2400.SV101-5=90 and 2400.REF01=F4\n","277C accept is generated and data correctly mapped to flat file.\n"]
["DAS2400.SV101-06...0003","DAS2400","X222.351.2400.SV101-6.030","SV101-6",3,null,null,null,null,"\nTo verify a 277CA accept is generated when 2400.SV101-6=90 and 2400.REF01 is  = F4\n","Submit claim with 2400.SV101-6=90 and 2400.REF01=F4\n","277C accept is generated and data correctly mapped to flat file.\n"]
["DAS2400.SV104...0008","DAS2400","X222.351.2400.SV104.080","SV104",8,null,null,null,null,"\nTo verify a 277CA accept is generated when 2400.SV101-2 is associated with proc option DR or PP, that 2400.SV104=2 and that 2400.SV101-3, SV101-4 SV101-5 or SV101-6 is = RT or LT\n","Submit claim with 2400.SV101-2=HCPCS (K0001>RR>KH>RT) of file with proc option = DR  and SV104=2 SV101-5=RT","277C accept is generated and data correctly mapped to flat file.\n"]
["DAS2400.SV104..DR.0070","DAS2400","X222.351.2400.SV104.070","SV104",70,null,null,null,null,"To verify a 277CA accept is generated when 2400.SV101-2 is associated with proc option DR or PP that 2400.SV104 must be = 1 or 2\n","\nSubmit claim with 2400.SV101-2=HCPCS (K0001>RR>KH) of file with proc option = DR and SV104=1\n","277C accept is generated and data correctly mapped to flat file.\n"]
["DAS2400.SV104..DR.0071","DAS2400","X222.351.2400.SV104.070","SV104",71,null,null,null,null,"To verify a 277CA accept is generated when 2400.SV101-2 is associated with proc option DR or PP that 2400.SV104 must be = 1 or 2\n","\nSubmit claim with 2400.SV101-2=HCPCS (K0001>RR>KH)of file with proc option = DR and SV104=2\n","277C accept is generated and data correctly mapped to flat file.\n"]
["DAS2400.SV104..PP.0070","DAS2400","X222.351.2400.SV104.070","SV104",70,null,null,null,null,"To verify a 277CA accept is generated when 2400.SV101-2 is associated with proc option DR or PP that 2400.SV104 must be = 1 or 2","Submit claim with 2400.SV101-2=HCPCS (K0001>RR>KH) of file with proc option = PP  and SV104=1","283 accept is generated and data icorrectly mapped to flat file."]
["DAS2400.SV104..PP.0071","DAS2400","X222.351.2400.SV104.070","SV104",71,null,null,null,null,"To verify a 277CA accept is generated when 2400.SV101-2 is associated with proc option DR or PP that 2400.SV104 must be = 1 or 2","Submit claim with 2400.SV101-2=HCPCS (K0001>RR>KH) of file with proc option = PP  and SV104=2","284 accept is generated and data icorrectly mapped to flat file."]
["DAS2400.SV107-01...0030","DAS2400","X222.351.2400.SV107-1.030","SV107-1",30,null,null,null,null,"To verify a 277 accept is generated when 2400.SV107-1 is >=1 and <=12","Submit claim with 2400.SV107-1=4","277T accept is generated and data correctly mapped to flat file."]
["DAS2400.SV107-01...0031","DAS2400","X222.351.2400.SV107-1.030","SV107-1",31,null,null,null,null,"To verify a 277 accept is generated when 2400.SV107-1 is >=1 and <=12","Submit claim with 2400.SV107-1=1","277T accept is generated and data correctly mapped to flat file."]
["DAS2400.SV107-02...0030","DAS2400","X222.351.2400.SV107-2.030","SV107-2",30,null,null,null,null,"To verify a 277 accept is generated when 2400.SV107-2 is >=1 and <=12","Submit claim with 2400.SV107-2=4","277T accept is generated and data correctly mapped to flat file."]
["DAS2400.SV107-02...0031","DAS2400","X222.351.2400.SV107-2.030","SV107-2",31,null,null,null,null,"To verify a 277 accept is generated when 2400.SV107-2 is >=1 and <=12","Submit claim with 2400.SV107-2=1","277T accept is generated and data correctly mapped to flat file."]
["DAS2400.SV107-03...0030","DAS2400","X222.351.2400.SV107-3.030","SV107-3",30,null,null,null,null,"To verify a 277CA accept is generated when 2400.SV107-3 is >=1 and <=12","Submit claim with 2400.SV107-3=4","277T accept is generated and data correctly mapped to flat file."]
["DAS2400.SV107-03...0031","DAS2400","X222.351.2400.SV107-3.030","SV107-3",31,null,null,null,null,"To verify a 277CA accept is generated when 2400.SV107-3 is >=1 and <=12","Submit claim with 2400.SV107-3=1","277T accept is generated and data correctly mapped to flat file."]
["DAS2400.SV107-04...0030","DAS2400","X222.351.2400.SV107-4.030","SV107-4",30,null,null,null,null,"\nTo verify a 277CA accept is generated when 2400.SV107-4 is >=1 and <=12\n\n","Submit claim with 2400.SV107-4=4","277T accept is generated and data correctly mapped to flat file."]
["DAS2400.SV107-04...0031","DAS2400","X222.351.2400.SV107-4.030","SV107-4",31,null,null,null,null,"To verify a 277CA accept is generated when 2400.SV107-4 is >=1 and <=12","Submit claim with 2400.SV107-4=1","277T accept is generated and data correctly mapped to flat file."]
["DAS2400.SV502...0001","DAS2400","X222.359.2400.SV502.010\nX222.359.2400.SV502.020","SV502",1,null,null,null,null,"To verify that a 999 accept is generated when 2400.SV502 is present and = DA","Submit claim with 2400.SV5 and SV502 = DA","999 accept  generated and the data is mapped correctly to the flat file"]
["DAS2400.SV503...0003","DAS2400","X222.359.2400.SV503.030","SV503",3,null,null,null,null,"To verify a 277T accept is generate when 2400.SV503 is >= 0","Submit claim with 2400.SV503 = 21","277T accept is generated and data mapped correctly to the flat file"]
["DAS2400.SV504...0030","DAS2400","X222.359.2400.SV504.030","SV504",30,null,null,null,null,"To verify that a 277T accept is generated when 2400.SV504 contains 0,1 or 2 decimals","Submit claim with 2400.SV504=123","277T accept is generated and data correctly mapped to flat file."]
["DAS2400.SV504...0031","DAS2400","X222.359.2400.SV504.030","SV504",31,null,null,null,null,"To verify that a 277T accept is generated when 2400.SV504 contains 0,1 or 2 decimals","Submit claim with 2400.SV504=12.3","277T accept is generated and data correctly mapped to flat file."]
["DAS2400.SV504...0032","DAS2400","X222.359.2400.SV504.030","SV504",32,null,null,null,null,"To verify a 277T accept is generated when 2400.SV504 contains 0,1 or 2 decimals","Submit claim with 2400.SV504=1.23","277T accept is generated and data correctly mapped to flat file."]
["DAS2400.SV504...0033","DAS2400","X222.359.2400.SV504.040","SV504",33,null,null,null,null,"\n\nTo verify  a 277T accept is generated when 2400.SV504 is = to OR greater than 0\n","Submit claim with 2400.SV504=0","277T accept is generated and data correctly mapped to flat file."]
["DAS2400.SV505...0001","DAS2400","X222.359.2400.SV505.010\nX222.359.2400.SV505.020","SV505",1,null,null,null,null,"To verify that a 999 accept is generated when 2400.SV5 and SV505 present and numeric","Submit claim with 2400.SV5 with 2400.SV505 = 21","999 accept  generated and the data is mapped correctly to the flat file"]
["DAS2400.SV505...0004","DAS2400","X222.359.2400.SV505.040","SV505",4,null,null,null,null,"\nTo verify a 277T accept is generate when 2400.SV505 is  >= 0\n","Submit claim with 2400.SV505 = 21","277T accept and data mapped correctly to the flat file"]
["DAS2400.SV505...0030","DAS2400","X222.359.2400.SV505.030","SV505",30,null,null,null,null,"\nTo verify a 277T accept is generated when 2400.SV505 contains 0,1 or 2 decimals\n","Submit claim with 2400.SV505=123","277T accept is generated and data correctly mapped to flat file."]
["DAS2400.SV505...0031","DAS2400","X222.359.2400.SV505.030","SV505",31,null,null,null,null,"\nTo verify a 277T accept is generated when 2400.SV505 contains 0,1 or 2 decimals\n","Submit claim with 2400.SV505=12.3","277T accept is generated and data correctly mapped to flat file."]
["DAS2400.SV505...0032","DAS2400","X222.359.2400.SV505.030","SV505",32,null,null,null,null,"\nTo verify a 277T accept is generated when 2400.SV505 contains 0,1 or 2 decimals\n","Submit claim with 2400.SV505=1.23","277T accept is generated and data correctly mapped to flat file."]
["DAS2400.SV505...0035","DAS2400","X222.359.2400.SV505.035","SV505",35,null,null,null,null,"To verify a 999 accept  is generated when 2400.SV505 is not greater than 99,999.99","Submit claim with 2400.SV505 =  90,000.00","999 accept  generated and the data is mapped correctly to the flat file"]
["DAS2400.SV505...0036","DAS2400","X222.359.2400.SV505.035","SV505",36,null,null,null,null,"To verify a 999 accept is generated when 2400.SV505 is = to or  greater  than 0","Submit claim with 2400.SV505 =  0","999 accept  generated and the data is mapped correctly to the flat file"]
["DAS2410.LIN03...0003","DAS2410","X222.423.2410.LIN03.030","LIN03",3,null,null,null,null,"To verify a 277 is generated when 2410.LIN03 is  a valid NDC with the associated HCPCS\n","\nSubmit a claim with LIN03 with a valid NDC code 00004110020 for HCPCS SV101-2=L9900\n","277 accept is generated and data is correctly mapped to the flat file \n"]
["DAS2410.LIN03...0004","DAS2410","X222.423.2410.LIN03.040","LIN03",4,null,null,null,null,"To verify  277 accept is generated when 2410.LIN03 is a valid NDC with the associated HCPCS with the proc option value of OD for  \"Oral Cancer\"\n","Submit a claim with 2410.LIN03 = valid NDC code valid for HCPCS SV101-2 that has a Proc Option = OD (oral cancer)\n","277 accept is generated and data is correctly mapped to the flat file \n"]
["DAS2440.FRM...0025","DAS2440","X222.494.2440.FRM.025","FRM",25,null,null,null,null,"To verify a 277A is generated when: \n2440.FRM01=1A or 1B, \n2440.FRM01=1C and \n2440.FRM01=05 are present when 2440.LQ=484.03\n","Submit claim with 2440.LQ02=484.03,\n2440.FRM01=1A  \n2440.FRM01=1C and \n2440.FRM01=05\n","277 accept is received and data is mapped correctly to the flat file.\n"]
["DAS2440.FRM03...0060","DAS2440","X222.494.2440.FRM03.060","FRM03",38,null,null,null,null,"To verify that a 999 accept  is generated when 2440.FRM03 is present when 2440.LQ02=484.03 and 2440.FRM01=1A, 1B, 02,03 or 05","Submit claim with 2440.LQ02-484.03 and 2440.FRM01= 03 with 2440.FRM03 = test info 2","999 accept is generated with no errors"]
["DAS2440.FRM03...0070","DAS2440","X222.494.2440.FRM03.070","FRM03",43,null,null,null,null,"To verify a 999 accept is received when 2440.FRM03 is 1 - 50 characters","Submit a claim where 2440.FRM03 is = 1-50 characters","999 Accept is received and data is mapped correctly to the flat file."]
["DAS2440.FRM03...0110","DAS2440","X222.494.2440.FRM03.110","FRM03",110,null,null,null,null,"To verify that a 999 accept is generated when 2400.FRM03 is not present when some but not all of FRM02, FRM04 FRM05  is also not present  ","Submit claims with FRM03 and FRM04 is not present,  FRM02 and FRM05 is present,","999 accept is generated with no errors  and data is correctly mapped to the flat file"]
["DAS2440.FRM04...0030","DAS2440","X222.494.2440.FRM04.030","FRM04",5,null,null,null,null,"To verify that a 999 accept is generated when 2400.FRM04 is not present when some but not all of FRM02, FRM03 FRM05  is also not present  ","Submit claims with FRM04 and FRM02 is not present,  FRM03 and FRM05 is present,","999 accept is generated with no errors  and data is correctly mapped to the flat file"]
["DAS2440.FRM04...0045","DAS2440","X222.494.2440.FRM04.045","FRM04",3,null,null,null,null,"To verify that a 999 accept  is generated when 2440.FRM04 is present when 2440.LQ02=484.03 and 2440.FRM01=1C ","Submit claim with 2440.LQ02=484.03 and 2440.FRM01=1C and  2440.FRM04 = 20090329 ","999 accept is generated with no errors  and data is correctly mapped to the flat file"]
["DAS2440.FRM05...0020","DAS2440","X222.494.2440.FRM05.020","FRM05",4,null,null,null,null,"To verify that a 999 accept  is generated when 2440.FRM05 is present when 2440.LQ02=10.03 and 2400.FRM01= 08B, 08E or 08H","Submit claim with  2440.LQ02=10.03 and 2440.FRM01= 08H and 2440.FRM05=90.1 ","999 accept is generated with no errors  and data is correctly mapped to the flat file"]
["DAS2440.FRM05...0040","DAS2440","X222.494.2440.FRM05.040","FRM05",6,null,null,null,null,"To verify that a 999 accept  is generated when 2440.FRM05 contains 0 or 1 decimal","Submit claim with  2440.FRM05=50 ","999 accept is generated with no errors  and data is correctly mapped to the flat file"]
["DAS2440.LQ...0003","DAS2440","X222.492.2440.LQ.030","LQ",3,null,null,null,null,"\nTo verify a 277 accept is generated when:\n2400.PWK01=CT \n2400.PWK02=AD  and\n2440.LQ is present\n","Submit claim with 2400.PWK01=CT\n2400.PWK02=AD and\n2400.LQ is present\n","277 accept is received and data is mapped correctly to the flat file.\n"]
["DAS2440.LQ...0020","DAS2440","X222.492.2440.LQ.020\nX222.492.2440.LQ.030","LQ",2,null,null,null,null,"To verify that a 999 accept  is generated when  the 2400.CR3, 2400.PWK01= CT, PWK02=AD and 2440.LQ areall present","Submit claim with a 2400.CR3, 2400.PWK01=CT & PKW02=AD and a complete and accurate 2440.LQ","999 accept is generated with no errors"]
["DAS2440.LQ01...0010","DAS2440","X222.492.2440.LQ01.010","LQ01",1,null,null,null,null," To verify that a 999 accept is generated when 2440.LQ01 is present."," Submit a claim with 2440.LQ01 present"," 999 accept is generated and data is mapped to flat file"]
["DR72400.CRC...0020","DR72400","X222.373.2400.CRC.020","CRC",1,null,null,null,null,"To verify that a 277CA reject is generated when more than 3 iterations for 2400.CRC01=09 are present","Submit a claim with 4 iterations of 2400.CRC01=09","277CA rejected is received with CSCC A7: \"Acknowledgement /Rejected for Invalid Information...\"\nCSC 732: \"Information submitted inconsistent with billing guidelines.\"\nCSC 335: \"Durable medical equipment certification.\""]
["DR72400.CRC...0021","DR72400","X222.373.2400.CRC.020","CRC",3,null,null,null,null,"To verify that a 277CA reject is generated when 2400.CRC01=70 are present","Submit a claim with  2400.CRC01=70","277CA rejected is received with CSCC A7: \"Acknowledgement /Rejected for Invalid Information...\"\nCSC 732: \"Information submitted inconsistent with billing guidelines.\"\nCSC 335: \"Durable medical equipment certification.\""]
["DR72400.DTP03.463..0020","DR72400","X222.384.2400.DTP03.020","DTP03",2,null,null,null,null,"To verify that a 277CA reject is generated when 2400.DTP01=463, and DTP03 is a future date","Submit a claim with 2400.DTP01=463, DTP03=20150928","277CA rejected is received with  CSC 510 Future date; 529 certification revision date"]
["DR72400.DTP03.472..0050","DR72400","X222.380.2400.DTP03.050","DTP03",4,null,null,null,null,"To verify that a 277 reject is generated when 2400.DTP03 when DPT01=472 and DTP03 is a future date","Submit a claim with 2400.DTP01=472 and DPT03=20150220","277 reject is received with CSC 510 & 187"]
["DR72400.DTP03.472..0070","DR72400","X222.380.2400.DTP03.070","DTP",1,null,null,null,null,"To verify that a 277CA reject is generated when 2400.DTP01=472, DTP02=D8 or RD8 and the CCYYMM of the 1st date is = to the CCYYMM of the second date and SV101-3 -4 -5 or -6 is  RR and SV104 is not = 1","Submit a claim with  2400.DTP01=472, DTP02=RD8 and the CCYYMM of the 1st date is = to the CCYYMM of the second date and SV101-3 -4 -5 or -6 is = RR and SV104 is not = 1","277CA rejected is received with  CSC 187 date of service","9/1/09 edit doc line 2771"]
["DR72400.DTP03.472..0080","DR72400","X222.380.2400.DTP03.080","DTP03",3,null,null,null,null,"To verify that a 277CA reject is generated when 2400.DTP01=472, DTP02 RD8 and the second date is a future date but proc option is not = IS, PA, PE, PI, PK, PL, PP, PS or PX in the HPCPS file","Submit a claim with 2400.DTP01=472, DTP02=RD8 and the second date is a future date and proc option is not = IS","277CA rejected is received with  CSC 187 date of service"]
["DR72400.REF.EW..0040","DR72400","X222.403.2400.REF02.040","REF",1,null,null,null,null,"To verify that a 999 reject is generated when 2400.REF01=ew, and REF02 is great than 50 characters","Submit a claim when REF01=EW and REF02 is more than 50 characters long","277CA rejected is received with  CSC 512 length invalid; CSC 252 authorization/certification number"]
["DR72400.REF.EW..0050","DR72400","X222.403.2400.REF02.050","REF",2,null,null,null,null,"To verify that a 277 reject is generated when 2400.REF02 is not accepted AN characters","Submit a claim with 2400.REF01=EW and REF02=123<tab>4678","277 rejecte is received with CSC 511 & 252"]
["DR72400.REF.F4..0010","DR72400","X222.405.2400.REF.010","REF ",1,null,null,null,null,"To verify that a 277CA reject is generated when 2400.REF01=F4 is not present when 2400.SV101-3 -4 -5 or -6 is = 90","Submit a claim when 2400.SV101-3=90 is present but 2400.REF01=F4 is not present ","277CA rejected is received with  CSC 544 CLIA"]
["DR72400.SV101-03...0030","DR72400","X222.351.2400.SV101-3.030","SV101-03",1,null,null,null,null,"To verify that a 277CA reject is generated when 2400.SV101-3=90 and 2400.REF01 is not = F4","Submit claim with  SV101-3=90 and no 2400.REF=F4","277CA reject is generated with CSC 544 CLIA"]
["DR72400.SV101-05...0030","DR72400","X222.351.2400.SV101-5.030","SV101-05",1,null,null,null,null,"To verify that a 277CA reject is generated when 2400.SV101-5=90 and 2400.REF01 is not = F4","Submit claim with  SV101-5=90 and no 2400.REF=F4","277CA reject is generated with CSC 544 CLIA"]
["DR72400.SV104...0070","DR72400","X222.351.2400.SV104.070","SV104",1,null,null,null,null,"To verify that a 277CA reject is generated when 2400.SV101-2 is associate with proc option DR or PP, that 2400.SV104 must be = 1 or 2","Submit claim with 2400.SV101-2 = HCPCS on file with proc option = DR (E0145:MS) and SV104 = 3","277CA reject is generated with CSC 476 missing or invalid units of service; CSC 454 procedure code for services rendered"]
["DR72400.SV107-01...0030","DR72400","X222.351.2400.SV107-1.030","SV107-01",1,null,null,null,null,"To verify that a 277CA reject is generated when 2400.SV107-1 is <1 and >12","Submit claim with 2400.SV107-1 = 13","277CA reject is generated with CSC 477 diagnosis code pointer missing or invalid"]
["DR72400.SV107-01...0031","DR72400","X222.351.2400.SV107-1.030","SV107-01",2,null,null,null,null,"To verify that a 277CA reject is generated when 2400.SV107-1 is <1 and >12","Submit claim with 2400.SV107-1 = 0","277CA reject is generated with CSC 477 diagnosis code pointer missing or invalid"]
["DR72400.SV107-02...0030","DR72400","X222.351.2400.SV107-2.030","SV107-02",1,null,null,null,null,"To verify that a 277CA reject is generated when 2400.SV107-2 is <1 and >12","Submit claim with 2400.SV107-2 = 13","277CA reject is generated with CSC 477 diagnosis code pointer missing or invalid"]
["DR72400.SV107-02...0031","DR72400","X222.351.2400.SV107-2.030","SV107-02",2,null,null,null,null,"To verify that a 277CA reject is generated when 2400.SV107-2 is <1 and >12","Submit claim with 2400.SV107-2 = 0","277CA reject is generated with CSC 477 diagnosis code pointer missing or invalid"]
["DR72400.SV107-03...0030","DR72400","X222.351.2400.SV107-3.030","SV107-03",1,null,null,null,null,"To verify that a 277CA reject is generated when 2400.SV107-3 is <1 and >12","Submit claim with 2400.SV107-3 = 13","277CA reject is generated with CSC 477 diagnosis code pointer missing or invalid"]
["DR72400.SV107-03...0031","DR72400","X222.351.2400.SV107-3.030","SV107-03",2,null,null,null,null,"To verify that a 277CA reject is generated when 2400.SV107-3 is <1 and >12","Submit claim with 2400.SV107-3 = 0","277CA reject is generated with CSC 477 diagnosis code pointer missing or invalid"]
["DR72400.SV107-04...0030","DR72400","X222.351.2400.SV107-4.030","SV107-04",1,null,null,null,null,"To verify that a 277CA reject is generated when 2400.SV107-4 is <1 and >12","Submit claim with 2400.SV107-4 = 13","277CA reject is generated with CSC 477 diagnosis code pointer missing or invalid"]
["DR72400.SV107-04...0031","DR72400","X222.351.2400.SV107-4.030","SV107-04",2,null,null,null,null,"To verify that a 277CA reject is generated when 2400.SV107-4 is <1 and >12","Submit claim with 2400.SV107-4 = 0","277CA reject is generated with CSC 477 diagnosis code pointer missing or invalid"]
["DR72400.SV503...0030","DR72400","X222.359.2400.SV503.030","SV503",1,null,null,null,null,"To verify that a 277CA reject is generated when 2400.SV503 is not 1 - 3 digits ","Submit claim with 2400.SV503 = 1234","277CA reject is generated with CSC 512 length invalid for receivers appl; CSC 260 length of medical necessity including begin date "]
["DR72400.SV503...0031","DR72400","X222.359.2400.SV503.031","SV503",2,null,null,null,null,"To verify that a 277CA reject is generated when 2400.SV503 is not >0   (cannot be a negative)","Submit claim with 2400.SV503 =  -12 ","277CA reject is generated with CSC 402 amount must be greater than 0; CSC 260 length of medical necessity including begin date "]
["DR72400.SV504...0030","DR72400","X222.359.2400.SV504.030","SV504",1,null,null,null,null,"To verify that a 277CA reject is generated when 2400.SV504 contains more than 2 decimals  ","Submit claim with 2400.SV504 =  1.234","277CA reject is generated with CSC 697 Too many decimals; CSC 185 Rental Price for DME"]
["DR72400.SV504...0040","DR72400","X222.359.2400.SV504.040","SV504",2,null,null,null,null,"To verify that a 277CA reject is generated when 2400.SV504 is greater than 99,999.99","Submit claim with 2400.SV504 =  100000000000000000.00","277CA reject is generated with CSC 512 length invalid for receivers appl; CSC 185 Rental Price for DME"]
["DR72400.SV505...0030","DR72400","X222.359.2400.SV505.030","SV505",1,null,null,null,null,"To verify that a 277CA reject is generated when 2400.SV505 contains more than 2 decimals  ","Submit claim with 2400.SV505 =  1.234","277CA reject is generated with CSC 697 Too many decimals; CSC 185 Rental Price for DME"]
["DR72400.SV505...0040","DR72400","X222.359.2400.SV505.040","SV505",2,null,null,null,null,"To verify that a 277CA reject is generated when 2400.SV505 is greater than 99,999.99","Submit claim with 2400.SV505 =  100000000000000000.99","277CA reject is generated with CSC 512 length invalid for receivers appl; CSC 185 Rental Price for DME"]
["DR72430.SVD03-02...0020","DR72400","X222.480.2430.SVD03-2.020","SVD03-02",1,null,null,null,null,"To verify that a 277 reject is generated when the 2430.SVD03-2 contans an invalid DME specific HCPCS code for the DTP01=472","Submit claim with 2430.SVD03-1=HC and an invalid DME HCPCS code in 2430.SVD03-2 for the date in 2400.DTP03 when DTP01=472 ","277 with CSC 507 HCPCS and CSC 710 Line Adjudiction Information and data is correctly mapped to the flat file "]
["DR72440.FRM...0025","DR72400","X222.494.2440.FRM.025","FRM",1,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ is 484.03 2440.FRM01  = 1A or 1B and 2440.FRM01=05 is also present","Submit a claim with   2440.LQ = 484.03  and 2440.FRM01=1A and no 2440.FRM01=05","Accepted 999 with 277CA error CSC TBD01 situational segment/element required "]
["DR72440.FRM...0027","DR72400","X222.494.2440.FRM.025","FRM",3,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ is 484.03 2440.FRM01  = 1A or 1B and 2440.FRM01=05 is also present","Submit a claim with   2440.LQ = 484.03  and 2440.FRM01=05 and no 2440.FRM01=1A or 1B","Accepted 999 with 277CA error CSC TBD01 situational segment/element required "]
["DR72440.FRM...0045","DR72400","X222.494.2440.FRM.045","FRM",5,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02 is 484.03 and 2440.FRM01  = 1B and 2440.FRM03 >= 89.0 when one occurrence of FRM01=07, 08, or 09 is not present","Submit a claim with   2440.LQ = 484.03  and 2440.FRM01=1B, FRM03=89.0,with no FRM01=07, 08 OR 09                                                                                                                               ","Accepted 999 with 277CA error CSC TBD01 situational segment/element required "]
["DR72440.FRM...0046","DR72400","X222.494.2440.FRM.045","FRM",6,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02 is 484.03 and 2440.FRM01  = 1B+I14 and 2440.FRM03 >= 89.0 when one occurrence of FRM01=07, 08, or 09 is not present","Submit a claim with   2440.LQ = 484.03  and 2440.FRM01=1B, FRM03=93.0,with no FRM01=07, 08 OR 09                                                                                                                               ","Accepted 999 with 277CA error CSC TBD01 situational segment/element required "]
["DR72440.FRM01...0040","DR72400","X222.494.2440.FRM01.040","FRM01",2,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02 is 484.03 and 2440.FRM01  = 6A or 6B nd no FRM01=6C is present","Submit a claim where 2440.LQ02 is 484.03 and 2440.FRM01=6A and no FRM01 = 6C is present","Accepted 999 with 277CA error CSC 699 Question/Respones from Supporting Documentation Form"]
["DR72440.FRM01...0050","DR72400","X222.494.2440.FRM01.050","FRM01",4,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02 is 484.03 and 2440.FRM01=6C and no FRM01=6A or 6B is present","Submit a claim where 2440.LQ02 is 484.03 and 2440.FRM01=6C and no FRM01 = 6A is present","Accepted 999 with 277CA error CSC 699 Question/Respones from Supporting Documentation Form"]
["DR72440.FRM02...0035","DR72400","X222.494.2440.FRM02.035","FRM02",1,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02 is 484.03 and 2440.FRM01=04, 07, 08 or 09 and FRM02 is not present.","Submit a claim where 2440.LQ02 is 484.03 and 2440.FRM01=04 and no FRM02 is present","Accepted 999 with 277CA error CSC TBD01 situational segment/element required "]
["DR72440.FRM02...0037","DR72400","X222.494.2440.FRM02.035","FRM02",3,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02 is 484.03 and 2440.FRM01=04, 07, 08 or 09 and FRM02 is not present.","Submit a claim where 2440.LQ02 is 484.03 and 2440.FRM01=08 and no FRM02 is present","Accepted 999 with 277CA error CSC TBD01 situational segment/element required "]
["DR72440.FRM03...0022","DR72400","X222.494.2440.FRM03.020","FRM03",3,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02=04.04 and FRM01 is 07B, 09B, 10B or 10C and FRM03 is missing","Submit a claim where 2440.LQ02 is 04.04 and 2440.FRM01=10B but FRM03 is not present","Accepted 999 with 277CA error CSC 699 Question/Respones from Supporting Documentation Form"]
["DR72440.FRM03...0024","DR72400","X222.494.2440.FRM03.020","FRM03",4,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02=04.04 and FRM01 is 07B, 09B, 10B or 10C and FRM03 is missing","Submit a claim where 2440.LQ02 is 04.04 and 2440.FRM01=10C but FRM03 is not present","Accepted 999 with 277CA error CSC 699 Question/Respones from Supporting Documentation Form"]
["DR72440.FRM03...0030","DR72400","X222.494.2440.FRM03.030","FRM03",5,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02=06.03 and FRM01 is 02 or 03 and FRM03 is missing","Submit a claim where 2440.LQ02 is 06.03 and 2440.FRM01=02 but FRM03 is not present","Accepted 999 with 277CA error CSC 699 Question/Respones from Supporting Documentation Form"]
["DR72440.FRM03...0031","DR72400","X222.494.2440.FRM03.030","FRM03",6,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02=06.03 and FRM01 is 02 or 03 and FRM03 is missing","Submit a claim where 2440.LQ02 is 06.03 and 2440.FRM01=03 but FRM03 is not present","Accepted 999 with 277CA error CSC 699 Question/Respones from Supporting Documentation Form"]
["DR72440.FRM03...0041","DR72400","X222.494.2440.FRM03.040","FRM03",8,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02=09.03 and FRM01 =01, 01A, 01B, 01C, 02, 02A, 02B, 02C, 03 OR 04 and FRM03 is missing","Submit a claim where 2440.LQ02 is 09.03 and 2440.FRM01=01A but FRM03 is not present","Accepted 999 with 277CA error CSC 699 Question/Respones from Supporting Documentation Form"]
["DR72440.FRM03...0043","DR72400","X222.494.2440.FRM03.040","FRM03",10,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02=09.03 and FRM01 =01, 01A, 01B, 01C, 02, 02A, 02B, 02C, 03 OR 04 and FRM03 is missing","Submit a claim where 2440.LQ02 is 09.03 and 2440.FRM01=01C but FRM03 is not present","Accepted 999 with 277CA error CSC 699 Question/Respones from Supporting Documentation Form"]
["DR72440.FRM03...0045","DR72400","X222.494.2440.FRM03.040","FRM03",12,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02=09.03 and FRM01 =01, 01A, 01B, 01C, 02, 02A, 02B, 02C, 03 OR 04 and FRM03 is missing","Submit a claim where 2440.LQ02 is 09.03 and 2440.FRM01=02A but FRM03 is not present","Accepted 999 with 277CA error CSC 699 Question/Respones from Supporting Documentation Form"]
["DR72440.FRM03...0047","DR72400","X222.494.2440.FRM03.040","FRM03",14,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02=09.03 and FRM01 =01, 01A, 01B, 01C, 02, 02A, 02B, 02C, 03 OR 04 and FRM03 is missing","Submit a claim where 2440.LQ02 is 09.03 and 2440.FRM01=02C but FRM03 is not present","Accepted 999 with 277CA error CSC 699 Question/Respones from Supporting Documentation Form"]
["DR72440.FRM03...0049","DR72400","X222.494.2440.FRM03.040","FRM03",16,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02=09.03 and FRM01 =01, 01A, 01B, 01C, 02, 02A, 02B, 02C, 03 OR 04 and FRM03 is missing","Submit a claim where 2440.LQ02 is 09.03 and 2440.FRM01=04 but FRM03 is not present","Accepted 999 with 277CA error CSC 699 Question/Respones from Supporting Documentation Form"]
["DR72440.FRM03...0051","DR72400","X222.494.2440.FRM03.050","FRM03",18,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02=10.03 and FRM01=03, 03A, 03B, 04, 04A, 04B, 05, 06, 08A, 08C, 08D, 08F, 08G OR 09 and FRM03 is missing","Submit a claim where 2440.LQ02 is 10.03 and 2440.FRM01=03A but FRM03 is not present","Accepted 999 with 277CA error CSC 699 Question/Respones from Supporting Documentation Form"]
["DR72440.FRM03...0053","DR72400","X222.494.2440.FRM03.050","FRM03",20,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02=10.03 and FRM01=03, 03A, 03B, 04, 04A, 04B, 05, 06, 08A, 08C, 08D, 08F, 08G OR 09 and FRM03 is missing","Submit a claim where 2440.LQ02 is 10.03 and 2440.FRM01=04 but FRM03 is not present","Accepted 999 with 277CA error CSC 699 Question/Respones from Supporting Documentation Form"]
["DR72440.FRM03...0055","DR72400","X222.494.2440.FRM03.050","FRM03",22,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02=10.03 and FRM01=03, 03A, 03B, 04, 04A, 04B, 05, 06, 08A, 08C, 08D, 08F, 08G OR 09 and FRM03 is missing","Submit a claim where 2440.LQ02 is 10.03 and 2440.FRM01=04B but FRM03 is not present","Accepted 999 with 277CA error CSC 699 Question/Respones from Supporting Documentation Form"]
["DR72440.FRM03...0057","DR72400","X222.494.2440.FRM03.050","FRM03",24,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02=10.03 and FRM01=03, 03A, 03B, 04, 04A, 04B, 05, 06, 08A, 08C, 08D, 08F, 08G OR 09 and FRM03 is missing","Submit a claim where 2440.LQ02 is 10.03 and 2440.FRM01=06 but FRM03 is not present","Accepted 999 with 277CA error CSC 699 Question/Respones from Supporting Documentation Form"]
["DR72440.FRM03...0059","DR72400","X222.494.2440.FRM03.050","FRM03",26,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02=10.03 and FRM01=03, 03A, 03B, 04, 04A, 04B, 05, 06, 08A, 08C, 08D, 08F, 08G OR 09 and FRM03 is missing","Submit a claim where 2440.LQ02 is 10.03 and 2440.FRM01=08C but FRM03 is not present","Accepted 999 with 277CA error CSC 699 Question/Respones from Supporting Documentation Form"]
["DR72440.FRM03...0061","DR72400","X222.494.2440.FRM03.050","FRM03",28,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02=10.03 and FRM01=03, 03A, 03B, 04, 04A, 04B, 05, 06, 08A, 08C, 08D, 08F, 08G OR 09 and FRM03 is missing","Submit a claim where 2440.LQ02 is 10.03 and 2440.FRM01=08F but FRM03 is not present","Accepted 999 with 277CA error CSC 699 Question/Respones from Supporting Documentation Form"]
["DR72440.FRM03...0063","DR72400","X222.494.2440.FRM03.050","FRM03",30,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02=10.03 and FRM01=03, 03A, 03B, 04, 04A, 04B, 05, 06, 08A, 08C, 08D, 08F, 08G OR 09 and FRM03 is missing","Submit a claim where 2440.LQ02 is 10.03 and 2440.FRM01=09 but FRM03 is not present","Accepted 999 with 277CA error CSC 699 Question/Respones from Supporting Documentation Form"]
["DR72440.FRM03...0080","DR72400","X222.494.2440.FRM03.080","FRM03",37,null,null,null,null,"To verify a 277 reject is received when 2440.FRM03 is not 1 - 50 characters","Submit a claim where 2440.FRM03 is greater than 50 characters","277 reject CSC 512 & 699 is received  "]
["DR72440.FRM03...0120","DR72400","X222.494.2440.FRM03.125","FRM03",32,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02=484.03 and 2440.FRM01=1A, 1B, 02, 03 or 05 but FRM03 is not present","Submit a claim where 2440.LQ02 is 484.03 and 2440.FRM01=1A but FRM03 is not present","Accepted 999 with 277CA error CSC TBD01 situational segment/element required "]
["DR72440.FRM03...0122","DR72400","X222.494.2440.FRM03.125","FRM03",34,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02=484.03 and 2440.FRM01=1A, 1B, 02, 03 or 05 but FRM03 is not present","Submit a claim where 2440.LQ02 is 484.03 and 2440.FRM01=02 but FRM03 is not present","Accepted 999 with 277CA error CSC TBD01 situational segment/element required "]
["DR72440.FRM03...0124","DR72400","X222.494.2440.FRM03.125","FRM03",36,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02=484.03 and 2440.FRM01=1A, 1B, 02, 03 or 05 but FRM03 is not present","Submit a claim where 2440.LQ02 is 484.03 and 2440.FRM01=05 but FRM03 is not present","Accepted 999 with 277CA error CSC TBD01 situational segment/element required "]
["DR72440.FRM04...0045","DR72400","X222.494.2440.FRM04.045","FRM04",2,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ=484.03 and FRM01=1C is present but 2440.FRM04 is not present","Submit a claim where 2440.LQ-484.03 and FRM01=1C but 2440.FRM04 is not present ","Accepted 999 with 277CA error CSC TBD01 situational segment/element required "]
["DR72440.FRM05...0020","DR72400","X222.494.2440.FRM05.020\n","FRM05",1,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ=10.03 and FRM01= 08B, 08E or 08H but  FRM05 is not present","Submit a claim where 2440.LQ02=10.03 and FRM01=08B but 2440.FRM05 is not present ","Accepted 999 with 277CA error CSC 699 Question/Respones from Supporting Documentation Form"]
["DR72440.FRM05...0022","DR72400","X222.494.2440.FRM05.020\n","FRM05",3,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ=10.03 and FRM01= 08B, 08E or 08H but  FRM05 is not present","Submit a claim where 2440.LQ02=10.03 and FRM01=08H but 2440.FRM05 is not present ","Accepted 999 with 277CA error CSC 699 Question/Respones from Supporting Documentation Form"]
["DR72440.FRM05...0040","DR72400","X222.494.2440.FRM05.040","FRM05",5,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.FRM05 is not  limited to 0 or 1 decimal","Submit a claim where 2440.FRM05 is = 10.03","Accepted 999 with 277CA error CSC 697 Too many decimals"]
["DR72440.LQ02...0020","DR72400","X222.492.2440.LQ02.020","LQ02",1,null,null,null,null,"To verify a 999 accept , with a reject on the 277CA is received when 2440.LQ02 is not a valid DMERC CMN Form","Submit a claim with   2440.LQ where LQ02 segment is not a CMN Form","Accepted 999 with 277CA error CSC 698 Form type identifier"]
["DR92010BA.PER05...0001","DR92010BA","X222.131.2010BA.PER05.010","PER05",1,null,null,null,null,"To verify that a 999 REJECT  is generated when 2010BA.PER05 does not =EX\n","Submit claim with 2410BA.PER05= XE\n","IK403 = 7: \"Invalid Code Value\"\n"]
["DR92010BA.PER05...0010","DR92400","X222.131.2010BA.PER05.010","PER05",1,null,null,null,null,"To verify that a 999 reject is generated when 2010BA.PER05 is not = EX","Submit claim with a complete and accurate 2010BA.PER where PER05 is not = EX","999 reject IK403=7 invalid code value is generated"]
["DR92400.CR3...0003","DR92400","X222.371.2400.CR3.030","CR3",3,null,null,null,null,"\nTo verify a 999 reject is generated when multiple iterations of 2400.CR3 are present.\n","Submit a claim with more than 1 iteration of 2400.CR3\n","IK304 = 5: \"Segment Exceeds Maximum Use\""]
["DR92400.CR3...0020","DR92400","X222.371.2400.CR3.020","CR3",20,null,null,null,null,"To verify a 999 reject is generated when 2400.CR3 is not present when 2400.PWK02=AD and/or DTP01=463 and/or CRC01=09, 2440 LQ and/or FRM is present\n","Submit a claim with no 2400.CR3 when 2400.PWK02=AD is present\n","IK304 = I6: \"Implementation Dependent Segment Missing\""]
["DR92400.CR3...0021","DR92400","X222.371.2400.CR3.020","CR3",21,null,null,null,null,"\nTo verify a 999 reject is generated when 2400.CR3 is not present when 2400.PWK02=AD and/or DTP01=463 and/or CRC01=09,  2440 LQ and/or FRM is present\n","Submit a claim with no 2400.CR3 with 2440.LQ is present\n","IK304 = I6: \"Implementation Dependent Segment Missing\""]
["DR92400.CR3...0022","DR92400","X222.371.2400.CR3.020","CR3",22,null,null,null,null,"\nTo verify a 999 REJECT is generated when 2400.CR3 is not present when 2400.PWK02=AD and/or DTP01=463 and/or CRC01=09, 2440 LQ and/or FRM is present\n","Submit a claim with no 2400.CR3 with 2400.DTP01=463 is present\n","IK304 = I6: \"Implementation Dependent Segment Missing\""]
["DR92400.CR3...0023","DR92400","X222.371.2400.CR3.020","CR3",23,null,null,null,null,"\nTo verify that a 999 reject is generated when 2400.CR3 is not present when 2400.PWK02=AD and/or DTP01=463 and/or CRC01=09, 2440 LQ and/or FRM is present\n","Submit a claim with no 2400.CR3 with 2440.FRM present\n","IK304 = I6: \"Implementation Dependent Segment Missing\""]
["DR92400.CR3...0024","DR92400","X222.371.2400.CR3.020","CR3",24,null,null,null,null,"\nTo verify a 999 reject is generated when 2400.CR3 is not present but 2400.PWK02=AD and/or DTP01=463 and/or CRC01=09, 2440 LQ and/or FRM is present\n","Submit a claim with no 2400.CR3 but 2400.CRC01=09 is present\n","IK304 = I6: \"Implementation Dependent Segment Missing\""]
["DR92400.CR3...0025","DR92400","X222.371.2400.CR3.020","CR3",25,null,null,null,null,"\nTo verify a 999 reject is generated when 2400.CR3 is not present but 2400.PWK02=AD and/or DTP01=463 and/or CRC01=09, LQ and/or FRM is present\n","Submit a claim with  no 2400.CR3 but 2400.FRM is present and  2400.LQ\n","IK304 = I6: \"Implementation Dependent Segment Missing\""]
["DR92400.CR3...0030","DR92400","X222.371.2400.CR3.030","CR3",6,null,null,null,null,"To verify that a 999 reject is generated when multiple iterations of 2400.CR3 are present.","Submit a claim with 2 iterations of 2400.CR3","999 reject is received with IK304=5 segment exceeds maximum use"]
["DR92400.CR301...0001","DR92400","X222.371.2400.CR301.010","CR301",1,null,null,null,null,"\nTo verify a 999 REJECT is generated when 2400.CR3 is present and CR301 is NOT present\n","Submit a claim with 2400.CR3 and CR301 is NOT present ","IK403 = 1: \"Required Data Element Missing\""]
["DR92400.CR301...0002","DR92400","X222.371.2400.CR301.020","CR301",2,null,null,null,null,"\nTo verify a 999 REJECT is generated when 2400.DTP01=607 and 2400.CR301 is NOT =  to 'R' or 'S'\n","Submit a claim with 2400.DTP01=607 and 2400.CR3 with CR301= T","IK403 = 7: \"Invalid Code Value\""]
["DR92400.CR301...0003","DR92400","X222.371.2400.CR301.030","CR301",3,null,null,null,null,"To verify a 999 reject is generated when 2400.CR301 is not a valid value","Submit a claim with 2400.CR301=V","IK403 = 7: \"Invalid Code Value\""]
["DR92400.CR301...0010","DR92400","X222.371.2400.CR301.010","CR301",1,null,null,null,null,"To verify that a 999 reject is generated when 2400.CR3 is present but CR301 is not present","Submit a claim with 2400.CR3 but no CR301","999 reject is received with IK403=1 required data element missing"]
["DR92400.CR301...0020","DR92400","X222.371.2400.CR301.020","CR301",2,null,null,null,null,"To verify that a 999 reject is generated when 2400.DTP01=607 but 2400.CR301 is not = R or S","Submit a claim with 2400.CR3 and CR301= I","999 reject is received with IK403= 7  invalid code value"]
["DR92400.CR301...0030","DR92400","X222.371.2400.CR301.030","CR301",3,null,null,null,null,"To verify that a 999 reject is generated when 2400.CR301 is not = R or S","Submit a claim with 2400.CR3 and CR301=T","999 reject is received with IK403= 7  invalid code value"]
["DR92400.CR302...0001","DR92400","X222.371.2400.CR302.010","CR302",1,null,null,null,null,"To verify that a 999 reject is generated when a 2400.CR302 is not present\n","Submit a claim with 2400.CR302 not present","IK403 = 1: \"Required Data Element Missing\""]
["DR92400.CR302...0002","DR92400","X222.371.2400.CR302.020","CR302",2,null,null,null,null,"To verify that a 999 reject is generated when 2400.CR302 does not = MO\n","Submit a claim with 2400.CR3 and CR301= OM\n","IK403 = 7: \"Invalid Code Value\"\n"]
["DR92400.CR302...0010","DR92400","X222.371.2400.CR302.010","CR302",1,null,null,null,null,"To verify that a 999 reject is generated when 2400.CR3 is present but CR302 is not present","Submit a claim with 2400.CR3 but no CR302","999 reject is received with IK403=1 required data element missing"]
["DR92400.CR302...0020","DR92400","X222.371.2400.CR302.020","CR302",2,null,null,null,null,"To verify that a 999 reject is generated when 2400.CR301 is not = MO","Submit a claim with 2400.CR3 and CR302= WK","999 reject is received with IK403= 7  invalid code value"]
["DR92400.CR303...0001","DR92400","X222.371.2400.CR303.010","CR303",1,null,null,null,null,"To verify a 999 REJECT is generated when a 2400.CR303 is NOT present  ","Submit a claim with 2400.CR303 NOT present","IK403 = 1: \"Required Data Element Missing\""]
["DR92400.CR303...0010","DR92400","X222.371.2400.CR303.010","CR303",1,null,null,null,null,"To verify that a 999 reject is generated when 2400.CR3 is present but CR303 is not present","Submit a claim with 2400.CR3 but no CR303","999 reject is received with IK403=1 required data element missing"]
["DR92400.CR303...0030","DR92400","X222.371.2400.CR303.030","CR303",2,null,null,null,null,"To verify that a 999 reject is generated when 2400.CR3 is present but CR303 is not numeric","Submit a claim with 2400.CR3 and CR3 is = AB12 a non numeric value ","999 reject is received with IK403=6 invalid character in data element"]
["DR92400.CRC...0002","DR92400","X222.378.2400.CRC.020","CRC",2,null,null,null,null,"To verify a 999 reject is generated when  3 iterations of 2400.CRC with CRC01=09","Submit a claim with  3 iterations of CRC01=09","IK304 = 5: \"Segment Exceeds Maximum Use\""]
["DR92400.CRC.09..0020","DR92400","X222.378.2400.CRC.020","CRC",1,null,null,null,null,"To verify that a 999 reject is generated when more than 3 iterations for 2400.CRC01=09 are present","Submit a claim with 4 iterations of 2400.CRC01=09","999 reject is received with IK304=5 segment exceeds maximum use "]
["DR92400.CRC.09..0030","DR92400","X222.378.2400.CRC.030","CRC",2,null,null,null,null,"To verify that a 999 reject is generated when 2400.CR3 is present and 2400.CRC01=09 is not present","Submit a claim with 2400.CR3 and NO 2400.CRC01=09","999 reject is received with IK304=I6 implementation dependent segment missing"]
["DR92400.CRC01.09..0001","DR92400","X222.378.2400.CRC01.010","CRC01",1,null,null,null,null,"To verify a 999 Reject is generated when 2400.CRC is present and 2400.CRC01 is not present","\nSubmit a claim with 2400.CRC and 2400.CRC01 not present\n","IK403 = 1: \"Required Data Element Missing\""]
["DR92400.CRC01.09..0002","DR92400","X222.378.2400.CRC01.020","CRC01",2,null,null,null,null,"To verify a 999 reject is generated when 2400.CRC is present and 2400.CRC01 is not= 09","Submit a claim with 2400.CRC and 2400.CRC01  =90","IK403 = 7: \"Invalid Code Value\""]
["DR92400.CRC01.09..0010","DR92400","X222.378.2400.CRC01.010","CRC01",1,null,null,null,null,"To verify that a 999 reject is generated when 2400.CRC is present and 2400.CRC01 is not present","Submit a claim with 2400.CRC and 2400.CRC01=09 is not present","999 reject is received with IK403=1 required data element missing"]
["DR92400.CRC01.09..0020","DR92400","X222.378.2400.CRC01.020","CRC01",2,null,null,null,null,"To verify that a 999 reject is generated when 2400.CRC is present and 2400.CRC01 is not = 09","Submit a claim with 2400.CRC and 2400.CRC01 is not =09","999 reject is received with IK403=7invalid code value"]
["DR92400.CRC02.09..0001","DR92400","X222.378.2400.CRC02.010","CRC02",1,null,null,null,null,"\nTo verify a 999 REJECT is generated when 2400.CRC is present and 2400.CRC02 is NOT present\n","Submit a claim with 2400.CRC and 2400.CRC02 is not present\n","IK403 = 1: \"Required Data Element Missing\""]
["DR92400.CRC02.09..0010","DR92400","X222.378.2400.CRC02.010","CRC02",1,null,null,null,null,"To verify that a 999 reject is generated when 2400.CRC is present and 2400.CRC02 is not present","Submit a claim with 2400.CRC and NO 2400.CRC02","999 reject is received with IK304=1 required data element missing"]
["DR92400.CRC02.09..0020","DR92400","X222.378.2400.CRC02.020","CRC02",2,null,null,null,null,"To verify that a 999 reject is generated when 2400.CRC is present and 2400.CRC02 is not valid values N or Y","Submit a claim with 2400.CRC and 2400.CRC02=W","999 reject is received with IK304=7 invalid code values"]
["DR92400.CRC02.09.N.0002","DR92400","X222.378.2400.CRC02.020","CRC02",2,null,null,null,null,"\nTo verify a 999 reject is generated when 2400.CRC is present and 2400.CRC02 contains a invalid value\n","Submit a claim with 2400.CRC and 2400.CRC02=M","IK403 = 7: \"Invalid Code Value\"\n"]
["DR92400.CRC02.09.Y.0002","DR92400","X222.378.2400.CRC02.020","CRC02",2,null,null,null,null,"\nTo verify a 999 REJECT is generated when 2400.CRC is present and 2400.CRC02 contains a invalid value\n","Submit a claim with 2400.CRC and 2400.CRC02=U\n","IK403 = 7: \"Invalid Code Value\""]
["DR92400.CRC03.09..0001","DR92400","X222.378.2400.CRC03.010","CRC03",1,null,null,null,null,"\nTo verify a 999 reject is generated when 2400.CRC is present and 2400.CRC03 is not present\n","Submit a claim with 2400.CRC and 2400.CRC03 is not present\n","IK403 = 1: \"Required Data Element Missing\"\n"]
["DR92400.CRC03.09..0010","DR92400","X222.378.2400.CRC03.010","CRC03",1,null,null,null,null,"To verify that a 999 reject is generated when 2400.CRC is present and 2400.CRC03 is not present","Submit a claim with 2400.CRC and NO 2400.CRC03","999 reject is received with IK304=1 required data element missing"]
["DR92400.CRC03.09..0020","DR92400","X222.378.2400.CRC03.020","CRC03",2,null,null,null,null,"To verify that a 999 reject is generated when 2400.CRC is present and 2400.CRC03 is not valid values 38, ZV","Submit a claim with 2400.CRC and 2400.CRC03=AL","999 reject is received with IK304=7 invalid code values"]
["DR92400.CRC03.09..0021","DR92400","X222.378.2400.CRC03.020","CRC03",3,null,null,null,null,"To verify that a 999 reject is generated when 2400.CRC is present and 2400.CRC03 is not valid values 38, ZV","Submit a claim with 2400.CRC and 2400.CRC03=37","999 reject is received with IK304=7 invalid code values"]
["DR92400.CRC03.09..0022","DR92400","X222.378.2400.CRC03.020","CRC03",4,null,null,null,null,"To verify that a 999 reject is generated when 2400.CRC is present and 2400.CRC032 is not valid values 38, ZV","Submit a claim with 2400.CRC and 2400.CRC02=P1","999 reject is received with IK304=7 invalid code values"]
["DR92400.CRC03.09.38.0002","DR92400","X222.378.2400.CRC03.020","CRC03",2,null,null,null,null,"\nTo verify a 999 REJECT generated when 2400.CRC is present and 2400.CRC03 is not A valid value\n","Submit a claim with 2400.CRC and 2400.CRC03=83\n","IK403 = 7: \"Invalid Code Value\"\n"]
["DR92400.CRC03.09.ZV.0002","DR92400","X222.378.2400.CRC03.020","CRC03",2,null,null,null,null,"To verify a 999 reject generated when 2400.CRC is present and 2400.CRC03 is not a valid value\n","\nSubmit a claim with 2400.CRC and 2400.CRC03=VZ\n","IK403 = 7: \"Invalid Code Value\"\n"]
["DR92400.CRC04...0010","DR92400","X222.378.2400.CRC04.010","CRC04",1,null,null,null,null,"To verify that a 999R reject is generated when 2400.CRC04 is  present, CRC03 must be present. ","Submit a claim with  2400.CRC04=38 and CRC03 = SPACES","999R reject is received with IK403 = 2: \"Conditional Required Data Element Missing\".","9/1/09 edit doc line 2753"]
["DR92400.CRC04.09..0001","DR92400","X222.378.2400.CRC04.010","CRC04",1,null,null,null,null,"\nTo verify a 999 reject is generated when 2400.CRC04 is present and 2400.CRC03 is not present\n","Submit a claim with 2400.CRC04 and NO 2400.CRC03\n","IK403 = 2: \"Conditional Required Data Element Missing\"\n"]
["DR92400.CRC04.09..0002","DR92400","X222.378.2400.CRC04.020","CRC04",2,null,null,null,null,"\nTo verify a 999 REJECT is generated when 2400.CRC04 is populated with a invalid value \n","Submit a claim with 2400.CRC04=83\n","IK403 = 7: \"Invalid Code Value\"\n"]
["DR92400.CRC04.09..0010","DR92400","X222.378.2400.CRC04.010","CRC04",1,null,null,null,null,"To verify that a 999 reject is generated when 2400.CRC04 is present, 2400.CRC03 must be present.","Submit a claim with 2400.CRC and NO 2400.CRC04","999 reject is received with IK403 = 2: \"Conditional Required Data Element Missing\""]
["DR92400.CRC04.09..0020","DR92400","X222.378.2400.CRC04.020","CRC04",2,null,null,null,null,"To verify that a 999 reject is generated when 2400.CRC is present and 2400.CRC04 is not valid values 38, ZV","Submit a claim with 2400.CRC and 2400.CRC04=AL","999 reject is received with IK304=7 invalid code values"]
["DR92400.CRC04.09..0021","DR92400","X222.378.2400.CRC04.020","CRC04",3,null,null,null,null,"To verify that a 999 reject is generated when 2400.CRC is present and 2400.CRC04 is not valid values 38, ZV","Submit a claim with 2400.CRC and 2400.CRC04=37","999 reject is received with IK304=7 invalid code values"]
["DR92400.CRC04.09..0022","DR92400","X222.378.2400.CRC04.020","CRC04",4,null,null,null,null,"To verify that a 999 reject is generated when 2400.CRC is present and 2400.CRC04 is not valid values 38, ZV","Submit a claim with 2400.CRC and 2400.CRC04=P1","999 reject is received with IK304=7 invalid code values"]
["DR92400.DTP.304..0002","DR92400","X222.386.2400.DTP.020","DTP",2,null,null,null,null,"To verify that a 999 REJECT is received when 2400.DTP when DTP01 is  = 304","Submit a claim with 2400.DTP when DTP01=304","IK304 = I9: \"Implementation Dependent \"Not Used\" Segment Present\""]
["DR92400.DTP.304..0020","DR92400","X222.386.2400.DTP.020","DTP",9,null,null,null,null,"To verify that a 999 reject is generated when 2400.DTP01=304 is present ","Submit a claims with 2400.DTP01=304","999 reject is received with IK403=i9 not used segment is present"]
["DR92400.DTP.455..0002","DR92400","X222.389.2400.DTP.020","DTP",2,null,null,null,null,"To verify that a 999 REJECT is received when 2400.DTP when DTP01 is=455  ","Submit a claim with 2400.DTP when DTP01=455","IK304 = I9: \"Implementation Dependent \"Not Used\" Segment Present\""]
["DR92400.DTP.455..0020","DR92400","X222.389.2400.DTP.020","DTP",10,null,null,null,null,"To verify that a 999 reject is generated when 2400.DTP01=455 is present ","Submit a claims with 2400.DTP01=455","999 reject is received with IK403=i9 not used segment is present"]
["DR92400.DTP.461..0002","DR92400","X222.385.2400.DTP.020","DTP",2,null,null,null,null,"To verify that a 999 REJECT is generated when 2400.DTP01=461 is present when 2400.CRC01=09, CRC03 or CRC04=38 and CRC02=Y is NOT present","Submit a claim with 2400.DTP01=461 is not present when 2400.CRC01=09 and CRC03 or CRC04=38 and CRC02=Y ","IK304 = I6: \"Implementation Dependent Segment Missing\""]
["DR92400.DTP.461..0003","DR92400","X222.385.2400.DTP.030","DTP",3,null,null,null,null,"To verify that a 999 reject is generated when more than one iteration of  2400.DTP01=461 is present  ","Submit a claim with 2 2400.CR301=461 segment","IK304 = 5: \"Segment Exceeds Maximum Use\""]
["DR92400.DTP.461..0020","DR92400","X222.385.2400.DTP.020","DTP",7,null,null,null,null,"To verify that a 999 reject is generated when 2400.DTP01=461 is not present when 2400.CRC01=09 and CRC03 or CRC04=38 and CRC02=Y is present","Submit a claim with 2400.DTP01=461 is not present when 2400.CRC01=09 and CRC03 or CRC04=38 and CRC02=Y","999 reject is received with IK304=I6 implementation dependent segment missing"]
["DR92400.DTP.461..0030","DR92400","X222.385.2400.DTP.030","DTP",8,null,null,null,null,"To verify that a 999 reject is generated when more than one iteration of  2400.DTP01=461 is present  ","Submit a claim with 2 2400.DTP01=461 segments","999 reject is received with IK304=5 segment exceeds maximum use"]
["DR92400.DTP.463..0002","DR92400","X222.384.2400.DTP.020","DTP",2,null,null,null,null,"To verify that a 999 reject is generated when 2400.DTP01=463 is NOT present when 2400.CR3 is present ","Submit a claim with 2400.CR3 and 2400.DTP01=463 is not present","IK304 = I6: \"Implementation Dependent Segment Missing\""]
["DR92400.DTP.463..0003","DR92400","X222.384.2400.DTP.030","DTP",3,null,null,null,null,"To verify that a 999 accept is generated when more than one iteration of  2400.DTP01=463 is present  ","Submit a claim with 2 2400.CR301=463 segments"," IK304=5 segment exceeds maximum use"]
["DR92400.DTP.463..0020","DR92400","X222.384.2400.DTP.020","DTP",3,null,null,null,null,"To verify that a 999 reject is generated when 2400.DTP01=463 is not present when 2400.CR3 is present ","Submit a claim with 2400.CR3 and no 2400.DTP01=463","999 reject is received with IK304=I6 implementation dependent segment missing"]
["DR92400.DTP.463..0030","DR92400","X222.384.2400.DTP.030","DTP",3,null,null,null,null,"To verify that a 999 reject is generated when multiple 2400.DTP01=463 segments are present","Submit a claim with 2 iterations of 2400.DTP01=463","999 reject is received with IK304=5 segment exceeds maximum use"]
["DR92400.DTP.607..0020","DR92400","X222.383.2400.DTP.020","DTP",20,null,null,null,null,"\nTo verify a 999 reject is generated when 2400.DTP01=607 is not present and 2400.CR301= R or S\n","\nSubmit a claim with 2400.CR301=S and 2400.DTP01 is not populated\n","IK304 = I6: \"Implementation Dependent Segment Missing\"\n"]
["DR92400.DTP.607..0021","DR92400","X222.383.2400.DTP.020","DTP",21,null,null,null,null,"\nTo verify a 999 reject is generated when 2400.DTP01=607 is not present and 2400.CR301= R or S\n","Submit a claim with 2400.CR301=R and 2400.DTP01 is not populated\n","IK304 = I6: \"Implementation Dependent Segment Missing\"\n"]
["DR92400.DTP.607..0022","DR92400","X222.384.2400.DTP.020","DTP",3,null,null,null,null,"To verify that a 999 reject is generated when multiple 2400.DTP01=607 segments are present","Submit a claim with 2 iterations of 2400.DTP01=607","999 reject is received with IK304=5 segment exceeds maximum use"]
["DR92400.DTP01.461..0010","DR92400","X222.385.2400.DTP01.010","DTP01",5,null,null,null,null,"To verify that a 999 reject is generated when 2400.DTP is present with no DPT01","Submit a claims with 2400.DTP is present with no DPT01","999 reject is received with IK403=1 required data element missing"]
["DR92400.DTP01.461..0020","DR92400","X222.385.2400.DTP01.020","DTP01",6,null,null,null,null,"To verify that a 999 reject is generated when 2400.DTP is present with DPT01 not= 461","Submit a claims with 2400.DTP is present with DPT01=999","999 reject is received with IK403=7 invalid code value"]
["DR92400.DTP01.463..0010","DR92400","X222.384.2400.DTP01.010","DTP01",3,null,null,null,null,"To verify that a 999 reject is generated when 2400.DTP is present with no DPT01","Submit a claims with 2400.DTP is present with no DPT01","999 reject is received with IK403=1 required data element missing"]
["DR92400.DTP01.463..0020","DR92400","X222.384.2400.DTP01.020","DTP01",4,null,null,null,null,"To verify that a 999 reject is generated when 2400.DTP is present with DPT01 not= 463","Submit a claims with 2400.DTP is present with DPT01=999","999 reject is received with IK403=7 invalid code value"]
["DR92400.DTP01.607..0002","DR92400","X222.383.2400.DTP01.020","DTP01",2,null,null,null,null,"To verify that a 999 REJECT is generated when 2400.DTP is present with a invalid DPT01","Submit a claim with 2400.DTP is present with DPT01=706","IK403 = 7: \"Invalid Code Value\""]
["DR92400.DTP01.607..0010","DR92400","X222.383.2400.DTP01.010","DTP01",1,null,null,null,null,"To verify that a 999 reject is generated when 2400.DTP is present with no DPT01","Submit a claims with 2400.DTP is present with no DPT01","999 reject is received with IK403=1 required data element missing"]
["DR92400.DTP01.607..0020","DR92400","X222.383.2400.DTP01.020","DTP01",2,null,null,null,null,"To verify that a 999 reject is generated when 2400.DTP is present with DPT01 not= 607","Submit a claims with 2400.DTP is present with DPT01=999","999 reject is received with IK403=7 invalid code value"]
["DR92400.DTP02.461..0010","DR92400","X222.385.2400.DTP02.010","DTP02",5,null,null,null,null,"To verify that a 999 reject is generated when 2400.DTP01=461 is present with no DPT02","Submit a claims with 2400.DTP01=461 is present with no DPT02=D8 ","999 reject is received with IK403=1 required data element missing"]
["DR92400.DTP02.461..0020","DR92400","X222.385.2400.DTP02.020","DTP02",6,null,null,null,null,"To verify that a 999 reject is generated when 2400.DTP01=461 is present when DPT02 is not = D8","Submit a claims with 2400.DTP01=461 is present with DPT02=RD8","999 reject is received with IK403=7 invalid code value"]
["DR92400.DTP02.463..0010","DR92400","X222.384.2400.DTP02.010","DTP02",3,null,null,null,null,"To verify that a 999 reject is generated when 2400.DTP01=463 is present with no DPT02","Submit a claims with 2400.DTP01=463 is present with no DPT02=D8 ","999 reject is received with IK403=1 required data element missing"]
["DR92400.DTP02.463..0020","DR92400","X222.384.2400.DTP02.020","DTP02",4,null,null,null,null,"To verify that a 999 reject is generated when 2400.DTP01=463 is present when DPT02 is not = D8","Submit a claims with 2400.DTP01=463 is present with DPT02=RD8","999 reject is received with IK403=7 invalid code value"]
["DR92400.DTP02.463.D8.0002","DR92400","X222.384.2400.DTP02.020","DTP02",2,null,null,null,null,"To verify that a 999 REJECT is generated when 2400.DTP01=463 is present when DPT02 is NOT= D8","Submit a claim with 2400.DTP01=463 is present with DPT02=RD8 ","IK403 = 7: \"Invalid Code Value\""]
["DR92400.DTP02.607..0002","DR92400","X222.383.2400.DTP02.020","DTP02",2,null,null,null,null,"To verify that a 999 REJECT is generated when 2400.DTP01=607 is present AND DPT02 is =8D","Submit a claims with 2400.DTP01=607 is present with DPT02=8D","IK403 = 7: \"Invalid Code Value\""]
["DR92400.DTP02.607..0010","DR92400","X222.383.2400.DTP02.010","DTP02",1,null,null,null,null,"To verify that a 999 reject is generated when 2400.DTP01=607 is present with no DPT02","Submit a claims with 2400.DTP01=607 is present with no DPT02=D8 ","999 reject is received with IK403=1 required data element missing"]
["DR92400.DTP02.607..0020","DR92400","X222.383.2400.DTP02.020","DTP02",2,null,null,null,null,"To verify that a 999 reject is generated when 2400.DTP01=607 is present when DPT02 is not = D8","Submit a claims with 2400.DTP01=607 is present with DPT02=RD8","999 reject is received with IK403=7 invalid code value"]
["DR92400.DTP03.461..0010","DR92400","X222.385.2400.DTP03.010","DTP03",5,null,null,null,null,"To verify that a 999 reject is generated when 2400.DTP01=461 is present when DPT03 is not = a valid date in the CCYYMMDD format","Submit a claims with 2400.DTP01=461 is present with DPT03=04052009","999 reject is received with IK403=8 invalid date"]
["DR92400.DTP03.463..0010","DR92400","X222.385.2400.DTP03.010","DTP03",4,null,null,null,null,"To verify that a 999 reject is generated when 2400.DTP01=463 is present when DPT03 is not = a valid date in the CCYYMMDD format","Submit a claims with 2400.DTP01=463 is present with DPT03=04052009","999 reject is received with IK403=8 invalid date"]
["DR92400.DTP03.607..0010","DR92400","X222.383.2400.DTP03.010","DTP03",3,null,null,null,null,"To verify that a 999 reject is generated when 2400.DTP01=607 is present when DPT03 is not = a valid date in the CCYYMMDD format","Submit a claim with 2400.DTP01=607 is present with DPT03=04052009","999 reject is received with IK403=8 invalid date"]
["DR92400.FRM...0060","DR92400","X222.494.2440.FRM.060","FRM",3,null,null,null,null,"To verify that a 999 reject is generated when more than 99 2440.FRM segments are present","Submit a claim with 100 2400.FRM segments","999 reject is generated with IK304= 5 segment exceeds maximum use"]
["DR92400.FRM01...0010","DR92400","X222.494.2440.FRM01.010","FRM01",1,null,null,null,null,"To verify that a 999 reject is generated when 2440.FRM01 is blank","Submit a claim with  a 2440.FRM where FRM01 is blank","999 reject is generated with IK403= 1  required data element missing"]
["DR92400.FRM01...0020","DR92400","X222.494.2440.FRM01.020","FRM01",2,null,null,null,null,"To verify that a 999 reject is generated when 2440.FRM01 is not valid for the value in 2440.LQ02","Submit a claim with 2440.FRM where FRM01 is >20 characters ","999 reject is generated with IK403= 5  data element to long"]
["DR92400.FRM02...0010","DR92400","X222.494.2440.FRM02.010","FRM02",1,null,null,null,null,"To verify that a 999 reject is generated when 2440.FRM02 is not equal to N, Y or W","Submit a claim with  a 2440.FRM where FRM02 is Z","999 reject is generated with IK403= 7 invalid code value"]
["DR92400.FRM03...0010","DR92400","X222.494.2440.FRM03.010","FRM03",1,null,null,null,null,"To verify that a 999 reject is generated when 2440.FRM03 contains only a space","Submit a claim with 2440.FRM segment where FRM03 that contains a space","999 reject is generated with IK403= 6 invalid character"]
["DR92400.FRM04...0010","DR92400","X222.494.2440.FRM04.010","FRM04",1,null,null,null,null,"To verify that a 999 reject is generated when 2440.FRM04 does not contain a valid date in the CCYYMMDD format ","Submit a claim with  2440.FRM segment where FRM04  contains an invalid date 01232009","999 reject is generated with IK403= 8 invalid date"]
["DR92400.FRM05...0010","DR92400","X222.494.2440.FRM05.010","FRM05",1,null,null,null,null,"To verify that a 999 reject is generated when 2440.FRM05 is not numeric","Submit a claim where 2400.FRM05 contains an alpha","999 reject is generated with IK403= 6 invalid character"]
["DR92400.FRM05...0012","DR92400","X222.494.2440.FRM05.010","FRM05",4,null,null,null,null,"To verify that a 999 reject is generated when 2440.FRM05 contains invalid character","Submit a claim where 2400.FRM05 contains a special character <TAB>","999 reject is generated with IK403= 6 invalid character"]
["DR92400.LQ...0010","DR92400","X222.492.2440.LQ.010","LQ",1,null,null,null,null,"To verify that a 999 reject is generated when  2400.CR3 is present but 2440.LQ is not ","Submit a claim with  a complete and accurate 2400.CR3 but no 2440.LQ","999 reject is generated with IK304=I6 segment missing"]
["DR92400.LQ01...0010","DR92400","X222.492.2440.LQ01.010","LQ01",1,null,null,null,null,"To verify that a 999 reject is generated when  2440.LQ is present but 2440.LQ01 is not","Submit a claim with  a complete and accurate 2400.CR3 a 2440.LQ segment with LQ01=  blanks","999 reject is generated with IK403=1 required element missing  "]
["DR92400.LQ01...0020","DR92400","X222.492.2440.LQ01.020","LQ01",2,null,null,null,null,"To verify that a 999 reject is generated when  2440.LQ is present but 2440.LQ01 is not","Submit a claim with  a complete and accurate 2400.CR3 a 2440.LQ segment with the LQ01=  RR","999 reject is generated with IK403=1 required element missing  "]
["DR92400.LQ02...0010","DR92400","X222.492.2440.LQ02.010","LQ02",1,null,null,null,null,"To verify that a 999 reject is generated when  2440.LQ is present but 2440.LQ02 is not","Submit a claim with  a complete and accurate 2400.CR3 a 2440.LQ segment with LQ02=  blanks","999 reject is generated with IK403=1 required element missing  "]
["DR92400.LQ02...0020","DR92400","X222.492.2440.LQ02.020","LQ02",2,null,null,null,null,"To verify that a 999 reject is generated when 2440.LQ is present and 2440.LQ02 contains only a space","Submit a claim with  a complete and accurate 2400.CR3 a 2440.LQ02= contains a space","999 reject is generated with IK403= 6 invalid character"]
["DR92400.PWK.CT..0003","DR92400","X222.366.2400.PWK.030","PWK",3,null,null,null,null,"To verify that a 999 accept is generated when there is  more than one iteration of 2400.PWK01=CT ","Submit a claim with 2 iterations of 2400.PWK01=CT ","IK304 = 5: \"Segment Exceeds Maximum Use\""]
["DR92400.PWK.CT..0020","DR92400","X222.366.2400.PWK.020","PWK",1,null,null,null,null,"To verify that a 999 reject is generated when 2400.PWK is not present when 2400.CR3 is present","Submit a claim with 2400.CR3 but 2400.PWK is not present","999 reject is received with IK304=I6 implementation dependent segment missing"]
["DR92400.PWK.CT..0030","DR92400","X222.366.2400.PWK.030","PWK",2,null,null,null,null,"To verify that a 999 reject is generated when there is more than one iteration of 2400.PWK01=CT ","Submit a claim with 2 iterations of 2400.PWK01=CT ","999 reject is received with IK304=5 segment exceeds maximum use"]
["DR92400.PWK01.CT..0001","DR92400","X222.366.2400.PWK01.010","PWK01",1,null,null,null,null,"To verify that a 999 reject is generated when 2400.PWK01 is not present  ","Submit a claim with 2400.PWK is present and 2400.PWK01  is not present","IK403 = 1: \"Required Data Element Missing\""]
["DR92400.PWK01.CT..0002","DR92400","X222.366.2400.PWK01.020","PWK01",2,null,null,null,null,"To verify that a 999 REJECT is generated when 2400.PWK01 is NOT = CT","Submit a claim where 2400.PWK01 is = TC","IK403 = 7: \"Invalid Code Value\""]
["DR92400.PWK01.CT..0010","DR92400","X222.366.2400.PWK01.010","PWK01",1,null,null,null,null,"To verify that a 999 reject is generated when 2400.PWK is present but PKW01 is not present ","Submit a claim with 2400.PWK is present but PWK01 is not present","999 reject is received with IK403=1 required data element missing"]
["DR92400.PWK01.CT..0020","DR92400","X222.366.2400.PWK01.020","PWK01",2,null,null,null,null,"To verify that a 999 reject is generated when 2400.PWK01 is not = CT","Submit a claim where 2400.PWK01 is = AM","999 reject is received with IK403=7 invalid code value"]
["DR92400.PWK02..AB.0002","DR92400","X222.366.2400.PWK02.020","PWK02",2,null,null,null,null,"To verify a 999 REJECT is generated when 2400.PKW02 is a invalid code ","Submit a claim with  PWK02 is = BA","IK403 = 7: \"Invalid Code Value\""]
["DR92400.PWK02..AD.0002","DR92400","X222.366.2400.PWK02.020","PWK02",2,null,null,null,null,"To verify a 999 REJECT is generated when 2400.PKW02 is a invalid code ","Submit a claim with  PWK02 is = DA","IK403 = 7: \"Invalid Code Value\""]
["DR92400.PWK02..AF.0002","DR92400","X222.366.2400.PWK02.020","PWK02",2,null,null,null,null,"To verify a 999 REJECT is generated when 2400.PKW02 is a invalid code ","Submit a claim with  PWK02 is = FA","IK403 = 7: \"Invalid Code Value\""]
["DR92400.PWK02..AG.0002","DR92400","X222.366.2400.PWK02.020","PWK02",2,null,null,null,null,"To verify a 999 REJECT is generated when 2400.PKW02 is a invalid code ","Submit a claim with  PWK02 is = GA","IK403 = 7: \"Invalid Code Value\""]
["DR92400.PWK02..NS.0002","DR92400","X222.366.2400.PWK02.020","PWK02",2,null,null,null,null,"To verify a 999 REJECT is generated when 2400.PKW02 is a invalid code ","Submit a claim with  PWK02 is = SN","IK403 = 7: \"Invalid Code Value\""]
["DR92400.PWK02.CT..0010","DR92400","X222.366.2400.PWK02.010","PWK02",1,null,null,null,null,"To verify that a 999 reject is generated when 2400.PWK is present but PKW02 is not present ","Submit a claim with 2400.PWK is present but PWK02 is not present","999 reject is received with IK403=1 required data element missing"]
["DR92400.PWK02.CT..0020","DR92400","X222.366.2400.PWK02.020","PWK02",2,null,null,null,null,"To verify that a 999 reject is generated when 2400.PWK is present but PKW02 is not a valid code (ab, ad, af, ag, ns)","Submit a claim with  PWK02 is = ZZ","999 reject is received with IK403=7 invalid code value"]
["DR92400.SV5...0020","DR92400","X222.359.2400.SV5.020","SV5",1,null,null,null,null,"To verify that a 999 reject is generated when 2400.SV101-3 -4 -5 or -6 =s RR, NU or UE, and more than one 2400.SV5 is present","Submit claim with  2400SV101-3 = RR and 2 itterations of SV5","999 reject is generated with IK304=5 segment exceeds maximum use"]
["DR92400.SV5...0024","DR92400","X222.359.2400.SV5.020","SV5",5,null,null,null,null,"To verify that a 999 reject is generated when 2400.SV101-3 -4 -5 or -6 =s RR, NU or UE, and more than one 2400.SV5 is present","Submit claim with  2400SV101-3 = NU and 2 itterations of SV5","999 reject is generated with IK304=5 segment exceeds maximum use"]
["DR92400.SV5...0028","DR92400","X222.359.2400.SV5.020","SV5",9,null,null," "," ","To verify that a 999 reject is generated when 2400.SV101-3 -4 -5 or -6 =s RR, NU or UE, and more than one 2400.SV5 is present","Submit claim with  2400SV101-3 = UE and 2 itterations of SV5","999 reject is generated with IK304=5 segment exceeds maximum use","9/01/09 edit doc line 2601"]
["DR92400.SV501-01...0001","DR92400","X222.359.2400.SV501-1.010\nX222.359.2400.SV501-1.020","SV501-1",1,null,null,null,null," To verify that a 999 REJECT is generate when 2400.SV501-1 is not present","Submit claim with  2400.SV501-1 = BLANK","IK403 = 1: \"Required Data Element Missing\""]
["DR92400.SV501-01...0002","DR92400","X222.359.2400.SV501-1.020","SV501-1",2,null,null,null,null," To verify that a 999 REJECT is generate when 2400.SV501-1 is not = 'HC'","Submit claim with  2400.SV501-1 is = CH  ","IK403 = 7: \"Invalid Code Value\""]
["DR92400.SV501-02...0001","DR92400","X222.359.2400.SV501-2.010","SV501-2",1,null,null,null,null,"To verify that a 999 reject is generated when 2400.SV502-1 procedure code is NOT = 2400.SV101-2 procedure code","Submit claim with  2400.SV101-2 = E1390 and 2400.SV501-2 = E1391","IK403 = I12: \"Implementation Pattern Match Failure\""]
["DR92400.SV502...0002","DR92400","X222.359.2400.SV502.020","SV502",2,null,null,null,null,"To verify a 999 reject is generated when 2400.SV502 is not = DA","submit claim with 2400.SV502=AD","IK403 = 7: \"Invalid Code Value\""]
["DR92400.SV505...0002","DR92400","X222.359.2400.SV505.020","SV505",2,null,null,null,null,"To verify a 999 reject is generated when 2400.SV505 is not numeric\n","Submit claim with 2400.SV505=AA\n","IK403 = 6: \"Invalid Character in Data Element\""]
["DR92400.SV506...0001","DR92400","X222.359.2400.SV506.010","SV506",1,null,null,null,null,"To verify that a 999 reject is generated when 2400.SV5 is present with no SV506 ","Submit claim with 2400.SV506 not present","IK403 = 1: \"Required Data Element Missing\""]
["DR92440.FRM03...0090","DR92400","X222.494.2440.FRM03.090","FRM03",38,null,null,null,null,"To verify a 999 reject is received when 2440.FRM03 is not AN characters","Submit a claim where 2440.FRM03 is a special character <Tab> character","999 reject \"IK403 = 6: \"Invalid Character in Data Element\". "]
["NAT00.111-AM.001","NAT00",null,"111-AM",1,null,null,null,null,"Submit an NCPDP file with correct order of fields in Transaction Header Segment to ensure no rejection.","Step 1. Submit a NCPDP file with fields in following order:\r\nBin Number (101-A1) followed by, \r\nVersion/Release Number (102-A2) then,\r\nTransaction Code (103-A3) then,\r\nProcessor Control Number (104-A4) then,\r\nTransaction Count (109-A9) then,\r\nService Provider ID Qualifier (202-B2) then,\r\nService Provider ID (201-B1) then,\r\nDate of Service (401-D1) then\r\nSoftware Vendor/Certification ID (110-AK) \r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect no errors.\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = R (no batch level errors)"]
["NAT00.701.001","NAT00",null,701,1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 701 \"Segment Identifier\" (Batch Header)  to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 701 = 00\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect no errors.\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = R (no batch level errors)"]
["NAT00.701.002","NAT00",null,701,2,null,null,null,null,"Submit an NCPDP file with no repetition of Transaction Header Segment to get accepted acknowledgement.","Step 1. Submit a NCPDP file with one occurrence of  \r\n111-AM (Transaction Header Segment) = 00\r\n\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\n\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect no errors.\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = R (no batch level errors)"]
["NAT00.702.001","NAT00",null,702,1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 702 \"File Type\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 702 = T\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect no errors.\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = R (no batch level errors)"]
["NAT00.702.002","NAT00",null,702,2," ",null,null,null,"Submit an NCPDP file with 702 \"File Type\" = T when Trading Partner ID is set up on trading partner database for Test only","Step 1. Submit a NCPDP file with \"T\" in 702 for a sender ID that is set up in trading partner database for submitting test files only.\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect no errors.\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = R (no batch level errors)"]
["NAT00.702.003","NAT00",null,702,3,null,null,null,null,"Submit an NCPDP file with 702 \"File Type\" = P when Trading Partner ID is set up on trading partner database for Production","Step 1. Submit a NCPDP file with \"P\" in 702 for a sender ID that is set up in trading partner database for submitting production files.\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect no errors.\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = R (no batch level errors)"]
["NAT00.806-5C.001","NAT00",null,"806-5C",1,null,null,null,null,"Submit an NCPDP file with correct value (all numerics) in 806-5C \"Batch Number\" (Batch Header) to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 806-5C = 0002647\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect no errors.\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = R (no batch level errors)"]
["NAT00.806-5C.002","NAT00",null,"806-5C",2,null,null,null,"need to change sender id in 2nd file ","Duplicate file checking - same batch number & create date, different sender ID, different day","Note: 702 file type must = P for duplicate logic to be envoked\r\n\r\nStep 1. Submit a NCPDP file where  806-5C = 0002648, 880-K1 = a valid sender ID, and 880-K2 = 20090102 \r\n\r\nStep 2.  Obtain & verify the NCPDP response file\r\n\r\nStep 3.  On the next day, submit another NCPDP file where  806-5C = 0002648, 880-K1 = a different valid sender ID than that used in file day before, and 880-K2 = 20090102 \r\n\r\nStep 4.  Obtain & verify the NCPDP response file\r\n\r\n","1. Field 880-K6 in NCPDP Response file transmission header = R  (no batch level errors) for first submission.\r\n\r\n2.  1. Field 880-K6 in NCPDP Response file transmission header = R  (no batch level errors) for second submission.","NAT00.806-5C.002b file is for second submission"]
["NAT00.806-5C.003","NAT00",null,"806-5C",3,null,null,null,"need to change sender id in 2nd file ","Duplicate file checking - same batch number & create date, different sender ID, same day","Note: 702 file type must = P for duplicate logic to be envoked\r\n\r\nStep 1. Submit a NCPDP file where  806-5C = 0004321, 880-K1 = a valid sender ID, and 880-K2 = 20090102 \r\n\r\nStep 2.  Submit another NCPDP file on the same day where  806-5C = 0004321, 880-K1 = a different valid sender ID than that used in first file, and 880-K2 = 20090102 \r\n\r\nStep 3. After files are submitted, obtain NCPDP response files\r\n\r\nStep 4. Verify the response files.\r\n","1. Field 880-K6 in NCPDP Response file transmission header = R  (no batch level errors) for first submission.\r\n\r\n2.  1. Field 880-K6 in NCPDP Response file transmission header = R  (no batch level errors) for second submission.","NAT00.806-5C.003b file is for second submission"]
["NAT00.880-K1.001","NAT00",null,"880-K1",1,null,null,null,null,"Submit an NCPDP file with valid value in 880-K1 \"Sender ID\" (Sender ID is set up on trading partner database) to get accepted acknowledgement.","Step 1. Submit a NCPDP file with valid data in 880-K1 where sender ID is set up in trading partner database.\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect no errors.\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = R (no batch level errors)"]
["NAT00.880-K1.002","NAT00",null,"880-K1",2,null,null,null,null,"Submit an NCPDP file with valid format (contains Alphanumeric) in 880-K1 \"Sender ID\" (Batch Header)  to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 880-K1  is valid\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect no errors.\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = R (no batch level errors)"]
["NAT00.880-K1.003","NAT00",null,"880-K1",3,null,null,null,null,"Submit an NCPDP file with 880-K1 \"Sender ID\" (Batch Header) present to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 880-K1 is valid\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect no errors.\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = R (no batch level errors)"]
["NAT00.880-K2.001","NAT00",null,"880-K2",1,null,null,null,null,"Submit an NCPDP file with correct value (valid format) in 880-K2 Creation date to get accepted acknowledgement","Step 1 submit a NCPDP file where 880-K2 = 20090306  Step 2 After file is submitted, obtain NCPDP acknowledgements  Step 3 Verify the acknowledgements","1. Local TRN acknowledgment will reflect no errors.\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = R (no batch level errors)"]
["NAT00.880-K2.002","NAT00",null,"880-K2",2,null,null,null,null,"Submit an NCPDP file with 880-K2 Creation date present to get accepted acknowledgement","Step 1 submit a NCPDP file where 880-K2 = 20090306  Step 2 After file is submitted, obtain NCPDP acknowledgements  Step 3 Verify the acknowledgements","1. Local TRN acknowledgment will reflect no errors.\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = R (no batch level errors)"]
["NAT00.880-K2.003","NAT00",null,"880-K2",3,null,null,null,null,"Submit an NCPDP file 880-K2 Creation datenot = future date to get accepted acknowledgement","Step 1 submit a NCPDP file where 880-K2 = 20090306  Step 2 After file is submitted, obtain NCPDP acknowledgements  Step 3 Verify the acknowledgements","1. Local TRN acknowledgment will reflect no errors.\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = R (no batch level errors)"]
["NAT00.880-K3.001","NAT00",null,"880-K3",1,null,null,null,null,"Submit an NCPDP file with correct value (format HHMM) in 880-K3 \"Creation Time\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 880-K3 = 1810\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect no errors.\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = R (no batch level errors)"]
["NAT00.880-K3.002","NAT00",null,"880-K3",2,null,null,null,null,"Submit an NCPDP file 880-K3 \"Creation Time\" IS PRESENT to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 880-K3 = 1810\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect no errors.\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = R (no batch level errors)"]
["NAT00.880-K6.001","NAT00",null,"880-K6",1,null,null,null,null,"Submit an NCPDP file with 880-K6 present ","Step 1. Submit a NCPDP file where 880-K6 = T\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect no errors.\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = R (no batch level errors)"]
["NAT00.880-K7.001","NAT00",null,"880-K7",1,null,null,null,null,"Submit an NCPDP file for Jurisdication A 880-K7 \"Receiver ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 880-K7 = 16003\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect no errors.\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = R (no batch level errors)"]
["NAT00.880-K7.002","NAT00",null,"880-K7",2,null,null,null,null,"Submit an NCPDP file for Jurisdication B 880-K7 \"Receiver ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 880-K7 = 17003\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect no errors.\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = R (no batch level errors)"]
["NAT00.880-K7.003","NAT00",null,"880-K7",3,null," ",null,null,"Submit an NCPDP file for Jurisdication C 880-K7 \"Receiver ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 880-K7 = 18003\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect no errors.\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = R (no batch level errors)"]
["NAT01.111-AM.001","NAT01",null,"111-AM",1,null," ",null,null,"Submit an NCPDP file with correct order of fields in Patient Segment to ensure no rejection.","Step 1. Submit a NCPDP file where \r\nSegment Identification (111-AM) = 01, is the first field in the file followed by Patient First name (310-CA) \r\n\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\n\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.111-AM.002","NAT01",null,"111-AM",2,null," ",null,null,"Submit an NCPDP file with correct value (on code list) in 111-AM \"Segment Identification\" (Patient Segment) to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 111-AM = 01\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.111-AM.003","NAT01",null,"111-AM",3,null,null,null,null,"Submit an NCPDP file with no repetition of Patient Segment to get accepted acknowledgement.","Step 1. Submit a NCPDP file with one occurrence of \r\n111-AM (Patient Segment) = 01\r\n\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\n\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.304-C4.001","NAT01",null,"304-C4",1,null,null,null,null,"Submit an NCPDP file with correct value (contains all numerics) in 304-C4 \"Date of Birth\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 304-C4 = 20010607\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.304-C4.002","NAT01",null,"304-C4",2,null," ",null,null,"Transmission Accepted/Transaction Captured NCPDP Response file for 1 claim bill  (i.e. 1 line item) -- 304-C4 \"Date Of Birth\"  ","Step 1:  Submit a NCPDP file with one T07 claim segment and all valid data in entire file -- including Patient Segment 304-C4 Date of Birth = 19350101 \r\nStep 2:  After file is submitted, obtain the NCPDP response file\r\nStep 3:  Verify Response Patient Segment in NCPDP response file ","1.  304-C4 Patient Date of Birth in Response Patient Segment = 19350101\r\n2.  Header Response Status (501-F1) = A\r\n3.  Transaction Response Status (112-AN) = C "]
["NAT01.304-C4.003","NAT01",null,"304-C4",3,null,null,null,null,"Transmission Accepted/Transaction Captured NCPDP Response file for 2 claim bill  (i.e. 2 line items) -- 304-C4 \"Date Of Birth\"  ","Step 1:  Submit a NCPDP file with two T07 claim segments and all valid data in entire file -- including Patient Segment 304-C4 Date of Birth = 19350101 \r\nStep 2:  After file is submitted, obtain the NCPDP response file\r\nStep 3:  Verify Response Patient Segment in NCPDP response file ","1.  304-C4 Patient Date of Birth in Response Patient Segment = 19350101\r\n2.  Header Response Status (501-F1) = A\r\n3.  Transaction Response Status (112-AN) = C for both transactions"]
["NAT01.305-C5.001","NAT01",null,"305-C5",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 305-C5 \"Patient Gender Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 305-C5 = 2\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.305-C5.002","NAT01",null,"305-C5",2,null," ",null,null,"Submit an NCPDP file with correct value (numeric) in 305-C5 \"Patient Gender Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 305-C5 = 2\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.305-C5.003","NAT01",null,"305-C5",3,null,null,null,null,"Submit an NCPDP file with correct value (not > 1 position ) in 305-C5 \"Patient Gender Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 305-C5 = 1\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.307-C7.001","NAT01",null,"307-C7",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 307-C7 \"Place of Service\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 307-C7 = 01\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.307-C7.002","NAT01",null,"307-C7",2,null,null,null,null,"Submit an NCPDP file with correct value (numeric) in 307-C7 \"Place of Service\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 307-C7 = 11\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.307-C7.003","NAT01",null,"307-C7",3,null,null,null,null,"Submit an NCPDP file with correct value (not > 2 positions) in 307-C7 \"Place of Service\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 307-C7 = 03\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.310-CA.001","NAT01",null,"310-CA",1,null," ",null,null,"Transmission Accepted/Transaction Captured NCPDP Response file for 1 claim bill  (i.e. 1 line item) -- 310-CA \"Patient First Name\"  ","Step 1:  Submit a NCPDP file with one T07 claim segment and all valid data in entire file -- including Patient Segment 310-CA First Name = John\r\nStep 2:  After file is submitted, obtain the NCPDP response file\r\nStep 3:  Verify Response Patient Segment in NCPDP response file ","1.  310-CA Patient First Name in Response Patient Segment = John\r\n2.  Header Response Status (501-F1) = A\r\n3.  Transaction Response Status (112-AN) = C "]
["NAT01.310-CA.002","NAT01",null,"310-CA",2,null,null,null,null,"Transmission Accepted/Transaction Captured NCPDP Response file for 2 claim bill  (i.e. 2 line items) -- 310-CA \"Patient First Name\"  ","Step 1:  Submit a NCPDP file with two T07 claim segments and all valid data in entire file -- including Patient Segment 310-CA First Name = John\r\nStep 2:  After file is submitted, obtain the NCPDP response file\r\nStep 3:  Verify Response Patient Segment in NCPDP response file ","1.  310-CA Patient First Name in Response Patient Segment = John\r\n2.  Header Response Status (501-F1) = A\r\n3.  Transaction Response Status (112-AN) = C for both transactions"]
["NAT01.310-CA.003","NAT01",null,"310-CA",3,null,null,null,null,"Transmission Accepted/Transaction Captured NCPDP Response file for 3 claim bill  (i.e. 3 line items)  -- 310-CA \"Patient First Name\"  ","Step 1:  Submit a NCPDP file with three T07 claim segments and all valid data in entire file -- including Patient Segment 310-CA First Name = John\r\nStep 2:  After file is submitted, obtain the NCPDP response file\r\nStep 3:  Verify Response Patient Segment in NCPDP response file ","1.  310-CA Patient First Name in Response Patient Segment = John\r\n2.  Header Response Status (501-F1) = A\r\n3.  Transaction Response Status (112-AN) = C for all three  transactions"]
["NAT01.311-CB.001","NAT01",null,"311-CB ",2,null,null,null,null,"Submit an NCPDP file with correct value (contains Alphanumerics) in 311-CB \"Patient Last Name\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 311-CB = WOODS\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.311-CB.002","NAT01",null,"311-CB ",6,null,null,null,null,"Submit an NCPDP file with correct value (is present) in 311-CB \"Patient Last Name\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 311-CB = JACOBSON\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.322-CM.001","NAT01",null,"322-CM",1,null,null,null," ","Submit an NCPDP file with correct value (is alphanumeric) in 322-CM \"Patient Street Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 322-CM =  123 Apple St \r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.322-CM.002","NAT01",null,"322-CM",2,null," ",null," ","Submit an NCPDP file with correct value (not > 30 positions) in 322-CM \"Patient Street Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 322-CM =  456 George St\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.323-CN.001","NAT01",null,"323-CN",1,null,null," ",null,"Submit an NCPDP file with correct value (is alphanumeric) in 323-CN \"Patient City Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 323-CN =   Syracuse\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.323-CN.002","NAT01",null,"323-CN",2,null," ",null,null,"Submit an NCPDP file with correct value (not > 20 positions) in 323-CN \"Patient City Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 323-CN =   Harrisburg\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.324-CO.001","NAT01",null,"324-CO",1,null,null," ",null,"Submit an NCPDP file with correct value (is alphanumeric) in 324-CO \"Patient State/Province Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 324-CO =  NY\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.324-CO.002","NAT01",null,"324-CO",2,null," ",null,null,"Submit an NCPDP file with correct value (not > 2 positions) in 324-CO \"Patient State/Province Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 324-CO =  PA\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.325-CP.001","NAT01",null,"325-CP",1,null,null,null,null,"Submit an NCPDP file with correct value(ALPHANUMERICS)  in 325-CP \"Patient Zip/Postal Zone\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 325-CP = 17109\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.325-CP.002","NAT01",null,"325-CP",2,null,null," ",null,"Submit an NCPDP file with correct value (NOT > 15 positions) in 325-CP \"Patient Zip/Postal Zone\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 325-CP = 171091211\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.326-CQ.001","NAT01",null,"326-CQ",1,null,null," ",null,"Submit an NCPDP file with correct value (is numeric) in 326-CQ \"Patient Phone Number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 326-CQ = 7177069999\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.326-CQ.002","NAT01",null,"326-CQ",2,null," ",null,null,"Submit an NCPDP file with correct value (= exactly 10 positions) in 326-CQ \"Patient Phone Number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 326-CQ =  3154445656\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.331-CX.001","NAT01",null,"331-CX",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list)  in 331-CX \"Patient ID Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 331-CX = 04\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.331-CX.002","NAT01",null,"331-CX",2,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 331-CX \"Patient ID Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 331-CX = 1J\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.332-CY.001","NAT01",null,"332-CY",1,null,null,null,null,"Submit an NCPDP file with correct value (is alphanumeric) in 332-CY \"Patient ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 332-CY =  valid HIC\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.332-CY.002","NAT01",null,"332-CY",2,null," ",null,null,"Submit an NCPDP file with correct value (not > 20 positions) in 332-CY \"Patient ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 332-CY =  valid HIC\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.333-CZ.001","NAT01",null,"333-CZ",1,null,null," ",null,"Submit an NCPDP file with correct value (is numeric) in 333-CZ \"Employer ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 333-CZ = 1234567890\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.333-CZ.002","NAT01",null,"333-CZ",2,null," ",null,null,"Submit an NCPDP file with correct value (= exactly 10 positions) in 333-CZ \"Employer ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 333-CZ =  9876543210\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.334-1C.001","NAT01",null,"334-1C",1,null,null," ",null,"Submit an NCPDP file with correct value (is alphanumeric) in 334-1C \"Smoker/Nonsmoker Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 334-1C = 1\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.334-1C.002","NAT01",null,"334-1C",2,null," ",null,null,"Submit an NCPDP file with correct value (not > 1 position) in 334-1C \"Smoker/Nonsmoker Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 334-1C = 1 \r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.335-2C.001","NAT01",null,"335-2C",1,null,null," ",null,"Submit an NCPDP file with correct value (is alphanumeric) in 335-2C \"Pregnancy Indicator\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 335-2C = 1\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.335-2C.002","NAT01",null,"335-2C",2,null," ",null,null,"Submit an NCPDP file with correct value (not > 1 position) in 335-2C \"Pregnancy Indicator\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 335-2C =  1 \r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.350-HN.001","NAT01",null,"350-HN",1,null,null,null,null,"Submit an NCPDP file with correct value (contains Alphanumerics) in 350-HN \"Patient Email Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 350-HN = JSMITH@NCPDP.ORG\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.350-HN.002","NAT01",null,"350-HN",2,null," ",null,null,"Submit an NCPDP file with correct value (> 80 positions) in 350-HN \"Patient Email Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 350-HN = JSMITH@NCPDP.ORGNG Step 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.384-4X.001","NAT01",null,"384-4X",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 384-4X \"Patient Residence\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 384-4X= 1\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT01.384-4X.002","NAT01",null,"384-4X",2,null,null,null,null,"Submit an NCPDP file with correct value (is numeric) in 384-4X \"Patient Residence\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 384-4X= 1\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT02.111-AM.001","NAT02",null,"111-AM",1,null,null,null,null,"Submit an NCPDP file with correct order of fields in Pharmacy Provider Segment to ensure no rejection.","Step 1. Submit a NCPDP file where \r\nSegment Identification (111-AM) = 02, is the first field in the file followed by Provider ID Qualifier (465-EY), then Provider ID (444-E9).\r\n\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\n\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT02.111-AM.002","NAT02",null,"111-AM",2,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 111-AM \"Segment Identification\" (Pharmacy Provider Segment) to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 111-AM = 02\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT02.444-E9.001","NAT02",null,"444-E9",1,null,null,null,null,"Submit an NCPDP file with valid value first position of 444-E9 \"Provider ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file with a  10 digit NPI in 449-E9 where the first position = 1\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT02.444-E9.002","NAT02",null,"444-E9",2,null,null,null,null,"Submit an NCPDP file with valid value (contains a valid check digit) in 444-E9 Provider ID to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 444-E9 = 1234567893 \r\n(When Provider ID Qualifier 465-EY = 01)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT03.111-AM.001","NAT03",null,"111-AM",1,null,null,null,null,"Submit an NCPDP file with correct order of fields in Prescriber Segment to ensure no rejection.","Step 1. Submit a NCPDP file where \r\nSegment Identification (111-AM) = 03, is the first field in the file followed by Prescriber ID Qualifier (466-EZ)\r\n\r\nStep 2. After file is submitted, obtain NCPDP response.\r\n\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT03.111-AM.002","NAT03",null,"111-AM",2,null,null,null,null,"Submit an NCPDP file with three repetitions of Prescriber Segment to get accepted acknowledgement.","Step 1. Submit a NCPDP file with 4 occurrences of AM-03 Prescriber Segment -- each within distinct group separators (i.e. 1 prescriber segment for each AM-07 line item within same transaction header (claim)).\r\n\r\nStep 2. After file is submitted, obtain NCPDP response.\r\n\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT03.364-2J.001","NAT03",null,"364-2J",1,null," ",null,null,"Submit an NCPDP file with correct value (contains Alphanumerics) in 364-2J \"Prescriber Street Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 364-2J = 300 E PARK DRIVE\r\nStep 2. After file is submitted, obtain NCPDP response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT03.364-2J.002","NAT03",null,"364-2J",2,null," ",null,null,"Submit an NCPDP file with 364-2J \"Prescriber Street Address\" not greater than 30 characters to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 364-2J = 300 E PARK DRIVE\r\nStep 2. After file is submitted, obtain NCPDP response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT03.365-2K.001","NAT03",null,"365-2K",1,null," ",null,null,"Submit an NCPDP file with correct value (contains Alphanumerics) in 365-2K \"Prescriber Street Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 365-2K = 300 E PARK DRIVE\r\nStep 2. After file is submitted, obtain NCPDP response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT03.365-2K.002","NAT03",null,"365-2K",2,null," ",null,null,"Submit an NCPDP file with 365-2K \"Prescriber Street Address\" not greater than 30 characters to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 365-2K = 300 E PARK DRIVE\r\nStep 2. After file is submitted, obtain NCPDP response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT03.366-2M.001","NAT03",null,"366-2M",1,null,null,null,null,"Submit an NCPDP file with correct value (contains Alphanumeric) in 366-2M \"Prescriber City Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 366-2M = HARRISBURG\r\nStep 2. After file is submitted, obtain NCPDP response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT03.366-2M.002","NAT03",null,"366-2M",2,null,null,null,null,"Submit an NCPDP file with 366-2M \"Prescriber City Address\" not greater than 20 characters to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 366-2M = HARRISBURG\r\nStep 2. After file is submitted, obtain NCPDP response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT03.367-2N.001","NAT03",null,"367-2N",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 367-2N \"Prescriber State/ Province Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 367-2N = PA\r\nStep 2. After file is submitted, obtain NCPDP response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT03.368-2P.001","NAT03",null,"368-2P",1,null,null,null,null,"Submit an NCPDP file with 368-2P \"Prescriber Zip/Postal Zone\" a valid 5 digit zip cod to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 368-2P = 17111\r\nStep 2. After file is submitted, obtain NCPDP response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT03.368-2P.002","NAT03",null,"368-2P",2,null,null,null,null,"Submit an NCPDP file with 368-2P \"Prescriber Zip/Postal Zone\" a valid 9 digit zip code to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 368-2P = 132012458\r\nStep 2. After file is submitted, obtain NCPDP response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT03.411-DB.001","NAT03",null,"411-DB",1,null,null,null,null,"Submit an NCPDP file with a valid 1st pos = 1  411-DB \"Prescriber ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 411-DB = 1234567893 when 466-EZ = 01\r\nStep 2. After file is submitted, obtain NCPDP response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT03.411-DB.002","NAT03",null,"411-DB",2,null,null,null,null,"Submit an NCPDP file with a valid check digit in 411-DB \"Prescriber ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 411-DB = 1234567893 (When Prescriber ID Qualifier, 466-EZ = 01)\r\nStep 2. After file is submitted, obtain NCPDP response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT03.421-DL.001","NAT03",null,"421-DL",1,null,null,null,null,"Submit an NCPDP file with 421-DL\"Primary Care Provider ID\" 1st pos=1 when 468-2E = 01 to get accepted acknowledgement.","Step 1. Submit a NCPDP file with 10 digit NPI in 421-DL where first position = 1, 468-2E = 01\r\nStep 2. After file is submitted, obtain NCPDP response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT03.421-DL.002","NAT03",null,"421-DL",2,null,null,null,null,"Submit an NCPDP file with a valid check digit in 421-DL \"Primary Care Provider ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 421-DL = 1234567893 \r\n when 468-2E = 01\r\nStep 2. After file is submitted, obtain NCPDP response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT03.427-DR.001","NAT03",null,"427-DR",1,null,null,null,null,"Submit an NCPDP file with correct value (contains Alphanumeric) in 427-DR \"Prescriber Last Name\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 427-DR = GARNETT\r\nStep 2. After file is submitted, obtain NCPDP response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT03.427-DR.002","NAT03",null,"427-DR",2,null,null," ",null,"Submit an NCPDP file with 427-DR \"Prescriber Last Name\" not great than 15 characters to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 427-DR = GARNETT\r\nStep 2. After file is submitted, obtain NCPDP response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT03.466-EZ.001","NAT03",null,"466-EZ",1,null,null,null,null,"Submit an NCPDP file with 466-EZ Prescriber ID Qualifier present to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 466-EZ = 01\r\nStep 2. After file is submitted, obtain NCPDP response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT03.466-EZ.002","NAT03",null,"466-EZ",2,null,null,null,null,"Submit an NCPDP file with 466-EZ Prescriber ID Qualifier valid (01)  to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 466-EZ = 01\r\nStep 2. After file is submitted, obtain NCPDP response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT03.468-2E.001","NAT03",null,"468-2E",1,null,null,null,null,"Submit an NCPDP file with 468-2E present to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 468-2E= 01 \r\nStep 2. After file is submitted, obtain NCPDP response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT03.468-2E.002","NAT03",null,"468-2E",2,null,null,null,null,"Submit an NCPDP file with 468-2E present when 421-DL is present to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 468-2E = 01 ; 421-DL is present\r\nStep 2. After file is submitted, obtain NCPDP response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT03.470-4E.001","NAT03",null,"470-4E",1,null,null,null,null,"Submit an NCPDP file with correct value (contains Alphanumeric) in 470-4E \"Primary Care Provider Last Name\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 470-4E = BRYANT\r\nStep 2. After file is submitted, obtain NCPDP response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT03.470-4E.002","NAT03",null,"470-4E",2,null,null,null,null,"Submit an NCPDP file with 470-4E \"Primary Care Provider Last Name\"not greater than 15 characters to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 470-4E = BRYANT\r\nStep 2. After file is submitted, obtain NCPDP response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT03.498-PM.001","NAT03",null,"498-PM",1,null,null,null,null,"Submit an NCPDP file with exactly 10 numeric digits in 498-PM \"Prescriber Phone Number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 498-PM = 7171250228\r\nStep 2. After file is submitted, obtain NCPDP response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.111-AM.001","NAT04",null,"111-AM",1,null,null,null,null,"Submit an NCPDP file with correct order of fields in Insurance Segment to ensure no rejection.","Step 1. Submit a NCPDP file where \r\nSegment Identification (111-AM) = 04, is the first field in the file followed by Cardholder ID (302-C2), then Patient Relationship Code (306-C6) \r\n\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\n\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.111-AM.002","NAT04",null,"111-AM",2,null,null,null,null,"Submit an NCPDP file with no repetition of Insurance Segment to get accepted acknowledgement.","Step 1. Submit a NCPDP file with one occurrence of \r\n111-AM (Insurance Segment) = 04\r\n\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\n\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.115-N5.001","NAT04",null,"115-N5",1,null,null,null,null,"Submit an NCPDP file with correct value (contains Alphanumerics) in 115-N5 \"Medicaid ID Number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 115-N5 = STR42657\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.115-N5.002","NAT04",null,"115-N5",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 20 positions) in 115-N5 \"Medicaid ID Number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 115-N5 = AB111222223333344444\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.116-N6.001","NAT04",null,"116-N6",1,null,null,null,null,"Submit an NCPDP file with correct value (alphanumerics) in 116-N6 \"Medicaid Agency Number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 116-N6 = MAN123456\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.116-N6.002","NAT04",null,"116-N6",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 15 positions) in 116-N6 \"Medicaid Agency Number\"  to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 116-N6 = MAN123456789000\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.301-C1.001","NAT04",null,"301-C1",1,null,null,null,null,"Submit an NCPDP file with correct value (alphanumeric) 301-C1 \"Group ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 301-C1 = QWER24242\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.301-C1.002","NAT04",null,"301-C1",2,null," "," ",null,"Submit an NCPDP file with correct value (not > 15 positions) 301-C1 \"Group ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 301-C1 = GROUPID12345678\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.302-C2.001","NAT04",null," 302-C2",1,null,null,null,null,"Submit an NCPDP file with correct value (present with valid HICN ) in 302-C2 \"Cardholder ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 302-C2 = a valid HICN\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.302-C2.002","NAT04",null," 302-C2",2,null,null,null,null,"Submit an NCPDP file with correct value (< spaces with valid HICN) in 302-C2 \"Cardholder ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 302-C2 = a valid HICN\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.303-C3.001","NAT04",null,"303-C3",1,null,null,null,null,"Submit an NCPDP file with correct value (contains Alphanumeric) in 303-C3 \"Person Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 303-C3 = 001\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.303-C3.002","NAT04",null,"303-C3",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 3 positions) in 303-C3 \"Person Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 303-C3 = 234\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.306-C6.001","NAT04",null,"306-C6",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 306-C6 \"Patient Relationship Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 306-C6 = 1\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.306-C6.002","NAT04",null,"306-C6",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 1 position) in 306-C6 \"Patient Relationship Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 306-C6 = 1\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.309-C9.001","NAT04",null,"309-C9",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 309-C9 \"Eligibility Clarification Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 309-C9 = 1\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.309-C9.002","NAT04",null,"309-C9",2,null,null,null,null,"Submit an NCPDP file with correct value (numerics) in 309-C9 \"Eligibility Clarification Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 309-C9 = 2\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.312-CC.001","NAT04",null,"312-CC",1,null,null,null,null,"Submit an NCPDP file with correct value (contains all alphas) in 312-CC \"Cardholder First name\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 312-CC = SMITH\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.312-CC.002","NAT04",null,"312-CC",2,null," ",null,null,"Submit an NCPDP file with correct value (is present) in 312-CC \"Cardholder First name\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 312-CC = MARKS\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.314-CE.001","NAT04",null,"314-CE",1,null,null,null,null,"Submit an NCPDP file with correct value (contains Alphanumeric) in 314-CE \"Home Plan\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 314-CE = 599\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.314-CE.002","NAT04",null,"314-CE",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 3 positions) in 314-CE \"Home Plan\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 314-CE = 600\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.356-NU.001","NAT04",null,"356-NU",1,null,null,null,null,"Submit an NCPDP file with correct value (alphanumerics) in356-NU \"Other Payer Cardholder ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 356-NU = OPCID12345\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.356-NU.002","NAT04",null,"356-NU",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 20 positions) in 356-NU \"Other Payer Cardholder ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 356-NU = OPCID123458888888888\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.359-2A.001","NAT04",null,"359-2A",1,null,null,null,null,"Submit an NCPDP file with correct value (contains Alphanumerics) in 359-2A \"Medigap ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 359-2A= AB25\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.359-2A.002","NAT04",null,"359-2A",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 20 positions) in 359-2A \"Medigap ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 359-2A= ABCDE123456789123456\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.360-2B.001","NAT04",null,"360-2B",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 360-2B \"Medicaid Indicator\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 360-2B = PA\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.360-2B.002","NAT04",null,"360-2B",2,null,null,null,null,"Submit an NCPDP file with correct value (present) in 360-2B \"Medicaid Indicator\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 360-2B = NY\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.361-2D.001","NAT04",null,"361-2D",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 361-2D \"Provider Accept Assignment Indicator\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 361-2D = Y\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.361-2D.002","NAT04",null,"361-2D",2,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 361-2D \"Provider Accept Assignment Indicator\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 361-2D = N\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.524-FO.001","NAT04",null,"524-FO",1,null,null,null,null,"Submit an NCPDP file with correct value (contains Alphanumerics)  in 524-FO \"Plan ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 524-FO = PQ789\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.524-FO.002","NAT04",null,"524-FO",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 8 positions)  in 524-FO \"Plan ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 524-FO =QWER2424\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.990-MG.001","NAT04",null,"990-MG",1,null,null,null,null,"Submit an NCPDP file with correct value (numerics) in 990=MG \"Other Payer BIN number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 990-MG = 123456\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.990-MG.002","NAT04",null,"990-MG",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 6 positions) in 990-MG \"Other Payer BIN number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 990-MG = 456789\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.991-MH.001","NAT04",null,"991-MH",1,null,null,null,null,"Submit an NCPDP file with correct value (alphanumerics) in 991-MG \"Other Payer processer control number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 991-MH = CNTL123\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.991-MH.002","NAT04",null,"991-MH",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 10 positions) in 991-MH \"Other Payer processer control number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 991-MH = CNTRL12345\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.992-MJ.001","NAT04",null,"992-MJ",1,null,null,null,null,"Submit an NCPDP file with correct value (alphanumerics) in 992-MJ \"Other PayerGroup ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 992-MJ = OPGID12345\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.992-MJ.002","NAT04",null,"992-MJ",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 12 positions) in 992-MJ \"Other Payer Group ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 992-MJ = OPGID1234588\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.997-G2.001","NAT04",null,"997-G2",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 997-G2 \"CMS Part D Defined Qualified Facility\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 997-G2 = N\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT04.997-G2.002","NAT04",null,"997-G2",2,null,null," ",null,"Submit an NCPDP file with correct value (alpha numeric) in 997-G2 \"CMS Part D Defined Qualified Facility\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 997-G2 =Y\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.111-AM.001","NAT05",null,"111-AM",1,null,null,null,null,"Submit an NCPDP file with correct order of fields in Coordination of Benefits/Other Payments Segment to ensure no rejection.","Step 1. Submit a NCPDP file where \r\nSegment ID (111-AM) is first field in the file followed by\r\nCoordination of Benefits/Other Payments Count (337-4C), then Other Payer Coverage Type (338-5C), then Other Payer Reject Count (471-5E) \r\n\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\n\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.111-AM.002","NAT05",null,"111-AM",2,null,null,null,null,"Submit an NCPDP file with three repetitions of Coordination of Benefits/Other Payments Segment to get accepted acknowledgement.","Step 1. Submit a NCPDP file with 4 occurrences of AM-05 Coordination of Benefits/Other Payments Segment -- each within distinct group separators (i.e. 1 COB/other payer segment for each AM-07 line item within same transaction header (claim)).\r\n\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\n\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.337-4C.001","NAT05",null,"337-4C",1,null,null,null,null,"Matched 1 occurrence (for Medicare Edit) of 337-4C \"Coordination of Benefits/Other Payments Count\" ","Step 1. Submit a NCPDP file with 1 occurrence of 337-4C and the associated fields, where 337-4C = 1\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.338-5C.001","NAT05",null,"338-5C",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 338-5C \"Other Payer Coverage Type\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 338-5C = 01\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.338-5C.002","NAT05",null,"338-5C",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 2) in 338-5C \"Other Payer Coverage Type\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 338-5C =02\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.339-6C.001","NAT05",null,"339-6C",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 339-6C \"Other Payer ID Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 339-6C = 01\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.339-6C.002","NAT05",null,"339-6C",2,null," ",null,null,"Submit an NCPDP file with correct value (not > 2) in 339-6C \"Other Payer ID Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 339-6C = 02\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.340-7C.001","NAT05",null,"340-7C",1,null,null,null,null,"Submit an NCPDP file with correct value (contains Alphanumeric) in 340-7C \"Other Payer ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 340-7C = 42CD\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.340-7C.002","NAT05",null,"340-7C",2," ",null,null,null,"Submit an NCPDP file with correct value (not > 10 positions) in 340-7C \"Other Payer ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 340-7C = ABG123456\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.341-HB.001","NAT05",null,"341-HB",1,null,null,null,null,"Matched 9 occurrences of 341-HB \"Other Payer Amount Paid Count\" ","Step 1. Submit a NCPDP file with 9 occurrences of 341-HB and the associated fields, where 341-HB = 9\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.341-HB.002","NAT05",null,"341-HB",2," ",null,null,null,"Submit an NCPDP file with correct value (contains numeric) in 341-HB \"Other Payer Amount Paid Count\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 341-HB = 1\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.342-HC.001","NAT05",null,"342-HC",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 342-HC \"Other Payer Amount Paid Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 342-HC = 07\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.342-HC.002","NAT05",null,"342-HC",2," ",null,null,null,"Submit an NCPDP file with correct value (alphanumeric) in 342-HC \"Other Payer Amount Paid Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 342-HC = 01\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.351-NP.001","NAT05",null,"351-NP",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 351-NP \"Other Payer-Patient Responsibility Amount Qualifier \" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 351-NP = 01\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.351-NP.002","NAT05",null,"351-NP",2," ",null,null,null,"Submit an NCPDP file with correct value (alphanumeric) in 351-NP \"Other Payer-Patient Responsibility Amount Qualifier \" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 351-NP = 03\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.352-NQ.001","NAT05",null,"352-NQ",1,null,null,null,null,"Submit an NCPDP file with correct value (numeric) in 352-NQ \"Other Payer-Patient Responsibility Amount \" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 351-NQ = 52E (1.e. $5.25)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.352-NQ.002","NAT05",null,"352-NQ",2,null," ",null,null,"Submit an NCPDP file with correct value (presnt if 351-NP is present) in 352-NQ \"Other Payer-Patient Responsibility Amount \" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 351-NQ = 152E (1.e. $15.25)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.353-NR.001","NAT05",null,"353-NR",1,null,null,null,null,"Matched 25 occurrences of 353-NR \"Other Payer-Patient Responsibility Amount Count\" ","Step 1. Submit a NCPDP file with 25 occurrences of 353-NR and the associated fields, where 353-NR = 25\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.353-NR.002","NAT05",null,"353-NR",2,null,null,null,null,"Submit an NCPDP file with correct value (all Numerics) in 353-NR \"Other Payer-Patient Responsibility Amount Count\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 353-NR = 01\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.392-MU.001","NAT05",null,"392-MU",1,null,null,null,null,"Matched 4 occurrences of 392-MU \"Benefit Stage Count\" ","Step 1. Submit a NCPDP file with 4 occurrences of 392-MU and the associated fields, where 392-MU = 4\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.392-MU.002","NAT05",null,"392-MU",2,null,null,null,null,"Submit an NCPDP file with correct value (contains Numeric) in 392-MU \"Benefit Stage Count\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 392-MU = 1\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.393-MV.001","NAT05",null,"393-MV",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 393-MV \"Benefit Stage Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 393-MV = 01\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.393-MV.002","NAT05",null,"393-MV",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 2) in 393-MV \"Benefit Stage Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 393-MV = 01\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.394-MW.001","NAT05",null,"394-MW",1,null,null,null,null,"Submit an NCPDP file with correct value  (numeric) in 394-MW \"Benefit Stage Amount\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 393-MW =42C (i.e. $4.23)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.394-MW.002","NAT05",null,"394-MW",2,null," ",null,null,"Submit an NCPDP file with correct value  (not > 8 positions ) in 394-MW \"Benefit Stage Amount\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 393-MW =2222242C (i.e. $222224.23)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.431-DV.001","NAT05",null,"431-DV",1," ",null,null,null,"Submit an NCPDP file with correct value  (numeric) in 431-DV \"Other Payer Amount Paid\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 431-DV = 79I (i.e. $7.99)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.431-DV.002","NAT05",null,"431-DV",2,null,null,null,null,"Submit an NCPDP file with correct value  (presnt with 342-HC) in 431-DV \"Other Payer Amount Paid\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 431-DV = 279I (i.e. $27.99)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.443-E8.001","NAT05",null,"443-E8",1,null,null,null,null,"Submit an NCPDP file with correct value (all Numerics) in 443-E8 \"Other Payer Date\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 443-E8 = 20081224\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.443-E8.002","NAT05",null,"443-E8",2," ",null,null,null,"Submit an NCPDP file with correct value (not > 8 positions) in 443-E8 \"Other Payer Date\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 443-E8 = 20090202\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.471-5E.001","NAT05",null,"471-5E",1,null,null,null,null,"Matched 5 occurrences of 471-5E \"Other Payer Reject Count\" ","Step 1. Submit a NCPDP file with 5 occurrences of 471-5E and the associated fields, where 471-5E = 5\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.471-5E.002","NAT05",null,"471-5E",2,null,null,null,null,"Submit an NCPDP file with correct value (all Numerics) in 471-5E \"Other Payer Reject Count\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 471-5E = 01\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.472-6E.001","NAT05",null,"472-6E",1,null,null,null," ","Submit an NCPDP file with correct value (on code list) in 472-6E \"Other Payer Reject Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 472-6E = HB\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.472-6E.002","NAT05",null,"472-6E",2," ",null,null,null,"Submit an NCPDP file with correct value (not > 3 postions) in 472-6E \"Other Payer Reject Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 472-6E = HB\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.993-A7.001","NAT05",null,"993-A7",1,null,null,null,null,"Submit an NCPDP file with correct value (alpha numeric) in 993-A7 \"Internal Control Number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 993-A7=123456789ABCD alpha numerics\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT05.993-A7.002","NAT05",null,"993-A7",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 30 positons) in 993-A7 \"Internal Control Number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 993-A7=123456789123456789123456789111\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.111-AM.001","NAT06",null,"111-AM",1,null,null," ",null,"Submit an NCPDP file with correct order of fields in Workers' Compensation Segment to ensure no rejection.","Step 1. Submit a NCPDP file where \r\nSegment ID (111-AM) = 06 is first field in the file followed by\r\nDate of Injury (434-DY) = 20090105, then\r\nPay to Qualifier (118-TS) \r\n\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\n\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.111-AM.002","NAT06",null,"111-AM",2,null," ",null,null,"Submit an NCPDP file with three repetitions of Workers' Compensation Segment to get accepted acknowledgement.","Step 1. Submit a NCPDP file with 4 occurrences of AM-06 Worker's Comp Segment -- each within distinct group separators (i.e. 1 Worker's Comp segment for each AM-07 line item within same transaction header (claim)).\r\n\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\n\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.117-TR.001","NAT06",null,"117-TR",1,null," ",null,null,"Submit an NCPDP file with correct value (on code list) in 117-TR \"Billing Entity Type Indicator\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 117-TR = 00\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.117-TR.002","NAT06",null,"117-TR",2,null,null,null,null,"Submit an NCPDP file with correct value (numeric) in 117-TR \"Billing Entity Type Indicator\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 117-TR = 01\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.118-TS.001","NAT06",null,"118-TS",1,null," ",null,null,"Submit an NCPDP file with correct value (on code list) in 118-TS \"Pay to Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 118-TS = 11\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.118-TS.002","NAT06",null,"118-TS",2,null," ",null,null,"Submit an NCPDP file with correct value alpha numeric) in 118-TS \"Pay to Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 118-TS = 00\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.119-TT.001","NAT06",null,"119-TT",1,null,null,null,null,"Submit an NCPDP file with correct value (contains Alphanumeric) in 119-TT \"Pay to ID \" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where  118-TS-01, 119-TT = 1NNNNNNNNN\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.119-TT.002","NAT06",null,"119-TT",2,null," ",null,null,"Submit an NCPDP file with correct value (not > 15 positions) in 119-TT \"Pay to ID \" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where  118-TS-00, 119-TT = 1NNNNNNNNN\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.120-TU.001","NAT06",null,"120-TU",1,null,null,null,null,"Submit an NCPDP file with correct value (contains Alphanumeric) in 120-TU \"Pay to Name\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 120-TU = ABC COMPANY\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.120-TU.002","NAT06",null,"120-TU",2,null," ",null,null,"Submit an NCPDP file with correct value (> spaces) in 120-TU \"Pay to Name\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 120-TU = ABC COMPANY\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.121-TV.001","NAT06",null,"121-TV",1,null,null,null,null,"Submit an NCPDP file with correct value (alpha numerics)  in 121-TV \"Pay to Street Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 121-TV = 40 LAKEPOINT DRIVE\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.121-TV.002","NAT06",null,"121-TV",2,null,null,null,null,"Submit an NCPDP file with correct value (> spaces)  in 121-TV \"Pay to Street Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 121-TV = 40 OLIVE PLACE\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.122-TW.001","NAT06",null,"122-TW",1,null,null,null,null,"Submit an NCPDP file with correct value (contains alphanumeric) in 122-TW \"Pay to City Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 122-TW = NEW YORK\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.122-TW.002","NAT06",null,"122-TW",2,null,null,null,null,"Submit an NCPDP file with correct value (> spaces) in 122-TW \"Pay to City Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 122-TW = NEW YORK\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.123-TX.001","NAT06",null,"123-TX",1,null,null,null,null,"Submit an NCPDP file with correct value (valid state code) in 123-TX \"Pay to State/Province Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 123-TX = NY\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.123-TX.002","NAT06",null,"123-TX",2," ",null,null,null,"Submit an NCPDP file with correct value (alpha numeric) in 123-TX \"Pay to State/Province Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 123-TX =NYA\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.124-TY.001","NAT06",null,"124-TY",1,null,null,null,null,"Submit an NCPDP file with correct value ( valid value)  in 124-TY \"Pay to Zip/Postal Zone\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 124-TY = 17109\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.124-TY.002","NAT06",null,"124-TY",2,null," ",null,null,"Submit an NCPDP file with correct value ( numerics)  in 124-TY \"Pay to Zip/Postal Zone\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 124-TY = 17109\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.125-TZ.001","NAT06",null,"125-TZ",1,null,null,null,null,"Submit an NCPDP file with correct value (valid value)  in 125-TZ \"Generic Equivalent Product ID Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 125-TZ = 03\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.125-TZ.002","NAT06",null,"125-TZ",2," ",null,null,null,"Submit an NCPDP file with correct value (alpha numerics)  in 125-TZ \"Generic Equivalent Product ID Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 125-TZ = A3\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.126-UA.001","NAT06",null,"126-UA",1,null,null,null,null,"Submit an NCPDP file with correct value (contains alphanumeric) in 126-UA \"Generic equivalent product ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 126-UA = 789XYZ\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.126-UA.002","NAT06",null,"126-UA",2,null," ",null,null,"Submit an NCPDP file with correct value (not > 19 positions) in 126-UA \"Generic equivalent product ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 126-UA = 123456789PID\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.315-CF.001","NAT06",null,"315-CF",1,null,null,null,null,"Submit an NCPDP file with correct value (contains Alphanumeric) in 315-CF \"Employer Name\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 315-CF = MCDONALDS CORPORATION\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.315-CF.002","NAT06",null,"315-CF",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 30 positions) in 315-CF \"Employer Name\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 315-CF = MCDONALDS CORPORATION\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.316-CG.001","NAT06",null,"316-CG",1,null,null,null,null,"Submit an NCPDP file with correct value (contains Alphanumerics) in 316-CG \"Employer Street Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 316-CG = 100 WEST STREET\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.316-CG.002","NAT06",null,"316-CG",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 30 positions) in 316-CG \"Employer Street Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 316-CG = 100 WEST STREET\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.317-CH.001","NAT06",null,"317-CH",1,null,null,null,null,"Submit an NCPDP file with correct value (contains Alphanumerics) in 317-CH \"Employer City Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 317-CH = PITTSBURG\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.317-CH.002","NAT06",null,"317-CH",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 20 positions) in 317-CH \"Employer City Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 317-CH = PITTSBURG\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.318-CI.001","NAT06",null,"318-CI",1,null," ",null,null,"Submit an NCPDP file with correct value (on code list) in 318-CI \"Employer State/Province Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 318-CI = NY\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.318-CI.002","NAT06",null,"318-CI",2,null,null,null,null,"Submit an NCPDP file with correct value (not >2 positions) in 318-CI \"Employer State/Province Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 318-CI = NY\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.319-CJ.001","NAT06",null,"319-CJ",1,null,null,null,null,"Submit an NCPDP file with correct value (alpha numeric) in 319-CJ \"Employer Zip/Postal Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 319-CJ = 17101\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.319-CJ.002","NAT06",null,"319-CJ",2,null,null,null,null,"Submit an NCPDP file with correct value (valid 5 digit code) in 319-CJ \"Employer Zip/Postal Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 319-CJ = 17101\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.320-CK.001","NAT06",null,"320-CK",1,null,null,null,null,"Submit an NCPDP file with correct value (all numeric) in 320-CK \"Employer Phone Number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 320-CK = 7172545960\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.320-CK.002","NAT06",null,"320-CK",2,null,null,null,null,"Submit an NCPDP file with correct value (= exactly 10 positions) in 320-CK \"Employer Phone Number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 320-CK = 7172545960\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.321-CL.001","NAT06",null,"321-CL",1,null,null,null,null,"Submit an NCPDP file with correct value (contains Alphanumeric) in 321-CL \"Employer Contact Name\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 321-CL = JIM FURYK\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.321-CL.002","NAT06",null,"321-CL",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 30 positions in 321-CL \"Employer Contact Name\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 321-CL = JIM FURYK\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.327-CR.001","NAT06",null,"327-CR",1,null,null,null,null,"Submit an NCPDP file with correct value (contains Alphanumeric) in 327-CR \"Carrier ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 327-CR = A521 \r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.327-CR.002","NAT06",null,"327-CR",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 10 positions) in 327-CR \"Carrier ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 327-CR = A521 \r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.434-DY.001","NAT06",null,"434-DY",1,null,null,null,null,"Submit an NCPDP file with correct value (all numeric) in 434-DY \"Date of injury\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 434-DY = 20070516\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.434-DY.002","NAT06",null,"434-DY",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 8 positions) in 434-DY \"Date of injury\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 434-DY = 20070516\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.435-DZ.001","NAT06",null,"435-DZ",1,null," ",null,null,"Submit an NCPDP file with correct value (contains Alphanumeric) in 435-DZ \"Claim/Reference ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 435-DZ = BC9875\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT06.435-DZ.002","NAT06",null,"435-DZ",2,null," ",null,null,"Submit an NCPDP file with correct value (not > 30 positions) in 435-DZ \"Claim/Reference ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 435-DZ = BC9875\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.111-AM.001","NAT07",null,"111-AM",1,null,null," ",null,"Submit an NCPDP file with correct order of fields in Claim Segment to ensure no rejection.","Step 1. Submit a NCPDP file where \r\nSegment ID (111-AM) =07 is the first field in the file followed by:\r\nPrescription Service Reference Number Qualifier (455-EM), then\r\nPrescription Service Reference Number (402-D2), then\r\nProduct/Service ID Qualifier (436-E1), then \r\nProduct/Service ID (407-D7), then\r\nPrescription Origin Code (419-DJ), then\r\nFill Number (403-D3)\r\n\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\n\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.111-AM.002","NAT07",null,"111-AM",2,null,null,null,null,"Submit an NCPDP file with three repetitions of Claim Segment to get accepted acknowledgement.","Step 1. Submit a NCPDP file with 4 occurrences of AM-07 Claim Segment -- each within distinct group separators (i.e. 4 line items within same transaction header (claim)).\r\n\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\n\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.147-U7.001","NAT07",null,"147-U7",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 147-U7 \"Pharmacy Service Type\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 147-U7 = 8\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.147-U7.002","NAT07",null,"147-U7",2,null,null,null,null,"Submit an NCPDP file with correct value (numeric) in 147-U7 \"Pharmacy Service Type\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 147-U7 = 04\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.308-C8.001","NAT07",null,"308-C8",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 308-C8 \"Other Coverage Code\" to ensure no IG edits.","Step 1. Submit a NCPDP file where 308-C8= 00\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.308-C8.002","NAT07",null,"308-C8",2," ",null,null,null,"Submit an NCPDP file with correct value (numeric) in 308-C8 \"Other Coverage Code\" to ensure no IG edits.","Step 1. Submit a NCPDP file where 308-C8= 2\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.330-CW.001","NAT07",null,"330-CW",1,null,null,null,null,"Submit an NCPDP file with correct value (numeric) in 330-CW \"Alternate ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 330-CW =  123456\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.330-CW.002","NAT07",null,"330-CW",2," ",null,null,null,"Submit an NCPDP file with correct value (not > 20 positions ) in 330-CW \"Alternate ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 330-CW = 12345678901234567890\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.343-HD.001","NAT07",null,"343-HD",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 343-HD \"Dispensing Status\" to ensure no IG edits","Step 1. Submit a NCPDP file where 343-HD = P\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.343-HD.002","NAT07",null,"343-HD",2,null," ",null,null,"Submit an NCPDP file with correct value (alphanumeric) in 343-HD \"Dispensing Status\" to ensure no IG edits","Step 1. Submit a NCPDP file where 343-HD = C\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.344-HF.001","NAT07",null,"344-HF",1,null,null,null,null,"Submit an NCPDP file with correct value (numeric) in 344-HF \"Quantity Intended to be Dispensed\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 344-HF =  60\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.344-HF.002","NAT07",null,"344-HF",2," ",null,null,null,"Submit an NCPDP file with correct value (not >  9 posiitons) in 344-HF \"Quantity Intended to be Dispensed\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 344-HF = 1000000.55\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.345-HG.001","NAT07",null,"345-HG",1,null,null,null,null,"Submit an NCPDP file with correct value (numeric) in 345-HG \"Days Supply Intended to be Dispensed\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 345-HG =  60\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.345-HG.002","NAT07",null,"345-HG",2," ",null,null,null,"Submit an NCPDP file with correct value (not >  3 posiitons) in 345-HG \"Days Supply Intended to be Dispensed\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 345-HG = 900\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.354-NX.001","NAT07",null,"354-NX",1,null,null,null,null,"Submit an NCPDP file with correct value (numeric) in 354-NX \"Submission Clarification Code Count\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 354-NX = 1\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.354-NX.002","NAT07",null,"354-NX",2,null,null," ",null,"Matched 2 occurrences of 354-NX \"Submission Clarification Code Count\" ","Step 1. Submit a NCPDP file with 2 occurrences of 354-NX and the associated fields, where 354-NX = 2\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.357-NV.001","NAT07",null,"357-NV",1,null," ",null,null,"Submit an NCPDP file with correct value (on code list)  in 357-NV \"Delay Reason Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 357-NV = 11\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.357-NV.002","NAT07",null,"357-NV",2,null,null,null,null,"Submit an NCPDP file with correct value (numeric)  in 357-NV \"Delay Reason Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 357-NV = 05\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.391-MT.001","NAT07",null,"391-MT",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 391-MT \"Patient Assignment Indicator\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 391-MT = Y\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.391-MT.002","NAT07",null,"391-MT",2,null,null,null,null,"Submit an NCPDP file with correct value (alphanumeric) in 391-MT \"Patient Assignment Indicator\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 391-MT = N \r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.402-D2.001","NAT07",null,"402-D2",1,null,null,null,null,"Submit an NCPDP file with correct value (numerics) in 402-D2 \"Prescription/Service Reference Number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 402-D2=123456789012\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.402-D2.002","NAT07",null,"402-D2",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 12 positions) in 402-D2 \"Prescription/Service Reference Number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 402-D2=123456789012\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.403-D3.001","NAT07",null,"403-D3",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 403-D3 \"Fill Number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 403-D3 = 99\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.403-D3.002","NAT07",null,"403-D3",2," ",null,null,null,"Submit an NCPDP file with correct value (numeric) in 403-D3 \"Fill Number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 403-D3 = 02\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.405-D5.001","NAT07",null,"405-D5",1,null,null,null,null,"Submit an NCPDP file with correct value (numeric) in 405-D5 \"Days Supply\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 405-D5 = 10\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.405-D5.002","NAT07",null,"405-D5",2," ",null," ",null,"Submit an NCPDP file with correct value (present) in 405-D5 \"Days Supply\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 405-D5 = 30\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.406-D6.001","NAT07",null,"406-D6",1,null,null,null,null,"Submit an NCPDP file with correct value (numeric) in 406-D6 \"Compound Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 406-D6 =  1\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.406-D6.002","NAT07",null,"406-D6",2," ",null,null,null,"Submit an NCPDP file with correct value (present) in 406-D6 \"Compound Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 406-D6 = 2\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.407-D7.001","NAT07",null,"407-D7",1,null,null,null,null,"Submit an NCPDP file with correct value (valid NDC Code) in 407-D7 \"Product/Service ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 407-D7 = a valid NDC code in format MMMMMDDDDPP format if 436-E1=03\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.407-D7.002","NAT07",null,"407-D7",2,null," ",null,null,"Submit an NCPDP file with correct value (alphanumeric) in 407-D7 \"Product/Service ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 407-D7 = a valid NDC code in format MMMMMDDDDPP format\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.408-D8.001","NAT07",null,"408-D8",1,null,null,null,null,"Submit an NCPDP file with correct value (alphanumeric) in 408-D8 \"Dispense as Written\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 408-D8 =  1\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.408-D8.002","NAT07",null,"408-D8",2," ",null,null,null,"Submit an NCPDP file with correct value (present) in 408-D8 \"Dispense as Written\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 408-D8 = 2\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.414-DE.001","NAT07",null,"414-DE",1,null,null,null,null,"Submit an NCPDP file with correct value (numeric) in 414-DE \"Date Prescription Written\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 414-DE = 20090822\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.414-DE.002","NAT07",null,"414-DE",2,null,null," ",null,"Submit an NCPDP file with correct value (not > 8 positions) in 414-DE \"Date Prescription Written\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 414-DE = 20091222\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.415-DF.001","NAT07",null,"415-DF",1,null,null,null,null,"Submit an NCPDP file with correct value (numeric) in 415-D8 \"Number of Refills Authorized\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 415-D8 =  11\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.415-DF.002","NAT07",null,"415-DF",2," ",null,null,null,"Submit an NCPDP file with correct value (valid value 1 - 99) in 415-D8 \"Number of Refills Authorized\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 415-D8 = 26\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.418-DI.001","NAT07",null,"418-DI",1,null,null,null,null,"Submit an NCPDP file with correct value (numeric) in 418-DI \"Level of ServiceCode\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 418-DI =  1\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.418-DI.002","NAT07",null,"418-DI",2," ",null,null,null,"Submit an NCPDP file with correct value (not >  2 posiitons) in 418-DI \"Level of ServiceCode\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 418-DI = 02\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.419-DJ.001","NAT07",null,"419-DJ",1,null,null,null,null,"Submit an NCPDP file with correct value (numeric) in 419-DJ \"Prescription Origin Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 419-DJ =  1\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.419-DJ.002","NAT07",null,"419-DJ",2," ",null,null,null,"Submit an NCPDP file with correct value (valid value 0-5) in 419-DJ \"Prescription Origin Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 419-DJ = 2\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.420-DK.001","NAT07",null,"420-DK",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 420-DK \"Submission Clarification Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 420-DK= 99, 354-NX present\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.420-DK.002","NAT07",null,"420-DK",2,null,null,null,null,"Submit an NCPDP file with correct value (numeric) in 420-DK \"Submission Clarification Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 420-DK= 2, 354-NX present\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.429-DT.001","NAT07",null,"429-DT",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 429-DT \"Special Packaging Indicator\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 429-DT = 2\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.429-DT.002","NAT07",null,"429-DT",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 1 position) in 429-DT \"Special Packaging Indicator\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 429-DT = 4\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.445-EA.001","NAT07",null,"445-EA",1,null,null,null,null,"Submit an NCPDP file with correct value (alphanumeric) in 445-EA \"Originally Prescribed Product/Service Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 445-EA =  123456789\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.445-EA.002","NAT07",null,"445-EA",2," ",null,null,null,"Submit an NCPDP file with correct value (not > 19 posiitons) in 445-EA \"Originally Prescribed Product/Service Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 445-EA = 1234567890123456789\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.446-EB.001","NAT07",null,"446-EB",1,null,null,null,null,"Submit an NCPDP file with correct value (numeric) in 446-EB \"Originally prescribed quantity\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 446-EB =  30\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.446-EB.002","NAT07",null,"446-EB",2," ",null,null,null,"Submit an NCPDP file with correct value (not > 9 positions ) in 446-EB \"Originally prescribed quantity\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 446-EB = 1234567.89\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.453-EJ.001","NAT07",null,"453-EJ",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 453-EJ \"Originally Prescribed Product/Service ID Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 453-EJ =11\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.453-EJ.002","NAT07",null,"453-EJ",2,null,null,null,null,"Submit an NCPDP file with correct value (alphanumeric) in 453-EJ \"Originally Prescribed Product/Service ID Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 453-EJ =20\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.454-EK.001","NAT07",null,"454-EK",1,null,null,null,null,"Submit an NCPDP file with correct value (numeric) in 454-EK \"Scheduled Prescription ID Number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 454-EK =  222555\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.454-EK.002","NAT07",null,"454-EK",2," ",null,null,null,"Submit an NCPDP file with correct value (not > 12  positions ) in 454-EK \"Scheduled Prescription ID Number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 454-EK = 123456789012\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.455-EM.001","NAT07",null,"455-EM",1,null,null,null,null,"Submit an NCPDP file with correct value (is alphanumeric) in 455-EM \"\"Prescription/Service Reference Number Qualifier\"  \" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 455-EM = 1\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.455-EM.002","NAT07",null,"455-EM",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 2 positions) in 455-EM \"\"Prescription/Service Reference Number Qualifier\"  \" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 455-EM = 1\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.456-EN.001","NAT07",null,"456-EN",1,null,null,null,null,"Submit an NCPDP file with correct value (numeric) in 456-EN \"Associated Prescription/Service Reference Number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 456-EN = 1234567 \r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.456-EN.002","NAT07",null,"456-EN",2,null," ",null,null,"Submit an NCPDP file with correct value (not > 12 positions) in 456-EN \"Associated Prescription/Service Reference Number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 456-EN = 123456789012\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.457-EP.001","NAT07",null,"457-EP",1,null,null,null,null,"Submit an NCPDP file with correct value (numeric) in 457-EP \"Associated Prescription/Service Date\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 457-EP = 20100101\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.457-EP.002","NAT07",null,"457-EP",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 8 positions) in 457-EP \"Associated Prescription/Service Date\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 457-EP = 20091212\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.458-SE.001","NAT07",null,"458-SE",1,null,null,null,null,"Matched 10 occurrences of 458-SE \"Procedure Modifier Code Count\" ","Step 1. Submit a NCPDP file with 10 occurrences of 458-SE and the associated fields, where 458-SE = 10\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.458-SE.002","NAT07",null,"458-SE",2,null,null,null,null,"Submit an NCPDP file with correct value (numeric) in 458-SE \"Procedure Modifier Code Count\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 458-SE = 1\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.459-ER.001","NAT07",null,"459-ER",1,null,null,null,null,"Submit an NCPDP file with correct value (alphanumeric) in 459-ER \"Procedure Modifier Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 459-ER = KH\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.459-ER.002","NAT07",null,"459-ER",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 2 positions) in 459-ER \"Procedure Modifier Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 459-ER = KE\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.460-ET.001","NAT07",null,"460-ET",1,null,null,null,null,"Submit an NCPDP file with correct value (numeric) in 460-ET \"Quantity Prescribed\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 460-ET =  55.5\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.460-ET.002","NAT07",null,"460-ET",2," ",null,null,null,"Submit an NCPDP file with correct value (not > 9 positions ) in 460-ET \"Quantity Prescribed\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 460-ET = 1234567.89\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.461-EU.001","NAT07",null,"461-EU",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 461-EU \"Prior Authorization Type Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 461-EU = 1\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.461-EU.002","NAT07",null,"461-EU",2,null,null,null,null,"Submit an NCPDP file with correct value (numeric) in 461-EU \"Prior Authorization Type Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 461-EU = 9\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.462-EV.001","NAT07",null,"462-EV",1,null,null,null,null,"Submit an NCPDP file with correct value (numeric) in 462-EV \"Prior Authorization Number Submitted\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 462-EV =  91100000004\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.462-EV.002","NAT07",null,"462-EV",2," ",null,null,null,"Submit an NCPDP file with correct value (not > 11 posiitons) in 462-EV \"Prior Authorization Number Submitted\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 462-EV = 91100000002\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.463-EW.001","NAT07",null,"463-EW",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 463-EW \"Intermediary Authorization Type ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 463-EW = 0\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.463-EW.002","NAT07",null,"463-EW",2," ",null,null,null,"Submit an NCPDP file with correct value (numeric) in 463-EW \"Intermediary Authorization Type ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 463-EW = 1\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.464-EX.001","NAT07",null,"464-EX",1,null,null,null,null,"Submit an NCPDP file with correct value (alphanumeric) in 464-EX \"Imtermediary Authporization ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 464-EX =  456789\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.464-EX.002","NAT07",null,"464-EX",2," ",null,null,null,"Submit an NCPDP file with correct value (not >  11 posiitons) in 464-EX \"Imtermediary Authporization ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 464-EX = 12345678901\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.600-28.001","NAT07",null,"600-28",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 600-28 \"Unit of Measure\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 600-28 = EA\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.600-28.002","NAT07",null,"600-28",2," ",null,null,null,"Submit an NCPDP file with correct value (alphanumeric) in 600-28 \"Unit of Measure\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 600-28 = GM\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.995-E2.001","NAT07",null,"995-E2",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 995-E2 \"Route of Administration\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 995-E2 = 26643006\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.995-E2.002","NAT07",null,"995-E2",2," ",null,null,null,"Submit an NCPDP file with correct value (alphanumeric) in 995-E2 \"Route of Administration\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 995-E2 = 112239003\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.996-G1.001","NAT07",null,"996-G1",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 996-G1 \"Compound Type\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 996-G1 = 06\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT07.996-G1.002","NAT07",null,"996-G1",2,null,null,null,null,"Submit an NCPDP file with correct value (alphanumeric) in 996-G1 \"Compound Type\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 996-G1 = 4\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT08.111-AM.001","NAT08",null,"111-AM",1,null,null,null,null,"Submit an NCPDP file with correct order of fields in DUR/PPS Segment to ensure no rejection.","Step 1. Submit a NCPDP file where \r\nSegment Identification (111-AM) = 08, is the first field in the file followed by Professional Service Code (440-E5) \r\n\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\n\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT08.111-AM.002","NAT08",null,"111-AM",2,null,null,null,null,"Submit an NCPDP file with three repetitions of DUR/PPS Segment to get accepted acknowledgement.","Step 1. Submit a NCPDP file with 4 occurrences of AM-08 DUR/PPS Segment -- each within distinct group separators (i.e. 1 DUR/PPS segment for each AM-07 line item within same transaction header (claim)).\r\n\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\n\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT08.439-E4.001","NAT08",null,"439-E4",1,null,null,null,null,"Submit an NCPDP file with correct value \"AD\" in 439-E4 \"Reason For Service Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 439-E4 = AD\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT08.439-E4.002","NAT08",null,"439-E4",2,null," ",null,null,"Submit an NCPDP file with correct value = 2 positions in 439-E4 \"Reason For Service Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 439-E4 = AN\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT08.440-E5.001","NAT08",null,"440-E5",1,null,null,null,null,"Submit an NCPDP file with correct value \"CC\" in 440-E5 \"Professional Service Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 440-E5 = CC\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT08.440-E5.002","NAT08",null,"440-E5",2,null,null,null,null,"Submit an NCPDP file with correct value = 2 positions in 440-E5 \"Professional Service Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 440-E5 = DE\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT08.441-E6.001","NAT08",null,"441-E6",1,null,null,null,null,"Submit an NCPDP file with correct value(contains Alpha/Numeric) in 441-E6 \"Result of Service Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 441-E6 = 1A\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT08.441-E6.002","NAT08",null,"441-E6",2,null,null,null,null,"Submit an NCPDP file with correct value (contains 2 positions) in 441-E6 \"Result of Service Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 441-E6 = 00\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT08.473-7E.001","NAT08",null,"473-7E",1,null,null,null,null,"Sequenced 9 occurrences of 473- 7E \"DUR/PPS Code Counter\"","Step 1. Submit a NCPDP file with 9 occurrences of 473-7E where, \r\n473-7E = 1 (for 1 occurrence)\r\n473-7E = 2 (for 2 occurrences)\r\n473-7E = 3 (for 3 occurrences)\r\n473-7E = 4 (for 4 occurrences)\r\n473-7E = 5 (for 5 occurrences)\r\n473-7E = 6 (for 6 occurrences)\r\n473-7E = 7 (for 7 occurrences)\r\n473-7E = 8 (for 8 occurrences)\r\n473-7E = 9 (for 9 occurrences)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT08.473-7E.002","NAT08",null,"473-7E",2,null,null,null,null,"Submit an NCPDP file with correct value in 473-7E \"DUR/PPS Code Counter\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file with valid value in 473-7E field.\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT08.474-8E.001","NAT08",null,"474-8E",1,null,null,null,null,"Submit an NCPDP file with correct value \"15\" in 474-8E \"DUR/PPS Level Of Effort\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 474-8E = 15\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT08.474-8E.002","NAT08",null,"474-8E",2,null,null,null,null,"Submit an NCPDP file with correct value = 2 positions in 474-8E \"DUR/PPS Level Of Effort\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 474-8E = 11\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT08.475-J9.001","NAT08",null,"475-J9",1,null,null,null,null,"Submit an NCPDP file with correct value(on code list) in 475-J9 \"DUR Co-Agent ID Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 475-J9 = 09\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT08.475-J9.002","NAT08",null,"475-J9",2,null," ",null,null,"Submit an NCPDP file with correct value(= 2 positions) in 475-J9 \"DUR Co-Agent ID Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 475-J9 = 01\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT08.476-H6.001","NAT08",null,"476-H6",1,null,null,null,null,"Submit an NCPDP file with correct value (= alphanumerics) in 476-H6 \"DUR Co-Agent ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file with valid value in 476-H6 field.\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT08.476-H6.002","NAT08",null,"476-H6",2,null," ",null,null,"Submit an NCPDP file with correct value ( =<19 positions)  in 476-H6 \"DUR Co-Agent ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file with valid value in 476-H6 field.\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT09.111-AM.001","NAT09",null,"111-AM",1,null,null,null,null,"Submit an NCPDP file with correct order of fields in Coupon Segment to ensure no rejection.","Step 1. Submit a NCPDP file where \r\nSegment Identification (111-AM) = 09, is the first field in the file \r\nfollowed by Coupon Type (485-KE), then\r\nCoupon Number (486-ME), then\r\nCoupon Value Amount (487-NE)\r\n\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\n\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT09.111-AM.002","NAT09",null,"111-AM",2,null,null,null,null,"Submit an NCPDP file with three repetitions of Coupon Segment to get accepted acknowledgement.","Step 1. Submit a NCPDP file with 4 occurrences of AM-09 Coupon Segment -- each within distinct group separators (i.e. 1 Coupon segment for each AM-07 line item within same transaction header (claim)).\r\n\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\n\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT09.485-KE.001","NAT09",null,"485-KE",1,null,null,null,null,"Submit an NCPDP file with correct value(on code list) in 485-KE \"Coupon Type\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 485-KE = 02\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT09.485-KE.002","NAT09",null,"485-KE",2,null,null,null,null,"Submit an NCPDP file with correct value( = alphanumeric ) in 485-KE \"Coupon Type\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 485-KE = 01\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT09.486-ME.001","NAT09",null,"486-ME",1,null,null," ",null,"Submit an NCPDP file with correct value(contains Alpha/Numeric) in 486-ME \"Coupon Number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 486-ME = 1A\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT09.486-ME.002","NAT09",null,"486-ME",2,null,null,null,null,"Submit an NCPDP file with correct value(=15 positions) in 486-ME \"Coupon Number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 486-ME = 1A1234567891234\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT09.487-NE.001","NAT09",null,"487-NE",1,null,null,null,null,"Submit an NCPDP file with correct value in 487-NE \"Coupon Value Amount\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 487-NE = 121D (i.e. $12.14)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT10.111-AM.001","NAT10",null,"111-AM",1,null,null,null,null,"Submit an NCPDP file with correct order of fields in Compound Segment to ensure no rejection.","Step 1. Submit a NCPDP file where \r\nSegment Identification (111-AM) = 10, is the first field in the file followed by:\r\nCompound Dosage Form Description Code (450-EF), then\r\nCompound Dispensing Unit Form Indicator (451-EG), then\r\nCompound Ingredient Component Count (447-EC), then\r\nCompound Product ID Qualifier (488-RE), then \r\nCompound Product ID (489-TE), then\r\nCompound Ingredient Quantity (448-ED), then\r\nCompound Ingredient Drug Cost (449-EE)\r\n\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\n\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT10.362-2G.001","NAT10",null,"362-2G",1,null,null,null,null,"Submit an NCPDP file with correct value(contains numeric) in 362-2G \"Compound Ingredient Modifier Code Count\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 362-2G = 01\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT10.362-2G.002","NAT10",null,"362-2G",2,null,null,null,null,"Matched 10 occurrences of 362-2G \"Compound Ingredient Modifier Code Count\" ","Step 1. Submit a NCPDP file with 10 occurrences of 362-2G and the associated fields, where 362-2G = 10\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT10.363-2H.001","NAT10",null,"363-2H",1,null,null,null,null,"Submit an NCPDP file with correct value(contains alphanumeric) in 363-2H \"Compound Ingredient Modifier Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 363-2H = 1A\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT10.363-2H.002","NAT10",null,"363-2H",2,null,null,null,null,"Submit an NCPDP file with correct value(not > 2 positions) in 363-2H \"Compound Ingredient Modifier Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 363-2H = NU\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT10.447-EC.001","NAT10",null,"447-EC",1,null,null,null,null,"Matched 25 occurrences of 447-EC \"Compound Ingredient Component Count\" ","Step 1. Submit a NCPDP file with 25 occurrences of 447-EC and the associated fields, where 447-EC =25\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT10.447-EC.002","NAT10",null,"447-EC",2,null,null,null,null,"Submit an NCPDP file with correct value(on code list) in 447-EC \"Compound Ingredient Component Count\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 447-EC = 01\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT10.448-ED.001","NAT10",null,"448-ED",1,null,null,null,null,"Submit an NCPDP file with correct value (>9 positions) in 448-ED \"Compound Ingredient Quantity\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 448-ED = 123456789B  ($12345678.92)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT10.448-ED.002","NAT10",null,"448-ED",2,null,null,null,null,"Submit an NCPDP file with correct value( = numerics) in 448-ED \"Compound Ingredient Quantity\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 448-ED = 350{\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT10.449-EE.001","NAT10",null,"449-EE",1,null,null,null,null,"Submit an NCPDP file with correct valid value in 449-EE \"Compound Ingredient Drug Cost\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 449-EE = 420F (i.e. $42.06)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT10.449-EE.002","NAT10",null,"449-EE",2,null,null,null,null,"Submit an NCPDP file with correct value ( = numerics) in 449-EE \"Compound Ingredient Drug Cost\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 449-EE = 4220F (i.e. $422.06)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT10.450-EF.001","NAT10",null,"450-EF",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 450-EF \"Compound Dosage Form Description Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 450-EF = 11\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT10.450-EF.002","NAT10",null,"450-EF",2,null,null,null,null,"Submit an NCPDP file with correct value (= alpha numerics) in 450-EF \"Compound Dosage Form Description Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 450-EF = B4\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT10.451-EG.001","NAT10",null,"451-EG",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 451-EG \"Compound Dispensing Unit Form Indicator\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 451-EG = 3\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT10.451-EG.002","NAT10",null,"451-EG",2,null,null,null,null,"Submit an NCPDP file with correct value (= numerics) in 451-EG \"Compound Dispensing Unit Form Indicator\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 451-EG = 2\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT10.488-RE.001","NAT10",null,"488-RE",1,null,null,null,null,"Submit an NCPDP file with valid value (on code list) in 488-RE \"Compound Product ID Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 488-RE = 03\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT10.488-RE.002","NAT10",null,"488-RE",2,null,null,null,null,"Submit an NCPDP file with correct value (= alpha numerics) in 488-RE \"Compound Product ID Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 488-RE = A2\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT10.489-TE.001","NAT10",null,"489-TE",1,null,null,null,null,"Submit an NCPDP file with correct value present  in 489-TE \"Compound Product ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 489-TE 00026066520\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT10.489-TE.002","NAT10",null,"489-TE",2,null,null,null,null,"Submit an NCPDP file with correct value ( = alpha numerics) blank 489-TE \"Compound Product ID\" for service billing to get accepted acknowledgement.","Step 1. Submit a NCPDP file with 489-TE = 00026066520PC                    Step 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT10.490-UE.001","NAT10",null,"490-UE",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 490-UE \"Compound Ingredient Basis of Cost Determination\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 490-UE= 08\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT10.490-UE.002","NAT10",null,"490-UE",2,null,null,null,null,"Submit an NCPDP file with correct value (= alpha numerics) in 490-UE \"Compound Ingredient Basis of Cost Determination\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 490-UE= 1A\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.111-AM.001","NAT11",null,"111-AM",1,null,null,null,null,"Submit an NCPDP file with correct order of fields in Pricing Segment to ensure no rejection.","Step 1. Submit a NCPDP file where \r\nSegment Identification (111-AM) = 11, is the first field in the file followed by Basis of Cost Determination (423-DN) = 10\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.111-AM.002","NAT11",null,"111-AM",2,null,null,null,null,"Submit an NCPDP file with three repetitions of Pricing Segment to get accepted acknowledgement.","Step 1. Submit a NCPDP file with 4 occurrences of AM-11 Pricing Segment -- each within distinct group separators (i.e. 1 pricing segment for each AM-07 line item within same transaction header (i.e. claim)).\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.113-N3.001","NAT11",null,"113-N3",1,null,null,null,null,"Submit an NCPDP file with correct value (valid)  in 113-N3 \"MEDICAID PD AMOUNT Submitted\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 113-N3 = 50G(i.e.$5.07)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.113-N3.002","NAT11",null,"113-N3",2,null,null,null,null,"Submit an NCPDP file with correct value (= numerics)  in 113-N3 \"MEDICAID PD AMOUNT Submitted\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 113-N3 = 270G(i.e.$27.07)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.409-D9.001","NAT11",null,"409-D9",1,null,null,null,null,"Submit an NCPDP file with correct valid value in 409-D9 \"Ingredient Cost Submitted\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 409-D9 = 350{ (i.e. $35.00)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.409-D9.002","NAT11",null,"409-D9",2,null,null,null,null,"Submit an NCPDP file with correct value (= numeric) in 409-D9 \"Ingredient Cost Submitted\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 409-D9 = 320{ (i.e. $32.00)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.412-DC.001","NAT11",null,"412-DC",1,null,null,null,null,"Submit an NCPDP file with correct value in 412-DC \"Dispensing Fee Submitted\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 412-DC = $7.82\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.412-DC.002","NAT11",null,"412-DC",2,null,null,null,null,"Submit an NCPDP file with correct value (= numerics)  in 412-DC \"Dispensing Fee Submitted\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 412-DC = $42.82\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.423-DN.001","NAT11",null,"423-DN",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 423-DN \"Basis of Cost Determination\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 423-DN = 12\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.423-DN.002","NAT11",null,"423-DN",2,null,null,null,null,"Submit an NCPDP file with correct value (= alpha numerics) in 423-DN \"Basis of Cost Determination\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 423-DN = 07\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.426-DQ.001","NAT11",null,"426-DQ",1,null,null,null,null,"Submit an NCPDP file with correct valid value in 426-DQ \"Usual and Customary Charge\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 426-DQ = 254F\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.426-DQ.002","NAT11",null,"426-DQ",2,null,null," ",null,"Submit an NCPDP file with correct value (is numeric)  in 426-DQ \"Usual and Customary Charge\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 426-DQ = 2254F\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.430-DU.001","NAT11",null,"430-DU",1,null,null,null,null,"Submit an NCPDP file with > zero in 430-DU \"Gross Amount Due\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 430-DU  = 10{ (  (> zero)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.430-DU.002","NAT11",null,"430-DU",2,null,null,null,null,"Submit an NCPDP file with correct value (= numerics) zero in 430-DU \"Gross Amount Due\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 430-DU  = 20.0{ \r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.433-DX.001","NAT11",null,"433-DX",1,null,null,null,null,"Submit an NCPDP file with valid value in 433-DX \"Patient Paid Amount Submitted\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 433-DX = 235{ ((i.e. $23.50)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.433-DX.002","NAT11",null,"433-DX",2,null,null,null,null,"Submit an NCPDP file with correct value (= numerics)  in 433-DX \"Patient Paid Amount Submitted\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 433-DX = 123{ ((i.e. $12.30)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.438-E3.001","NAT11",null,"438-E3",1,null,null,null,null,"Submit an NCPDP file with correct valid value in 438-E3 \"Incentive Amount Submitted\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 438-E3 = $0.00\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.438-E3.002","NAT11",null,"438-E3",2,null,null,null,null,"Submit an NCPDP file with correct value (= numerics) in 438-E3 \"Incentive Amount Submitted\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 438-E3 = $15.00\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.478-H7.001","NAT11",null,"478-H7",1,null,null,null,null,"Matched 3 occurrences of 478-H7 \"Other Amount Claimed Submitted Count\" ","Step 1. Submit a NCPDP file with 3 occurrences of 478-H7 and the associated fields, where 478-H7 = 3\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.478-H7.002","NAT11",null,"478-H7",2,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 478-H7 \"Other Amount Claim Submitted Count\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 478-H7 = 1\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.479-H8.001","NAT11",null,"479-H8",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 479-H8 \"Other Amount Claim Submitted Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 479-H8 = 04\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.479-H8.002","NAT11",null,"479-H8",2,null,null,null,null,"Submit an NCPDP file with correct value (= alpha numerics) in 479-H8 \"Other Amount Claim Submitted Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 479-H8 = 02\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.480-H9.001","NAT11",null,"480-H9",1,null,null,null,null,"Submit an NCPDP file with correct value (valid )  in 480-H9 \"Other Amount Claimed Submitted\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 480-H9 = 106B (i.e. $10.62)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.480-H9.002","NAT11",null,"480-H9",2,null,null,null,null,"Submit an NCPDP file with correct value (= numerics )  in 480-H9 \"Other Amount Claimed Submitted\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 480-H9 = 2106B (i.e. $210.62)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.481-HA.001","NAT11",null,"481-HA",1,null,null,null,null,"Submit an NCPDP file with correct value (valid)  in 481-HA \"Flat Sales Tax Amount Submitted\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 481-HA = 50G(i.e.$5.07)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.481-HA.002","NAT11",null,"481-HA",2,null,null,null,null,"Submit an NCPDP file with correct value (= numerics)  in 481-HA \"Flat Sales Tax Amount Submitted\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 481-HA = 50G(i.e.$27.07)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.482-GE.001","NAT11",null,"482-GE",1,null,null,null,null,"Submit an NCPDP file with correct value (valid) in 482-GE \"Percentage Sales tax Amount Rate Submitted\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 482-GE = 30{ (i.e. $3.00)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.482-GE.002","NAT11",null,"482-GE",2,null,null,null,null,"Submit an NCPDP file with correct value (= numerics) in 482-GE \"Percentage Sales tax Amount Rate Submitted\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 482-GE = 370{ (i.e. $37.00)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.483-HE.001","NAT11",null,"483-HE",1,null,null,null,null,"Submit an NCPDP file with correct value (valid) in 483-HE \"Percentage Sales tax Rate Submitted\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 483-HE = 652.31\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.483-HE.002","NAT11",null,"483-HE",2," ",null,null,null,"Submit an NCPDP file with correct value (= numerics) in 483-HE \"Percentage Sales tax Rate Submitted\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 483-HE = 72.31\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.484-JE.001","NAT11",null,"484-JE",1,null,null,null,null,"Submit an NCPDP file with correct value (valid)  in 484-JE \"Percentage Sales Tax Basis Submitted\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 484-JE = 02\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT11.484-JE.002","NAT11",null,"484-JE",2,null,null," ",null,"Submit an NCPDP file with correct value (= alpha numerics)  in 484-JE \"Percentage Sales Tax Basis Submitted\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 484-JE = 03\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT13.111-AM.001","NAT13",null,"111-AM",1,null," ",null,null,"Submit an NCPDP file with three repetitions of Clinical Segment to get accepted acknowledgement.","Step 1. Submit a NCPDP file with 4 occurrences of AM-13 Clinical Segment -- each within distinct group separators (i.e. 1 Clinical segment for each AM-07 line item within same transaction header (claim)).\r\n\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\n\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT13.111-AM.002","NAT13",null,"111-AM",2,null,null,null,null,"Submit an NCPDP file with Clinical Segment present to get accepted acknowledgement.","Step 1. Submit a NCPDP file with AM-13 Clinical Segment present\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\n\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT13.424-DO.001","NAT13",null,"424-DO",1,null,null,null,null,"Submit an NCPDP file with correct value(on code list) in 424-DO \"Diagnosis Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where  424-DO = V42.0\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT13.424-DO.002","NAT13",null,"424-DO",2,null,null,null,null,"Submit an NCPDP file with correct value (not > 15 positions) in 424-DO \"Diagnosis Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where  424-DO = V42.0\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT13.491-VE.001","NAT13",null,"491-VE",1,null,null,null,null,"Matched 5 occurrences of 491-VE \"Diagnosis Code Count\" ","Step 1. Submit a NCPDP file with 5 occurrences of 491-VE and the associated fields, where 491-VE = 5\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT13.491-VE.002","NAT13",null,"491-VE",2,null,null,null,null,"Submit an NCPDP file with correct value(contains numeric) in 491-VE \"Diagnosis Code Count\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where  491-VE = 1\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT13.492-WE.001","NAT13",null,"492-WE",1,null,null,null,null,"Submit an NCPDP file with correct value(on code list) in 492-WE \"Diagnosis Code Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 492-WE = 01\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT13.492-WE.002","NAT13",null,"492-WE",2,null,null,null,null,"Submit an NCPDP file with correct value(= alpha numeric) in 492-WE \"Diagnosis Code Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 492-WE = 01\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT13.492-WE.003","NAT13",null,"492-WE",3,null,null,null,null,"Submit an NCPDP file with correct value(=2 positions) in 492-WE \"Diagnosis Code Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 492-WE = 01\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT13.493-XE.001","NAT13",null,"493-XE",1,null,null,null,null,"Sequenced 5 occurrences of 493- XE \"Clinical Information Counter\"","Step 1. Submit a NCPDP file with 5 occurrences of 493-XE where, \r\n493-XE = 1 (for 1 occurrence)\r\n493-XE = 2 (for 2 occurrences)\r\n493-XE = 3 (for 3 occurrences)\r\n493-XE = 4 (for 4 occurrences)\r\n493-XE = 5 (for 5 occurrences)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT13.493-XE.002","NAT13",null,"493-XE",2,null,null,null,null,"Submit an NCPDP file with correct value(contains numeric) in 493-XE \"Clinical Information Counter\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where  493-XE = 1\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT13.493-XE.003","NAT13",null,"493-XE",3,null,null,null,null,"Submit an NCPDP file with correct value(not > 1) in 493-XE \"Clinical Information Counter\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where  493-XE = 1\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT13.494-ZE.001","NAT13",null,"494-ZE",1,null,null,null,null,"Submit an NCPDP file with correct value(contains numeric) in 494-ZE \"Measurement Date\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 494-ZE = 20090303\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT13.494-ZE.002","NAT13",null,"494-ZE",2,null,null," ",null,"Submit an NCPDP file with correct value(not = future date) in 494-ZE \"Measurement Date\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 494-ZE = 20090903\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT13.494-ZE.003","NAT13",null,"494-ZE",3,null,null,null,null,"Submit an NCPDP file with correct value(= 8 positions) in 494-ZE \"Measurement Date\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 494-ZE = 20090803\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT13.495-H1.001","NAT13",null,"495-H1",1,null,null,null,null,"Submit an NCPDP file with correct value(contains numeric) in 495-H1 \"Measurement Time\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 495-H1 = 1020\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT13.495-H1.002","NAT13",null,"495-H1",2,null,null,null,null,"Submit an NCPDP file with correct value (= 4 position) in 495-H1 \"Measurement Time\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 495-H1 = 1028\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT13.495-H1.003","NAT13",null,"495-H1",3,null,null,null,null,"Submit an NCPDP file with correct value (valid HHMM) in 495-H1 \"Measurement Time\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 495-H1 = 1210\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT13.496-H2.001","NAT13",null,"496-H2",1,null,null,null,null,"Submit an NCPDP file with correct value(on code list) in 496-H2 \"Measurement Dimension\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 496-H2 = 17\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT13.496-H2.002","NAT13",null,"496-H2",2,null," ",null,null,"Submit an NCPDP file with correct value(=numerics) in 496-H2 \"Measurement Dimension\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 496-H2 = 02\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT13.497-H3.001","NAT13",null,"497-H3",1,null,null,null,null,"Submit an NCPDP file with valid weight value in 497-H3 \"Measurement Unit\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 497-H3 =  03 (When 498-H2 = 14)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT13.497-H3.002","NAT13",null,"497-H3",2,null,null,null,null,"Submit an NCPDP file with valid height value in 497-H3 \"Measurement Unit\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 497-H3 =  01 (When 496-H2 = 16)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT13.499-H4.001","NAT13",null,"499-H4",1,null,null,null,null,"Submit an NCPDP file with valid values (= alpha numerics) 499-H4 \"Measurement Value\"  to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 499-H4 = ABFD4569\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT13.499-H4.002","NAT13",null,"499-H4",2,null,null,null,null,"Submit an NCPDP file with 499-H4 \"Measurement Value\" present when 496-H2 & 497-H3 are present to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 499-H4 = ABCDE123456789A\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT14.369-2Q.001","NAT14",null,"369-2Q",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 369-2Q \"Additional Documentation Type ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 369-2Q = 001\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2. Reject code(s) in 511-FB field(s) are unrelated to 369-2Q field."]
["NAT14.369-2Q.002","NAT14",null,"369-2Q",2,null,null,null,null,"Submit an NCPDP file with 3 characters in 369-2Q \"Additional Documentation Type ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 369-2Q = 001\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2.  Reject code(s) in 511-FB field(s) are unrelated to 369-2Q field."]
["NAT14.370-2R.001","NAT14",null,"370-2R",1,null,null,null,null,"Submit an NCPDP file with correct value(contains numeric) in 370-2R \"Length of Need\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 370-2R = 786\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2. Reject code(s) in 511-FB field(s) are unrelated to 370-2R field."]
["NAT14.370-2R.002","NAT14",null,"370-2R",2,null,null,null,null,"Submit an NCPDP file with 3 characters in 370-2R \"Length of Need\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 370-2R = 786\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2. Reject code(s) in 511-FB field(s) are unrelated to 370-2R field."]
["NAT14.371-2S.001","NAT14",null,"371-2S",1,null,null,null,null,"Submit an NCPDP file with correct value(contains numeric) in 371-2S \"Length of Need Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 371-2S = 6\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2.  Reject code(s) in 511-FB field(s) are unrelated to 371-2S field."]
["NAT14.371-2S.002","NAT14",null,"371-2S",2,null,null,null,null,"Submit an NCPDP file with 2 characters  in 371-2S \"Length of Need Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 371-2S = 6\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2.  Reject code(s) in 511-FB field(s) are unrelated to 371-2S field."]
["NAT14.372-2T.001","NAT14",null,"372-2T",1,null,null,null,null,"Submit an NCPDP file with correct value(contains numeric) in 372-2T \"Length of Need\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 372-2T = 20090101\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2. Reject code(s) in 511-FB field(s) are unrelated to 372-2T field."]
["NAT14.372-2T.002","NAT14",null,"372-2T",2,null,null,null,null,"Submit an NCPDP file with 8 characters in 372-2T \"Length of Need\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 372-2T = 20090101\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2. Reject code(s) in 511-FB field(s) are unrelated to 372-2T field."]
["NAT14.373-2U.001","NAT14",null,"373-2U",1,null,null,null,null,"Submit an NCPDP file with correct value(on code list) in 373-2U \"Request Status\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 373-2U = 3\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2.  Reject code(s) in 511-FB field(s) are unrelated to 373-2U field."]
["NAT14.373-2U.002","NAT14",null,"373-2U",2,null,null,null,null,"Submit an NCPDP file 1 position in 373-2U \"Request Status\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 373-2U = 3\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2.  Reject code(s) in 511-FB field(s) are unrelated to 373-2U field."]
["NAT14.374-2V.001","NAT14",null,"374-2V",1,null,null,null,null,"Submit an NCPDP file with correct value(contains numeric) in 374-2V \"Request Period Begin Date\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 374-2V = 20090202\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2.  Reject code(s) in 511-FB field(s) are unrelated to 374-2V field."]
["NAT14.374-2V.002","NAT14",null,"374-2V",2," ",null,null,null,"Submit an NCPDP file with 8 characters in 374-2V \"Request Period Begin Date\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 374-2V = 20090202\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2. Reject code(s) in 511-FB field(s) are unrelated to 374-2V field."]
["NAT14.375-2W.001","NAT14",null,"375-2W",1,null,null,null,null,"Submit an NCPDP file with correct value(contains numeric) in 375-2W \"Request Period Recert/Revised Date\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 375-2W = 20090314\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2. Reject code(s) in 511-FB field(s) are unrelated to 375-2W field."]
["NAT14.375-2W.002","NAT14",null,"375-2W",2,null,null,null,null,"Submit an NCPDP file with 8 characters in 375-2W \"Request Period Recert/Revised Date\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 375-2W = 20090314\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2.  Reject code(s) in 511-FB field(s) are unrelated to 375-2W field."]
["NAT14.376-2X.001","NAT14",null,"376-2X",1,null,null,null,null,"Submit an NCPDP file with correct value(contains Alphanumeric) in 376-2X \"Supporting Documentation\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file with valid value in 376-2X field.\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2. Reject code(s) in 511-FB field(s) are unrelated to 376-2X field."]
["NAT14.376-2X.002","NAT14",null,"376-2X",2,null,null,null,null,"Submit an NCPDP file with =<65 characters in 376-2X \"Supporting Documentation\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file with valid value=< 65 characters in 376-2X field.\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2. Reject code(s) in 511-FB field(s) are unrelated to 376-2X field."]
["NAT14.377-2Z.001","NAT14",null,"377-2Z",1,null,null,null,null,"Submit an NCPDP file with 2 characters in 377-2Z \"Question Number/Letter Count\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 377-2Z = 15\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2. Reject code(s) in 511-FB field(s) are unrelated to 377-2Z field."]
["NAT14.377-2Z.002","NAT14",null,"377-2Z",2,null,null,null,null,"Submit an NCPDP file with correct value(contains numeric) in 377-2Z \"Question Number/Letter Count\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 377-2Z = 35\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2.  Reject code(s) in 511-FB field(s) are unrelated to 377-2Z field."]
["NAT14.378-4B.001","NAT14",null,"378-4B",1,null,null,null,null,"Submit an NCPDP file with correct value(contains Alphanumeric) in 378-4B \"Question Number/Letter\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 378-4B = AB2\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2. Reject code(s) in 511-FB field(s) are unrelated to 378-4B field."]
["NAT14.378-4B.002","NAT14",null,"378-4B",2,null,null,null,null,"Submit an NCPDP file with 3 characters in 378-4B \"Question Number/Letter\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 378-4B = AB2\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2. Reject code(s) in 511-FB field(s) are unrelated to 378-4B field."]
["NAT14.379-4D.001","NAT14",null,"379-4D",1,null,null,null,null,"Submit an NCPDP file with correct value= numerics in 379-4D \"Question Percent Response\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 379-4D = 111.11\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2. Reject code(s) in 511-FB field(s) are unrelated to 379-4D field."]
["NAT14.379-4D.002","NAT14",null,"379-4D",2,null,null,null,null,"Submit an NCPDP file with correct value in 379-4D \"Question Percent Response\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 379-4D = 111.11\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2. Reject code(s) in 511-FB field(s) are unrelated to 379-4D field."]
["NAT14.380-4G.001","NAT14",null,"380-4G",1,null,null,null,null,"Submit an NCPDP file with correct value(contains numeric) in 380-4G \"Question Date Response\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 380-4G = 20090404\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2. Reject code(s) in 511-FB field(s) are unrelated to 380-4G field."]
["NAT14.380-4G.002","NAT14",null,"380-4G",2,null,null,null,null,"Submit an NCPDP file with 8 characters in 380-4G \"Question Date Response\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 380-4G = 20090404\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2.  Reject code(s) in 511-FB field(s) are unrelated to 380-4G field."]
["NAT14.381-4H.001","NAT14",null,"381-4H",1,null,null,null,null,"Submit an NCPDP file with 381-4H \"Question Dollar Amount Response\"  = or not  > allowed number of positions to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 381-4H = 4587487659I (i.e.$458748765.99)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2. Reject code(s) in 511-FB field(s) are unrelated to 381-4H field."]
["NAT14.381-4H.002","NAT14",null,"381-4H",2,null,null,null,null,"Submit an NCPDP file with numerics 381-4H \"Question Dollar Amount Response\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 381-4H = 4587487659I (i.e.$458748765.99)\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2. Reject code(s) in 511-FB field(s) are unrelated to 381-4H field."]
["NAT14.382-4J.001","NAT14",null,"382-4J",1,null,null,null,null,"Submit an NCPDP file with alpha numerics  in 382-4J - Response to Question 01B  to get accepted acknowledgement.","Step 1. Submit a NCPDP file with 382-4J = 1234\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2.  No Medicare/DME edits for 382-4J occur"]
["NAT14.382-4J.002","NAT14",null,"382-4J",2,null,null,null,null,"Submit an NCPDP file with =<11 characters in 382-4J - Response to Question 01C to get accepted acknowledgement.","Step 1. Submit a NCPDP file with 383-4k = RESPONSE\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2. No Medicare/DME edits for 382-4J occur"]
["NAT14.383-4K.001","NAT14",null,"383-4K",1,null,null,null,null,"Submit an NCPDP file with alpha numerics in 383-4K - Response to Question 12 to get accepted acknowledgement.","Step 1. Submit a NCPDP file with 383-4k = question 2 response\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2. No Medicare/DME edits for 383-4K occur"]
["NAT14.383-4K.002","NAT14",null,"383-4K",2,null,null,null,null,"Submit an NCPDP file with =<30 characters in 383-4K - Response to Question 05A to get accepted acknowledgement.","Step 1. Submit a NCPDP file with 383-4K = narr resp\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment will = R (due to presence of AM14 segment)\r\n\r\n2. No Medicare/DME edits for 383-4K occur"]
["NAT15.111-AM.001","NAT15",null,"111-AM",1,null,null," ",null,"Submit an NCPDP file with correct order of fields in Facility Segment ensure no rejection.","Step 1. Submit a NCPDP file where \r\nSegment Identification (111-AM) = 15 is the first field in the file followed by Facility Name (385-3Q) \r\n\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\n\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT15.111-AM.002","NAT15",null,"111-AM",2,null,null,null,null,"Submit an NCPDP file without T15 Facility Segment to get accepted acknowledgement","Step 1. Submit a NCPDP file without a T15 Facility Segment where C07-C7 Place of Service = 01\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT15.336-8C.001","NAT15",null,"336-8C",1,null,null,null,null,"Submit an NCPDP file with correct value(contains Alphanumeric) in 336-8C \"Facility ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 336-8C = RAM5865835\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT15.385-3Q.001","NAT15",null,"385-3Q",1,null,null,null,null,"Submit an NCPDP file with correct value(contains Alphanumeric) in 385-3Q \"Facility Name\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 385-3Q = 1234ABCDF\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT15.386-3U.001","NAT15",null,"386-3U",1,null,null,null,null,"Submit an NCPDP file with correct value(contains Alphanumeric) in 386-3U \"Facility Street Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 386-3U = 76837637SDHGFS\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT15.387-3V.001","NAT15",null,"387-3V",1,null,null,null,null,"Submit an NCPDP file with correct value(contains Alphanumeric) in 387-3V \"Facility State/Province Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 387-3V = PA\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT15.387-3V.002","NAT15",null,"387-3V",2,null,null,null,null,"Submit an NCPDP file with valid state code in 387-3V \"Facility State/Province Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 387-3V = PA\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT15.388-5J.001","NAT15",null,"388-5J",1,null,null,null,null,"Submit an NCPDP file with correct value(contains Alphanumeric) in 388-5J \"Facility City Address\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 388-5J = KING1234\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT15.389-6D.001","NAT15",null,"389-6D",1,null,null,null,null,"Submit an NCPDP file with correct value(contains Alphanumeric) in 389-6D \"Facility Zip/Postal Zone\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 389-6D = BCDAT12346\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT15.389-6D.002","NAT15",null,"389-6D",2,null,null,null,null,"Submit an NCPDP file with 389-6D \"Facility Zip/Postal Zone\" present to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 389-6D = 13202\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT16.111-AM.001","NAT16",null,"111-AM",1,null,null,null,null,"Submit an NCPDP file with correct order of fields in Narrative Segment to ensure no rejection.","Step 1. Submit a NCPDP file where \r\nSegment Identification (111-AM) = 16, is the first field in the file followed by Narrative Message (390-BM) \r\n\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\n\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT16.111-AM.002","NAT16",null,"111-AM",2,null,null,null,null,"Submit an NCPDP file with three repetitions of Narrative Segment to get accepted acknowledgement.","Step 1. Submit a NCPDP file with 4 occurrences of AM-16 Narrative Segment -- each within distinct group separators (i.e. 1 Narrative segment for each AM-07 line item within same transaction header (claim)).\r\n\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\n\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT16.390-BM.001","NAT16",null,"390-BM",1,null,null,null,null,"Submit an NCPDP file present with valid narrative message 390-BM in segment T16","Step 1. Submit a NCPDP file with T16 Narrative Segment with free form text (other than spaces) beginning in first position of 390-BM\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT16.390-BM.002","NAT16",null,"390-BM",2,null,null,null,null,"Submit an NCPDP file with correct value(contains Alphanumeric) in 390-BM \"Narrative Message\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 390-BM = JOHN SMITH MEDICARE 574747\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 112-AN in AM21 segment = C\r\n\r\n2. Field 504-F4 in AM20 segment will contain a CCN."]
["NAT99.504-F4.001","NAT99",null,"504-F4",1,null,null,null,null,"Submit an NCPDP file with 504-F4 Free From Message present to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 504-F4 is present \r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect no errors.\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = R (no batch level errors)"]
["NAT99.504-F4.002","NAT99",null,"504-F4",2,null,null,null,null,"Submit an NCPDP file with 504-F4 Free From Message is not greater than 35 characters to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 504-F4 is not greater than 35 characters\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect no errors.\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = R (no batch level errors)"]
["NAT99.701.001","NAT99",null,701,1,null,null," ",null,"Submit an NCPDP file with correct value (on code list) in 701 \"Segment Identifier\" (Batch Trailer) to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 701 = 99\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect no errors.\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = R (no batch level errors)"]
["NAT99.751.001","NAT99",null,751,1,null,null,null,null,"Submit an NCPDP file with correct value (matches actual record count) in 751 \"Record Count\" (Batch Trailer) to get accepted acknowledgement.","Step 1. Submit a NCPDP file where value reported in 751 does match actual record count\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect no errors.\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = R (no batch level errors)"]
["NAT99.806-5C.001","NAT99",null,"806-5C",1,null,null,null,null,"Submit an NCPDP file with correct value (matches header) in 806-5C \"Batch Number\" (Batch Trailer) to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 806-5C in trailer matches 806-5C in header\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect no errors.\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = R (no batch level errors)"]
["NATG1.101-A1.001","NATG1",null,"101-A1",1,null,null,null,null,"Submit an NCPDP file with correct value (contains Numerics) in 101-A1 \"BIN Number\"  to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 101-A1 = 241226.\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NATG1.101-A1.002","NATG1",null,"101-A1",2,null," ",null,null,"Submit an NCPDP file with correct value (is present) in 101-A1 \"BIN Number\"  to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 101-A1 = 241226.\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NATG1.102-A2.001","NATG1",null,"102-A2",1,null,null,null,null,"Submit an NCPDP file with correct value (supported version from code list)\" in 102-A2 \"Version/Release Number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 102-A2 = D0\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NATG1.102-A2.002","NATG1",null,"102-A2",2,null,null,null,null,"Submit an NCPDP file with correct value (supported version from code list)\" in 102-A2 \"Version/Release Number\" (Batch Header) to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 102-A2 = 12\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NATG1.103-A3.001","NATG1",null,"103-A3",1,null,null,null,null,"Submit an NCPDP file with correct value (supported transaction from code list) in 103-A3 \"Transaction Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 103-A3 = B1\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NATG1.103-A3.002","NATG1",null,"103-A3",2,null,null,null,null,"Submit an NCPDP file with correct value (present) in 103-A3 \"Transaction Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 103-A3 = B1\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NATG1.104-A4.001","NATG1",null,"104-A4",1,null,null,null,null,"Submit an NCPDP file with correct value (present) in 104-A4 \"Processor Control Number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 104-A4 = 104-A4.001\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NATG1.104-A4.002","NATG1",null,"104-A4",2," ",null,null,null,"Submit an NCPDP file with correct value ( > spaces) in 104-A4 \"Processor Control Number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 104-A4 = 104-A4.002\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NATG1.109-A9.001","NATG1",null,"109-A9",1,null,null,null,null,"Submit an NCPDP file with correct value (matches actual # transactions) in 109-A9 \"Transaction Count\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file with one transaction and 109-A9 = 1\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NATG1.109-A9.002","NATG1",null,"109-A9",2," ",null,null,null,"Submit an NCPDP file with correct value (valid value) in 109-A9 \"Transaction Count\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file with one transaction and 109-A9 = 1\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NATG1.110-AK.001","NATG1",null,"110-AK",1,null,null,null,null,"Submit an NCPDP file with correct value (alpha numeric) in 110-AK \"Software Vendor/Certification ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 110-AK = XYZ456\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NATG1.110-AK.002","NATG1",null,"110-AK",2,null," ",null,null,"Submit an NCPDP file with correct value (not > 10 positions) in 110-AK \"Software Vendor/Certification ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 110-AK = XYZ456\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NATG1.111-AM.001","NATG1",null,"111-AM",1,null,null,null,null,"Submit an NCPDP file with correct order of  AMG1 elements  to get accepted acknowledgement.","Step 1. Submit a NCPDP file where G1 segment elements are in the proper order\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NATG1.201-B1.001","NATG1",null,"201-B1",1,null,null,null,null,"Submit an NCPDP file with correct value (contains a valid NPI) in 201-B1 \"Service Provider ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 201-B1 = a valid NPI # for a provider on file for electronic billing\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NATG1.201-B1.002","NATG1",null,"201-B1",2,null," ",null,null,"Submit an NCPDP file with correct value (present) in 201-B1 \"Service Provider ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 201-B1 = valid NPI\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NATG1.202-B2.001","NATG1",null,"202-B2",1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 202-B2 \"Service Provider ID Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 202-B2 = 01\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NATG1.202-B2.002","NATG1",null,"202-B2",2,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 202-B2 \"Service Provider ID Qualifier\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 202-B2 = 01\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NATG1.401-D1.001","NATG1",null,"401-D1",1,null,null,null,null,"Submit an NCPDP file with correct value (contains valid date) in 401-D1 \"Date of Service\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 401-D1 = 20090101\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NATG1.401-D1.002","NATG1",null,"401-D1",2," ",null,null,null,"Submit an NCPDP file with correct value (numerics) in 401-D1 \"Date of Service\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 401-D1 = 20090101\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NATG1.701.001","NATG1",null,701,1,null,null,null,null,"Submit an NCPDP file with correct value (on code list) in 701 \"Segment Identifier\" (Transaction Detail Data Record)  to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 701 = G1\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NATG1.880-K5.001","NATG1",null,"880-K5",1,null,null,null,null,"Submit an NCPDP file with correct value (present) in 880-K5 \"Transaction reference Number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 880-K5 =NATG1K5001\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NATG1.880-K5.002","NATG1",null,"880-K5",2,null,null,null,null,"Submit an NCPDP file with correct value (= exactly 10 positions) in 880-K5 \"Transaction reference Number\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 880-K5 =NATG1K5002\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1. Field 501-F1 in response header segment = A\r\n\r\n2. Field 112-AN in AM21 segment = C\r\n\r\n3. Field 504-F4 in AM20 segment will contain a CCN."]
["NRT00.102-A2.001","NRT00",null,"102-A2",1,null,null,null,null,"Submit an NCPDP file with invalid value in 102-A2 version/release number  not = 12","Step 1. Submit a NCPDP file with 102-A2=99\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect \"Unrecognized or Invalid File\" error.\r\n\r\n(NCPDP Response will not be generated for this condition)."]
["NRT00.111-AM.002","NRT00",null,"111-AM",2,null,null,null,null,"Submit a NCPDP file with incorrect order of transmission level segments to get rejected acknowledgement (AM01/AM04 not both first)","Step 1. Submit a NCPDP file where data detail segment 111-am=G1 is the first segment in the file followed by:\r\nPatient Segment 111-AM =01 then\r\nPrescriber segment 111-am=03  \r\nInsurance segment 111-am=04    \r\nClaim Segment 111-am =07                             Pricing segment 111-am=11\r\nClinical segment 111-am=13\r\nFacility segment 111-am=15 \r\n\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Field 501-F1 in response header segment = R\r\n\r\n2. Field 112-AN in AM21 segment = R\r\n\r\n3. Field 504-F4 in AM20 segment will indicate \"CLAIM REJECTED\" and the 511-FB field will contain reject code AM or R8."]
["NRT00.111-AM.003","NRT00",null,"111-AM",2,null,null,null,null,"Submit a NCPDP file with incorrect order of segments to get rejected acknowledgement (transaction level - segments outside of AM07 group)","Step 1. Submit a NCPDP file where data detail G1 segment is first, followed by:\r\nPatient Segment 111-AM =01 then \r\nInsurance segment 111-am=04                        Prescriber segment 111-am=03  \r\nClinical segment 111-am=13\r\nClaim Segment 111-am =07                            Pricing segment 111-am=11\r\nFacility segment 111-am=15\r\n\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1. Field 501-F1 in response header segment = R\r\n\r\n2. Field 112-AN in AM21 segment = R\r\n\r\n3. Field 504-F4 in AM20 segment will indicate \"CLAIM REJECTED\" and the 511-FB field will contain reject code AM or R8."]
["NRT00.701.001","NRT00",null,701,1,null,null,null,null,"Submit an NCPDP file with missing 701  \"Segment Identifier\" (Batch Header)  to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 701 = spaces   Step 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect \"Unrecognized or Invalid File\" error.\r\n\r\n(NCPDP Response will not be generated for this condition)."]
["NRT00.701.002","NRT00",null,701,2,null,null,null,null,"Submit an NCPDP file with invalid seg ID (not a valid standard segment identifier) 701  \"Segment Identifier\" (Batch Header)  to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 701 = 88   Step 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect \"Unrecognized or Invalid File\" error.\r\n\r\n(NCPDP Response will not be generated for this condition)."]
["NRT00.701.003","NRT00",null,701,3,null,null,null,null,"Submit an NCPDP file with multiple Transaction Header Segments 701=00 in a single physical file (i.e. multiple claims) to get rejected acknowledgement","Step 1. Submit a NCPDP file with multiple occurrences of  \r\n111-AM (Transaction Header Segment) = 00 within same batch.  \r\n\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\n\r\nStep 3. Verify the Response.","1.  Local TRN will reflect no errors \r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = E \r\n\r\n3. Field 504-F4 contains message \"1-MULT BATCHES NOT ALLOWED\"."]
["NRT00.702.001","NRT00",null,702,1,null,null,null,"Needs submitter number set up for TEST ONLY","Submit an NCPDP file with 702 \"File Type\" = P when Trading Partner ID is set up on database for Test only","Step 1. Submit a NCPDP file with \"P\" in 702 for a Trading Partner ID that is set up in trading partner database for submitting test files only.\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect \"File Format not Valid for Submitter\" error.\r\n\r\n(NCPDP Response will not be generated for this condition)."]
["NRT00.702.002","NRT00",null,702,2,null,null,null,"Needs submitter number NOT setup for Test","Submit an NCPDP file with 702 \"File Type\" = T when Trading Partner ID is not set up on database for submitting test files","Step 1. Submit a NCPDP file with \"T\" in 702 for a sender ID that is not set up in trading partner database for submitting test files \r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect \"File Format not Valid for Submitter\" error.\r\n\r\n(NCPDP Response will not be generated for this condition)."]
["NRT00.702.003","NRT00",null,702,3,null,null,null,null,"Submit an NCPDP file with 702 \"File Type\" = missing","Step 1. Submit a NCPDP file with 702 = spaces\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect \"Unrecognized or Invalid File\" error.\r\n\r\n(NCPDP Response will not be generated for this condition)."]
["NRT00.806-5C.001","NRT00",null,"806-5C",1,null,null,null,null,"Submit an NCPDP file with incorrect value (contains alphanumerics) in 806-5C \"Batch Number\" (Batch Header) to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 806-5C = 20AB252\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1.  Local TRN will reflect no errors\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = E \r\n\r\n3. Field 504-F4 contains message \"1-INVALID BATCH NUMBER.\""]
["NRT00.806-5C.002","NRT00",null,"806-5C",2,null,null,null,null,"Submit an NCPDP file with >7 CHARACTERS in 806-5C \"Batch Number\" (Batch Header) to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 806-5C = 12345678\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect \"Unrecognized or Invalid File\" error.\r\n\r\n(NCPDP Response will not be generated for this condition).","shifts all fields that follow to shift and causes other file recognition errors."]
["NRT00.806-5C.003","NRT00",null,"806-5C",3,null,null,null,null,"Submit an NCPDP file with SPACES in 806-5C \"Batch Number\" (Batch Header) to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 806-5C = SPACES\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1.  Local TRN will reflect no errors\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = E \r\n\r\n3. Field 504-F4 contains message \"1-INVALID BATCH NUMBER.\""]
["NRT00.880-K1.001","NRT00",null,"880-K1",1,null,null,null,"Need to ensure TP/Sender ID is not set up with NCPDP application on TP database.","Submit an NCPDP file with invalid value in 880-K1 \"Sender ID\" (Sender ID is not set up on trading partner database, and sender ID same as TP ID used to submit file) to get rejected acknowledgement.","Step 1. Submit a NCPDP file with valid data in 880-K1 where sender ID is same as TP ID used to submit the file, and is not set up in trading partner database.\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect \"File Format Not Valid for Submitter\" error.\r\n\r\n(NCPDP Response will not be generated for this condition)."]
["NRT00.880-K1.002","NRT00",null,"880-K1",2,null,null,null,null,"Submit an NCPDP file with missing 880-K1 \"Sender ID\"  to get rejected acknowledgement.","Step 1. Submit a NCPDP file with spaces  in 880-K1\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1.  Local TRN will reflect no errors\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = E \r\n\r\n3. Field 504-F4 contains message \"1-INVALID SENDER ID\"."]
["NRT00.880-K1.003","NRT00",null,"880-K1",3,null,null,null,null,"Submit an NCPDP file with >24 characters in 880-K1 \"Sender ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with valid data in 880-K1 with >24 characters\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1. Local TRN acknowledgment will reflect \"Unrecognized or Invalid File\" error.\r\n\r\n(NCPDP Response will not be generated for this condition).","shifts all fields that follow to shift and causes other file recognition errors."]
["NRT00.880-K2.001","NRT00",null,"880-K2",1,null,null,null,null,"Submit an NCPDP file with incorrect value (future date) in 880-K2 \"Creation Date\" to get rejected acknowledgement","Step 1. Submit a NCPDP file where 880-K2 = 20111106 \r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1.  Local TRN will reflect no errors\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = E \r\n\r\n3. Field 504-F4 contains message \"1-CREATE DATE . CURRENT DATE\""]
["NRT00.880-K2.002","NRT00",null,"880-K2",2,null,null,null,null,"Submit an NCPDP file with invalid date (invalid month) in 880-K2 \"Creation Date\" to get rejected acknowledgement","Step 1. Submit a NCPDP file where 880-K2 = 20092106\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1.  Local TRN will reflect no errors\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = E \r\n\r\n3. Field 504-F4 contains message \"1-INVALID CREATE DATE\""]
["NRT00.880-K2.003","NRT00",null,"880-K2",3,null,null,null," ","Submit an NCPDP file with invalid date (invalid day) in 880-K2 \"Creation Date\" to get rejected acknowledgement","Step 1. Submit a NCPDP file where 880-K2 = 20091156 \r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1.  Local TRN will reflect no errors\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = E \r\n\r\n3. Field 504-F4 contains message \"1-INVALID CREATE DATE\""]
["NRT00.880-K3.001","NRT00",null,"880-K3",1,null,null,null,null,"Submit an NCPDP file with incorrect value (contains alphanumerics) in 880-K3 \"Creation Time\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 880-K3 = A2B1\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1.  Local TRN will reflect no errors\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = E \r\n\r\n3. Field 504-F4 contains message \"1-INVALID CREATE TIME\""]
["NRT00.880-K3.002","NRT00",null,"880-K3",2,null,null,null,null,"Submit an NCPDP file with MISSING 880-K3 \"Creation Time\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 880-K3 = spaces\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1.  Local TRN will reflect no errors\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = E \r\n\r\n3. Field 504-F4 contains message \"1-INVALID CREATE TIME\""]
["NRT00.880-K6.001","NRT00",null,"880-K6",1,null,null,null,null,"Submit an NCPDP file with invalid E value in 880-K6 \"Transmission Type\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 880-K6 = E\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1.  Local TRN will reflect no errors\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = E \r\n\r\n3. Field 504-F4 contains message \"1-INVALID TRANSMISSION TYPE\"."]
["NRT00.880-K6.002","NRT00",null,"880-K6",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 880-K6 \"Transmission Type\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 880-K6 = H\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1.  Local TRN will reflect no errors\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = E \r\n\r\n3. Field 504-F4 contains message \"1-INVALID TRANSMISSION TYPE\"."]
["NRT00.880-K6.003","NRT00",null,"880-K6",3,null,null,null,null,"Submit an NCPDP file with missing  (=spaces) 880-K6 \"Transmission Type\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 880-K6 = spaces\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1.  Local TRN will reflect no errors\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = E \r\n\r\n3. Field 504-F4 contains message \"1-INVALID TRANSMISSION TYPE\"."]
["NRT00.880-K7.001","NRT00",null,"880-K7",1,null,null,null,null,"Submit an NCPDP file with invalid 880-K7 \"Receiver ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 880-K7 = 15003\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1.  Local TRN will reflect no errors\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = E \r\n\r\n3. Field 504-F4 contains message \"1-INVALID RECEIVER ID\""]
["NRT00.880-K7.002","NRT00",null,"880-K7",2,null,null,null,null,"Submit an NCPDP file with incorrect value (spaces) in 880-K7 \"Receiver ID\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 880-K7 = spaces\r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1.  Local TRN will reflect no errors\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = E \r\n\r\n3. Field 504-F4 contains message \"1-INVALID RECEIVER ID\""]
["NRT00.880-K7.003","NRT00",null,"880-K7",3,null,null,null,null,"Submit an NCPDP file with 880-K7 \"Receiver ID\" >24 characters to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 880-K7 = 25 characters \r\nStep 2. After file is submitted, obtain NCPDP acknowledgements.\r\nStep 3. Verify the acknowledgements.","1.  Local TRN will reflect no errors\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = E \r\n\r\n3. Field 504-F4 contains message \"1-INVALID RECEIVER ID\""]
["NRT01.111-AM.001","NRT01",null,"111-AM",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 111-AM \"Segment Identification\" (Patient Segment) to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 111-AM = 2X\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = PK"]
["NRT01.111-AM.002","NRT01",null,"111-AM",2,null,null,null,null,"Submit an NCPDP file with one repetition (back to back) of Patient Segment to get rejected acknowledgement.","Step 1. Submit a NCPDP file with two back to back iterations of \r\n111-AM (Patient Segment) = 01\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = PK"]
["NRT01.111-AM.003","NRT01",null,"111-AM",3,null,null," ",null,"Submit an NCPDP file with one repetition (not back to back) of Patient Segment to get rejected acknowledgement.","Step 1. Submit a NCPDP file with two occurrences (not back to back) of 111-AM (Patient Segment) = 01 within same Transaction Header\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = PK"]
["NRT01.304-C4.001","NRT01",null,"304-C4",1,null,null,null,null,"Submit an NCPDP file with incorrect value (invalid date) in 304-C4 \"Date of Birth\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 304-C4 = 20052335 \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 09"]
["NRT01.304-C4.002","NRT01",null,"304-C4",2,null,null,null,null,"Submit an NCPDP file with incorrect value (future date) in 304-C4 \"Date of Birth\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 304-C4 = 20150101 \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 7F"]
["NRT01.304-C4.003","NRT01",null,"304-C4",3,null,null,null,null,"Submit an NCPDP file with no value (not present) in 304-C4 \"Date of Birth\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 304-C4 = Spaces\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 09"]
["NRT01.305-C5.001","NRT01",null,"305-C5",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 305-C5 \"Patient Gender Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 305-C5 = 7\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 10"]
["NRT01.305-C5.002","NRT01",null,"305-C5",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not = 1 or 2) in 305-C5 \"Patient Gender Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 305-C5 = 0\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 10"]
["NRT01.305-C5.003","NRT01",null,"305-C5",3," ",null," ",null,"Submit an NCPDP file with incorrect value (> 1 position) in 305-C5 \"Patient Gender Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 305-C5 = 23\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 10"]
["NRT01.307-C7.001","NRT01",null,"307-C7",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 307-C7 \"Place of Service\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 307-C7 = 01\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 12"]
["NRT01.307-C7.002","NRT01",null,"307-C7",2,null," ",null,null,"Submit an NCPDP file with incorrect value (not numeric) in 307-C7 \"Place of Service\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 307-C7 = B1\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 12"]
["NRT01.307-C7.003","NRT01",null,"307-C7",3,null,null,null,null,"Submit an NCPDP file with incorrect value (> 2 positions) in 307-C7 \"Place of Service\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 307-C7 = 123  Step 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 12"]
["NRT01.310-CA.001","NRT01",null,"310-CA",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 310-CA \"Patients First Name\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 310-CA = MarK\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = CA"]
["NRT01.310-CA.002","NRT01",null,"310-CA",2,null," ",null,null,"Submit an NCPDP file with incorrect value (> 12 positions) in 310-CA \"Patients First Name\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 310-CA = JOHNALEXANDER\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = CA"]
["NRT01.310-CA.003","NRT01",null,"310-CA",3,null,null,null,null,"Submit an NCPDP file with incorrect value (not present when 306=C6=1 & 312-CC is > spaces) in 310-CA \"Patients First Name\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 310-CA not present, 306-C6=1, 312-CC-JOHN\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = CA"]
["NRT01.311-CB.001","NRT01",null,"311-CB",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not present) in 311-CB \"Patient Last Name\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 311-CB  not present\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = CB"]
["NRT01.311-CB.002","NRT01",null,"311-CB",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 311-CB \"Patient Last Name\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 311-CB = graHAMM\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = CB"]
["NRT01.322-CM.001","NRT01",null,"322-CM",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not > spaces) in 322-CM \"Patient Street Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 322-CM = Spaces\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = CM"]
["NRT01.322-CM.002","NRT01",null,"322-CM",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 322-CM \"Patient Street Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 322-CM = 123 Apple ST\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = CM"]
["NRT01.323-CN.001","NRT01",null,"323-CN",1,null,null," ",null,"Submit an NCPDP file with incorrect value (not > spaces) in 323-CN \"Patient City Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 323-CN = Spaces\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = CN"]
["NRT01.323-CN.002","NRT01",null,"323-CN",2,null,null," ",null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 323-CN \"Patient City Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 323-CN = alBANY\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = CN"]
["NRT01.324-C0.001","NRT01",null,"324-CO",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not > spaces) in 324-CO \"Patient State/Province Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 324-CO = Spaces\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = CO"]
["NRT01.324-C0.002","NRT01",null,"324-CO",2,null," ",null,null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 324-CO \"Patient State/Province Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 324-CO = Ma\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = CO"]
["NRT01.325-CP.001","NRT01",null,"325-CP",1,null,null,null,null,"Submit an NCPDP file with invalid value (not > spaces) in 325-CP \"Patient Zip/Postal Zone\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 325-CP = Spaces\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = CP"]
["NRT01.325-CP.002","NRT01",null,"325-CP",2,null,null,null,null,"Submit an NCPDP file with incorrect value (less than 5 positions) in 325-CP \"Patient Zip/Postal Zone\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 325-CP = 1710\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = CP"]
["NRT01.326-CQ.001","NRT01",null,"326-CQ",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not numeric)  in 326-CQ \"Patient Phone Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 326-CQ = ABC4177717\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) =CQ"]
["NRT01.326-CQ.002","NRT01",null,"326-CQ",2,null,null,null,null,"Submit an NCPDP file with incorrect value (>10 positions)  in 326-CQ \"Patient Phone Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 326-CQ = ABC41777174\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) =CQ"]
["NRT01.331-CX.001","NRT01",null,"331-CX",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 331-CX \"Patient ID Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 331-CX = 15\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = CX"]
["NRT01.331-CX.002","NRT01",null,"331-CX",2,null,null,null,null,"Submit an NCPDP file with Patient ID (332-CY), and no patient ID Qualifier (331-CX) to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 332-CY is present, 331-CX is not present\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = CX"]
["NRT01.332-CY.001","NRT01",null,"332-CY",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not alphanumeric)  in 332-CY \"Patient ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 332-CY = pt123456789\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) =CY"]
["NRT01.332-CY.002","NRT01",null,"332-CY",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 20 positions)  in 332-CY \"Patient ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 332-CY = PATID1234567890123456\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) =CY"]
["NRT01.333-CZ.001","NRT01",null,"333-CZ",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not alphanumeric)  in 333-CZ \"Employer ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 333-CZ = empID12345\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) "]
["NRT01.333-CZ.002","NRT01",null,"333-CZ",2,null,null,null,null,"Submit an NCPDP file with incorrect value (>10 positions)  in 333-CZ \"Employer ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 333-CZ = EMPID123456\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) "]
["NRT01.335-2C.001","NRT01",null,"335-2C",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not alphanumeric)  in 335-2C \"Pregnancy Indicator\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 335-2C = g\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) =2C"]
["NRT01.335-2C.002","NRT01",null,"335-2C",2,null," ",null,null,"Submit an NCPDP file with incorrect value (> 1 position)  in 335-2C \"Pregnancy Indicator\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 335-2C = 01\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 2C"]
["NRT01.350-HN.001","NRT01",null,"350-HN",1,null,null,null,null,"Submit an NCPDP file with incorrect value (contains invalid Alphanumeric) in 350-HN \"Patient Email Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 350-HN = NickY@KC5\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB)  "]
["NRT01.350-HN.002","NRT01",null,"350-HN",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 80 positions) in 350-HN \"Patient Email Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 350-HN = 81 POSITIONS\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB)  "]
["NRT01.384-4X.001","NRT01",null,"384-4X",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list)  in 384-4X \"Patient Residence\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 384-4X= 25\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 4X"]
["NRT01.384-4X.002","NRT01",null,"384-4X",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not numeric)  in 384-4X \"Patient Residence\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 384-4X= B5\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 4X"]
["NRT02.111-AM.001","NRT02",null,"111-AM",1,null,null,null," ","Submit an NCPDP file with incorrect order of fields in Pharmacy Provider Segment toensure rejection occurs.","Step 1. Submit a NCPDP file where \r\nProvider ID Qualifier (465-EY) = 02, is the first field in the file followed by Provider ID (444-E9), then Segment Identification (111-AM) = 02\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = AM (or RU)"]
["NRT02.111-AM.002","NRT02",null,"111-AM",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 111-AM \"Segment Identification\" (Pharmacy Provider Segment) to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 111-AM = L9\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = AM"]
["NRT02.444-E9.001","NRT02",null,"444-E9",1,null,null,null,null,"Submit an NCPDP file with incorrect first position of 444-E9 \"Provider ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with a  10 digit NPI in 449-E9 where the first position = 2\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = E9"]
["NRT02.444-E9.002","NRT02",null,"444-E9",2,null,null,null,null,"Submit an NCPDP file with incorrect format of 444-E9 \"Provider ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with a 9 digit NPI in 449-E9 where the first position = 1\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = E9"]
["NRT02.465-EY.001","NRT02",null,"465-EY",1,null,null,null,null,"Submit an NCPDP file with incorrect value in 465-EY \"Provider ID Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 465-EY = 03 \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 9U"]
["NRT02.465-EY.002","NRT02",null,"465-EY",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 465-EY \"Provider ID Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 465-EY = 84\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = EY"]
["NRT03.111-AM.001","NRT03",null,"111-AM",1,null,null," "," ","Submit an NCPDP file with incorrect order of fields in Prescriber Segment to ensure rejection occurs.","Step 1. Submit a NCPDP file where \r\nPrescriber ID Qualifier (466-EZ), is the first field in the file followed by Segment Identification (111-AM) = 03 \r\n\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\n\r\nStep 3. Verify the acknowledgement.","Response status segment reject code  "]
["NRT03.111-AM.002","NRT03",null,"111-AM",2,null,null,null,null,"Submit an NCPDP file with four repetitions of Prescriber Segment to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 5 occurrences of AM-03 Prescriber Segment -- each within distinct group separators (i.e. 1 prescriber segment for each AM-07 line item within same transaction header (claim)).\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code PN"]
["NRT03.364-2J.001","NRT03",null,"364-2J",1,null,null," ",null,"Submit an NCPDP file with incorrect value (exceeds maximum) in 364-2J \"Prescriber First Name\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 13 characters in 364-2J\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code "]
["NRT03.364-2J.002","NRT03",null,"364-2J",2,null,null,null,null,"Submit an NCPDP file with 364-2J not = to alphanumerics ","Step 1. Submit a NCPDP file with 364-2J = spaces              Step 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code"]
["NRT03.365-2K.001","NRT03",null,"365-2K",1,null,null,null,null,"Submit an NCPDP file with 365-2K Prescriber Street Address not = alpha numerics","Step 1. Submit a NCPDP file with 365-2K Prescriber Street Address = spaces\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code "]
["NRT03.365-2K.002","NRT03",null,"365-2K",2,null,null,null,null,"Submit an NCPDP file with incorrect value (exceeds maximum) in 365-2K \"Prescriber Street Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 31 characters in 365-2K\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code "]
["NRT03.366-2M.001","NRT03",null,"366-2M",1,null,null,null,null,"Submit an NCPDP file with 366-2M Prescriber City Address not alphanumerics","Step 1. Submit a NCPDP file with 366-2M = spaces\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code"]
["NRT03.366-2M.002","NRT03",null,"366-2M",2,null,null,null,null,"Submit an NCPDP file with incorrect value (exceeds maximum) in 366-2M \"Prescriber City Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 21 characters in 366-2M    \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code "]
["NRT03.367-2N.001","NRT03",null,"367-2N",1,null,null,null,null,"Submit an NCPDP file with 367-2N Prescriber State Address not = alphanumerics","Step 1. Submit a NCPDP file with 367-2N Prescriber State Address = spaces\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject code =2N"]
["NRT03.367-2N.002","NRT03",null,"367-2N",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 367-2N \"Prescriber State/ Province Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 367-2N =ZZ\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject code =2N"]
["NRT03.368-2P.001","NRT03",null,"368-2P",1,null,null,null,null,"Submit an NCPDP file with 368-2P Prescriber Zip/Postal Zone not = alphanumerics","Step 1. Submit a NCPDP file 368-2P= spaces\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject code = 2P"]
["NRT03.368-2P.002","NRT03",null,"368-2P",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 368-2P \"Prescriber Zip/Postal Zone\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 368-2P = 99999\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject code =2P"," "]
["NRT03.411-DB.001","NRT03",null,"411-DB",1,null,null,null,null,"Submit an NCPDP file with incorrect value (contains an invalid check digit) in 411-DB \"Prescriber ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 411-DB = 1234567892 (When Prescriber ID Qualifier, 466-EZ = 01)\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject code =56"]
["NRT03.411-DB.002","NRT03",null,"411-DB",2,null,null,null,null,"Submit an NCPDP file with incorrect value (first byte is not equal to 1) in 411-DB \"Prescriber ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 411-DB = 4234567893 (When Prescriber ID Qualifier, 466-EZ = 01)\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject code =56"]
["NRT03.421-DL.001","NRT03",null,"421-DL",1,null,null,null,null,"Submit an NCPDP file with incorrect format & first position of 421-DL \"Primary Care Provider ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 10 digit NPI in 421-DL where first position = 4\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject code =58"]
["NRT03.421-DL.002","NRT03",null,"421-DL",2,null,null,null,null,"Submit an NCPDP file with incorrect value (contains an invalid check digit) in 421-DL \"Primary Care Provider ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 421-DL = 1234567892 \r\n(When Primary Care Provider ID Qualifier, 468-2E = 01)\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject code =58"]
["NRT03.427-DR.001","NRT03",null,"427-DR",1,null,null,null,null,"Submit an NCPDP file with no value in 427-DR \"Prescriber Last Name\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 427-DR = Spaces\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject code =DR"]
["NRT03.427-DR.002","NRT03",null,"427-DR",2,null,null,null,null,"Submit an NCPDP file with incorrect value (exceeds maximum) in 427-DR \"Prescriber Last Name\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 16 charcters in 427-DR\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject code =DR"]
["NRT03.466-EZ.001","NRT03",null,"466-EZ",1,null,null,null,null,"Submit an NCPDP file with incorrect value in 466-EZ \"Prescriber ID Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 466-EZ = 02\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject code =EZ"]
["NRT03.466-EZ.002","NRT03",null,"466-EZ",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 466-EZ \"Prescriber ID Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 466-EZ = 24\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject code =EZ"]
["NRT03.468-2E.001","NRT03",null,"468-2E",1,null,null,null,null,"Submit an NCPDP file with incorrect value in 468-2E \"Primary Care Provider ID Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 468-2E = 03\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject code =2E"]
["NRT03.468-2E.002","NRT03",null,"468-2E",2,null,null,null,null,"Submit an NCPDP file with 421-DL Primary Care Provider ID and no 468-2E \"Primary Care Provider ID Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 421-DL is reported without 468-2E\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject code =2E"]
["NRT03.470-4E.001","NRT03",null,"470-4E",1,null,null,null,null,"Submit an NCPDP file with incorrect value (exceeds maximum) in 470-4E \"Primary Care Provider Last Name\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 16 characters in 470-4E\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject code "]
["NRT03.470-4E.002","NRT03",null,"470-4E",2,null,null,null,null,"Submit an NCPDP file with incorrect value (exceeds maximum) in 470-4E \"Primary Care Provider Last Name\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 16 characters in 470-4E\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject code "]
["NRT03.498-PM.001","NRT03",null,"498-PM",1,null,null,null,null,"Submit an NCPDP file with incorrect value (contains Alphanumeric) in 498-PM \"Prescriber Phone Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 498-PM = 717125A22B\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject code =3M"]
["NRT03.498-PM.002","NRT03",null,"498-PM",2,null,null,null,null,"Submit an NCPDP file with 498-PM \"Prescriber Phone Number\" > 10 characters to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 498-PM = 7171252222\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject code =3M"]
["NRT04.111-AM.001","NRT04",null,"111-AM",1,null,null,null," ","Submit an NCPDP file with incorrect order of fields in Insurance Segment to ensure rejection occurs.","Step 1. Submit a NCPDP file where \r\nPatient Relationship Code (306-C6), is the first field in the file followed by Segment Identification (111-AM) = 04\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) =PJ"]
["NRT04.111-AM.002","NRT04",null,"111-AM",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 111-AM \"Segment Identification\" (Insurance Segment) to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 111-AM = 2Z\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) =PJ"]
["NRT04.115-N5.001","NRT04",null,"115-N5",1,null,null,null,null,"Submit an NCPDP file with incorrect value (exceeds maximum >20 positions) in 115-N5 \"Medicaid ID Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file 115-N5 =MIDN12345678944444444\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code ( "]
["NRT04.115-N5.002","NRT04",null,"115-N5",2,null," ",null,null,"Submit an NCPDP file with incorrect value (not alphanumeric)  in 115-N5 \"Medicaid ID Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 115-N5=miDN12345\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code ( "]
["NRT04.116-N6.001","NRT04",null,"116-N6",1,null,null," "," ","Submit an NCPDP file with correct value (not alphanumeric) in 116-N6 \"Medicaid Agency Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 116-N6 = bd123BCB\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code ( "]
["NRT04.116-N6.002","NRT04",null,"116-N6",2,null,null," "," ","Submit an NCPDP file with correct value (>15 positions) in 116-N6 \"Medicaid Agency Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 116-N6 = MAN1234567898888\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code ( "]
["NRT04.301-C1.001","NRT04",null,"301-C1",1,null,null,null,null,"Submit an NCPDP file with correct value (not alphanumeric) in 301-C1 \"Group ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 116-N6 = bd123BCB\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) "]
["NRT04.301-C1.002","NRT04",null,"301-C1",2,null,null,null,null,"Submit an NCPDP file with correct value (> 15 positions) in 301-C1 \"Group ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 116-N6 = ABCDE12345123451\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) "]
["NRT04.302-C2.001","NRT04",null,"302-C2",1,null,null,null,null,"Submit an NCPDP file with incorrect Cardholder ID (first position) in 302-C2 to get rejected acknowledgement.","Step 1. Submit a NCPDP file where first position of 302-C2 = spaces\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 07"]
["NRT04.302-C2.002","NRT04",null,"302-C2",2,null,null,null,null,"Submit an NCPDP file with incorrect Cardholder ID (12th position) in 302-C2 to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 1st 3 positions of 302-C2 = 001 thru 999 and 12th position = spaces\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 07"]
["NRT04.303-C3.001","NRT04",null,"303-C3",1,null,null,null,null,"Submit an NCPDP file with incorrect value (exceeds maximum >3 positions) in 303-C3 \"Person Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 303-C3 = ZZZZ\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) "]
["NRT04.303-C3.002","NRT04",null,"303-C3",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 303-C3 \"Person Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 303-C3 = zZZZ\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) "]
["NRT04.306-C6.001","NRT04",null,"306-C6",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not numeric) in 306-C6 \"Patient Relationship Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 306-C6 = A\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 11"]
["NRT04.306-C6.002","NRT04",null,"306-C6",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 306-C6 \"Patient Relationship Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 306-C6 = 5\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 11"]
["NRT04.309-C9.001","NRT04",null,"309-C9",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not numerics) in 309-C9 \"Eligibility Clarification Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 309-C9 = R\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 14"]
["NRT04.309-C9.002","NRT04",null,"309-C9",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 1 position) in 309-C9 \"Eligibility Clarification Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 309-C9 = 32\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 14"]
["NRT04.312-CC.001","NRT04",null,"312-CC",1,null,null,null,null,"Submit an NCPDP file with no value in 312-CC \"Cardholder First name\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 312-CC = spaces\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = CC"]
["NRT04.312-CC.002","NRT04",null,"312-CC",2,null,null,null,null,"Submit an NCPDP file with incorrect value (exceeds maximum > 12 positions) in 312-CC \"Cardholder First name\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 312-CC = ABC4442222\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = CC"]
["NRT04.313-CD.001","NRT04",null,"313-CD",1,null,null,null,null,"Submit an NCPDP file with 313-CD \"Cardholder Last name\"  not present to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 313-CD is not present\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = CD"]
["NRT04.313-CD.002","NRT04",null,"313-CD",2,null,null,null,null,"Submit an NCPDP file with incorrect value (= MRspace) in 313-CD \"Cardholder Last name\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 313-CD = MR KENNY\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = CD"]
["NRT04.314-CE.001","NRT04",null,"314-CE",1,null,null,null,null,"Submit an NCPDP file with Invalid Value (exceed maximum >3 positions) in 314-CE \"Home Plan\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 314-CE = 6001\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) "]
["NRT04.314-CE.002","NRT04",null,"314-CE",2,null,null,null,null,"Submit an NCPDP file with Invalid Value (not alphanumeric) in 314-CE \"Home Plan\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 314-CE = b23\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) "]
["NRT04.356-NU.001","NRT04",null,"356-NU",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 356-NU  \"Other Payer Cardholder ID \" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 356-NU = hhl123456\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code ( "]
["NRT04.356-NU.002","NRT04",null,"356-NU",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 20 positions) in 356-NU  \"Other Payer Cardholder ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 356-NU = ABCDE1234512345123456\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code ( "]
["NRT04.359-2A.001","NRT04",null,"359-2A",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 359-2A  \"Medigap ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 359-2A = kkl123456\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code ( "]
["NRT04.359-2A.002","NRT04",null,"359-2A",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 20 positions) in 359-2A  \"Medigap ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 359-2A = ABCDE1234512345123456\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code ( "]
["NRT04.360-2B.001","NRT04",null,"360-2B",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 360-2B \"Medicaid Indicator\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 360-2B= FF\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 2B"]
["NRT04.360-2B.002","NRT04",null,"360-2B",2,null," ",null,null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 360-2B \"Medicaid Indicator\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 360-2B= 5Q\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 2B"]
["NRT04.361-2D.001","NRT04",null,"361-2D",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 361-2D \"Provider Accept Assignment Indicator\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 361-2D = G\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 2D"]
["NRT04.361-2D.002","NRT04",null,"361-2D",2,null,null," ",null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 361-2D \"Provider Accept Assignment Indicator\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 361-2D = g\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 2D"]
["NRT04.524-FO.001","NRT04",null,"524-FO",1,null,null,null,null,"Submit an NCPDP file with incorrect value (exceeds maximum >8 positions) in 524-FO \"Plan ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 524-FO = 1234ABCDE\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) "]
["NRT04.524-FO.002","NRT04",null,"524-FO",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not alpha numeric) in 524-FO \"Plan ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 524-FO = 1234abCDE\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) "]
["NRT04.990-MG.001","NRT04",null,"990-MG",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not numerics) in 990-MG \"Other Payer BIN Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 990-MG = AB2345\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code ( "]
["NRT04.990-MG.002","NRT04",null,"990-MG",2,null,null,null,null,"Submit an NCPDP file with correct value (>6 positions in 990-MG \"Other Payer BIN Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 990-MG = 1234567\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code ( "]
["NRT04.991-MH.001","NRT04",null,"991-MH",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 991-MH  \"Other Payer Cardholder ID \" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 991-MH = bsl12345 \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code ( "]
["NRT04.991-MH.002","NRT04",null,"991-MH",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 10 positions) in 991-MH  \"Other Payer Cardholder ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 991-MH = ABCDE123452\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code ( "]
["NRT04.992-MJ.001","NRT04",null,"992-MJ",1,null,null,null,null,"Submit an NCPDP file with correct value (> 15 positions) in 992-MJ \"Other Payer Group ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 992-MJ = PQR1234567891234\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code ( "]
["NRT04.992-MJ.002","NRT04",null,"992-MJ",2,null,null,null,null,"Submit an NCPDP file with correct value (not alphanumerics) in 992-MJ \"Other Payer Group ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 992-MJ =PqR78925\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code ( "]
["NRT04.997-G2.001","NRT04",null,"997-G2",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 997-G2 \"CMS Part D Defined Qualified Facility\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 997-G2 = S\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = G2"]
["NRT04.997-G2.002","NRT04",null,"997-G2",2," ",null,null,null,"Submit an NCPDP file with incorrect value (> 1 position) in 997-G2 \"CMS Part D Defined Qualified Facility\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 997-G2 = Y2\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = G2"]
["NRT05.111-AM.001","NRT05",null,"111-AM",1,null,null,null," ","Submit an NCPDP file with incorrect order of fields in Coordination of Benefits/Other Payments Segment to ensure rejection occurs.","Step 1. Submit a NCPDP file where \r\nSegment ID (111-AM) is first field in the file followed by\r\nOther Payer Reject Count (471-5E), then Coordination of Benefits/Other Payments Count (337-4C), then Other Payer Coverage Type (338-5C)\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = PE"]
["NRT05.111-AM.002","NRT05",null,"111-AM",2,null,null,null,null,"Submit an NCPDP file with four repetitions of Coordination of Benefits/Other Payments Segment to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 5 occurrences of AM-05 Coordination of Benefits/Other Payments Segment -- each within distinct group separators (i.e. 1 COB/other payer segment for each AM-07 line item within same transaction header (claim)).\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = PE"]
["NRT05.337-4C.001","NRT05",null,"337-4C",1,null,null,null,null,"Unmatched 1 occurrence (for Medicare Edit) of 337-4C \"Coordination of Benefits/Other Payments Count\" ","Step 1. Submit a NCPDP file with 1 occurrence of 337-4C and the associated fields, where 337-4C = 2\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = P4"]
["NRT05.337-4C.002","NRT05",null,"337-4C",2,null,null,null,null,"Matched 2 occurrences (for Medicare Edit) of 337-4C \"Coordination of Benefits/Other Payments Count\" ","Step 1. Submit a NCPDP file with 2 occurrences of 337-4C and the associated fields, where 337-4C = 2\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = P4"]
["NRT05.338-5C.001","NRT05",null,"338-5C",1,null,null,null,null,"Submit an NCPDP file with incorrect value (NOT ALPHANUMERIC) in 338-5C \"Other Payer Coverage Type\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 338-5C = p5\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 5C"]
["NRT05.338-5C.002","NRT05",null,"338-5C",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 338-5C \"Other Payer Coverage Type\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 338-5C = 10\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 5C"]
["NRT05.339-6C.001","NRT05",null,"339-6C",1,null,null,null,null,"Submit an NCPDP file with incorrect value ( not present with 340-7C) 339-6C \"Other Payer ID Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 339-6C is not present with 340-7C\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 6C"]
["NRT05.339-6C.002","NRT05",null,"339-6C",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 339-6C \"Other Payer ID Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 339-6C = 80 \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 6C"]
["NRT05.340-7C.001","NRT05",null,"340-7C",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not alphanumeric)  Other Payer ID (340-7C), to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 340-7C = k555\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 7C"]
["NRT05.340-7C.002","NRT05",null,"340-7C",2,null,null,null,null,"Submit an NCPDP file with incorrect value (exceeds maximum > 10 positions) in 340-7C \"Other Payer ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 340-7C = ABCD1234567\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 7C"]
["NRT05.341-HB.001","NRT05",null,"341-HB",1,null,null,null,null,"Matched 10 occurrences of 341-HB \"Other Payer Amount Paid Count\" ","Step 1. Submit a NCPDP file with 10 occurrences of 341-HB and the associated fields, where 341-HB = 10\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = SF"]
["NRT05.341-HB.002","NRT05",null,"341-HB",2,null,null,null,null,"Unmatched 9 occurrences of 341-HB \"Other Payer Amount Paid Count\" ","Step 1. Submit a NCPDP file with 9 occurrences of 341-HB and the associated fields, where 341-HB = 4\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = SF"]
["NRT05.342-HC.001","NRT05",null,"342-HC",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 342-HC \"Other Payer Amount Paid Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 342-HC = 50\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = HC"]
["NRT05.342-HC.002","NRT05",null,"342-HC",2,null,null,null,null,"Submit an NCPDP file with Other Payer Amount Paid (431-DV) , and no Other Payer Amount Paid Qualifier (342-HC) to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 431-DV is reported without 342-HC\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = HC"]
["NRT05.351-NP.001","NRT05",null,"351-NP",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 351-NP \"Other Payer-Patient Responsibility Amount Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 351-NP = 25\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = NP"]
["NRT05.351-NP.002","NRT05",null,"351-NP",2,null,null," ",null,"Submit an NCPDP file with incorrect value (> 2 positionst) in 351-NP \"Other Payer-Patient Responsibility Amount Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 351-NP =077\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = NP"]
["NRT05.352-NQ.001","NRT05",null,"352-NQ",1,"D",null,null,null,"Submit an NCPDP file with incorrect value (not numeric) in 352-NQ \"Other Payer-Patient Responsibility Amount\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 352-NQ = YZ30\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = NQ"]
["NRT05.352-NQ.002","NRT05",null,"352-NQ",2,null,null," ",null,"Submit an NCPDP file with incorrect value (> 8 positions) in 352-NQ \"Other Payer-Patient Responsibility Amount\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 352-NQ = 12345678{  ($1234567.80)\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = NQ"]
["NRT05.353-NR.001","NRT05",null,"353-NR",1,null,null,null,null,"Unmatched 25 occurrences of 353-NR \"Other Payer-Patient Responsibility Amount Count\" ","Step 1. Submit a NCPDP file with 25 occurrences of 353-NR and the associated fields, where 353-NR = 22\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = SH"]
["NRT05.353-NR.002","NRT05",null,"353-NR",2,null,null,null,null,"Submit an NCPDP file with incorrect value (contains Alphas) in 353-NR \"Other Payer-Patient Responsibility Amount Count\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 353-NR = YY\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = NR"]
["NRT05.392-MU.001","NRT05",null,"392-MU",1,null,null,null,null,"Unmatched 4 occurrences of 392-MU \"Benefit Stage Count\" ","Step 1. Submit a NCPDP file with 4 occurrences of 392-MU and the associated fields, where 392-MU = 2\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = MX"]
["NRT05.392-MU.002","NRT05",null,"392-MU",2,null,null,null,null,"Submit an NCPDP file with incorrect value (contains Alpha) in 392-MU \"Benefit Stage Count\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 392-MU = K\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = MU"]
["NRT05.393-MV.001","NRT05",null,"393-MV",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 393-MV \"Benefit Stage Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 393-MV = 45\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = MV"]
["NRT05.393-MV.002","NRT05",null,"393-MV",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not numeric) in 393-MV \"Benefit Stage Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 393-MV = 0g\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = MV"]
["NRT05.394-MW.001","NRT05",null,"394-MW",1,null,null,null,null,"Submit an NCPDP file with incorrect value (contains Alphas) in 394-MW \"Benefit Stage Amount\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 394-MW = BB\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = MW"]
["NRT05.394-MW.002","NRT05",null,"394-MW",2," ",null,null,null,"Submit an NCPDP file with incorrect value (> 8 positions) in 394-MW \"Benefit Stage Amount\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 394-MW = 12345678{   ($1234567.80)\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = MW"]
["NRT05.431-DV.001","NRT05",null,"431-DV",1,null,null,null,null,"Submit an NCPDP file with incorrect value (contains Alphas) in 431-DV \"Other Payer Amount Paid\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 431-DV = QWER\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = DV"]
["NRT05.431-DV.002","NRT05",null,"431-DV",2," ",null,null,null,"Submit an NCPDP file with Other Payer Amount Paid Qualifier (342-HC), and no Other Payer Amount Paid (431-DV) to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 342-HC is reported without 431-DV\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = DV"]
["NRT05.443-E8.001","NRT05",null,"443-E8",1,null,null,null,null,"Submit an NCPDP file with incorrect value (future date) in 443-E8 \"Other Payer Date\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 443-E8 = 20141226\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = E8"]
["NRT05.443-E8.002","NRT05",null,"443-E8",2,null,null,null,null,"Submit an NCPDP file with incorrect value (contains Alphanumeric) in 443-E8 \"Other Payer Date\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 443-E8 = 2005JA21\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = E8"]
["NRT05.471-5E.001","NRT05",null,"471-5E",1,null,null,null,null,"Unmatched 5 occurrences of 471-5E \"Other Payer Reject Count\" ","Step 1. Submit a NCPDP file with 5 occurrences of 471-5E and the associated fields, where 471-5E = 3\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = R2"]
["NRT05.471-5E.002","NRT05",null,"471-5E",2,null,null,null,null,"Submit an NCPDP file with incorrect value (contains Alphas) in  471-5E \"Other Payer Reject Count\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where  471-5E = RK\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 5E"]
["NRT05.472-6E.001","NRT05",null,"472-6E",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in  472-6E \"Other Payer Reject Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 472-6E = HJ\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 6E"]
["NRT05.472-6E.002","NRT05",null,"472-6E",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 3 positions) in  472-6E \"Other Payer Reject Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 472-6E = 22KK\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 6E"]
["NRT05.993-A7.001","NRT05",null,"993-A7",1,null,null,null,null,"Submit an NCPDP file with incorrect value (exceeds maximum) in 993-A7 \"Internal Control Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 31 characters in 993-A7\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB)  "]
["NRT05.993-A7.002","NRT05",null,"993-A7",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 993-A7 \"Internal Control Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 993-A7 =  pid123456789\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB)  "]
["NRT06.111-AM.001","NRT06",null,"111-AM",1,null,null,null,null,"Submit an NCPDP file with incorrect order of fields in Workers' Compensation Segment to ensure rejection occurs.","Step 1. Submit a NCPDP file where \r\nSegment ID (111-AM) = 06 is first field in the file followed by\r\nPay to Qualifier (118-TS), then\r\nDate of Injury (434-DY) \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) =PT"]
["NRT06.111-AM.002","NRT06",null,"111-AM",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 111-AM \"Segment Identification\" (Workers' Compensation Segment) to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 111-AM = 5P\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = PT"]
["NRT06.117-TR.001","NRT06",null,"117-TR",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 117-TR \"Billing Entity Type Indicator\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 117-TR = 07\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = TR"]
["NRT06.117-TR.002","NRT06",null,"117-TR",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 2 positions) in 117-TR \"Billing Entity Type Indicator\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 117-TR = 012\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = TR"]
["NRT06.118-TS.001","NRT06",null,"118-TS",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 118-TS \"Pay to Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 118-TS = 17\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = TS"]
["NRT06.118-TS.002","NRT06",null,"118-TS",2,null," ",null,null,"Submit an NCPDP file with incorrect value (> 2 positions) in 118-TS \"Pay to Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 118-TS = 123\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = TS"]
["NRT06.119-TT.001","NRT06",null,"119-TT",1,null,null,null,null,"Submit an NCPDP file with incorrect value (exceeds maximum) in 119-TT \"Pay to ID \" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with  119-TT =  16 characters\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = TT"]
["NRT06.119-TT.002","NRT06",null,"119-TT",2,null,null," ",null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 119-TT \"Pay to ID \" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 119-TT g8\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = TT"]
["NRT06.120-TU.001","NRT06",null,"120-TU",1,null,null,null,null,"Submit an NCPDP file with incorrect value (exceeds maximum) in 120-TU \"Pay to Name\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 21 characters in 120-TU\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = TU"]
["NRT06.120-TU.002","NRT06",null,"120-TU",2,null,null," ",null,"Submit an NCPDP file with incorrect value (not alphnumeric) in 120-TU \"Pay to Name\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 120-TU = max&gerry\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = TU"]
["NRT06.121-TV.001","NRT06",null,"121-TV",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 121-TV \"Pay to Street Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 121-TV = 40LhKE@T\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = TV"]
["NRT06.121-TV.002","NRT06",null,"121-TV",2," ",null," ",null,"Submit an NCPDP file with incorrect value (> 30 positions) in 121-TV \"Pay to Street Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 121-TV = 31 characters (4242 FALCONCREST MANER EAST)\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = TV"]
["NRT06.122-TW.001","NRT06",null,"122-TW",1,null,null,null,null,"Submit an NCPDP file with incorrect value (exceeds maximum) in 122-TW \"Pay to City Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 21 characters in 122-TW \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = TW"]
["NRT06.122-TW.002","NRT06",null,"122-TW",2," ",null,null,null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 122-TW \"Pay to City Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 122-TW =  NEW york\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = TW"]
["NRT06.123-TX.001","NRT06",null,"123-TX",1,null,null,null,null,"Submit an NCPDP file with incorrect value (invalid state code)  in 123-TX \"Pay to State/Province Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 123-TX = TB\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = TX"]
["NRT06.123-TX.002","NRT06",null,"123-TX",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 2 positions)  in 123-TX \"Pay to State/Province Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 123-TX = TXX\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = TX"]
["NRT06.124-TY.001","NRT06",null,"124-TY",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not alphanumeric ) \"XY567\" in 124-TY \"Pay to Zip/Postal Zone\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 124-TY = xY567\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = TY"]
["NRT06.124-TY.002","NRT06",null,"124-TY",2,null," ",null,null,"Submit an NCPDP file with incorrect value (> 15 positions ) \"XY567\" in 124-TY \"Pay to Zip/Postal Zone\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 124-TY = 1320224240000000\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = TY"]
["NRT06.125-TZ.001","NRT06",null,"125-TZ",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list)  in 125-TZ \"Generic Equivalent Product ID Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 125-TZ = 42\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = TZ"]
["NRT06.125-TZ.002","NRT06",null,"125-TZ",2,null,null," ",null,"Submit an NCPDP file with incorrect value (not alphanumeric)  in 125-TZ \"Generic Equivalent Product ID Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 125-TZ = 4g\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = TZ"]
["NRT06.126-UA.001","NRT06",null,"126-UA",1," ",null,null,null,"Submit an NCPDP file with incorrect value (> 19 characters) in 126-UA \"Generic equivalent product ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 126-UA = 20 characters\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = UA"]
["NRT06.126-UA.002","NRT06",null,"126-UA",2,null,null," ",null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 126-UA \"Generic equivalent product ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 126-UA = PIDa123456\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = UA"]
["NRT06.315-CF.001","NRT06",null,"315-CF",1,null,null,null,null,"Submit an NCPDP file withinvalid value (not alphanumeric) 315-CF Employer Name in T06 Worker's Comp Segment","Step 1. Submit a NCPDP file with 315-CF = ABCpEFG\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB)  "]
["NRT06.315-CF.002","NRT06",null,"315-CF",2,null,null,null,null,"Submit an NCPDP file with incorrect value (exceeds maximum) in 315-CF \"Employer Name\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 31 characters in 315-CF \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB)  "]
["NRT06.316-CG.001","NRT06",null,"316-CG",1,null,null,null,null,"Submit an NCPDP file with incorrect value (exceeds maximum) in 316-CG \"Employer Street Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file 316-CG 100 WEST ATMMMMMMMMMMMMMMMMMMMM\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) "]
["NRT06.316-CG.002","NRT06",null,"316-CG",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 316-CG \"Employer Street Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 316-CG = 125 aPPLE ST\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) "]
["NRT06.317-CH.001","NRT06",null,"317-CH",1,null,null,null,null,"Submit an NCPDP file with incorrect value (exceeds maximum) in 317-CH \"Employer City Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 21 characetrs in 317-CH \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) "]
["NRT06.317-CH.002","NRT06",null,"317-CH",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 317-CH \"Employer City Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 317-CH = NEW cITY\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) "]
["NRT06.318-CI.001","NRT06",null,"318-CI",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 318-CI \"Employer State/Province Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 318-CI = DD\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = CI"]
["NRT06.318-CI.002","NRT06",null,"318-CI",2,null," ",null,null,"Submit an NCPDP file with incorrect value (> 2 positions) in 318-CI \"Employer State/Province Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 318-CI = MAS\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = CI"]
["NRT06.319-CJ.001","NRT06",null,"319-CJ",1,null,null,null,null,"Submit an NCPDP file with incorrect value (exceeds maximum) in 319-CJ \"Employer Zip/Postal Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 16 characters in 319-CJ \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = CJ"]
["NRT06.319-CJ.002","NRT06",null,"319-CJ",2,null," ",null,null,"Submit an NCPDP file with incorrect value (not exactly 5 positions ) in 319-CJ \"Employer Zip/Postal Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with  319-CJ = 171018 (>5 <9) )\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = CJ"]
["NRT06.320-CK.001","NRT06",null,"320-CK",1,null,null,null,null,"Submit an NCPDP file with incorrect value (contains Alphanumeric) in 320-CK \"Employer Phone Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 320-CK = 717XYZ5960\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = CK"]
["NRT06.320-CK.002","NRT06",null,"320-CK",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 10 positions) in 320-CK \"Employer Phone Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 320-CK = 71744698744\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = CK"]
["NRT06.321-CL.001","NRT06",null,"321-CL",1,null,null,null,null,"Submit an NCPDP file with incorrect value (exceeds maximum) in 321-CL \"Employer Contact Name\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 31 characters in 321-CL \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB)  "]
["NRT06.321-CL.002","NRT06",null,"321-CL",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 321-CL \"Employer Contact Name\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 321-CL =JIM furYK\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB)  "]
["NRT06.327-CR.001","NRT06",null,"327-CR",1,null,null," ",null,"Submit an NCPDP file with incorrect value (exceeds maximum) in 327-CR \"Carrier ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 11 characters in 327-CR \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) "]
["NRT06.327-CR.002","NRT06",null,"327-CR",2,null,null," ",null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 327-CR \"Carrier ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 327-CR  WKc123456\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB)  "]
["NRT06.434-DY.001","NRT06",null,"434-DY",1,null,null,null,null,"Submit an NCPDP file with incorrect value (contains Alphanumeric) in 434-DY \"Date of injury\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 434-DY = 2009CD16\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = DY"]
["NRT06.434-DY.002","NRT06",null,"434-DY",2,null,null,null,null,"Submit an NCPDP file with incorrect value (future date) in 434-DY \"Date of injury\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 434-DY = 20121215\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = DY"]
["NRT06.435-DZ.001","NRT06",null,"435-DZ",1,null,null,null,null,"Submit an NCPDP file with incorrect value (exceeds maximum) in 435-DZ \"Claim/Reference ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 31 characters in 435-DZ \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB)  "]
["NRT06.435-DZ.002","NRT06",null,"435-DZ",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 435-DZ \"Claim/Reference ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with  435-DZ = wc123456789\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB)  "]
["NRT07.111-AM.001","NRT07",null,"111-AM",1,null,null," ",null,"Submit an NCPDP file with incorrect order of fields in Claim Segment to ensure rejection occurs.","Step 1. Submit a NCPDP file where \r\nSegment ID (111-AM)=07 is the first field in the file followed by:\r\nProduct/Service ID Qualifier (436-E1), then\r\nProduct/Service ID (407-D7), then\r\nPrescription Service Reference Number Qualifier (455-EM), then\r\nPrescription Service Reference Number (402-D2), then\r\nOther Coverage Code (308-C8)\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = PC"]
["NRT07.111-AM.002","NRT07",null,"111-AM",2,null,null,null,null,"Submit an NCPDP file with unmatched Prescription Service Reference Number Qualifier and Compound Billing Codes","Step 1. Submit a NCPDP file where 455-EM = 1, 406-D6 = 2,  and no T10 Compound segment.\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = PC"]
["NRT07.147-U7.001","NRT07",null,"147-U7",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 147-U7 \"Pharmacy Service Type\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 147-U7 = 56\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = U7"]
["NRT07.147-U7.002","NRT07",null,"147-U7",2,null," ",null,null,"Submit an NCPDP file with incorrect value (not numeric) in 147-U7 \"Pharmacy Service Type\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 147-U7 = B4\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = U7"]
["NRT07.308-C8.001","NRT07",null,"308-C8",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 308-C8 \"Other Coverage Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 308-C8= 05\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 13"]
["NRT07.308-C8.002","NRT07",null,"308-C8",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not numeric) in 308-C8 \"Other Coverage Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 308-C8= B6\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 13"]
["NRT07.343-HD.001","NRT07",null,"343-HD",1,null,null,null," ","Submit an NCPDP file with incorrect value (not on code list) in 343-HD \"Dispensing Status\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 343-HD = V\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = HD"]
["NRT07.343-HD.002","NRT07",null,"343-HD",2,null," "," ",null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 343-HD \"Dispensing Status\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 343-HD = p\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = HD"]
["NRT07.344-HF.001","NRT07",null,"344-HF",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not numeric) in 344-HF \"Quantity Intended to be Dispensed\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 344-HF  = AB\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 7T"]
["NRT07.344-HF.002","NRT07",null,"344-HF",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 9 position) in 344-HF \"Quantity Intended to be Dispensed\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 344-HF = 12345678.89\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 7T"]
["NRT07.345-HG.001","NRT07",null,"345-HG",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not numeric) in 345-HG \"Days Supply Intended to be Dispensed\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 345-HG  = A25\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 7U"]
["NRT07.345-HG.002","NRT07",null,"345-HG",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 3 positions) in 345-HG \"Days Supply Intended to be Dispensed\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 345-HG  = 1234\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 7U"]
["NRT07.354-NX.001","NRT07",null,"354-NX",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not numeric) in 354-NX \"Submission Clarification Code Count\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 354-NX = Z\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = SG"]
["NRT07.354-NX.002","NRT07",null,"354-NX",2,null,null,null,null,"Unmatched 3 occurrences of 354-NX \"Submission Clarification Code Count\" ","Step 1. Submit a NCPDP file with 3 occurrences of 354-NX and the associated fields, where 354-NX = 1\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = SG"]
["NRT07.357-NV.001","NRT07",null,"357-NV",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 357-NV \"Delay Reason Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 357-NV = 22\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = NV"]
["NRT07.357-NV.002","NRT07",null,"357-NV",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not numeric) in 357-NV \"Delay Reason Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 357-NV = A2\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = NV"]
["NRT07.391-MT.001","NRT07",null,"391-MT",1,null,null," ",null,"Submit an NCPDP file with incorrect value (not on code list) in 391-MT \"Patient Assignment Indicator\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 391-MT = C\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = MT"]
["NRT07.391-MT.002","NRT07",null,"391-MT",2,null,null," ",null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 391-MT \"Patient Assignment Indicator\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 391-MT = y\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = MT"]
["NRT07.402-D2.001","NRT07",null,"402-D2",1,null,null,null,null,"Submit an NCPDP file with incorrect value (exceeds maximum) in 402-D2 \"Prescription/Service Reference Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 402-D2=1234567890123\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 16"]
["NRT07.402-D2.002","NRT07",null,"402-D2",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not numeric) in 402-D2 \"Prescription/Service Reference Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 402-D2=AB123456\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 16"]
["NRT07.403-D3.001","NRT07",null,"403-D3",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not numeric) in 403-D3 \"Fill Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 403-D3 = 2P\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 17"]
["NRT07.403-D3.002","NRT07",null,"403-D3",2,null,null," ",null,"Submit an NCPDP file with incorrect value (> 2 positions)  in 403-D3 \"Fill Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 403-D3 = 999\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 17"]
["NRT07.405-D5.001","NRT07",null,"405-D5",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not numeric) in 405-d5 \"Days  Supply\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 405-D5 = h30\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 19"]
["NRT07.405-D5.002","NRT07",null,"405-D5",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 3 positions) in 405-d5 \"Days  Supply\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 405-D5 = 3300\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 19"]
["NRT07.406-D6.001","NRT07",null,"406-D6",1,null,null,null,null,"Submit an NCPDP file with mismatched 406-D6 compound billing information to get rejected acknowledgement.","Step 1. Submit a NCPDP file with Compound Segment (AM10) and:\r\n-- 406-D6 compound code =1 and/or\r\n-- 455-EM = 2 and \r\n-- 436-E1 = 07\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 20"]
["NRT07.406-D6.002","NRT07",null,"406-D6",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not numeric) in 406-D6 \"Compound Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 406-D6 = B \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 20"]
["NRT07.407-D7.001","NRT07",null,"407-D7",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not > spaces)  in 407-D7 \"Product/Service ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 407-D7 = Blank\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 21"]
["NRT07.407-D7.002","NRT07",null,"407-D7",2,null,null,null,null,"Submit an NCPDP file with incorrect value (invalid with 436=E1=03 in 407-D7 \"Product Service ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with:\r\n-- NDC qualifier '03' in 436-E1 and\r\n-- NDC code in 407-D7, that does not exist on internal drug file.\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1.  Response Status Segment Reject Code (511-FB) = 54 for 407-D7 \r\n\r\n2.  Response Status Segment Reject Code (511-FB) =E1 for 436-E1."]
["NRT07.408-D8.001","NRT07-408-D8",null,"408-D8",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 408-d8 \"Dispense as Written\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 408-D8  = g\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 22"]
["NRT07.408-D8.002","NRT07-408-D8",null,"408-D8",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 1 position) in 408-d8 \"Dispense as Written\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 408-D8  = 10\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 22"]
["NRT07.414-DE.001","NRT07",null,"414-DE",1,null,null,null,null,"Submit an NCPDP file with incorrect value (future date) in 414-DE \"Date Prescription Written\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 414-DE = 20160205\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 28"]
["NRT07.414-DE.002","NRT07",null,"414-DE",2,null,null,null,null,"Submit an NCPDP file with incorrect value (invalid date) in 414-DE \"Date Prescription Written\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 414-DE = 20014554\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 28"]
["NRT07.415-DF.001","NRT07",null,"415-DF",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not numeric) in 415-DF \"Number of Refills Authroized\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 415-DF  = A Step 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 29"]
["NRT07.415-DF.002","NRT07",null,"415-DF",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 2 positions) in  415-DF \"Number of Refills Authroized\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 415-DF   = 107\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 29"]
["NRT07.418-DI.001","NRT07-418-DI",null,"418-DI",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not numeric) in 418-DI \"Special Packaging Indicator\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 418-DI  = B \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 31"]
["NRT07.418-DI.002","NRT07-418-DI",null,"418-DI",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 2 position) 418-DI \"Special Packaging Indicator\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 418-DI  = 256\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 31"]
["NRT07.419-DJ.001","NRT07",null,"419-DJ",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not numeric) in 419-DJ \"Number of Refills Authroized\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 419-DJ  = A                                Step 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 33"]
["NRT07.419-DJ.002","NRT07",null,"419-DJ",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 1 positions) in 419-DJ \"Number of Refills Authroized\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 419-DJ  = 26\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 33"]
["NRT07.420-DK.001","NRT07",null,"420-DK",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 420-DK \"Submission Clarification Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 420-DK= 25\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 34"]
["NRT07.420-DK.002","NRT07",null,"420-DK",2,null,null,null,null,"Submit an NCPDP file with invalid value (not numeric) in 420-DK \"Submission Clarification Code\" to get accepted acknowledgement.","Step 1. Submit a NCPDP file where 420-DK = R2\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 8R"]
["NRT07.429-DT.001","NRT07",null,"429-DT",1,null," ",null,null,"Submit an NCPDP file with incorrect value (not numeric) in 429-DT \"Special Packaging Indicator\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 429-DT  = B \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = DT"]
["NRT07.429-DT.002","NRT07",null,"429-DT",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 1 position) 429-DT \"Special Packaging Indicator\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 429-DT  = 25\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = DT"]
["NRT07.436-E1.001","NRT07",null,"436-E1",1,null,null,null," ","Submit an NCPDP file with incorrect value (not present) in Product/Service ID Qualifier (436-E1) to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 436-E1 is not present\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = E1"]
["NRT07.436-E1.002","NRT07",null,"436-E1",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not numeric) in Product/Service ID Qualifier (436-E1), to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 436-E1 =ND\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = E1"]
["NRT07.442-E7.001","NRT07",null,"442-E7",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not numeric) in Quantity Dispensed (442-E7)","Step 1. Submit a NCPDP file where 343-HD = P or C and 442-E7 = 6M\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = E7"]
["NRT07.442-E7.002","NRT07",null,"442-E7",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 9 positions) in Quantity Dispensed (442-E7)","Step 1. Submit a NCPDP file where 343-HD = P or C and 442-E7 = 12345678.99\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = E7"]
["NRT07.445-EA.001","NRT07",null,"445-EA",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not present with453-EJ) in Originally Prescribed Product/Service Code (445-EA),  to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 445-EA is not present, 453-EJ is present\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = EJ"]
["NRT07.445-EA.002","NRT07",null,"445-EA",2," ",null,null,null,"Submit an NCPDP file with incorrect value (not > spaces with 453-EJ) in Originally Prescribed Product/Service Code (445-EA),  to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 445-EA = spaces, 453-EJ is present\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = EJ"]
["NRT07.446-EB.001","NRT07",null,"446-EB",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not numeric) in 446-EB \"Originally Prescribed Quantity\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 446-EB  = A                       Step 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject  "]
["NRT07.446-EB.002","NRT07",null,"446-EB",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 9 positions) in  446-EB \"Originally Prescribed Quantity\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 446-EB   = 12345678.89\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject  "]
["NRT07.453-EJ.001","NRT07",null,"453-EJ",1,null,null,null,null,"Submit an NCPDP file with incorrect value ( not present with 445-EA) Originally Prescribed Product/Service ID Qualifie (453-EJ), to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 453-EJ is not present. 445-EA is present\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = EA"]
["NRT07.453-EJ.002","NRT07",null,"453-EJ",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 453-EJ \"Originally Prescribed Product/Service ID Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 453-EJ = 06\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = EJ"]
["NRT07.454-EK.001","NRT07",null,"454-EK",1,null,null,null,null,"Submit an NCPDP file with correct value (not alphanumeric) in 454-EK \"Scheduled Prescription ID Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 454-EK = 2426bm\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = EK"]
["NRT07.454-EK.002","NRT07",null,"454-EK",2,null,null,null,null,"Submit an NCPDP file with correct value (> 12 positions) in 454-EK \"Scheduled Prescription ID Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 454-EK = 2426BM\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = EK"]
["NRT07.455-EM.001","NRT07",null,"455-EM",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not alphanumeric) in Prescription/Service Reference Number Qualifier (455-EM)","Step 1. Submit a NCPDP file where 455-EM =  k\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = EM"]
["NRT07.455-EM.002","NRT07",null,"455-EM",2,null," ",null,null,"Submit an NCPDP file with incorrect value (> 1 positions) in Prescription/Service Reference Number Qualifier (455-EM)","Step 1. Submit a NCPDP file where 455-EM = 12\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = EM"]
["NRT07.456-EN.001","NRT07",null,"456-EN",1,null,null,null,null,"Submit an NCPDP file with incorrect value (exceeds maximum > 12 positions) in 456-EN \"Associated Prescription/Service Reference Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 456-EN =  1234567890123\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = EN"]
["NRT07.456-EN.002","NRT07",null,"456-EN",2,null,null," ",null,"Submit an NCPDP file with incorrect value (not numeric) in 456-EN \"Associated Prescription/Service Reference Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 456-EN =  AB123456\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = EN"]
["NRT07.457-EP.001","NRT07",null,"457--EP",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not numeric) in 457-EP \"Associated Prescription/Service Date\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 457-EP = G0091122\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = EP"]
["NRT07.457-EP.002","NRT07",null,"457--EP",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 8 positions) in 457-EP \"Associated Prescription/Service Date\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 457-EP = 200911226\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = EP"]
["NRT07.458-SE.001","NRT07",null,"458-SE",1,null,null,null,null,"Unmatched 10 occurrences of 458-SE \"Procedure Modifier Code Count\" ","Step 1. Submit a NCPDP file with 10 occurrences of 458-SE and the associated fields, where 458-SE = 6\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = R3"]
["NRT07.458-SE.002","NRT07",null,"458-SE",2,null," ",null,null,"Submit an NCPDP file with incorrect value (not numerict) in 458-SE \"Procedure Modifier Code Count\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 458-SE - A4\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = R3"]
["NRT07.459-ER.001","NRT07",null,"459-ER",1,null,null," ",null,"Submit an NCPDP file with incorrect value (invalid modifier)  in 459-ER \"Procedure Modifier Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with:\r\n-- 436-E1 = 03\r\n-- 407-D7 NDC code \r\n-- 459-ER modifier code not valid according to internal pricing modifier table\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = ER"]
["NRT07.459-ER.002","NRT07",null,"459-ER",2,null,null," ",null,"Submit an NCPDP file with incorrect value (not alphanumeric)  in 459-ER \"Procedure Modifier Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with: 459-ER = hKH\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = ER"]
["NRT07.461-EU.001","NRT07",null,"461-EU",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 461-EU \"Prior Authorization Type Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 461-EU = 10\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = EU"]
["NRT07.461-EU.002","NRT07",null,"461-EU",2,null," ",null,null,"Submit an NCPDP file with incorrect value (not numeric) in 461-EU \"Prior Authorization Type Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 461-EU = G9\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = EU"]
["NRT07.462-EV.001","NRT07",null,"462-EV",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not numeric) in 462-EV \"Dispense as Written\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 462-EV  =G\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = EV"]
["NRT07.462-EV.002","NRT07",null,"462-EV",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 11 position) in 462-EV \"Dispense as Written\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 462-EV  = 123456789012\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = EV"]
["NRT07.463-EW.001","NRT07",null,"463-EW",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not numeric) in 463-EW \"Intermediary Authorization Type ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 463-EW =  1D\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = EW"]
["NRT07.463-EW.002","NRT07",null,"463-EW",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 2 positions) in 463-EW \"Intermediary Authorization Type ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 463-EW = 123\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = EW"]
["NRT07.464-EX.001","NRT07",null,"464-EX",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 464-EX \"Intermediary Authorization ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 464-EX  = bc123456\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = EX"]
["NRT07.464-EX.002","NRT07",null,"464-EX",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 11 positions) 464-EX \"Intermediary Authorization ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 464-EX  = 123456789012\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = EX"]
["NRT07.600-28.001","NRT07",null,"600-28",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 600-28 \"Unit of Measure\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where in 600-28 = KT\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 26"]
["NRT07.600-28.002","NRT07",null,"600-28",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 600-28 \"Unit of Measure\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where in 600-28 = kM\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = PZ"]
["NRT07.995-E2.001","NRT07",null,"995-E2",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 995-E2 \"Route of Administration\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 995-E2 = 9999999\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = E2"]
["NRT07.995-E2.002","NRT07",null,"995-E2",2,null,null,null,null,"Submit an NCPDP file with invalid Route of Administration (995-E2)","Step 1. Submit a NCPDP file where 995-E2 = valid value from SNOMED code list, but NOT = to 112239003 or 26643006  (= 992239003)\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 9Q"]
["NRT07.996-G1.001","NRT07",null,"996-G1",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 996-G1 \"Compound Type\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 996-G1 = 42\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = G1"]
["NRT07.996-G1.002","NRT07",null,"996-G1",2,null,null," ",null,"Submit an NCPDP file with incorrect value (not alphanumeric) in 996-G1 \"Compound Type\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 996-G1 = b2\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = G1"]
["NRT08.111-AM.001","NRT08",null,"111-AM",1,null,null," "," ","Submit an NCPDP file with incorrect order of fields in DUR/PPS Segment to ensure rejection occurs.","Step 1. Submit a NCPDP file where \r\nProfessional Service Code (440-E5), is the first field in the file followed by Segment Identification (111-AM) = 08\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = PH"]
["NRT08.439-E4.001","NRT08",null,"439-E4",1,null,null,null,null,"Submit an NCPDP file with missing 439-E4 \"Reason for Service Code\" in T08 DUR/PPS segment","Step 1. Submit a NCPDP file with T08 DUR/PPS segment, but no reason for service code (439-E4) reported\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = E4"]
["NRT08.439-E4.002","NRT08",null,"439-E4",2,null,null,null,null,"Submit an NCPDP file with invalid value (not on code list) correct value \"22\" in 439-E4 \"Reason For Service Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 439-E4 = 22\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = E4"]
["NRT08.440-E5.001","NRT08",null,"440-E5",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) \"11\" in 440-E5 \"Professional Service Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 440-E5 = AB\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = E5"]
["NRT08.440-E5.002","NRT08",null,"440-E5",2,null," ",null,null,"Submit an NCPDP file with incorrect value (not alphanumeric)  in 440-E5 \"Professional Service Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 440-E5 = A#\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = E5"]
["NRT08.441-E6.001","NRT08",null,"441-E6",1,null,null,null,null,"Submit an NCPDP file with incorrect value(not on code list) in 441-E6 \"Result of Service Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 441-E6 =  YY\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = E6"]
["NRT08.441-E6.002","NRT08",null,"441-E6",2," ",null,null,null,"Submit an NCPDP file with incorrect value(not alphanumeric) in 441-E6 \"Result of Service Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 441-E6 = 1#\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = E6"]
["NRT08.473-7E.001","NRT08",null,"473-7E",1,null,null,null,null,"Sequenced 10 occurrences of 473- 7E \"DUR/PPS Code Counter\"","Step 1. Submit a NCPDP file with 10 occurrences of 473-7E where, \r\n473-7E = 1 (for 1 occurrence)\r\n473-7E = 2 (for 2 occurrences)\r\n473-7E = 3 (for 3 occurrences)\r\n473-7E = 4 (for 4 occurrences)\r\n473-7E = 5 (for 5 occurrences)\r\n473-7E = 6 (for 6 occurrences)\r\n473-7E = 7 (for 7 occurrences)\r\n473-7E = 8 (for 8 occurrences)\r\n473-7E = 9 (for 9 occurrences)\r\n473-7E = 10 (for 10 occurrences)\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = P8/7E"]
["NRT08.473-7E.002","NRT08",null,"473-7E",2,null,null,null,null,"Unsequenced 9 occurrences of 473- 7E \"DUR/PPS Code Counter\"","Step 1. Submit a NCPDP file with 9 occurrences of 473-7E where, \r\n473-7E = 1 (for 1 occurrence)\r\n473-7E = 4 (for 2 occurrences)\r\n473-7E = 3 (for 3 occurrences)\r\n473-7E = 2 (for 4 occurrences)\r\n473-7E = 5 (for 5 occurrences)\r\n473-7E = 9 (for 6 occurrences)\r\n473-7E = 7 (for 7 occurrences)\r\n473-7E = 8 (for 8 occurrences)\r\n473-7E = 6 (for 9 occurrences)\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = P8"]
["NRT08.474-8E.001","NRT08",null,"474-8E",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not numeric) in 474-8E \"DUR/PPS Level Of Effort\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 474-8E = AA\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 8E"]
["NRT08.474-8E.002","NRT08",null,"474-8E",2," ",null,null,null,"Submit an NCPDP file with incorrect value (not on code list)  in 474-8E \"DUR/PPS Level Of Effort\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 474-8E = 16\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 8E"]
["NRT08.475-J9.001","NRT08",null,"475-J9",1,null,null,null,null,"Submit an NCPDP file with DUR Co-Agent ID Qualifier (475-J9), and no DUR Co-Agent ID (476-H6) to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 475-J9 is reported without 476-H6\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = J9"]
["NRT08.475-J9.002","NRT08",null,"475-J9",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not valid code for this field) in 475-J9 \"DUR Co-Agent ID Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where  475-J9 = 10\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = J9"]
["NRT08.476-H6.001","NRT08",null,"476-H6",1,null,null,null,null,"Submit an NCPDP file with DUR Co-Agent ID (476-H6), and no DUR Co-Agent ID Qualifier (475-J9) to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 476-H6 is reported without 475-J9\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = J9"]
["NRT08.476-H6.002","NRT08",null,"476-H6",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not alpha numeric) in 476-H6 \"DUR Co-Agent ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 476-H6 = Y#12YRRKK\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = H6"]
["NRT09.111-AM.001","NRT09",null,"111-AM",1,null,null," ",null,"Submit an NCPDP file with incorrect order of fields in Coupon Segment to ensure rejection occurs.","Step 1. Submit a NCPDP file where \r\nSegment Identification (111-AM) = 09, is the first field in the file \r\nfollowed by Coupon Type (485-KE), then\r\nCoupon Value Amount (487-NE), then\r\nCoupon Number (486-ME)\r\n\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\n\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = RU"]
["NRT09.111-AM.002","NRT09",null,"111-AM",2,null,null,null,null,"Submit an NCPDP file with four repetitions of Coupon Segment to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 5 occurrences of AM-09 Coupon Segment -- each within distinct group separators (i.e. 1 Coupon segment for each AM-07 line item within same transaction header (claim)).\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = R7"]
["NRT09.485-KE.001","NRT09",null,"485-KE",1,null,null,null,null,"Submit an NCPDP file with incorrect value(not on code list) in 485-KE \"Coupon Type\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where  485-KE = 88\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = KE"]
["NRT09.485-KE.002","NRT09",null,"485-KE",2," ",null,null,null,"Submit an NCPDP file with incorrect value(not present ) in 485-KE \"Coupon Type\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where  485-KE not present \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = KE"]
["NRT09.486-ME.001","NRT09",null,"486-ME",1,null,null,null,null,"Submit an NCPDP file with 486-ME \"Coupon Number\" missing to get rejected acknowledgement.","Step 1. Submit a NCPDP file where  486-ME  is not present\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = ME"]
["NRT09.486-ME.002","NRT09",null,"486-ME",2,null,null," ",null,"Submit an NCPDP file with 486-ME \"Coupon Number\" not= alpha numerics to get rejected acknowledgement.","Step 1. Submit a NCPDP file where  486-ME = g45\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = ME"]
["NRT09.487-NE.001","NRT09",null,"487-NE",1,null,null,null,null,"Submit an NCPDP file with incorrect value(contains invalid Alphanumeric) in 487-NE \"Coupon Value Amount\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where  487-NE = $DD.AA\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = NE"]
["NRT10.111-AM.001","NRT10",null,"111-AM",1,null,null," ",null,"Submit an NCPDP file with incorrect order of fields in Compound Segment to ensure rejection occurs.","Step 1. Submit a NCPDP file where \r\nSegment Identification (111-AM) = 10, is the first field in the file followed by:\r\nCompound Dosage Form Description Code (450-EF), then\r\nCompound Ingredient Drug Cost (449-EE), then\r\nCompound Dispensing Unit Form Indicator (451-EG), then\r\nCompound Ingredient Component Count (447-EC), then\r\nCompound Product ID Qualifier (488-RE), then \r\nCompound Product ID (489-TE), then\r\nCompound Ingredient Quantity (448-ED)\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = PF"]
["NRT10.362-2G.001","NRT10",null,"362-2G",1,null,null,null,null,"Submit an NCPDP file with incorrect value(contains invalid Alphas) in 362-2G \"Compound Ingredient Modifier Code Count\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 362-2G = YY\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 2G"]
["NRT10.362-2G.002","NRT10",null,"362-2G",2," ",null,null,null,"Unmatched 10 occurrences of 362-2G \"Compound Ingredient Modifier Code Count\" ","Step 1. Submit a NCPDP file with 10 occurrences of 362-2G and the associated fields, where 362-2G = 7\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 4M"]
["NRT10.363-2H.001","NRT10",null,"363-2H",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not found on modifier table)  Compound Ingredient Modifier Code 363-2H to get rejected acknowledgement","Step 1. Submit a NCPDP file where 363-2H Compound Ingredient Modifier Code = 88 is not on the internal Modifier table.\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 2H"]
["NRT10.363-2H.002","NRT10",null,"363-2H",2,null,null,null,null,"Submit an NCPDP file with incorrect value(not alpha numericss) in 363-2H \"Compound Ingredient Modifier Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 363-2H = g1\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 2H"]
["NRT10.447-EC.001","NRT10",null,"447-EC",1,null,null,null,null,"Matched 26 occurrences of 447-EC \"Compound Ingredient Component Count\" (Exceeds max use)","Step 1. Submit a NCPDP file with 26 occurrences of 447-EC and the associated fields, where 447-EC =26\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = P3"]
["NRT10.447-EC.002","NRT10",null,"447-EC",2,null,null,null,null,"Unmatched 25 occurrences of 447-EC \"Compound Ingredient Component Count\" ","Step 1. Submit a NCPDP file with 25 occurrences of 447-EC and the associated fields, where 447-EC =15\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = P3"]
["NRT10.448-ED.001","NRT10",null,"448-ED",1,null,null,null,null,"Submit an NCPDP file with incorrect value(not >0)  in 448-ED \"Compound Ingredient Component Count\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 448-ED = 0{\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = ED"]
["NRT10.448-ED.002","NRT10",null,"448-ED",2,null,null,null,null,"Submit an NCPDP file with incorrect value(> 9(7)v99)  in 448-ED \"Compound Ingredient Component Count\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 448-ED = 123456789{ ($12345678.90)\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = ED"]
["NRT10.449-EE.001","NRT10",null,"449-EE",1,null,null,null,null,"Submit an NCPDP file with incorrect value(contains invalid alphanumeric) in 449-EE \"Compound Ingredient Drug Cost\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 447-EC = 1A2B\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = EE"]
["NRT10.449-EE.002","NRT10",null,"449-EE",2,null," ",null,null,"Submit an NCPDP file with incorrect value( > 9(5)v99) in 449-EE \"Compound Ingredient Drug Cost\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 447-EC = 1234567A  ($123456.71)\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = EE"]
["NRT10.450-EF.001","NRT10",null,"450-EF",1,null,null,null,null,"Submit an NCPDP file with incorrect value(not on code list) in 450-EF \"Compound Dosage Form Description Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 450-EF = 19\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = EF"]
["NRT10.450-EF.002","NRT10",null,"450-EF",2,null,null," ",null,"Submit an NCPDP file with incorrect value(not alpha numeric) in 450-EF \"Compound Dosage Form Description Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 450-EF = #1\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = EF"]
["NRT10.451-EG.001","NRT10",null,"451-EG",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 451-EG \"Compound Dispensing Unit Form Indicator\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 451-EG = 4\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = EG"]
["NRT10.451-EG.002","NRT10",null,"451-EG",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not numerics) in 451-EG \"Compound Dispensing Unit Form Indicator\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 451-EG = G\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = EG"]
["NRT10.488-RE.001","NRT10",null,"488-RE",1,null,null,null,null,"Submit an NCPDP file with no value in 488-RE \"Compound Product ID Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 488-RE = Spaces\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = E1"]
["NRT10.488-RE.002","NRT10",null,"488-RE",2,null,null,null,null,"Submit an NCPDP file with invalid value in 488-RE \"Compound Product ID Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 488-RE = 04\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = E1"]
["NRT10.489-TE.001","NRT10",null,"489-TE",1,null,null,null,null,"Submit an NCPDP file with invalid value in 489-TE \"Compound Product ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with:\r\n-- an NDC code in the Compound Product ID 489-TE field and \r\n-- a Service From Date (401-D1) that's outside the range of effective dates for the NDC (according to internal drug file).\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 21"]
["NRT10.489-TE.002","NRT10",null,"489-TE",2,null,null,null,null,"Submit an NCPDP file with blank 489-TE \"Compound Product ID\" for Rx billing to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 455-EM = 1 and blank spaces in 489-TE \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 21"]
["NRT10.490-UE.001","NRT10",null,"490-UE",1,null,null,null,null,"Submit an NCPDP file with incorrect value(not on code list) in 490-UE \"Compound Ingredient Basis of Cost Determination\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 490-UE = 13\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = DN"]
["NRT10.490-UE.002","NRT10",null,"490-UE",2,null," ",null,null,"Submit an NCPDP file with incorrect value(not alpha numerics) in 490-UE \"Compound Ingredient Basis of Cost Determination\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 490-UE = A#\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = DN"]
["NRT11.111-AM.001","NRT11",null,"111-AM",1,null,null,null," ","Submit an NCPDP file with incorrect order of fields in Pricing Segment to ensure rejection occurs.","Step 1. Submit a NCPDP file where Basis of Cost Determination (423-DN), is the first field in the file followed by Segment Identification (111-AM) = 11 \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = PP"]
["NRT11.111-AM.002","NRT11",null,"111-AM",2,null,null,null,null,"Submit an NCPDP file with four repetitions of Pricing Segment to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 5 occurrences of AM-11 Pricing Segment -- each within distinct group separators (i.e. 1 pricing segment for each AM-07 line item within same transaction header (i.e. claim)).\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = PP"]
["NRT11.409-D9.001","NRT11",null,"409-D9",1,null,null,null,null,"Submit an NCPDP file with incorrect value (contains Alphanumeric) in 409-D9 \"Ingredient Cost Submitted\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 409-D9 = UV.34\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 23"]
["NRT11.409-D9.002","NRT11",null,"409-D9",2,null,null,null,null,"Submit an NCPDP file with incorrect value (>9(6)v99) in 409-D9 \"Ingredient Cost Submitted\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 409-D9 = 12345678{\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 23"]
["NRT11.412-DC.001","NRT11",null,"412-DC",1,null,null,null,null,"Submit an NCPDP file with incorrect value (contains Alphanumerics) in 412-DC \"Dispensing Fee Submitted\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 412-DC = 99NP\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = DC"]
["NRT11.412-DC.002","NRT11",null,"412-DC",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 9(6)v99) in 412-DC \"Dispensing Fee Submitted\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 412-DC = 12345678{                Step 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = DC"]
["NRT11.423-DN.001","NRT11",null,"423-DN",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 423-DN \"Basis of Cost Determination\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 423-DN = 69\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = DN"]
["NRT11.423-DN.002","NRT11",null,"423-DN",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not alpha numeric) in 423-DN \"Basis of Cost Determination\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 423-DN = f9\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = DN"]
["NRT11.426-DQ.001","NRT11",null,"426-DQ",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not numeric) in 426-DQ \"Usual and Customary Charge\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 426-DQ = 2D54{\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject "]
["NRT11.426-DQ.002","NRT11",null,"426-DQ",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not > zero) in 426-DQ \"Usual and Customary Charge\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 426-DQ = 12345670{\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject "]
["NRT11.430-DU.001","NRT11",null,"430-DU",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not >0) in 430-DU \"Gross Amount Due\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 430-DU=0\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = DU"]
["NRT11.430-DU.002","NRT11",null,"430-DU",2,null," ",null,null,"Submit an NCPDP file with incorrect value (>9(5)v99) in 430-DU \"Gross Amount Due\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 430-DU=12345678{\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = DU"]
["NRT11.433-DX.001","NRT11",null,"433-DX",1,null,null,null,null,"Submit an NCPDP file with incorrect value (contains Alphanumeric) in 433-DX \"Patient Paid Amount Submitted\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 433-DX = AB2E \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = DX"]
["NRT11.433-DX.002","NRT11",null,"433-DX",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 9(5)v99) in 433-DX \"Patient Paid Amount Submitted\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 433-DX = 1234567{ ($123456.70)\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = DX"]
["NRT11.438-E3.001","NRT11",null,"438-E3",1,null,null,null,null,"Submit an NCPDP file with incorrect value (contains Alphabumeric) in 438-E3 \"Incentive Amount Submitted\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 438-E3 = 1J25{\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = E3"]
["NRT11.438-E3.002","NRT11",null,"438-E3",2,null,null,null,null,"Submit an NCPDP file with incorrect value (c>9(5)v99) in 438-E3 \"Incentive Amount Submitted\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 438-E3 = 1234567{  ($123456.70)\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = E3"]
["NRT11.478-H7.001","NRT11",null,"478-H7",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 478-H7 \"Other Amount Claim Submitted Count\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 478-H7 = 5\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = R1"]
["NRT11.478-H7.002","NRT11",null,"478-H7",2,null,null,null,null,"Unmatched 3 occurrences of 478-H7 \"Other Amount Claimed Submitted Count\" ","Step 1. Submit a NCPDP file with 3 occurrences of 478-H7 and the associated fields, where 478-H7 = 1\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = R1"]
["NRT11.479-H8.001","NRT11",null,"479-H8",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 479-H8 \"Other Amount Claim Submitted Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 479-H8 = 72\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = H8"]
["NRT11.479-H8.002","NRT11",null,"479-H8",2,null," ",null,null,"Submit an NCPDP file with incorrect value (not alpha numerics) in 479-H8 \"Other Amount Claim Submitted Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 479-H8 = 7g\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = H8"]
["NRT11.480-H9.001","NRT11",null,"480-H9",1,null,null,null,null,"Submit an NCPDP file with incorrect value (>9(6)v99) in 480-H9 \"Other Amount Claimed Submitted\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 480-H9 = 12345678C ($1234567.83) \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = H9"]
["NRT11.480-H9.002","NRT11",null,"480-H9",2,null,null,null,null,"Submit an NCPDP file with  Other Amount Claim Submitted Qualifier (479-H8), and no Other Amount Claim Submitted (480-H9) to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 479-H8 is reported without 480-H9\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = H9"]
["NRT11.481-HA.001","NRT11",null,"481-HA",1,null,null,null,null,"Submit an NCPDP file with incorrect value (contains Alphas) in 481-HA \"Flat Sales Tax Amount Submitted\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 481-HA = ABCD\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code  "]
["NRT11.481-HA.002","NRT11",null,"481-HA",2,null,null,null,null,"Submit an NCPDP file with incorrect value (>9(6)v99) in 481-HA \"Flat Sales Tax Amount Submitted\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 481-HA = 12345678{\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code  "]
["NRT11.482-GE.001","NRT11-482-GE",null,"482-GE",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not numeric) in 482-GE \"Percentage Sales tax Rate Submitted\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 482-GE = D123\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code "]
["NRT11.482-GE.002","NRT11-482-GE",null,"482-GE",2,null,null," ",null,"Submit an NCPDP file with incorrect value (>9(6)V99) in 482-GE \"Percentage Sales tax Rate Submitted\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 482-GE = 12345678{\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code  "]
["NRT11.483-HE.001","NRT11",null,"483-HE",1,null,null,null,null,"Submit an NCPDP file with incorrect value (contains Alphas) in 483-HE \"Percentage Sales tax Rate Submitted\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 483-HE = BKRS\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = HE"]
["NRT11.483-HE.002","NRT11",null,"483-HE",2,null,null,null,null,"Submit an NCPDP file with without 483-HE \"Percentage Sales tax Rate Submitted\" when 482-GE is present o get rejected acknowledgement.","Step 1. Submit a NCPDP file with valid 482-GE greater than zero, and no 483-HE\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = HE"]
["NRT11.484-JE.001","NRT11-484-JE",null,"484-JE",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not alpha numeric) in 484-JE \"Percentage Sales tax Rate Submitted\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 484-JE = h2\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = JE"]
["NRT11.484-JE.002","NRT11-484-JE",null,"484-JE",2,null,null," ",null,"Submit an NCPDP file with incorrect value (>2 positions) in 484-JE \"Percentage Sales tax Rate Submitted\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 484-JE = 222\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = JE"]
["NRT13.491-VE.002","NRT13",null,"491-VE",2,null,null,null,null,"Submit an NCPDP file with incorrect value(contains invalid Alpha) in 491-VE \"Diagnosis Code Count\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where  491-VE = Z\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = P7"]
["NRT13.492-WE.002","NRT13",null,"492-WE",2,null,null,null,null,"Submit an NCPDP file with invalid value (ICD-10 not supported) in 492-WE \"Diagnosis Code Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 492-WE = 02\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) =WE"]
["NRT13.493-XE.002","NRT13",null,"493-XE",2,null,null,null,null,"Submit an NCPDP file with incorrect value(contains invalid Alpha) in 493-XE \"Clinical Information Counter\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 493-XE = N\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = XE"]
["NRT13.494-ZE.002","NRT13",null,"494-ZE",2,null,null,null,null,"Submit an NCPDP file with incorrect value(> 8 characters) in 494-ZE \"Measurement Date\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 494-ZE = 200910153\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = ZE"]
["NRT13.495-H1.001","NRT13",null,"495-H1",1,null,null,null,null,"Submit an NCPDP file with incorrect value(contains invalid Alpha) in 495-H1 \"Measurement Time\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 495-H1 = NNDD\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = H1"]
["NRT13.495-H1.002","NRT13",null,"495-H1",2,null,null," ",null,"Submit an NCPDP file with incorrect value(contains > 4 positions) in 495-H1 \"Measurement Time\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 495-H1 = 10263\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = H1"]
["NRT14.111-AM.001","NRT14",null,"111-AM",1,null," ",null,null,"Submit an NCPDP file with AM14  Additional Documentation Segment present to ensure rejection occurs","Step 1. Submit a NCPDP file where Segment Identification (111-AM) = 14 present\r\nAdditional Documentation\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = AQ"]
["NRT14.369-2Q.001","NRT14",null,"369-2Q",1,null,null,null,null,"Submit an NCPDP file with missing  369-2Q Additional Documentation Type ID","Step 1. Submit a NCPDP file with 369-2Q missing\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 2Q"]
["NRT14.369-2Q.002","NRT14",null,"369-2Q",2,null,null,null,null,"Submit an NCPDP file with incorrect value(not on code list) in 369-2Q \"Additional Documentation Type ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 369-2Q = 1DQ\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 2Q"]
["NRT14.370-2R.001","NRT14",null,"370-2R",1,null,null,null,null,"Submit an NCPDP file with Length of Need (370-2R) greater than 3 characters long ","Step 1. Submit a NCPDP file with 370-2R = 120\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 2R"]
["NRT14.370-2R.002","NRT14",null,"370-2R",2,null,null,null,null,"Submit an NCPDP file with incorrect value(contains invalid Alphanumeric) in 370-2R \"Length of Need\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 370-2R = Y24\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 2R"]
["NRT14.371-2S.001","NRT14",null,"371-2S",1,null,null,null,null,"Submit an NCPDP file with incorrect value(contains invalid Alphas) in 371-2S \"Length of Need Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 371-2S = PP\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 2S"]
["NRT14.371-2S.002","NRT14",null,"371-2S",2,null,null,null,null,"Submit an NCPDP file with > 2 characters in 371-2S \"Length of Need Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 371-2S = 025\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 2S"]
["NRT14.372-2T.001","NRT14",null,"372-2T",1,null,null,null,null,"Submit an NPPDP file with future dated 372.2T Prescriber/Supplier Date Signed","Step 1. Submit a NCPDP file with T14 Additional Doc segment and:\r\n-- 372.2T  = 20121015 (a future date) \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 2T"]
["NRT14.372-2T.002","NRT14",null,"372-2T",2,null,null,null,null,"Submit an NCPDP file with incorrect value(contains invalid Alphas) in 372-2T \"Length of Need\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 372-2T = YEARMONT\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 2T"]
["NRT14.373-2U.001","NRT14",null,"373-2U",1,null,null,null,null,"Submit an NCPDP file with incorrect value(not on code list) in 373-2U \"Request Status\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 373-2U = A\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 2U"]
["NRT14.373-2U.002","NRT14",null,"373-2U",2,null,null,null,null,"Submit an NCPDP file with >1 character in 373-2U \"Request Status\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 373-2U = 12\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 2U"]
["NRT14.374-2V.001","NRT14",null,"374-2V",1,null,null,null,null,"Submit an NCPDP file with future dated 374.2V Request Period Begin date","Step 1. Submit a NCPDP file where 374.2V is future dated 20140202\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 2V"]
["NRT14.374-2V.002","NRT14",null,"374-2V",2,null,null,null,null,"Submit an NCPDP file with missing 374.2V Request Period Begin date","Step 1. Submit a NCPDP file with T14 Additional Doc segment and:\r\n-- 373-2U = 2 and\r\n-- 369-2Q = 011 and \r\n--  no 374.2V \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 2V"]
["NRT14.375-2W.001","NRT14",null,"375-2W",1,null,null,null,null,"Submit an NCPDP file with incorrect value(contains invalid Alphas) in 375-2W \"Request Period Recert/Revised Date\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 375-2W = ABCDF786\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 2W"]
["NRT14.375-2W.002","NRT14",null,"375-2W",2,null,null,null,null,"Submit an NCPDP file withnot a valid date in 375-2W \"Request Period Recert/Revised Date\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 375-2W = 20091259\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 2W"]
["NRT14.376-2X.001","NRT14",null,"376-2X",1,null,null,null,null,"Submit an NCPDP file with incorrect value(exceeds maximum) in 376-2X \"Request Period Recert/Revised Date\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with >65  characters in 376-2X field.\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 2X"]
["NRT14.376-2X.002","NRT14",null,"376-2X",2," ",null,null,null,"Submit an NCPDP file with 376-2X \"Request Period Recert/Revised Date\" not = to alphanumerics to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 376-2X=45#56\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 2X"]
["NRT14.377-2Z.001","NRT14",null,"377-2Z",1,null,null,null,null,"Submit an NCPDP file with >2 numerics 377-2Z \"Question Number/Letter Count\"  to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 377-2Z = 236\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 4N"]
["NRT14.377-2Z.002","NRT14",null,"377-2Z",2," ",null,null,null,"Submit an NCPDP file with incorrect value(contains invalid alphas) in 377-2Z \"Question Number/Letter Count\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 377-2Z = 1S\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 2Z"]
["NRT14.378-4B.001","NRT14",null,"378-4B",1,null,null,null,null,"Submit an NCPDP file with incorrect value(exceeds maximum) in 378-4B \"Question Number/Letter\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 378-4B = F787 is >3 numerics\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 4B"]
["NRT14.378-4B.002","NRT14",null,"378-4B",2,null,null,null,null,"Submit an NCPDP file with 378-4B \"Question Number/Letter\" not = alpha numerics to get rejected acknowledgement.","#Step 1. Submit a NCPDP file where 378-4B = F#7\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 4B"]
["NRT14.379-4D.001","NRT14",null,"379-4D",1,null,null,null,null,"Submit an NCPDP file with incorrect value(contains invalid Alphas) in 379-4D \"Question Percent Response\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 379-4D = SSS.RR\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 4D"]
["NRT14.379-4D.002","NRT14",null,"379-4D",2,null,null,null,null,"Submit an NCPDP file with> allowed characters in 379-4D \"Question Percent Response\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 379-4D = 3459.55\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 4D"]
["NRT14.380-4G.001","NRT14",null,"380-4G",1,null,null,null,null,"Submit an NCPDP file with >8 numerics in 380-4G - Response to Question 11  to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 380-4G = 971995079\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 4G"]
["NRT14.380-4G.002","NRT14",null,"380-4G",2,null,null,null,null,"Submit an NCPDP file with incorrect value(contains invalid Alphas) in 380-4G \"Question Date Response\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 380-4G = 2009AD23\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 4G"]
["NRT14.381-4H.001","NRT14",null,"381-4H",1,null,null,null,null,"Submit an NCPDP file with incorrect value(contains invalid Alphanumeric) in 381-4H \"Question Dollar Amount Response\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 381-4H = A1B2C3D4\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 4H"]
["NRT14.381-4H.002","NRT14",null,"381-4H",2,null,null,null,null,"Submit an NCPDP file with 381-4H \"Question Dollar Amount Response\" invalid number of numerics to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 381-4H = 9999999999.99\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 4H"]
["NRT14.382-4J.001","NRT14",null,"382-4J",1,null,null,null,null,"Submit an NCPDP file with 382-4J - Response to Question 01B  = alphanumerics to get rejected acknowledgement","Step 1. Submit a NCPDP file with 382-4J = 5d6g\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 4J"]
["NRT14.382-4J.002","NRT14",null,"382-4J",2,null,null,null,null,"Submit an NCPDP file with 382-4J - Response to Question 01B >11 numerics to get rejected acknowledgement","Step 1. Submit a NCPDP file with 382-4J = 123456789012\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 4J"]
["NRT14.383-4K.001","NRT14",null,"383-4K",1,null,null,null,null,"Submit an NCPDP file with 383-4K Response to Question not = alphanumerics to get rejected acknowledgement","Step 1. Submit a NCPDP file with 383-4K = M\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 4K"]
["NRT14.383-4K.002","NRT14",null,"383-4K",2,null,null,null,null,"Submit an NCPDP file with 383-4K Question Response >30 characters to get rejected acknowledgement","Step 1. Submit a NCPDP file with 383-4K = B\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 4K"]
["NRT15.111-AM.001","NRT15",null,"111-AM",1,null," ",null," ","Submit an NCPDP file with incorrect order of fields in Facility Segment to ensure rejection occurs.","Step 1. Submit a NCPDP file where \r\nFacility Name (385-3Q) is the first field in the file followed by Segment Identification (111-AM) = 15\r\n\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\n\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = AQ"]
["NRT15.111-AM.002","NRT15",null,"111-AM",2,null,null,null,null,"Submit an NCPDP file without T15 Facility Segment to get rejected acknowledgement","Step 1. Submit a NCPDP file without a T15 Facility Segment where C07-C7 Place of Service = 02\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = AQ"]
["NRT15.336-8C.001","NRT15",null,"336-8C",1,null,null,null,null,"Submit an NCPDP file with incorrect value(exceeds maximum) in 336-8C \"Facility ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 11 characters in 336-8C field.\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB)  "]
["NRT15.385-3Q.001","NRT15",null,"385-3Q",1,null,null,null,null,"Submit an NCPDP file with non-alphabetic 1st position of Facility Name 385-3Q","Step 1. Submit a NCPDP file where the first position of the Facility name in 385-3Q is non-alphabetic \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 3Q"]
["NRT15.385-3Q.002","NRT15",null,"385-3Q",2,null,null,null,null,"Submit an NCPDP file with non-alphas in positions 2 - 30 of Facility Name 385-3Q","Step 1. Submit a NCPDP file where positions 2-30 of the Facility name in 385-3Q contain non-alphabetic characters (other than /, #, (, ), or %).\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 3Q"]
["NRT15.386-3U.001","NRT15",null,"386-3U",1,null,null,null,null,"Submit an NCPDP file with space in 1st position of Facility Address 386-3U","Step 1. Submit a NCPDP file where the first position of the Facility address in 386-3U is a space \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 3U"]
["NRT15.386-3U.002","NRT15",null,"386-3U",2,null,null,null,null,"Submit an NCPDP file with incorrect value(exceeds maximum) in 386-3U \"Facility Street Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 31 characters in 386-3U field.\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 3U"]
["NRT15.387-3V.001","NRT15",null,"387-3V",1,null,null,null,null,"Submit an NCPDP file with incorrect value(exceeds maximum) in 387-3V \"Facility State/Province Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 387-3V = MA1\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 3V"]
["NRT15.387-3V.002","NRT15",null,"387-3V",2,null,null,null,null,"Submit an NCPDP file with 387-3V \"Facility State/Province Address\" not=valid state code to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 387-3V = ZZ\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 3V"]
["NRT15.388-5J.001","NRT15",null,"388-5J",1,null,null,null,null,"Submit an NCPDP file with space in 1st position of Facility City 388-5J","Step 1. Submit a NCPDP file where the first position of the Facility City in 388-5J is a space \r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = 5J"]
["NRT15.388-5J.002","NRT15",null,"388-5J",2,null,null,null,null,"Submit an NCPDP file with incorrect value(exceeds maximum) in 388-5J \"Facility City Address\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 21 characters in 388-5J field.\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 5J"]
["NRT15.389-6D.001","NRT15",null,"389-6D",1,null,null,null,null,"Submit an NCPDP file with incorrect value(exceeds maximum) in 389-6D \"Facility Zip/Postal Zone\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 16 characters in 389-6D field.\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 6D"]
["NRT15.389-6D.002","NRT15",null,"389-6D",2,null,null,null,null,"Submit an NCPDP file with 389-6D \"Facility Zip/Postal Zone\" 1st 5 characters invalid to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 389-6D = 99999\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = 6D"]
["NRT16.111-AM.001","NRT16",null,"111-AM",1,null,null," "," ","Submit an NCPDP file with incorrect order of fields in Narrative Segment to ensure rejection occurs.","Step 1. Submit a NCPDP file where \r\nNarrative Message (390-BM) is the first field in the file followed by Segment Identification (111-AM) = 16\r\n\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\n\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = PQ"]
["NRT16.111-AM.002","NRT16",null,"111-AM",2,null,null,null,null,"Submit an NCPDP file with four repetitions of Narrative Segment to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 5 occurrences of AM-16 Narrative Segment -- each within distinct group separators (i.e. 1 Narrative segment for each AM-07 line item within same transaction header (claim)).\r\n\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\n\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = PQ"]
["NRT16.390-BM.001","NRT16",null,"390-BM",1,null,null,null,null,"Submit an NCPDP file with invalid narrative message 390-BM in segment T16","Step 1. Submit a NCPDP file with T16 Narrative Segment with a space as first position of free form text in 390-BM\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response Status Segment Reject Code (511-FB) = BM"]
["NRT16.390-BM.002","NRT16",null,"390-BM",2,null,null,null,null,"Submit an NCPDP file with incorrect value(exceeds maximum) in 390-BM \"Narrative Message\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file with 201 characters in 390-BM field.\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","Response status segment reject code (511-FB) = BM"]
["NRT99.504-F4.001","NRT99",null,"504-F4",1,null,null,null,null,"Submit an NCPDP file with 504-F4 Free From Message is not space filled to max positions to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 504-F4 is not space filled to max 35 positions.\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1.  Local TRN will reflect no errors\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = E \r\n\r\n3. Field 504-F4 contains message \"1-BATCH TRAILER < 56 BYTES\"."]
["NRT99.504-F4.002","NRT99",null,"504-F4",2,null,null,null,null,"Submit an NCPDP file with 504-F4 Free From Message is greater than 35 characters to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 504-F4 is greater than 35 characters\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1.  Local TRN will reflect no errors\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = E \r\n\r\n3. Field 504-F4 contains message \"1-BATCH TRAILER > 56 BYTES\"."]
["NRT99.701.001","NRT99",null,701,1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 701 \"Segment Identifier\" (Batch Trailer) to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 701 = LT\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1.  Local TRN will reflect no errors\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = E \r\n\r\n3. Field 504-F4 contains message \"1-BATCH TRAILER MISSING\"."]
["NRT99.751.001","NRT99",null,751,1,null,null,null,null,"Submit an NCPDP file with incorrect value (does not match actual record count) in 751 \"Record Count\" (Batch Trailer) to get rejected acknowledgement.","Step 1. Submit a NCPDP file where value reported in 751 does not match actual record count\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1.  Local TRN will reflect no errors\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = E \r\n\r\n3. Field 504-F4 contains message \"1-COUNT NOT EQUAL TO RECORDS SENT\"."]
["NRT99.806-5C.001","NRT99",null,"806-5C",1,null,null,null,null,"Submit an NCPDP file with incorrect value (does not match header) in 806-5C \"Batch Number\" (Batch Trailer) to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 806-5C in trailer does not match 806-5C in header\r\nStep 2. After file is submitted, obtain NCPDP acknowledgement.\r\nStep 3. Verify the acknowledgement.","1.  Local TRN will reflect no errors\r\n\r\n2. Field 880-K6 in NCPDP Response file transmission header = E \r\n\r\n3. Field 504-F4 contains message \"1-BATCH NUMBER MUST MATCH HEADER\"."]
["NRTG1.101-A1.001","NRTG1",null,"101-A1",1,null," ",null,null,"Submit an NCPDP file with incorrect value (not numeric) in 101-A1 \"BIN Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 101-A1 = 123DEF\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = R\r\n\r\n2. Field 112-AN in AM21 segment = R\r\n\r\n3. Field 504-F4 in AM20 segment will contain message \"CLAIM REJECTED\"\r\n\r\n4. Field 511-FB in AM21 segment = 01"]
["NRTG1.101-A1.002","NRTG1",null,"101-A1",2,null,null,null,null,"Submit an NCPDP file with incorrect value (> 6 positions) in 101-A1 \"BIN Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 101-A1 = 123DEFG\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = R\r\n\r\n2. Field 112-AN in AM21 segment = R\r\n\r\n3. Field 504-F4 in AM20 segment will contain message \"CLAIM REJECTED\"\r\n\r\n4. Field 511-FB in AM21 segment = 01 (as well as 02, 1R, 03, 15, AK, etc.)","THrows off rest of transaction header fields by shifting everything to right causing othere errors based on those fields not meeting data content criteria."]
["NRTG1.102-A2.001","NRTG1",null,"102-A2",1,null,null,null,null,"Submit an NCPDP file with incorrect value (on code list / unsupported version) in 102-A2 \"Version/Release Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 102-A2 = C4\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = R\r\n\r\n2. Field 112-AN in AM21 segment = R\r\n\r\n3. Field 504-F4 in AM20 segment will contain message \"CLAIM REJECTED\"\r\n\r\n4. Field 511-FB in AM21 segment = 1R"]
["NRTG1.102-A2.002","NRTG1",null,"102-A2",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 102-A2 \"Version/Release Number\" (Batch Header) to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 102-A2 = S1\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = R\r\n\r\n2. Field 112-AN in AM21 segment = R\r\n\r\n3. Field 504-F4 in AM20 segment will contain message \"CLAIM REJECTED\"\r\n\r\n4. Field 511-FB in AM21 segment = 02"]
["NRTG1.103-A3.001","NRTG1",null,"103-A3",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 103-A3 \"Transaction Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 103-A3 = TJ\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = R\r\n\r\n2. Field 112-AN in AM21 segment = R\r\n\r\n3. Field 504-F4 in AM20 segment will contain message \"CLAIM REJECTED\"\r\n\r\n4. Field 511-FB in AM21 segment = 03"]
["NRTG1.103-A3.002","NRTG1",null,"103-A3",2,null," ",null,null,"Submit an NCPDP file with incorrect value (not alphnumeric) in 103-A3 \"Transaction Code\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 103-A3 = T¶              Step 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = R\r\n\r\n2. Field 112-AN in AM21 segment = R\r\n\r\n3. Field 504-F4 in AM20 segment will contain message \"CLAIM REJECTED\"\r\n\r\n4. Field 511-FB in AM21 segment = 03"]
["NRTG1.104-A4.001","NRTG1",null,"104-A4",1,null,null,null,null,"Submit an NCPDP file with incorrect value (exceeds Maximum > 10 positions) in 104-A4 \"Processor Control Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 104-A4 = 104-A4.0014\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = R\r\n\r\n2. Field 112-AN in AM21 segment = R\r\n\r\n3. Field 504-F4 in AM20 segment will contain message \"CLAIM REJECTED\"\r\n\r\n4. Field 511-FB in AM21 segment = 04 (as well as 15, AK, 1U, 7B, etc.) ","THrows off rest of transaction header fields by shifting everything to right causing other errors based on those fields not meeting data content criteria."]
["NRTG1.104-A4.002","NRTG1",null,"104-A4",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not > spaces) in 104-A4 \"Processor Control Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 104-A4 = spaces\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = R\r\n\r\n2. Field 112-AN in AM21 segment = R\r\n\r\n3. Field 504-F4 in AM20 segment will contain message \"CLAIM REJECTED\"\r\n\r\n4. Field 511-FB in AM21 segment = 04"]
["NRTG1.109-A9.001","NRTG1",null,"109-A9",1,null,null,null,null,"Submit an NCPDP file with incorrect value (contains value not on code list) in 109-A9 \"Transaction Count\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 109-A9 = E\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = R\r\n\r\n2. Field 112-AN in AM21 segment = R\r\n\r\n3. Field 504-F4 in AM20 segment will contain message \"CLAIM REJECTED\"\r\n\r\n4. Field 511-FB in AM21 segment = A9"]
["NRTG1.109-A9.002","NRTG1",null,"109-A9",2,null,null,null,null,"Submit an NCPDP file with incorrect value (zero) in 109-A9 \"Transaction Count\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 109-A9 = 0\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = R\r\n\r\n2. Field 112-AN in AM21 segment = R\r\n\r\n3. Field 504-F4 in AM20 segment will contain message \"CLAIM REJECTED\"\r\n\r\n4. Field 511-FB in AM21 segment = A9"]
["NRTG1.110-AK.001","NRTG1",null,"110-AK",1,null," ",null,null,"Submit an NCPDP file with incorrect value (not > spaces) in 110-AK \"Software Vendor/Certification ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 110-AK = spaces\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = R\r\n\r\n2. Field 112-AN in AM21 segment = R\r\n\r\n3. Field 504-F4 in AM20 segment will contain message \"CLAIM REJECTED\"\r\n\r\n4. Field 511-FB in AM21 segment = AK"]
["NRTG1.110-AK.002","NRTG1",null,"110-AK",2,null," ",null,null,"Submit an NCPDP file with incorrect value (> 10 positions) in 110-AK \"Software Vendor/Certification ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 110-AK = 12345678901\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = R\r\n\r\n2. Field 112-AN in AM21 segment = R\r\n\r\n3. Field 504-F4 in AM20 segment will contain message \"CLAIM REJECTED\"\r\n\r\n4. Field 511-FB in AM21 segment = AK"]
["NRTG1.111-AM.001","NRTG1",null,"111-AM",1,null,null,null,null,"Submit an NCPDP file without Transaction Header Segment to ensure rejection occurs.","Step 1. Submit a NCPDP file with Batch Header & Trailer, but no Transaction Header \r\n\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\n\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = R\r\n\r\n2. Field 112-AN in AM21 segment = R\r\n\r\n3. Field 504-F4 in AM20 segment will contain message \"CLAIM REJECTED\"\r\n\r\n4. Field 511-FB in AM21 segment = R8"]
["NRTG1.201-B1.001","NRTG1",null,"201-B1",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not found on internal sub/prov relational file) in 201-B1 \"Service Provider ID\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 201-B1 =PA12345MI\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = R\r\n\r\n2. Field 112-AN in AM21 segment = R\r\n\r\n3. Field 504-F4 in AM20 segment will contain message \"CLAIM REJECTED\"\r\n\r\n4. Field 511-FB in AM21 segment = 6Y"]
["NRTG1.201-B1.002","NRTG1",null,"201-B1",2,null,null,null,null,"Submit a NCPDP file with spaces in 201-B1 Service Provider ID to get rejected acknowledgment","Step 1. Submit a NCPDP file where 201-B1 =spaces\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = R\r\n\r\n2. Field 112-AN in AM21 segment = R\r\n\r\n3. Field 504-F4 in AM20 segment will contain message \"CLAIM REJECTED\"\r\n\r\n4. Field 511-FB in AM21 segment = 05"]
["NRTG1.202-B2.001","NRTG1",null,"202-B2",1,null,null,null,null,"Submit an NCPDP file with incorrect value (not on code list) in 202-B2 \"Service Provider ID Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 202-B2 = K5\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = R\r\n\r\n2. Field 112-AN in AM21 segment = R\r\n\r\n3. Field 504-F4 in AM20 segment will contain message \"CLAIM REJECTED\"\r\n\r\n4. Field 511-FB in AM21 segment = B2"]
["NRTG1.202-B2.002","NRTG1",null,"202-B2",2,null,null,null,null,"Submit an NCPDP file with invalid value (not = 01)  in 202-B2 \"Service Provider ID Qualifier\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 202-B2 = 02\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = R\r\n\r\n2. Field 112-AN in AM21 segment = R\r\n\r\n3. Field 504-F4 in AM20 segment will contain message \"CLAIM REJECTED\"\r\n\r\n4. Field 511-FB in AM21 segment = 7B"]
["NRTG1.401-D1.001","NRTG1",null,"401-D1",1,null,null,null,null,"Submit an NCPDP file with incorrect value (contains invalid date) in 401-D1 \"Date of Service\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 401-D1 = 20012535\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = R\r\n\r\n2. Field 112-AN in AM21 segment = R\r\n\r\n3. Field 504-F4 in AM20 segment will contain message \"CLAIM REJECTED\"\r\n\r\n4. Field 511-FB in AM21 segment = 15"]
["NRTG1.401-D1.002","NRTG1",null,"401-D1",2," ",null,null,null,"Submit an NCPDP file with incorrect value (not numeric) in 401-D1 \"Date of Service\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 401-D1 = 200G1025\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = R\r\n\r\n2. Field 112-AN in AM21 segment = R\r\n\r\n3. Field 504-F4 in AM20 segment will contain message \"CLAIM REJECTED\"\r\n\r\n4. Field 511-FB in AM21 segment = 15"]
["NRTG1.880-K5.001","NRTG1",null,"880-K5",1,null,null,null,null,"Submit an NCPDP file with incorrect value (spaces) in 880-K5 \"Transaction Reference Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 880-K5 = SPACES\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = R\r\n\r\n2. Field 112-AN in AM21 segment = R\r\n\r\n3. Field 504-F4 in AM20 segment will contain message \"CLAIM REJECTED\"\r\n\r\n4. Field 511-FB in AM21 segment = K5"]
["NRTG1.880-K5.002","NRTG1",null,"880-K5",2,null,null,null,null,"Submit an NCPDP file with incorrect value (not = 10 positions ) in 880-K5 \"Transaction Reference Number\" to get rejected acknowledgement.","Step 1. Submit a NCPDP file where 880-K5 = 456789\r\nStep 2. After file is submitted, obtain NCPDP Response.\r\nStep 3. Verify the Response.","1. Field 501-F1 in response header segment = R\r\n\r\n2. Field 112-AN in AM21 segment = R\r\n\r\n3. Field 504-F4 in AM20 segment will contain message \"CLAIM REJECTED\"\r\n\r\n4. Field 511-FB in AM21 segment = errors such as 1R, 03, 15, AK, etc.","throws off rest of transaction header fields to appear that K5 field  is ten positions and other fields do not meet data content criteria."]
["PAS.BHT...0001","PAS","X222.071..BHT.010",null,null,null,null,null,null,"Ensure BHT is submitted","BHT is submitted","Accepted"]
["PAS.BHT...0002","PAS","X222.071..BHT.020",null,null,null,null,null,null,"Ensure only one BHT is submitted","One BHT is submitted","Accepted",null,"PAS.BHT...0001"]
["PAS.BHT01...0001","PAS","X222.071..BHT01.020                             X222.071..BHT01.020",null,null,null,null,null,null,"Ensure BHT01 is submitted and equals 0019","BHT01 = 0019","Accepted",null,"PAS.BHT...0001"]
["PAS.BHT02..00.0002","PAS","X222.071..BHT02.020",null,null,null,null,null,null,"Ensure BHT02 is submitted and has valid value","BHT02 = 00 ","Accepted",null,"PAS.BHT...0001"]
["PAS.BHT02..18.0002","PAS","X222.071..BHT02.020",null,null,null,null,null,null,"Ensure BHT02 is submitted and has valid value","BHT02=18","Accepted"]
["PAS.BHT03...0002","PAS","X222.071..BHT03.010                          X222.071..BHT03.020\r\nX222.071..BHT03.030",null,null,null,null,null,null,"Ensure BHT03 is submitted with 1 - 30 accepted AN characters","BHT03 = Test Case Id","Accepted",null,"PAS.BHT...0001"]
["PAS.BHT04...0001","PAS","X222.071..BHT04.010                             X222.071..BHT04.020",null,null,null,null,null,"Change BHT04 wildcard to valid date","BHT04 must be present and in valid CCYYMMDD format","BHT04 =valid date","Accepted",null,"PAS.BHT...0001"]
["PAS.BHT05...0001","PAS","X222.071..BHT05.010",null,null,null,null,null,null,"BHT05 must be present","HHMM, HHMMSS, HHMMSSD, HHMMSSDD","Accepted",null,"PAS.BHT...0001"]
["PAS.BHT05...0002","PAS","X222.071..BHT05.020",null,null,null,null,null,null,"BHT05 is submitted in a valid format","BHT05 must a valid time in a valid time format.","Accepted",null,"PAS.BHT...0001"]
["PAS.BHT06...0002","PAS","X222.071..BHT06.020",null,null,null,null,null,null,"BHT06 = CH","BHT06 = CH","Accepted",null,"PAS.BHT...0001"]
["PAS.BHT06..CH.0001","PAS","X222.071..BHT06.010",null,null,null,null,null,null,"BHT06 is submitted and equal CH","BHT06 must be present.","Accepted",null,"PAS.BHT...0001"]
["PAS.GE...0001","PAS","X222.C8..GE.010",null,null,null,null,null,null,"GE must be present.",null,"Accepted",null,"PAS.BHT...0001"]
["PAS.GE01...0001","PAS","X222.C8..GE01.010  X222.C8..GE01.020  X222.C8..GE01.030  X222.C8..GE01.040",null,null,null,null,null,null,"GE01 must be present, must be numeric, must equal the number of transaction sets included in the functional group, and must be > 0.","GE01 = 1","Accepted",null,"PAS.BHT...0001"]
["PAS.GE02...0001","PAS","X222.C8..GE02.010  X222.C8..GE02.020",null,null,null,null,null,null,"GE02 must be present and must = GS06.","GE01 = 100000001","Accepted",null,"PAS.BHT...0001"]
["PAS.GS...0001","PAS","X222.C7..GS.020",null,null,null,null,null,null,"Ensure GS is submitted","GS is present","Accepted",null,"PAS.BHT...0001"]
["PAS.GS01...0001","PAS","X222.C7..GS01.010                                      X222.C7..GS01.020",null,null,null,null,null,null,"Ensure only one GS is submitted within an ISA-IEA envelope","One GS is present within an ISA - IEA envelope","Accepted",null,"PAS.BHT...0001"]
["PAS.GS02...0001","PAS","X222.C7..GS02.010\r\nX222.C7..GS02.020                                                             X222.C7..GS03.020\r\nX222.C7..GS02.040",null,null,null,null,null,null,"Ensure GS01 = HC and contains a valid value","GS01 = HC","Accepted",null,"PAS.BHT...0001"]
["PAS.GS03...0001","PAS","X222.C7..GS03.010\r\nX222.C7..GS03.020                                                 X222.C7..GS03.030\r\nX222.C7..GS03.040",null,null,null,null,null,null,"Ensure GS02 is present, contains at least two non-space characters, and submitted with 2 - 15 accepted AN characters","GS02 = SSSSSS","Accepted",null,"PAS.BHT...0001"]
["PAS.GS04...0001","PAS","X222.C7..GS04.010\r\nX222.C7..GS04.020\r\nX222.C7..GS04.030",null,null,null,null,null,null,"Ensure GS03 is present, contains at least two non-space characters, and submitted with 2 - 15 accepted AN characters","GS03 = PPPPP","Accepted",null,"PAS.BHT...0001"]
["PAS.GS05...0001","PAS","X222.C7..GS05.010\r\nX222.C7..GS05.020",null,null,null,null,null,"Change GS04 wildcard to valid date","Ensure GS04 is submitted with a valid non-future date in CCYYMMDD format","GS04 = 20091006","Accepted",null,"PAS.BHT...0001"]
["PAS.GS06...0001","PAS","X222.C7..GS06.010\r\nX222.C7..GS06.020\r\nX222.C7..GS06.030\r\nX222.C7..GS06.040",null,null,null,null,null,null,"Ensure GS05 is submitted with a valid time in a valid format","GS05 = 1248","Accepted",null,"PAS.BHT...0001"]
["PAS.GS07...0001","PAS","X222.C7..GS07.010                       X222.C7..GS07.020",null,null,null,null,null,null,"Ensure GS06 is numeric, greater than 0, less than 999999999","GS06 = 100000001","Accepted",null,"PAS.BHT...0001"]
["PAS.GS08...0001","PAS","X222A1.60..GS08.010",null,null,null,null,null,null,"GS08 = 005010X222A1",null,"Accepted",null,"PAS.BHT...0001"]
["PAS.GS08...0002","PAS","X222A1.60..GS08.020",null,null,null,null,null,null,"GS08 = 005010X222A1","Ensure GS08 is 005010X222A1","Accepted",null,"PAS.BHT...0001"]
["PAS.IEA...0001","PAS","X222.C10..IEA.010  X222.C10..IEA.020",null,null,null,null,null,null,"IEA must be present and only one iteration of IEA is allowed.",null,"Accepted",null,"PAS.BHT...0001"]
["PAS.IEA01...0001","PAS","X222.C10..IEA01.010  X222.C10..IEA01.020  X222.C10..IEA01.030  X222.C10..IEA01.040",null,null,null,null,null,null,"IEA01 must be present, must be numeric, must equal the number of functional groups included in the interchange, and must be > 0.",null,"Accepted",null,"PAS.BHT...0001"]
["PAS.IEA02...0001","PAS","X222.C10..IEA02.010  X222.C10..IEA02.020",null,null,null,null,null,null,"IEA02 must be present and must = ISA13.",null,"Accepted",null,"PAS.BHT...0001"]
["PAS.ISA...0001","PAS","X222.C3..ISA.010",null,null,null,null,null,null,"ISA must be present.","ISA must be present.","Accepted",null,"PAS.BHT...0001"]
["PAS.ISA...0010","PAS","X222.C3..ISA.010",null,null,null,null,null,null,"ISA must be present.","ISA must be present.","Accepted",null,"PAS.BHT...0001"]
["PAS.ISA...0015","PAS","X222.C3..ISA.015",null,null,null,null,null,null,"Only one iteration of ISA within an ISA-IEA envelope","Submit one ISA iteration within an existing ISA-IEA envelope","Accepted",null,"PAS.BHT...0001"]
["PAS.ISA01..00.0001","PAS","X222.C3..ISA01.010",null,null,null,null,null,null,"ISA01 must be present.","ISA01 = 00","Accepted",null,"PAS.BHT...0001"]
["PAS.ISA01..01.0001","PAS","X222.C3..ISA01.020",null,null,null,null,null,null,"ISA01 must be present.","ISA01 = 00","Accepted",null,"PAS.BHT...0001"]
["PAS.ISA01..01.0002","PAS","X222.C3..ISA02.010\r\nX222.C3..ISA02.020",null,null,null,null,null,null,"ISA01 must be valid values.",null,"Accepted",null,"PAS.BHT...0001"]
["PAS.ISA02...0001","PAS","X222.C3..ISA02.030",null,null,null,null,null,"Provide valid value in ISA02","Ensure ISA 02 is present, and 10 AN characters","Populate ISA02 with 10 AN values","Accepted",null,"PAS.BHT...0001"]
["PAS.ISA02...0003","PAS","X222.C3..ISA02.030",null,null,null,null,null,"Provide valid value in ISA02","ISA02 must be populated with accepted AN characters OR ISA02 must be populated with all spaces.","Populate ISA02 with 10 AN values","Accepted",null,"PAS.BHT...0001"]
["PAS.ISA03..00.0001","PAS","X222.C3..ISA03.010\r\nX222.C3..ISA03.020",null,null,null,null,null,null,"Ensure ISA 03 is present with valid value","ISA03 value = 00","Accepted",null,"PAS.BHT...0001"]
["PAS.ISA03..01.0001","PAS","X222.C3..ISA03.010\r\nX222.C3..ISA03.020",null,null,null,null,null,null,"Ensure ISA 03 is present with valid value","ISA 03 value = 01","Accepted",null,"PAS.ISA03..00.0001"]
["PAS.ISA04...0001","PAS","X222.C3..ISA04.010\r\nX222.C3..ISA04.020",null,null,null,null,null,null,"ISA04 must be present.","Populate ISA04 with 10 AN values or spaces","Accepted",null,"PAS.BHT...0001"]
["PAS.ISA04...0003","PAS","X222.C3..ISA04.030",null,null,null,null,null,null,"Ensure ISA 04 is present, and 10 AN characters","Populate ISA04 with 10 AN values or spaces","Accepted",null,"PAS.BHT...0001"]
["PAS.ISA05...0001","PAS","X222.C3..ISA03.010\r\nX222.C3..ISA05.010",null,null,null,null,null,null,"ISA05 must be present.","ISA05 must be \"27\", \"28\" or \"ZZ\".","Accepted",null,"PAS.BHT...0001"]
["PAS.ISA05..27.0001","PAS","X222.C3..ISA05.010",null,null,null,null,null,null,"ISA05 must be present.","ISA05 = 27","Accepted",null,"PAS.BHT...0001"]
["PAS.ISA05..27.0002","PAS","X222.C3..ISA05.010",null,null,null,null,null,null,"ISA05 must be \"27\", \"28\" or \"ZZ\".","Valid values are  27, 28,  ZZ","Accepted",null,"PAS.BHT...0001"]
["PAS.ISA06...0001","PAS","X222.C3..ISA06.010\r\nX222.C3..ISA06.020\r\nX222.C3..ISA06.030\r\nX222.C3..ISA06.040",null,null,null,null,null,"Change wild card to valid value.  Default is SSSSSS and 9 spaces","Ensure ISA 06 is present, has 15 characters,  at least one non space and AN characters are utilized","ISA 06 = SSSSSS plus 9 spaces","Accepted",null,"PAS.BHT...0001"]
["PAS.ISA07...0001","PAS","X222.C3..ISA07.010",null,null,null,null,null,null,"ISA07 must be present.","ISA05 must be \"27\", \"28\" or \"ZZ\".","Accepted"]
["PAS.ISA07..27.0001","PAS","X222.C3..ISA07.010",null,null,null,null,null,null,"Ensure ISA07 is present and includes a valid value","Valid values are 01, 14, 20, 27, 28, 29, 30, 33, ZZ","Accepted",null,"PAS.BHT...0001"]
["PAS.ISA07..28.0001","PAS","X222.C3..ISA07.010",null,null,null,null,null,null,"ISA07 must be present.","ISA05 must be \"27\", \"28\" or \"ZZ\".","Accepted"]
["PAS.ISA08...0001","PAS","X222.C3..ISA08.010\r\nX222.C3..ISA08.020\r\nX222.C3..ISA08.030\r\nX222.C3..ISA08.040",null,null,null,null,null,"Change wild card to valid value.  Default is PPPPP ","Ensure ISA 08 is present, has 15 characters,  at least one non space and AN characters are utilized","ISA08 = PPPPP plus 10 spaces","Accepted",null,"PAS.BHT...0001"]
["PAS.ISA09...0001","PAS","X222.C3..ISA09.010\r\nX222.C3..ISA09.020\r\nX222.C3..ISA09.030",null,null,null,null,null,"Change wild card to valid value.  Default is 6DIGIT","Ensure ISA 09 is present, in YYMMDD format and not future dated","ISA09 = vallid date in YYMMDD format","Accepted",null,"PAS.BHT...0001"]
["PAS.ISA10...0001","PAS","X222.C3..ISA10.010\r\nX222.C3..ISA10.020",null,null,null,null,null,null,"Ensure ISA 10 is present and in HHMM format","ISA10 =1248","Accepted",null,"PAS.BHT...0001"]
["PAS.ISA11...0001","PAS","X222.C3..ISA11.010\r\nX222.C3..ISA11.020\r\nX222.C3..ISA11.030",null,null,null,null,null,null,"Ensure ISA 11 is present, one character and not a space","ISA 11 = `","Accepted",null,"PAS.BHT...0001"]
["PAS.ISA12..00501.0001","PAS","X222.C3..ISA12.010\r\nX222.C3..ISA12.020",null,null,null,null,null,null,"Ensure ISA 12 is present and equal to 00501","ISA 12 = 00501","Accepted",null,"PAS.BHT...0001"]
["PAS.ISA13...0001","PAS","X222.C3..ISA13.010\r\nX222.C3..ISA13.020\r\nX222.C3..ISA13.030\r\nX222.C3..ISA13.040\r\nX222.C3..ISA13.050",null,null,null,null,null,null,"Ensure ISA13 is present, numeric, 9 positions, greater than zero and unsigned.","ISA13 = 000000001","Accepted",null,"PAS.BHT...0001"]
["PAS.ISA14..0.0001","PAS","X222.C3..ISA14.010\r\nX222.C3..ISA14.020",null,null,null,null,null,null,"Ensure ISA14 is present and has a valid value","ISA14 = 0                   valid values are 0, 1,","Accepted",null,"PAS.BHT...0001"]
["PAS.ISA15..P.0001","PAS","X222.C3..ISA15.010\r\nX222.C3..ISA15.020",null,null,null,null,null,null,"Ensure ISA15 is present and has a valid value","ISA15 = P                  valid valies are P, T","Accepted",null,"PAS.BHT...0001"]
["PAS.ISA16...0001","PAS","X222.C3..ISA16.010\r\nX222.C3..ISA16.020\r\nX222.C3..ISA16.030",null,null,null,null,null,null,"Ensure ISA 16 is present, one AN character and not a space","ISA16 = >","Accepted",null,"PAS.BHT...0001"]
["PAS.SE...0001","PAS","X222.496..SE.010",null,null,null,null,null,null,"SE must be present.",null,"Accepted",null,"PAS.BHT...0001"]
["PAS.SE01...0001","PAS","X222.496..SE01.010  X222.496..SE01.020  X222.496..SE01.030  X222.496..SE01.040",null,null,null,null,null,null,"SE01 must be present, must be numeric, must equal the transaction segment count and must be > 0.",null,"Accepted",null,"PAS.BHT...0001"]
["PAS.SE02...0001","PAS","X222.496..SE02.010  X222.496..SE02.020",null,null,null,null,null,null,"SE02 must be present and must = ST02.",null,"Accepted",null,"PAS.BHT...0001"]
["PAS.ST...0001","PAS","X222.070..ST.010",null,null,null,null,null,null,"Ensure ST is submitted","ST is submitted","Accepted",null,"PAS.BHT...0001"]
["PAS.ST...0002","PAS","X222.070..ST.020",null,null,null,null,null,null,"Ensure one interation of a ST is submitted","One ST is present","Accepted",null,"PAS.BHT...0001"]
["PAS.ST01...0001","PAS","X222.070..ST01.010\r\nX222.070..ST01.020",null,null,null,null,null,null,"Ensure ST01 is present and equals 837","ST01 = 837","Accepted",null,"PAS.BHT...0001"]
["PAS.ST02...0001","PAS","X222.070..ST02.010",null,null,null,null,null,null,"ST02 must be present.","Ensure ST02 is present","Accepted",null,"PAS.BHT...0001"]
["PAS.ST02...0002","PAS","X222.070..ST02.020",null,null,null,null,null,null,"ST02 must be 4-9 characters.","Ensure ST02 is submtited with 4 - 9 AN characters. ","Accepted",null,"PAS.BHT...0001"]
["PAS.ST02...0003","PAS","X222.070..ST02.030",null,null,null,null,null,null,"ST02 must contain at least four non-space characters.","Ensure ST02 has at least 4 non-space characters","Accepted",null,"PAS.BHT...0001"]
["PAS.ST02...0004","PAS","X222.070..ST02.040",null,null,null,null,null,null,"ST02 must be populated with accepted AN characters.","Ensure ST02 is populated with accepted AN characters","Accepted",null,"PAS.BHT...0001"]
["PAS.ST02...0005","PAS","X222.070..ST02.050",null,null,null,null,null,null,"ST02 must be a unique number within the ISA-IEA envelope.","Ensure ST02 is unique within the current envelope.","Accepted",null,"PAS.BHT...0001"]
["PAS.ST03...0001","PAS","X222.070..ST03.010\r\nX222A1.014..ST03.020",null,null,null,null,null,null,"Ensure ST 03 is submitted and equal to 005010X222A1","ST03 = 005010X222A1","Accepted",null,"PAS.BHT...0001"]
["PAS1000A....0001","PAS1000A","X222.074.1000A..010",null,null,null,null,null,null,"Ensure one iteration 1000A NM1 is received.","Ensure one 1000A NM1 is submitted","Accepted",null,"PAS1000A.NM1...0001"]
["PAS1000A.NM1...0001","PAS1000A","X222.074.1000A.NM1.010",null,null,null,null,null,null,"Ensure 1000A NM1 is received","Ensure 1000A NM1 loop is present","Accepted"]
["PAS1000A.NM101...0001","PAS1000A","X222.074.1000A.NM101.010",null,null,null,null,null,null,"Ensure valid value is submitted in the 1000A NM101","Ensure 1000A.NM101 is submitted.","Accepted"]
["PAS1000A.NM101.41..0002","PAS1000A","X222.074.1000A.NM101.020",null,null,null,null,null,null,"Ensure valid value is submitted in the 1000A NM101","NM101 = 41","Accepted"]
["PAS1000A.NM102...0002","PAS1000A","X222.074.1000A.NM102.020",null,null,null,null,null,null,"1000A.NM102 must be valid values. ","NM102 = 1 or NM102 = 2","Accepted",null,"\nPAS1000A.NM102..1.0001"]
["PAS1000A.NM102..1.0001","PAS1000A","X222.074.1000A.NM102.010",null,null,null,null,null,null,"Must be present","NM102 = 1","Accepted"]
["PAS1000A.NM102..2.0001","PAS1000A","X222.074.1000A.NM102.010",null,null,null,null,null,null,"Must be present","NM102 = 2","Accepted"]
["PAS1000A.NM103...0001","PAS1000A","X222.074.1000A.NM103.010",null,null,null,null,null,null,"1000A.NM103 must be present.","NM103 = TEST PART B SUBMITTER","Accepted"]
["PAS1000A.NM103...0002","PAS1000A","X222.074.1000A.NM103.020",null,null,null,null,null,null,"Ensure 1000A NM103 has 1 - 60 AN characters ","NM103 = TEST PART B SUBMITTER","Accepted",null,"PAS1000A.NM103...0001"]
["PAS1000A.NM103...0003","PAS1000A","X222.074.1000A.NM103.030",null,null,null,null,null,null,"1000A.NM103 must contain at least one non-space character.","NM103 = TEST PART B SUBMITTER","Accepted",null,"PAS1000A.NM103...0001"]
["PAS1000A.NM103...0004","PAS1000A","X222.074.1000A.NM103.040",null,null,null,null,null,null,"1000A.NM103 must be populated with accepted AN characters.","NM103 = TEST PART B SUBMITTER","Accepted",null,"PAS1000A.NM103...0001"]
["PAS1000A.NM104...0001","PAS1000A","X222.074.1000A.NM104.010",null,null,null,null,null,null,"Ensure 1000A NM104 is not submitted when 1000A NM102 = 2","Ensure NM104 is not submitted when NM102 = 2","Accepted"]
["PAS1000A.NM104...0003","PAS1000A","X222.074.1000A.NM104.030",null,null,null,null,null,null,"1000A.NM104 must be 1 - 35 characters.","NM104 = SUBMIT","Accepted"]
["PAS1000A.NM104...0005","PAS1000A","X222.074.1000A.NM104.050",null,null,null,null,null,null,"1000A.NM104 must contain at least one non-space character.","NM104 = SUBMIT","Accepted",null,"PAS1000A.NM104...0003"]
["PAS1000A.NM104...0006","PAS1000A","X222.074.1000A.NM104.060",null,null,null,null,null,null,"1000A.NM104 must be populated with accepted AN characters.","NM104 = SUBMIT","Accepted",null,"PAS1000A.NM104...0003"]
["PAS1000A.NM105...0001","PAS1000A","X222.074.1000A.NM105.010",null,null,null,null,null,null,"1000A.NM105 must contain at least one non-space character.","Ensure NM105 is not submitted when NM102 = 2","Accepted"]
["PAS1000A.NM105...0002","PAS1000A","X222.074.1000A.NM105.020",null,null,null,null,null,null,"Ensure 1000A NM105 is not submitted when 1000A NM102 = 2","Ensure NM105 is not submitted when NM102 = 2","Accepted",null,"PAS1000A.NM105...0001"]
["PAS1000A.NM105...0004","PAS1000A","X222.074.1000A.NM105.040",null,null,null,null,null,null,"1000A.NM105 must be 1 - 25 characters.","NM105 = A","Accepted"]
["PAS1000A.NM105...0006","PAS1000A","X222.074.1000A.NM105.060",null,null,null,null,null,null,"1000A.NM105 must be populated with accepted AN characters.","NM105 = A","Accepted",null,"PAS1000A.NM105...0004"]
["PAS1000A.NM105...0007","PAS1000A","X222.074.1000A.NM105.065","NM105",null,null,null,null,null,"1000A.NM105 must be populated with The first position of 1000A.NM105 must be alphabetic (A…Z).","NM105 = A","Accepted",null,"PAS1000A.NM105...0004"]
["PAS1000A.NM108...0001","PAS1000A","X222.074.1000A.NM108.010",null,null,null,null,null,null,"1000A.NM108 must be present.","NM108 = 46","Accepted"]
["PAS1000A.NM108...0002","PAS1000A","X222.074.1000A.NM108.020",null,null,null,null,null,null,"1000A.NM108 must be \"46\".","NM108 = 46","Accepted",null,"PAS1000A.NM108...0001"]
["PAS1000A.NM109...0001","PAS1000A","X222.074.1000A.NM109.010",null,null,null,null,null,null,"1000A.NM109 must be present.","NM109 = SSSSSS","Accepted"]
["PAS1000A.NM109...0002","PAS1000A","X222.074.1000A.NM109.020",null,null,null,null,null,null,"1000A.NM109 must contain at least two non-space characters.","NM109 = SSSSSS","Accepted",null,"PAS1000A.NM109...0001"]
["PAS1000A.NM109...0003","PAS1000A","X222.074.1000A.NM109.030",null,null,null,null,null,null,"1000A.NM109 must be 2-80 characters.","NM109 = SSSSSS","Accepted",null,"PAS1000A.NM109...0001"]
["PAS1000A.NM109...0005","PAS1000A","X222.074.1000A.NM109.050",null,null,null,null,null,null,"1000A.NM109 must be populated with accepted AN characters.","NM109 = SSSSSS","Accepted",null,"PAS1000A.NM109...0001"]
["PAS1000A.NM109...0007","PAS1000A","X222.074.1000A.NM109.070",null,null,null,null,null,null,"1000A.NM109 must be an approved electronic submitter.","NM109 = SSSSSS","Accepted",null,"PAS1000A.NM109...0001"]
["PAS1000A.PER...0001","PAS1000A","X222.076.1000A.PER.010",null,null,null,null,null,null,"Ensure 1000A PER is submitted","1000A PER is submitted","Accepted"]
["PAS1000A.PER...0002","PAS1000A","X222.076.1000A.PER.020",null,null,null,null,null,null,"Ensure only two or less iterations 1000A PER is received.","Only two or less 1000A PER is submitted","Accepted"]
["PAS1000A.PER01...0001","PAS1000A","X222.076.1000A.PER01.010",null,null,null,null,null,null,"Ensure 1000A PER01 is submitted with a valid value","PER01 = IC","Accepted"]
["PAS1000A.PER01...0002","PAS1000A","X222.076.1000A.PER01.020",null,null,null,null,null,null,"1000A.PER01 must be \"IC\".","PER01 = IC","Accepted",null,"PAS1000A.PER01...0001"]
["PAS1000A.PER02...0001","PAS1000A","X222.076.1000A.PER02.010",null,null,null,null,null,null,"1000A.PER02 must contain at least one non-space character.","PER02 = TEST CONTACT","Accepted"]
["PAS1000A.PER02...0002","PAS1000A","X222.076.1000A.PER02.020",null,null,null,null,null,null,"For the 1st 1000A.PER transmitted, 1000A.PER02 must not = 1000A.NM103. ","PER02 = TEST CONTACT","Accepted"]
["PAS1000A.PER02...0004","PAS1000A","X222.076.1000A.PER02.040",null,null,null,null,null,null,"For the 2nd 1000A.PER transmitted, 1000A.PER02 must not be present.","Only one PER submitted","Accepted",null,"PAS1000A.PER02...0001"]
["PAS1000A.PER02...0006","PAS1000A","X222.076.1000A.PER02.060",null,null,null,null,null,null,"1000A.PER02 must be 1 - 60 characters.","Only one PER submitted","Accepted",null,"PAS1000A.PER02...0001"]
["PAS1000A.PER02...0008","PAS1000A","X222.076.1000A.PER02.080",null,null,null,null,null,null,"1000A.PER02 must be populated with accepted AN characters.","Only one PER submitted","Accepted",null,"PAS1000A.PER02...0001"]
["PAS1000A.PER03..EM.0001","PAS1000A","X222.076.1000A.PER03.010",null,null,null,null,null,null,"1000A.PER03 must be present.","PER03 = EM","Accepted"]
["PAS1000A.PER03..FX.0001","PAS1000A","X222.076.1000A.PER03.010",null,null,null,null,null,null,"1000A.PER03 must be present.","PER03 = FX","Accepted"]
["PAS1000A.PER03..TE.0001","PAS1000A","X222.076.1000A.PER03.010",null,null,null,null,null,null,"1000A.PER03 must be present.","PER03 = TE","Accepted"]
["PAS1000A.PER04...0001","PAS1000A","X222.076.1000A.PER04.010\nX222.076.1000A.PER04.070",null,null,null,null,null,null," ","PER04 = 4105551212","Accepted"]
["PAS1000A.PER04...0002","PAS1000A","X222.076.1000A.PER04.020",null,null,null,null,null,null,"1000A.PER04 must contain at least one non-space character.","PER04 = 4105551212","Accepted",null,"PAS1000A.PER04.0001"]
["PAS1000A.PER04...0005","PAS1000A","X222.076.1000A.PER04.050",null,null,null,null,null,null,"1000A.PER04 must be populated with accepted AN characters.","PER04 = 4105551212","Accepted",null,"PAS1000A.PER04.0001"]
["PAS1000A.PER05...0002","PAS1000A","X222.076.1000A.PER05.020",null,null,null,null,null,null,"If 2010AA.PER05 is \"EX\" 2010AA.PER03 must be \"TE\"","PER05  = EX","Accepted"]
["PAS1000A.PER05..EM.0001","PAS1000A","X222.076.1000A.PER05.010",null,null,null,null,null,null,"1000A.PER05 must be valid values.","PER05  = EM","Accepted"]
["PAS1000A.PER05..EX.0001","PAS1000A","X222.076.1000A.PER05.010",null,null,null,null,null,null,"1000A.PER05 must be valid values.","PER05  = EM","Accepted",null,"PAS1000A.PER05..EM.0001"]
["PAS1000A.PER05..FX.0001","PAS1000A","X222.076.1000A.PER05.010",null,null,null,null,null,null,"1000A.PER05 must be valid values.","PER05  = EM","Accepted",null,"PAS1000A.PER05..EM.0001"]
["PAS1000A.PER05..TE.0001","PAS1000A","X222.076.1000A.PER05.010",null,null,null,null,null,null,"1000A.PER05 must be valid values.","PER05  = EM","Accepted",null,"PAS1000A.PER05..EM.0001"]
["PAS1000A.PER06...0001","PAS1000A","X222.076.1000A.PER06.010\nX222.076.1000A.PER06.070",null,null,null,null,null,null,"If 1000A.PER06 is present, 1000A.PER05 must be present.","PER06 = 1234","Accepted"]
["PAS1000A.PER06...0002","PAS1000A","X222.076.1000A.PER06.020",null,null,null,null,null,null,"1000A.PER06 must contain at least one non-space character.","PER06 = 1234","Accepted",null,"PAS1000A.PER06...0001"]
["PAS1000A.PER06...0003","PAS1000A","X222.076.1000A.PER06.030",null,null,null,null,null,null,"1000A.PER06 must be 1 - 256 characters.","PER06 = 1234","Accepted",null,"PAS1000A.PER06...0001"]
["PAS1000A.PER06...0005","PAS1000A","X222.076.1000A.PER06.050",null,null,null,null,null,null,"1000A.PER06 must be populated with accepted AN characters.","PER06 = 1234","Accepted",null,"PAS1000A.PER06...0001"]
["PAS1000A.PER07..EM.0001","PAS1000A","X222.076.1000A.PER07.010   X222.076.1000A.PER07.020",null,null,null,null,null,null,"1000A.PER07 must be valid values.","Valid values are EM, EX, FX, TE","Accepted"]
["PAS1000A.PER07..EX.0001","PAS1000A","X222.076.1000A.PER07.010   X222.076.1000A.PER07.020",null,null,null,null,null,null,"1000A.PER07 must be valid values.","Valid values are EM, EX, FX, TE","Accepted"]
["PAS1000A.PER07..FX.0001","PAS1000A","X222.076.1000A.PER07.010   X222.076.1000A.PER07.020",null,null,null,null,null,null,"1000A.PER07 must be valid values.","Valid values are EM, EX, FX, TE","Accepted"]
["PAS1000A.PER07..TE.0001","PAS1000A","X222.076.1000A.PER07.010   X222.076.1000A.PER07.020",null,null,null,null,null,null,"1000A.PER07 must be valid values.","Valid values are EM, EX, FX, TE","Accepted"]
["PAS1000A.PER08...0001","PAS1000A","X222.076.1000A.PER08.010\nX222.076.1000A.PER08.070",null,null,null,null,null,null,"If 1000A.PER08 is present, 1000A.PER07 must be present.","PER07=TE    PER08 = 4105558888","Accepted"]
["PAS1000A.PER08...0002","PAS1000A","X222.076.1000A.PER08.020",null,null,null,null,null,null,"1000A.PER08 must contain at least one non-space character.","PER07=TE    PER08 = 4105558888","Accepted",null,"PAS1000A.PER08...0001"]
["PAS1000A.PER08...0003","PAS1000A","X222.076.1000A.PER08.030",null,null,null,null,null,null,"1000A.PER08 must be 1 - 256 characters.","PER07=TE    PER08 = 4105558888","Accepted",null,"PAS1000A.PER08...0001"]
["PAS1000A.PER08...0005","PAS1000A","X222.076.1000A.PER08.050",null,null,null,null,null,null,"1000A.PER08 must be populated with accepted AN characters.","PER07=TE    PER08 = 4105558888","Accepted",null,"PAS1000A.PER08...0001"]
["PAS2000A.HL...0001","PAS2000A","X222.081.2000A.HL.010",null,null,null,null,null,null,"2000A.HL must be present.",null,"Accepted"]
["PAS2000A.HL...0002","PAS2000A","X222.081.2000A.HL.020",null,null,null,null,null,null,"Only one iteration of 2000A.HL is allowed.",null,"Accepted",null,"PAS2000A.HL...0001"]
["PAS2000A.HL01...0001","PAS2000A","X222.081.2000A.HL01.010",null,null,null,null,null,null,"2000A.HL01 must be present.","HL01 = 1","Accepted"]
["PAS2000A.HL01...0002","PAS2000A","X222.081.2000A.HL01.020",null,null,null,null,null,null,"2000A.HL01 must be 1 - 12 characters.","HL01 = 1","Accepted",null,"PAS2000A.HL01...0001"]
["PAS2000A.HL01...0003","PAS2000A","X222.081.2000A.HL01.030",null,null,null,null,null,null,"2000A.HL01 must be numeric.","HL01 = 1","Accepted",null,"PAS2000A.HL01...0001"]
["PAS2000A.HL01...0004","PAS2000A","X222.081.2000A.HL01.040",null,null,null,null,null,null,"The first HL01 must be \"1\".","HL01 = 1","Accepted",null,"PAS2000A.HL01...0001"]
["PAS2000A.HL03...0001","PAS2000A","X222.081.2000A.HL03.010",null,null,null,null,null,null,"2000A.HL03 must be present.","HL03 = 20","Accepted"]
["PAS2000A.HL03...0002","PAS2000A","X222.081.2000A.HL03.020",null,null,null,null,null,null,"2000A.HL03 must be \"20\".","HL03 = 20","Accepted",null,"PAS2000A.HL03...0001"]
["PAS2000A.HL04...0001","PAS2000A","X222.081.2000A.HL04.010",null,null,null,null,null,null,"2000A.HL04 must be present.","HL04 = 1","Accepted"]
["PAS2000A.HL04...0002","PAS2000A","X222.081.2000A.HL04.020",null,null,null,null,null,null,"2000A.HL04 must be \"1'.","HL04 = 1","Accepted",null,"PAS2000A.HL04...0001"]
["PAS2000A.PRV...0001","PAS2000A","X222.083.2000A.PRV.010",null,null,null,null,null,null,"Ensure only one iteration of PRV is submitted","One PRV is submitted","Accepted"]
["PAS2000A.PRV01...0001","PAS2000A","X222.083.2000A.PRV01.010",null,null,null,null,null,null,"2000A PRV01 must be present.","PRV01 = BI","Accepted"]
["PAS2000A.PRV01...0002","PAS2000A","X222.083.2000A.PRV01.020",null,null,null,null,null,null,"2000A.PRV01 must be \"BI\".","PRV01 = BI","Accepted",null,"PAS2000A.PRV01...0001"]
["PAS2000A.PRV02...0001","PAS2000A","X222.083.2000A.PRV02.010",null,null,null,null,null,null,"2000A.PRV02 must be present.","PRV02 = PXC","Accepted"]
["PAS2000A.PRV02...0002","PAS2000A","X222.083.2000A.PRV02.020",null,null,null,null,null,null,"2000A.PRV02 must be \"PXC\".","PRV02 = PXC","Accepted",null,"PAS2000A.PRV02...0001"]
["PAS2000A.PRV03...0001","PAS2000A","X222.083.2000A.PRV03.010",null,null,null,null,null,null,"2000A.PRV03 must be present.","PRV03 = 193200000X","Accepted"]
["PAS2000A.PRV03...0002","PAS2000A","X222.083.2000A.PRV03.020",null,null,null,null,null,null,"2000A.PRV03 must be a valid Provider Taxonomy Code","PRV03 = 193200000X","Accepted",null,"PAS2000A.PRV03...0001"]
["PAS2000B.HL...0001","PAS2000B","X222.114.2000B.HL.010\r\nX222.114.2000B.HL.020",null,null,null,null,null,null,"Ensure a flat file is generated when HL is submitted","One iteration of HL is submitted","Accepted"]
["PAS2000B.HL01...0001","PAS2000B","X222.114.2000B.HL01.010",null,null,null,null,null,null,"2000B.HL01 must be present.","HL01 = 2","Accepted"]
["PAS2000B.HL01...0002","PAS2000B","X222.114.2000B.HL01.020",null,null,null,null,null,null,"2000B.HL01 must be 1 - 12 characters.","HL01 = 2","Accepted",null,"PAS2000B.HL01...0001"]
["PAS2000B.HL01...0003","PAS2000B","X222.114.2000B.HL01.030",null,null,null,null,null,null,"2000B.HL01 must be numeric.","HL01 = 2","Accepted",null,"PAS2000B.HL01...0001"]
["PAS2000B.HL01...0004","PAS2000B","X222.114.2000B.HL01.040",null,null,null,null,null,null,"2000B.HL01 must be equal the value of the previous HL01 (2000A.HL01) plus one. ","HL01 = 2","Accepted",null,"PAS2000B.HL01...0001"]
["PAS2000B.HL02...0001","PAS2000B","X222.114.2000B.HL02.010",null,null,null,null,null,null,"2000B.HL02 must be present.","HL02 = 1","Accepted"]
["PAS2000B.HL02...0002","PAS2000B","X222.114.2000B.HL02.020",null,null,null,null,null,null,"2000B.HL02 must be equal to the value of the HL01 (2000A.HL01) of the parent HL. ","HL02 = 1","Accepted",null,"PAS2000B.HL02...0001"]
["PAS2000B.HL03...0001","PAS2000B","X222.114.2000B.HL03.010",null,null,null,null,null,null,"2000B.HL03 must be present.","HL03 = 22","Accepted"]
["PAS2000B.HL03...0002","PAS2000B","X222.114.2000B.HL03.020",null,null,null,null,null,null,"2000B.HL03 must be \"22\".","HL03 = 22","Accepted",null,"PAS2000B.HL03...0001"]
["PAS2000B.HL04...0001","PAS2000B","X222.114.2000B.HL04.015 ","HL04",1,null,null,null,null,"2000B.HL04 must be \"0\".","HL04 = 0","Accepted"]
["PAS2000B.HL04...0015","PAS2000B","X222.114.2000B.HL04.015",null,null,null,null,null,null,"2000B.HL04 must be \"0\".","HL04 = 0","Accepted"]
["PAS2000B.PAT...0001","PAS2000B","X222.119.2000B.PAT.010",null,null,null,null,null,null,"Ensure a flat file is generated when 1 PAT is submitted","PAT is submitted","Accepted"]
["PAS2000B.PAT02...0001","PAS2000B","X222.119.2000B.PAT02.010",null,null,null,null,null,null,"Ensure a flat file is generated when PAT is not submitted","PAT is not submitted","Accepted",null,"PAS.BHT...0001"]
["PAS2000B.PAT05...0001","PAS2000B","X222.119.2000B.PAT05.010",null,null,null,null,null,"PAT is submitted","Ensure PAT05 contains valid value","PAT05 = D8","Accepted"]
["PAS2000B.PAT06...0001","PAS2000B","X222.119.2000B.PAT06.010",null,null,null,null,null,"PAT 05 is submitted","If 2000B.PAT05 is present, 2000B.PAT06 must be present.","PAT06 = 20090201","Accepted"]
["PAS2000B.PAT06...0002","PAS2000B","X222.119.2000B.PAT06.020",null,null,null,null,null,"PAT 05 is submitted","2000B.PAT06 must be a valid date in CCYYMMDD format.","PAT06 = 20090201","Accepted",null,"PAS2000B.PAT06...0001"]
["PAS2000B.PAT07...0001","PAS2000B","X222.119.2000B.PAT07.010",null,null,null,null,null,"PAT is submitted","Ensure PAT07 has a valid value","PAT07 = 01","Accepted",null,"PAS2000B.PAT09...0001"]
["PAS2000B.PAT08...0001","PAS2000B","X222.119.2000B.PAT08.010\r\nX222.119.2000B.PAT08.015",null,null,null,null,null,"PAT07 is submitted","Ensure PAT08 is submitted with a value > 0 and <= 9999.99","PAT08 = 275","Accepted",null,"PAS2000B.PAT09...0001"]
["PAS2000B.PAT09...0001","PAS2000B","X222.119.2000B.PAT09.010",null,null,null,null,null,"PAT is submitted","2000B.PAT09 must be \"Y\".","PAT09 = Y","Accepted"]
["PAS2000B.SBR...0001","PAS2000B","X222.116.2000B.SBR.010",null,null,null,null,null,null,"2000B.SBR must be present.","One iteration of SBR is submitted","Accepted"]
["PAS2000B.SBR...0002","PAS2000B","X222.116.2000B.SBR.020",null,null,null,null,null,null,"Only one iteration of 2000B.SBR is allowed.","One iteration of SBR is submitted","Accepted",null,"PAS2000B.SBR...0001"]
["PAS2000B.SBR01..P.0001","PAS2000B","X222.116.2000B.SBR01.010","SBR01",1,null,null,null,null,"Ensure a SBR01 is submitted with a valid value","SBR01 = P","Accepted"]
["PAS2000B.SBR01..S.0001","PAS2000B","X222.116.2000B.SBR01.010","SBR01",1,null,null,null,null,"Ensure a SBR01 is submitted with a valid value","SBR01 = S","Accepted"]
["PAS2000B.SBR02...0002","PAS2000B","X222.116.2000B.SBR02.020",null,null,null,null,null,null,"2000B.SBR02 must be \"18\".","SBR02 = 18","Accepted"]
["PAS2000B.SBR05.12..0001","PAS2000B","X222.116.2000B.SBR05.010","SBR05",1,null,null,null,"SBR01 not equal to P","Ensure a SBR05 is submitted with a valid value","SBR05 = 12","Accepted"]
["PAS2000B.SBR05.13..0001","PAS2000B","X222.116.2000B.SBR05.010","SBR05",1,null,null,null,"SBR01 not equal to P","Ensure a SBR05 is submitted with a valid value","SBR05 = 13","Accepted"]
["PAS2000B.SBR05.14..0001","PAS2000B","X222.116.2000B.SBR05.010","SBR05",1,null,null,null,"SBR01 not equal to P","Ensure a SBR05 is submitted with a valid value","SBR05 = 14","Accepted"]
["PAS2000B.SBR05.15..0001","PAS2000B","X222.116.2000B.SBR05.010","SBR05",1,null,null,null,"SBR01 not equal to P","Ensure a SBR05 is submitted with a valid value","SBR05 = 15","Accepted"]
["PAS2000B.SBR05.16..0001","PAS2000B","X222.116.2000B.SBR05.010","SBR05",1,null,null,null,"SBR01 not equal to P","Ensure a SBR05 is submitted with a valid value","SBR05 = 16","Accepted"]
["PAS2000B.SBR05.41..0001","PAS2000B","X222.116.2000B.SBR05.010","SBR05",1,null,null,null,"SBR01 not equal to P","Ensure a SBR05 is submitted with a valid value","SBR05 = 41","Accepted"]
["PAS2000B.SBR05.42..0001","PAS2000B","X222.116.2000B.SBR05.010","SBR05",1,null,null,null,"SBR01 not equal to P","Ensure a SBR05 is submitted with a valid value","SBR05 = 42","Accepted"]
["PAS2000B.SBR05.43..0001","PAS2000B","X222.116.2000B.SBR05.010","SBR05",1,null,null,null,"SBR01 not equal to P","Ensure a SBR05 is submitted with a valid value","SBR05 = 43","Accepted"]
["PAS2000B.SBR05.47..0001","PAS2000B","X222.116.2000B.SBR05.010","SBR05",1,null,null,null,"SBR01 not equal to P","Ensure a SBR05 is submitted with a valid value","SBR05 = 47","Accepted"]
["PAS2000B.SBR07...0001","PAS2000B","X222.116.2000B.SBR07.010","SBR07",1,null,null,null,null,"Ensure SBR07 is not submitted","SBR07 not submitted","Accepted"]
["PAS2000B.SBR08...0001","PAS2000B","X222.116.2000B.SBR08.010","SBR08",1,null,null,null,null,"Ensure SBR08 is not submitted","SBR08 not submitted","Accepted"]
["PAS2000C.HL...0001","PAS2000C","X222.142.2000C.HL.010","HL",1,null,null,null,null,"a flat file is generated when  2000C data elements are not submitted","2000C is not submitted","Accepted"]
["PAS2010AA....0001","PAS2010AA","X222.087.2010AA..010",null,null,null,null,null,null,"Only one iteration of 2010AA is allowed.",null,"Accepted"]
["PAS2010AA.N3...0001","PAS2010AA","X222.091.2010AA.N3.010  X222.091.2010AA.N3.020",null,null,null,null,null,null,"2010AA.N3 must be present and only one iteration of 2010AA.N3 is allowed.","One N3 is submitted","Accepted"]
["PAS2010AA.N301...0001","PAS2010AA","X222.091.2010AA.N301.010\r\nX222.091.2010AA.N301.020                                     X222.091.2010AA.N301.030\r\nX222.091.2010AA.N301.050",null,null,null,null,null,null,"Ensure a flat file is generated when N301 is submitted with 1-55 AN characters and does not equal Post Office Box, P.O.Box, PO Box, Lock Box, Lock Bin with at least one non-space character.","N301 = 234 ANYSTREET LN.","Accepted"]
["PAS2010AA.N302...0005","PAS2010AA","X222.091.2010AA.N302.005                               X222.091.2010AA.N302.010\r\nX222.091.2010AA.N302.030",null,null,null,null,null,null,"Ensure a flat file is generated when N302 is submitted with 1-55 AN characters and does not equal Post Office Box, P.O.Box, PO Box, Lock Box, Lock Bin with at least one non-space character.","N302 = SUITE 450","Accepted"]
["PAS2010AA.N4...0001","PAS2010AA","X222.092.2010AA.N4.010 X222.092.2010AA.N4.020",null,null,null,null,null,null,"Ensure a flat file is generated with N4 is submitted and only one iteration of 2010AA.N4 is allowed.","N4 is submitted","Accepted"]
["PAS2010AA.N401...0001","PAS2010AA","X222.092.2010AA.N401.010\r\nX222.092.2010AA.N401.030",null,null,null,null,null,null,"Ensure a flat file is generated when N401 is submitted with 2 - 30 AN characters","N401 = DALLAS","Accepted"]
["PAS2010AA.N401...0002","PAS2010AA","X222.092.2010AA.N401.020                          X222.092.2010AA.N401.050",null,null,null,null,null,null,"Ensure a flat file is generated when N402 is submitted with 2 Alpha characters  (at least one non-space character).","N402 = TX","Accepted",null,"PAS2010AA.N401...0001"]
["PAS2010AA.N402...0001","PAS2010AA","X222.092.2010AA.N402.010",null,null,null,null,null,null,"If 2010AA.N404 is not present, 2010AA.N402 must be present.","N404 not submitted, N402 submitted","Accepted"]
["PAS2010AA.N403...0001","PAS2010AA","X222.092.2010AA.N403.010",null,null,null,null,null,null,"If 2010AA.N404 is not present, 2010AA.N403 must be present.","N404 not submitted, N403 submitted","Accepted"]
["PAS2010AA.NM1...0001","PAS2010AA","X222.087.2010AA.NM1.010",null,null,null,null,null,null,"Ensure a flat file is generated when 2010AA NM1 is submitted","NM1 is submitted","Accepted"]
["PAS2010AA.NM101...0001","PAS2010AA","X222.087.2010AA.NM101.010                              X222.087.2010AA.NM101.020",null,null,null,null,null,null,"Ensure a flat file is generated when NM101 is submitted with a valid value of 85","NM101 = 85","Accepted"]
["PAS2010AA.NM102..1.0001","PAS2010AA","X222.087.2010AA.NM102.010",null,null,null,null,null,null,"2010AA.NM102 must be present.","NM102 = 1","Accepted"]
["PAS2010AA.NM102..1.0002","PAS2010AA","X222.087.2010AA.NM102.020",null,null,null,null,null,null,"2010AA.NM102 must be valid values.","NM102 = 1","Accepted",null,"PAS2010AA.NM102..1.0001"]
["PAS2010AA.NM103...0001","PAS2010AA","X222.087.2010AA.NM103.010                X222.087.2010AA.NM103.020\r\nX222.087.2010AA.NM103.030\r\nX222.087.2010AA.NM103.050",null,null,null,null,null,null,"Ensure a flat file is generated when NM103 is submitted with 1-60 accepted characters with at least one non-space character.","NM103 = MASTERS CLINIC","Accepted"]
["PAS2010AA.NM104...0001","PAS2010AA","X222.087.2010AA.NM104.010                                X222.087.2010AA.NM104.030\r\nX222.087.2010AA.NM104.040\r\nX222.087.2010AA.NM104.060",null,null,null,null,null,"NM102 = 1","Ensure a flat file is generated when NM104 is submitted when 1-35 accepted AN characters are submitted with at least one non-space character.","NM104 = FIRST","Accepted"]
["PAS2010AA.NM105...0001","PAS2010AA","X222.087.2010AA.NM105.010                               X222.087.2010AA.NM105.030\r\nX222.087.2010AA.NM105.040\r\nX222.087.2010AA.NM105.060",null,null,null,null,null,"NM102 = 1","Ensure a flat file is generated when NM105 is submitted when 1-25 AN characters are submitted with at least one non-space character.","NM105 = MIDDLE","Accepted"]
["PAS2010AA.NM105...0007","PAS2010AA","X222.087.2010AA.NM105.065","NM105",null,null,null,null,null,"2010AA.NM105 must be populated with The first position of 2010AA.NM105 must be alphabetic (A…Z).","NM105 = A","Accepted",null,"PAS2010AA.NM105...0004"]
["PAS2010AA.NM107...0001","PAS2010AA","X222.087.2010AA.NM107.010                          X222.087.2010AA.NM107.030\r\nX222.087.2010AA.NM107.040\r\nX222.087.2010AA.NM107.060",null,null,null,null,null,"NM102 = 1","Ensure a flat file is generated when NM107 is submitted when 1-10 AN characters are submitted with at least one non-space character.","NM107 = SUFFIX","Accepted"]
["PAS2010AA.NM108...0003","PAS2010AA","X222.087.2010AA.NM108.030",null,null,null,null,null,null,"2010AA.NM108 must be \"XX\".","NM108 = XX","Accepted"]
["PAS2010AA.NM109...0002","PAS2010AA","X222.087.2010AA.NM109.020",null,null,null,null,null,"NM108 = XX","Ensure a flat file is generated when valid information is submitted in NM109","NM109 = NNNNNNNNNN","Accepted"]
["PAS2010AA.PER...0002","PAS2010AA","X222.098.2010AA.PER.020",null,null,null,null,null,null,"Only two iterations of 2010AA.PER are allowed.","two PER are submitted","Accepted"]
["PAS2010AA.PER01...0002","PAS2010AA","X222.098.2010AA.PER01.020",null,null,null,null,null,null,"Ensure PER01 is accepted when valid value IC is submitted","PER01 = IC","Accepted"]
["PAS2010AA.PER02...0001","PAS2010AA","X222.098.2010AA.PER02.010                  X222.098.2010AA.PER02.020\r\nX222.098.2010AA.PER02.030                  X222.098.2010AA.PER02.040\r\nX222.098.2010AA.PER02.050\r\nX222.098.2010AA.PER02.070",null,null,null,null,null,null,"Ensure for 1st PER that PER02 is submitted, does not equal 1000A PER02, 1-60 accepted AN characters and must contain at least one non-space character..  For the 2nd 2010AA.PER transmitted, 2010AA.PER02 must not be present.","PER02 = MASTERS CLINIC CONTACT","Accepted"]
["PAS2010AA.PER03..EM.0001","PAS2010AA","X222.098.2010AA.PER03.010",null,null,null,null,null,null,"Ensure PER03 is submitted with valid values","PER03 = EM","Accepted"]
["PAS2010AA.PER03..FX.0001","PAS2010AA","X222.098.2010AA.PER03.010",null,null,null,null,null,null,"Ensure PER03 is submitted with valid values","PER03 = FX","Accepted"]
["PAS2010AA.PER03..TE.0001","PAS2010AA","X222.098.2010AA.PER03.010",null,null,null,null,null,null,"Ensure PER03 is submitted with valid values","PER03 = TE","Accepted"]
["PAS2010AA.PER04...0001","PAS2010AA","X222.098.2010AA.PER04.010 X222.098.2010AA.PER04.020     X222.098.2010AA.PER04.030  ",null,null,null,null,null,null,"2010AA.PER04 must be present. 2010AA.PER04 must be populated with accepted AN characters andmust be 1 - 256 characters.","PER04 = 9725551212","Accepted"]
["PAS2010AA.PER04...0005","PAS2010AA","X222.098.2010AA.PER04.050",null,null,null,null,null,null,"2010AA.PER04 must be populated with accepted AN characters andmust be 1 - 256 characters.","PER04 = 9725551212","Accepted",null,"PAS2010AA.PER04...0001"]
["PAS2010AA.PER05..EM.0001","PAS2010AA","X222.098.2010AA.PER05.010",null,null,null,null,null,null,"Ensure PER05 contains a valid value","PER05 = EM","Accepted"]
["PAS2010AA.PER05..EX.0001","PAS2010AA","X222.098.2010AA.PER05.020",null,null,null,null,null,"PER03 = TE","Ensure PER05 contains EX when PER03 =TE","PER05 = EX","Accepted"]
["PAS2010AA.PER05..EX.0002","PAS2010AA","X222.098.2010AA.PER05.020",null,null,null,null,null,"PER03 = TE","Ensure PER05 contains EX when PER03 =TE","PER05 = EX","Accepted"]
["PAS2010AA.PER05..FX.0001","PAS2010AA","X222.098.2010AA.PER05.010",null,null,null,null,null,null,"Ensure PER05 contains a valid value","PER05 = FX","Accepted"]
["PAS2010AA.PER05..TE.0001","PAS2010AA","X222.098.2010AA.PER05.010",null,null,null,null,null,null,"Ensure PER05 contains a valid value","PER05 = TE","Accepted"]
["PAS2010AA.PER06...0001","PAS2010AA","X222.098.2010AA.PER06.010",null,null,null,null,null,null,"If 2010AA.PER06 is present 2010AA.PER05 must be present.","PER06 = 9725551213","Accepted"]
["PAS2010AA.PER06...0002","PAS2010AA","X222.098.2010AA.PER06.020",null,null,null,null,null,null,"2010AA.PER06 must be 1 - 256 characters.","PER06 = 1234","Accepted"]
["PAS2010AA.PER06...0004","PAS2010AA","X222.098.2010AA.PER06.040",null,null,null,null,null,null,"2010AA.PER06 must be populated with accepted AN characters.","PER06 = 1234","Accepted",null,"PAS2010AA.PER06...0002"]
["PAS2010AA.PER06...0015","PAS2010AA","X222.098.2010AA.PER06.015",null,null,null,null,null,null,"2010AA.PER06 must contain at least one non-space character.","PER06 = 1234","Accepted",null,"PAS2010AA.PER06...0002"]
["PAS2010AA.PER07..EM.0001","PAS2010AA","X222.098.2010AA.PER07.010                  X222.098.2010AA.PER07.020",null,null,null,null,null,null,"If 2010AA.PER07 is present, 2010AA.PER05 must be present.  Ensure PER07 contains a valid value","PER07 = EM","Accepted"]
["PAS2010AA.PER07..EX.0001","PAS2010AA","X222.098.2010AA.PER07.010                  X222.098.2010AA.PER07.020",null,null,null,null,null,null,"If 2010AA.PER07 is present, 2010AA.PER05 must be present.  Ensure PER07 contains a valid value","PER07 = EX","Accepted"]
["PAS2010AA.PER07..FX.0001","PAS2010AA","X222.098.2010AA.PER07.010                  X222.098.2010AA.PER07.020",null,null,null,null,null,null,"If 2010AA.PER07 is present, 2010AA.PER05 must be present.  Ensure PER07 contains a valid value","PER07 = FX","Accepted",null,"PAS2010AA.PER05..EX.0001"]
["PAS2010AA.PER07..TE.0001","PAS2010AA","X222.098.2010AA.PER07.010                  X222.098.2010AA.PER07.020",null,null,null,null,null,null,"If 2010AA.PER07 is present, 2010AA.PER05 must be present.  Ensure PER07 contains a valid value","PER07 = TE","Accepted"]
["PAS2010AA.PER07..TE.0003","PAS2010AA","X222.098.2010AA.PER07.030",null,null,null,null,null,null,"If 2010AA.PER07 is \"EX\", 2010AA.PER05 must be \"TE\".","2010AA.PER07 = \"EX\", 2010AA.PER05 = \"TE\".","Accepted"]
["PAS2010AA.PER08...0001","PAS2010AA","X222.098.2010AA.PER08.010\nX222.098.2010AA.PER08.060",null,null,null,null,null,null,"If 2010AA.PER07 is present, 2010AA.PER08 must be present.","2010AA.PER07  is present, 2010AA.PER08 is present.","Accepted"]
["PAS2010AA.PER08...0002","PAS2010AA","X222.098.2010AA.PER08.020",null,null,null,null,null,null,"2010AA.PER08 must be 1 - 256 characters.",null,"Accepted",null,"PAS2010AA.PER08...0001"]
["PAS2010AA.PER08...0004","PAS2010AA","X222.098.2010AA.PER08.040",null,null,null,null,null,null,"2010AA.PER08 must be populated with accepted AN characters.",null,"Accepted",null,"PAS2010AA.PER08...0001"]
["PAS2010AA.PER08...0015","PAS2010AA","X222.098.2010AA.PER08.015",null,null,null,null,null,null,"2010AA.PER08 must contain at least one non-space character.",null,"Accepted",null,"PAS2010AA.PER08...0001"]
["PAS2010AA.REF...0002","PAS2010AA","X222.094.2010AA.REF.020",null,null,null,null,null,null,"Only one iteration of 2010AA.REF with REF01 = \"EI\" or \"SY\" is allowed.",null,"Accepted"]
["PAS2010AA.REF01.EI..0001","PAS2010AA","X222.094.2010AA.REF01.010                         X222.094.2010AA.REF01.020",null,null,null,null,null,null,"Ensure REF01 is submitted with a valid value","REF01 = EI","Accepted"]
["PAS2010AA.REF01.SY..0001","PAS2010AA","X222.094.2010AA.REF01.010                         X222.094.2010AA.REF01.020",null,null,null,null,null,null,"Ensure REF01 is submitted with a valid value","REF01 = SY","Accepted"]
["PAS2010AB.N3...0002","PAS2010AB","X222.103.2010AB.N3.020",null,null,null,null,null,"2010AB NM1 must be present","Ensure a flat file is generated when one N3 is submitted","One N3 is submitted","Accepted",null,"PAS2010AB.N4...0001"]
["PAS2010AB.N301...0001","PAS2010AB","X222.103.2010AB.N301.010\r\nX222.103.2010AB.N301.030\r\nX222.103.2010AB.N301.050",null,null,null,null,null,null,"Ensure a flat file is generated when N301 is submitted with 1-55 AN characters and does not equal Post Office Box, P.O.Box, PO Box, Lock Box, Lock Bin","N301 = 123 PAYMENT ST.","Accepted"]
["PAS2010AB.N302...0004","PAS2010AB","X222.103.2010AB.N302.040\r\nX222.103.2010AB.N302.060",null,null,null,null,null,null,"Ensure a flat file is generated when N302 is submitted with 1-55 AN characters and does not equal Post Office Box, P.O.Box, PO Box, Lock Box, Lock Bin","N302 = SUITE 100","Accepted"]
["PAS2010AB.N4...0001","PAS2010AB","X222.104.2010AB.N4.010",null,null,null,null,null,null,"If 2010AB.NM1 is present, 2010AB.N4 must be present.",null,"Accepted"]
["PAS2010AB.N4...0002","PAS2010AB","X222.104.2010AB.N4.020",null,null,null,null,null,null,"Only one iteration of 2010AB.N4 is allowed.",null,"Accepted",null,"PAS2010AB.N4...0001"]
["PAS2010BA.N4...0005","PAS2010BA","X222A1.017.2010BA.N4.005","N4",5,null,null,null,null,"Ensure a flat file is generated when N4 is submitted and SBR02 is 18","2010BA.N4  must be present when 2000B.SBR02 is \"18\".","Accepted",null,"PAS2010BA.N4...0001"]
["PAS2010BA.N403...0002","PAS2010BA","X222.125.2010BA.N403.020",null,null,null,null,null,null,"Ensure a flat file is generated when 2010BA.N403 is valid postal/zip Code when N404 equals US or blank","N403 =  ZIPCDFOUR N404 = US or blank","Accepted"]
["PAS2010BA.N407...0005","PAS2010BA","X222.125.2010BA.N407.005",null,null,null,null,null,null,"Ensure a flat file is generated when N407 is not submitted ","N407 not submitted","Accepted"]
["PAS2010BA.NM105...0007","PAS2010BA","X222.121.2010BA.NM105.045","NM105",null,null,null,null,null,"2010BA.NM105 must be populated with The first position of 2010BA.NM105 must be alphabetic (A…Z).","NM105 = A","Accepted",null,"PAS2010BA.NM105...0004"]
["PAS2010BA.PER04...0001","PAS2010BA","X222.131.2010BA.PER04.010    X222.131.2010BA.PER04.020\r\nX222.131.2010BA.PER04.060",null,null,null,null,null,null,"2010BA.PER04 must contain at least one non-space character, must be present, be 1 - 256 accepted AN characters.","PER04 = 4105551212","Accepted"]
["PAS2010BA.REF02.Y4..0001","PAS2010BA","X222.130.2010BA.REF02.010 X222.130.2010BA.REF02.020\r\nX222.130.2010BA.REF02.030\r\nX222.130.2010BA.REF02.050",null,null,null,null,null,"2010AA NM109 is not present","To verify when 2010BA.REF01 = \"Y4\" and  2010BA.REF02 segment is 1-50 characters, claim is accepted"," Submit a claim with\n2010BA.REF01 = \"Y4\",\n2010BA.REF02 = 1234567890ABCDEFGHIJ1234567890ABCDEFGHIJ1234567890","Accepted","When 2010BA.REF01 = \"Y4\", 2010BA.REF02 must be 1 - 50 characters."]
["PAS2300.AMT...0001","PAS2300","X222.188.2300.AMT.010",null,null,null,null,null,null,"Only one iteration of 2300.AMT is allowed.","One 2300.AMT segment submitted","Accepted",null,"\nPAS2300.AMT01...0001"]
["PAS2300.AMT01...0001","PAS2300","X222.188.2300.AMT01.010   X222.188.2300.AMT01.020",null,null,null,null,null,"1 Segment AMT01=F5","2300.AMT01 must be present.","AMT01=F5","Accepted"]
["PAS2300.AMT02...0005","PAS2300","X222.188.2300.AMT02.005\r\nX222.188.2300.AMT02.010\r\nX222.188.2300.AMT02.015\r",null,null,null,null,null,"1 Segment AMT02=valid dollar amount <=99999.99 and >0","To ensure that when (AMT02=valid numeric amount) is submitted and remainder of claim is valid, claim will be accepted without errors.  2300.AMT02 is limited to 0, 1 or 2 decimal positions.","ATM02=150.00","Accepted"]
["PAS2300.AMT02...0005","PAS2300","X222.188.2300.AMT02.005\r\nX222.188.2300.AMT02.010\r\nX222.188.2300.AMT02.015\r",null,null,null,null,null,"1 Segment AMT02=valid dollar amount <=99999.99 and >0","To ensure that when (AMT02=valid numeric amount) is submitted and remainder of claim is valid, claim will be accepted without errors.  2300.AMT02 is limited to 0, 1 or 2 decimal positions.","ATM02=150.00","Accepted"]
["PAS2300.CLM...0001","PAS2300","X222.157.2300.CLM.010                         X222.157.2300.CLM.020",null,null,null,null,null,null,"A flat file is generated when CLM is submitted","CLM submitted","Accepted",null,"\nPAS2300.CLM10...0001"]
["PAS2300.CLM01...0001","PAS2300","X222.157.2300.CLM01.010              X222.157.2300.CLM01.020                              X222.157.2300.CLM01.030              X222.157.2300.CLM01.050",null,null,null,null,null,null,"A FLAT FILE is generated when valid 1 - 38 AN values are submitted with at least one non-space character.  CLM01 must be present.","CLM01 = 1234","Accepted",null,"\nPAS2300.CLM10...0001"]
["PAS2300.CLM02...0001","PAS2300","X222.157.2300.CLM02.010                          X222.157.2300.CLM02.020                           X222.157.2300.CLM02.040",null,null,null,null,null,null,"A flat file is generated when a 0 decimal numeric amount is > 0 and < 99,999.99 and equals the sum of 2400.SV102 amounts.  CLM02 must be present\r\n","CLM02 = 950","Accepted",null,"\nPAS2300.CLM10...0001"]
["PAS2300.CLM05-01...0001","PAS2300","X222.157.2300.CLM05-1.010",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM05-01 = 22","Accepted",null,"PAS1000A.NM109...0001"]
["PAS2300.CLM05-03...0001","PAS2300","X222.157.2300.CLM05-3.010",null,null,null,null,null,null,"A flat flie is generated when valid value of 1 is submitted","CLM05-03 = 1","Accepted",null,"PAS1000A.NM109...0001"]
["PAS2300.CLM06..N.0001","PAS2300","X222.157.2300.CLM06.010",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM06 = N","Accepted",null,"PAS2300.CLM07..B.0001"]
["PAS2300.CLM06..Y.0001","PAS2300","X222.157.2300.CLM06.010",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM06 = Y","Accepted",null,"PAS.ISA03..01.0001"]
["PAS2300.CLM07..A.0001","PAS2300","X222.157.2300.CLM07.010",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM07 = A","Accepted",null,"PAS2300.CLM08..W.0001"]
["PAS2300.CLM07..B.0001","PAS2300","X222.157.2300.CLM07.010",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM07 = B","Accepted"]
["PAS2300.CLM07..C.0001","PAS2300","X222.157.2300.CLM07.010",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM07 = C","Accepted"]
["PAS2300.CLM08..N.0001","PAS2300","X222.157.2300.CLM08.010",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM08 = N","Accepted",null,"PAS2300.CLM09..Y.0001"]
["PAS2300.CLM08..W.0001","PAS2300","X222.157.2300.CLM08.010",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM08 = W","Accepted"]
["PAS2300.CLM08..Y.0001","PAS2300","X222.157.2300.CLM08.010",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM08 = Y","Accepted"]
["PAS2300.CLM09..I.0001","PAS2300","X222.157.2300.CLM09.010",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM09 = I","Accepted",null,"PAS2300.CLM10...0001"]
["PAS2300.CLM09..Y.0001","PAS2300","X222.157.2300.CLM09.010",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM09 = Y","Accepted"]
["PAS2300.CLM10...0001","PAS2300","X222.157.2300.CLM10.010",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM10 = P","Accepted"]
["PAS2300.CLM11-01..AA.0002","PAS2300","X222.157.2300.CLM11-1.020",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM11-1 = AA","Accepted",null," "]
["PAS2300.CLM11-01..EM.0002","PAS2300","X222.157.2300.CLM11-1.020",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM11-1 = EM","Accepted"]
["PAS2300.CLM11-01..OA.0002","PAS2300","X222.157.2300.CLM11-1.020",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM11-1 = OA","Accepted"]
["PAS2300.CLM11-02...0001","PAS2300","X222.157.2300.CLM11-2.010",null,null,null,null,null,null,"A flat file is generated when CLM11-2 is not submitted","CLM11-2 is not submitted","Accepted"]
["PAS2300.CLM11-02..AA.0001","PAS2300","X222.157.2300.CLM11-2.020",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM11-2 = AA","Accepted"]
["PAS2300.CLM11-02..EM.0001","PAS2300","X222.157.2300.CLM11-2.020",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM11-2 = EM","Accepted"]
["PAS2300.CLM11-02..OA.0001","PAS2300","X222.157.2300.CLM11-2.020",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM11-2 = OA","Accepted"]
["PAS2300.CLM11-04...0001","PAS2300","X222.157.2300.CLM11-4.010",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM11-4 = TX","Accepted"]
["PAS2300.CLM11-05...0001","PAS2300","X222.157.2300.CLM11-5.010",null,null,null,null,null,"2300.CLM11-1 or 2300.CLM11-2 must be \"AA\" and 2300.CLM11-4 is not present","A flat flie is generated when valid value is submitted","CLM11-5 = MX","Accepted"]
["PAS2300.CLM20..1.0001","PAS2300","X222.157.2300.CLM20.010",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM20 = 1","Accepted"]
["PAS2300.CLM20..10.0001","PAS2300","X222.157.2300.CLM20.010",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM20 = 10","Accepted"]
["PAS2300.CLM20..11.0001","PAS2300","X222.157.2300.CLM20.010",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM20 = 11","Accepted"]
["PAS2300.CLM20..15.0001","PAS2300","X222.157.2300.CLM20.010",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM20 = 15","Accepted"]
["PAS2300.CLM20..2.0001","PAS2300","X222.157.2300.CLM20.010",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM20 = 2","Accepted"]
["PAS2300.CLM20..3.0001","PAS2300","X222.157.2300.CLM20.010",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM20 = 3","Accepted"]
["PAS2300.CLM20..4.0001","PAS2300","X222.157.2300.CLM20.010",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM20 = 4","Accepted"]
["PAS2300.CLM20..5.0001","PAS2300","X222.157.2300.CLM20.010",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM20 = 5","Accepted"]
["PAS2300.CLM20..6.0001","PAS2300","X222.157.2300.CLM20.010",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM20 = 6","Accepted"]
["PAS2300.CLM20..7.0001","PAS2300","X222.157.2300.CLM20.010",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM20 = 7","Accepted"]
["PAS2300.CLM20..8.0001","PAS2300","X222.157.2300.CLM20.010",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM20 = 8","Accepted"]
["PAS2300.CLM20..9.0001","PAS2300","X222.157.2300.CLM20.010",null,null,null,null,null,null,"A flat flie is generated when valid value is submitted","CLM20 = 9","Accepted"]
["PAS2300.DTP02.314..0001","PAS2300","X222.172.2300.DTP02.010\nX222.172.2300.DTP02.030",null,null,null,null,null,"1 Segment DTP01 = 314; DTP02=RD8; DTP03=valid date (no segments where 2300.DTP01=360 OR 361)","To ensure that when DTP01=314, DTP02=RD8 and remainder of claim is valid, claim will be accepted without errors","DTP02=RD8","Accepted"]
["PAS2300.HI.BG..0001","PAS2300","X222.242.2300.HI.010",null,null,null,null,null,null,"Only two iteration of 2300.HI with HI01-1 = \"BG\" are allowed. ",null,"Accepted"]
["PAS2300.HI.BK..0001","PAS2300","X222.226.2300.HI.010",null,null,null,null,null,null,"2300.HI with HI01-1 = \"BK\" must be present.",null,"Accepted",null,"\r\nPAS2300.HI01-01.BK..0002"]
["PAS2300.HI.BK..0004","PAS2300","X222.226.2300.HI.040",null,null,null,null,null,null,"Only one iteration of 2300.HI with HI01-1 = \"BK\" is allowed. ",null,"Accepted",null,"\r\nPAS2300.HI01-01.BK..0002"]
["PAS2300.HI01-01.BG..0001","PAS2300","X222.242.2300.HI01-1.010  X222.242.2300.HI01-1.020",null,null,null,null,null,null,"2300.HI01-1 must be present.  2300.HI01-1 must be \"BG\".",null,"Accepted"]
["PAS2300.HI01-01.BK..0002","PAS2300","X222.226.2300.HI01-1.010 X222.226.2300.HI01-1.020",null,null,null,null,null,"1 Segment where HI01-1=BK","2300.HI01-1 must be present. 2300.HI01-1 must = \"BK\"","HI01-1=BK","Accepted"]
["PAS2300.HI01-01.BP..0001","PAS2300","X222.239.2300.HI01-1.010  X222.239.2300.HI01-1.020  ",null,null,null,null,null,null,"2300.HI01-1 must be present and must be \"BP\"",null,"Accepted"]
["PAS2300.HI01-02.BK..0001","PAS2300","X222.226.2300.HI01-2.010",null,null,null,null,null,null,"2300.HI01-2 must be present.",null,"Accepted"]
["PAS2300.HI01-02.BK..0003","PAS2300","X222.226.2300.HI01-2.030",null,null,null,null,null,null,"If 2400.SV107-1, SV107-2, SV107-3, or SV107-4 is \"1\" and  2300.HI01-1 is \"BK\" then 2300.HI01-2 must be a valid ICD-9-CM Diagnosis code on the date in 2400.DTP03 when DTP01 = \"472\", based on  the ICD-9-CM Diagnosis Code list.",null,"Accepted",null,"\r\nPAS2300.HI01-02.BK..0001"]
["PAS2300.HI01-02.BK..0007","PAS2300","X222.226.2300.HI01-2.070",null,null,null,null,null,null,"If 2400.SV107-1, SV107-2, SV107-3 and SV107-4 are not \"1\" and 2300.HI01-1 is \"BK\",  2300.HI01-2 must be a valid ICD-9-CM Principal Diagnosis code for every date in the DOS range for this claim., based on  the ICD-9-CM Diag list.",null,"Accepted",null,"\r\nPAS2300.HI02-01.BF..0002"]
["PAS2300.HI01-02.BK..0010","PAS2300","X222.226.2300.HI01-2.100",null,null,null,null,null,null,"2300.HI01-2 must not contain a \".\"",null,"Accepted",null,"\r\nPAS2300.HI01-02.BK..0001"]
["PAS2300.HI01-02.BK..0012","PAS2300","X222.226.2300.HI01-2.120",null,null,null,null,null,null,"If 2300.HI01-1 equals BK, then 2300.HI01-2 must not begin with \"E\".",null,"Accepted",null,"\r\nPAS2300.HI01-02.BK..0001"]
["PAS2300.HI01-02.BP..0001","PAS2300","X222.239.2300.HI01-2.010  X222.239.2300.HI01-2.015  X222.239.2300.HI01-2.020",null,null,null,null,null,null,"2300.HI01-2 must be present.  2300.HI01-2 must be a valid HCPCS Principle Procedure code. 2300.HI02 can only be present if 2300.HI01 is present.",null,"Accepted"]
["PAS2300.HI02-01.BF..0002","PAS2300","X222.226.2300.HI02-1.020  ",null,null,null,null,null,"1 Segment where HI02-01=BF, HI02-02=valid value","To ensure that when HI02-1=BF is submitted and remainder of claim is valid, claim will be accepted without errors.","HI02-1=BF","Accepted"]
["PAS2300.HI02-01.BO..0001","PAS2300","X222.239.2300.HI02-1.010",null,null,null,null,null,null,"IK403 = 7: \"Invalid Code Value\"",null,"Accepted"]
["PAS2300.HI02-02.BF..0002","PAS2300","X222.226.2300.HI02-2.020",null,null,null,null,null,null,"If 2400.SV107-1, SV107-2, SV107-3, or SV107-4 is \"2\" and  2300.HI02-1 is \"BF\" then 2300.HI02-2 must be a valid ICD-9-CM Diagnosis code on the date in 2400.DTP03 when DTP01 = \"472\", based on  the ICD-9-CM Diagnosis Code list.",null,"Accepted"]
["PAS2300.HI02-02.BF..0006","PAS2300","X222.226.2300.HI02-2.060",null,null,null,null,null,null,"If 2400.SV107-1, SV107-2, SV107-3 and SV107-4 are not \"2\" and 2300.HI02-1 is \"BF\",  2300.HI02-2 must be a valid ICD-9-CM Principal Diagnosis code for every date in the DOS range for this claim., based on  the ICD-9-CM Diag list.",null,"Accepted",null,"\r\nPAS2300.HI02-01.BF..0002"]
["PAS2300.HI02-02.BF..0009","PAS2300","X222.226.2300.HI02-2.090",null,null,null,null,null,null,"2300.HI02-2 must not contain a \".\"",null,"Accepted",null,"\r\nPAS2300.HI02-02.BF..0002"]
["PAS2300.HI02-02.BG..0001","PAS2300","X222.242.2300.HI01-2.010  X222.242.2300.HI01-2.015  X222.242.2300.HI01-2.020",null,null,null,null,null,null,"2300.HI01-2 must be present.  2300.HI01-2 must be a valid Condition code.  2300.HI02 can only be present if 2300.HI01 is present.",null,"Accepted"]
["PAS2300.HI02-02.BO..0001","PAS2300","X222.239.2300.HI02-2.010",null,null,null,null,null,null,"CSCC A7: \"Acknowledgement /Rejected for Invalid Information...\"\r\nCSC 454:  \"Procedure code for services rendered\"",null,"Accepted"]
["PAS2300.HI03.BF..0001","PAS2300","X222.226.2300.HI03.010",null,null,null,null,null,null,"2300.HI03 can only be present if 2300.HI02 is present.",null,"Accepted",null,"\r\nPAS2300.HI03-01.BF..0002"]
["PAS2300.HI03-01.BF..0002","PAS2300","X222.226.2300.HI03-1.020",null,null,null,null,null,"1 Segment where HI03-1=BF","To ensure that when HI03-1=BF is submitted and remainder of claim is valid, claim will be accepted without errors.","HI03-1=BF","Accepted"]
["PAS2300.HI03-01.BG..0001","PAS2300","X222.242.2300.HI03-1.010",null,null,null,null,null,null,"2300.HI03-1 must be \"BG\".",null,"Accepted"]
["PAS2300.HI03-02.BF..0002","PAS2300","X222.226.2300.HI03-2.020",null,null,null,null,null,null,"If 2400.SV107-1, SV107-2, SV107-3, or SV107-4 is \"3\" and  2300.HI03-1 is \"BF\" then 2300.HI03-2 must be a valid ICD-9-CM Diagnosis code on the date in 2400.DTP03 when DTP01 = \"472\", based on  the ICD-9-CM Diagnosis Code list.",null,"Accepted"]
["PAS2300.HI03-02.BG..0001","PAS2300","X222.242.2300.HI03-2.010",null,null,null,null,null,null,"2300.HI03-2 must be a valid Condition code.",null,"Accepted"]
["PAS2300.HI04.BF..0001","PAS2300","X222.226.2300.HI04.010",null,null,null,null,null,null,"2300.HI04-1 must = \"BF\"",null,"Accepted",null,"\nPAS2300.HI04-01.BF..0002"]
["PAS2300.HI04.BG..0001","PAS2300","X222.242.2300.HI04.010",null,null,null,null,null,null,"2300.HI04 can only be present if 2300.HI03 is present.",null,"Accepted",null,"\nPAS2300.HI04-01.BG..0001"]
["PAS2300.HI04-01.BF..0002","PAS2300","X222.226.2300.HI04-1.020",null,null,null,null,null,"1 Segment where HI04-1=BF","If 2400.SV107-1, SV107-2, SV107-3, or SV107-4 is \"4\" and  2300.HI04-1 is \"BF\" then 2300.HI04-2 must be a valid ICD-9-CM Diagnosis code on the date in 2400.DTP03 when DTP01 = \"472\", based on  the ICD-9-CM Diagnosis Code list.","HI04-1=BF","Accepted"]
["PAS2300.HI04-01.BG..0001","PAS2300","X222.242.2300.HI04-1.010",null,null,null,null,null,null,"2300.HI04-1 must be \"BG\".",null,"Accepted"]
["PAS2300.HI04-02.BF..0002","PAS2300","X222.226.2300.HI04-2.020",null,null,null,null,null,null,"If 2400.SV107-1, SV107-2, SV107-3 and SV107-4 are not \"4\" and 2300.HI04-1 is \"BF\",  2300.HI04-2 must be a valid ICD-9-CM Principal Diagnosis code for every date in the DOS range for this claim., based on  the ICD-9-CM Diag list.",null,"Accepted"]
["PAS2300.HI04-02.BF..0006","PAS2300","X222.226.2300.HI04-2.060",null,null,null,null,null,null,"2300.HI04-2 must not contain a \".\"",null,"Accepted"]
["PAS2300.HI04-02.BF..0009","PAS2300","X222.226.2300.HI04-2.090",null,null,null,null,null,null,"2300.HI04-2 must not contain a \".\"",null,"Accepted",null,"\nPAS2300.HI04-02.BF..0002"]
["PAS2300.HI04-02.BG..0001","PAS2300","X222.242.2300.HI04-2.010",null,null,null,null,null,null,"2300.HI04-2 must be a valid Condition code.",null,"Accepted"]
["PAS2300.HI05.BF..0001","PAS2300","X222.226.2300.HI05.010",null,null,null,null,null,null,"2300.HI05 can only be present if 2300.HI04 is present.",null,"Accepted",null,"\nPAS2300.HI05-01.BF..0002"]
["PAS2300.HI05.BG..0001","PAS2300","X222.242.2300.HI05.010",null,null,null,null,null,null,"2300.HI05 can only be present if 2300.HI04 is present.",null,"Accepted",null,"\nPAS2300.HI05-01.BG..0001"]
["PAS2300.HI05-01.BF..0002","PAS2300","X222.226.2300.HI05-1.020",null,null,null,null,null,"1 Segment where HI05-1=BF","2300.HI05-1 must = \"BF\"","HI05-1=BF","Accepted"]
["PAS2300.HI05-01.BG..0001","PAS2300","X222.242.2300.HI05-1.010",null,null,null,null,null,null,"2300.HI05-1 must be \"BG\".",null,"Accepted"]
["PAS2300.HI05-02.BF..0002","PAS2300","X222.226.2300.HI05-2.020",null,null,null,null,null,null,"If 2400.SV107-1, SV107-2, SV107-3, or SV107-4 is \"5\" and  2300.HI05-1 is \"BF\" then 2300.HI05-2 must be a valid ICD-9-CM Diagnosis code on the date in 2400.DTP03 when DTP01 = \"472\", based on  the ICD-9-CM Diagnosis Code list.",null,"Accepted"]
["PAS2300.HI05-02.BF..0006","PAS2300","X222.226.2300.HI05-2.060",null,null,null,null,null,null,"If 2400.SV107-1, SV107-2, SV107-3 and SV107-4 are not \"5\" and 2300.HI05-1 is \"BF\",  2300.HI05-2 must be a valid ICD-9-CM Principal Diagnosis code for every date in the DOS range for this claim., based on  the ICD-9-CM Diag list.",null,"Accepted"]
["PAS2300.HI05-02.BF..0009","PAS2300","X222.226.2300.HI05-2.090",null,null,null,null,null,null,"2300.HI05-2 must not contain a \".\"",null,"Accepted",null,"\nPAS2300.HI05-02.BF..0002"]
["PAS2300.HI05-02.BG..0001","PAS2300","X222.242.2300.HI05-2.010",null,null,null,null,null,null,"2300.HI05-2 must be a valid Condition code.",null,"Accepted"]
["PAS2300.HI06.BF..0001","PAS2300","X222.226.2300.HI06.010",null,null,null,null,null,null,"2300.HI06 can only be present if 2300.HI05 is present.",null,"Accepted",null,"\nPAS2300.HI06-01.BF..0002"]
["PAS2300.HI06.BG..0001","PAS2300","X222.242.2300.HI06.010",null,null,null,null,null,null,"2300.HI06 can only be present if 2300.HI05 is present.",null,"Accepted",null,"\nPAS2300.HI06-01.BG..0001"]
["PAS2300.HI06-01.BF..0002","PAS2300","X222.226.2300.HI06-1.020",null,null,null,null,null,"1 Segment where HI06-1=BF","2300.HI06-1 must = \"BF\"","HI06-1=BF","Accepted"]
["PAS2300.HI06-01.BG..0001","PAS2300","X222.242.2300.HI06-1.010",null,null,null,null,null,null,"2300.HI06-1 must be \"BG\".",null,"Accepted"]
["PAS2300.HI06-02.BF..0002","PAS2300","X222.226.2300.HI06-2.020",null,null,null,null,null,null,"If 2400.SV107-1, SV107-2, SV107-3, or SV107-4 is \"6\" and  2300.HI06-1 is \"BF\" then 2300.HI06-2 must be a valid ICD-9-CM Diagnosis code on the date in 2400.DTP03 when DTP01 = \"472\", based on  the ICD-9-CM Diagnosis Code list.",null,"Accepted"]
["PAS2300.HI06-02.BF..0006","PAS2300","X222.226.2300.HI06-2.060",null,null,null,null,null,null,"If 2400.SV107-1, SV107-2, SV107-3 and SV107-4 are not \"6\" and 2300.HI06-1 is \"BF\",  2300.HI06-2 must be a valid ICD-9-CM Principal Diagnosis code for every date in the DOS range for this claim., based on  the ICD-9-CM Diag list.",null,"Accepted"]
["PAS2300.HI06-02.BF..0009","PAS2300","X222.226.2300.HI06-2.090",null,null,null,null,null,null,"2300.HI06-2 must not contain a \".\"",null,"Accepted",null,"\nPAS2300.HI06-02.BF..0002"]
["PAS2300.HI06-02.BG..0001","PAS2300","X222.242.2300.HI06-2.010",null,null,null,null,null,null,"2300.HI06-2 must be a valid Condition code.",null,"Accepted"]
["PAS2300.HI07.BF..0001","PAS2300","X222.226.2300.HI07.010",null,null,null,null,null,null,"2300.HI07 can only be present if 2300.HI06 is present.",null,"Accepted",null,"\nPAS2300.HI07-01.BF..0002"]
["PAS2300.HI07.BG..0001","PAS2300","X222.242.2300.HI07.010",null,null,null,null,null,null,"2300.HI07 can only be present if 2300.HI06 is present.",null,"Accepted",null,"\nPAS2300.HI07-01.BG..0001"]
["PAS2300.HI07-01.BF..0002","PAS2300","X222.226.2300.HI07-1.020",null,null,null,null,null,"1 Segment where HI07-1=BF","2300.HI07-1 must = \"BF\"","HI07-1=BF","Accepted"]
["PAS2300.HI07-01.BG..0001","PAS2300","X222.242.2300.HI07-1.010",null,null,null,null,null,null,"2300.HI07-1 must be \"BG\".",null,"Accepted"]
["PAS2300.HI07-02.BF..0002","PAS2300","X222.226.2300.HI07-2.020",null,null,null,null,null,null,"If 2400.SV107-1, SV107-2, SV107-3, or SV107-4 is \"7\" and  2300.HI07-1 is \"BF\" then 2300.HI07-2 must be a valid ICD-9-CM Diagnosis code on the date in 2400.DTP03 when DTP01 = \"472\", based on  the ICD-9-CM Diagnosis Code list.",null,"Accepted"]
["PAS2300.HI07-02.BF..0006","PAS2300","X222.226.2300.HI07-2.060",null,null,null,null,null,null,"If 2400.SV107-1, SV107-2, SV107-3 and SV107-4 are not \"7\" and 2300.HI07-1 is \"BF\",  2300.HI07-2 must be a valid ICD-9-CM Principal Diagnosis code for every date in the DOS range for this claim., based on  the ICD-9-CM Diag list.",null,"Accepted"]
["PAS2300.HI07-02.BF..0009","PAS2300","X222.226.2300.HI07-2.090",null,null,null,null,null,null,"2300.HI07-2 must not contain a \".\"",null,"Accepted",null,"\nPAS2300.HI07-02.BF..0002"]
["PAS2300.HI07-02.BG..0001","PAS2300","X222.242.2300.HI07-2.010",null,null,null,null,null,null,"2300.HI07-2 must be a valid Condition code.",null,"Accepted"]
["PAS2300.HI08.BF..0001","PAS2300","X222.226.2300.HI08.010",null,null,null,null,null,null,"2300.HI08 can only be present if 2300.HI07 is present.",null,"Accepted",null,"\nPAS2300.HI08-01.BF..0002"]
["PAS2300.HI08.BG..0001","PAS2300","X222.242.2300.HI08.010",null,null,null,null,null,null,"2300.HI08 can only be present if 2300.HI07 is present.",null,"Accepted",null,"\nPAS2300.HI08-01.BG..0001"]
["PAS2300.HI08-01.BF..0002","PAS2300","X222.226.2300.HI08-1.020",null,null,null,null,null,"1 Segment where HI08-1=BF","2300.HI08-1 must = \"BF\"","HI08-1=BF","Accepted"]
["PAS2300.HI08-01.BG..0001","PAS2300","X222.242.2300.HI08-1.010",null,null,null,null,null,null,"2300.HI08-1 must be \"BG\".",null,"Accepted"]
["PAS2300.HI08-02.BF..0002","PAS2300","X222.226.2300.HI08-2.020",null,null,null,null,null,null,"If 2400.SV107-1, SV107-2, SV107-3, or SV107-4 is \"8\" and  2300.HI08-1 is \"BF\" then 2300.HI08-2 must be a valid ICD-9-CM Diagnosis code on the date in 2400.DTP03 when DTP01 = \"472\", based on  the ICD-9-CM Diagnosis Code list.",null,"Accepted"]
["PAS2300.HI08-02.BF..0006","PAS2300","X222.226.2300.HI08-2.060",null,null,null,null,null,null,"If 2400.SV107-1, SV107-2, SV107-3 and SV107-4 are not \"8\" and 2300.HI08-1 is \"BF\",  2300.HI08-2 must be a valid ICD-9-CM Principal Diagnosis code for every date in the DOS range for this claim., based on  the ICD-9-CM Diag list.",null,"Accepted"]
["PAS2300.HI08-02.BF..0009","PAS2300","X222.226.2300.HI08-2.090",null,null,null,null,null,null,"2300.HI08-2 must not contain a \".\"",null,"Accepted",null,"\nPAS2300.HI08-02.BF..0002"]
["PAS2300.HI08-02.BG..0001","PAS2300","X222.242.2300.HI08-2.010",null,null,null,null,null,null,"2300.HI08-2 must be a valid Condition code.",null,"Accepted"]
["PAS2300.HI09.BF..0001","PAS2300","X222.226.2300.HI09.010",null,null,null,null,null,null,"2300.HI09 can only be present if 2300.HI08 is present.",null,"Accepted",null,"\nPAS2300.HI09-01.BF..0002"]
["PAS2300.HI09.BG..0001","PAS2300","X222.242.2300.HI09.010",null,null,null,null,null,null,"2300.HI09 can only be present if 2300.HI08 is present.",null,"Accepted",null,"\nPAS2300.HI09-01.BG..0001"]
["PAS2300.HI09-01.BF..0002","PAS2300","X222.226.2300.HI09-1.020",null,null,null,null,null,"1 Segment where HI09-1=BF","2300.HI09-1 must = \"BF\"","HI09-1=BF","Accepted"]
["PAS2300.HI09-01.BG..0001","PAS2300","X222.242.2300.HI09-1.010",null,null,null,null,null,null,"2300.HI09-1 must be \"BG\".",null,"Accepted"]
["PAS2300.HI09-02.BF..0002","PAS2300","X222.226.2300.HI09-2.020",null,null,null,null,null,null,"If 2400.SV107-1, SV107-2, SV107-3, or SV107-4 is \"9\" and  2300.HI09-1 is \"BF\" then 2300.HI09-2 must be a valid ICD-9-CM Diagnosis code on the date in 2400.DTP03 when DTP01 = \"472\", based on  the ICD-9-CM Diagnosis Code list.",null,"Accepted"]
["PAS2300.HI09-02.BF..0007","PAS2300","X222.226.2300.HI09-2.070",null,null,null,null,null,null,"If 2400.SV107-1, SV107-2, SV107-3 and SV107-4 are not \"9\" and 2300.HI09-1 is \"BF\",  2300.HI09-2 must be a valid ICD-9-CM Principal Diagnosis code for every date in the DOS range for this claim., based on  the ICD-9-CM Diag list.",null,"Accepted"]
["PAS2300.HI09-02.BF..0010","PAS2300","X222.226.2300.HI09-2.100",null,null,null,null,null,null,"2300.HI09-2 must not contain a \".\"",null,"Accepted",null,"\nPAS2300.HI09-02.BF..0002"]
["PAS2300.HI09-02.BG..0001","PAS2300","X222.242.2300.HI09-2.010",null,null,null,null,null,null,"2300.HI09-2 must be a valid Condition code.",null,"Accepted"]
["PAS2300.HI10.BF..0001","PAS2300","X222.226.2300.HI10.010",null,null,null,null,null,null,"2300.HI10 can only be present if 2300.HI09 is present.",null,"Accepted",null,"\nPAS2300.HI10-01.BF..0002"]
["PAS2300.HI10.BG..0001","PAS2300","X222.242.2300.HI10.010",null,null,null,null,null,null,"2300.HI10 can only be present if 2300.HI09 is present.",null,"Accepted",null,"\nPAS2300.HI10-01.BG..0001"]
["PAS2300.HI10-01.BF..0002","PAS2300","X222.226.2300.HI10-1.020",null,null,null,null,null,"1 Segment where HI10-1=BF","2300.HI10=-1 must = \"BF\"","HI10-1=BF","Accepted"]
["PAS2300.HI10-01.BG..0001","PAS2300","X222.242.2300.HI10-1.010",null,null,null,null,null,null,"2300.HI10-1 must be \"BG\".",null,"Accepted"]
["PAS2300.HI10-02.BF..0002","PAS2300","X222.226.2300.HI10-2.020",null,null,null,null,null,null,"If 2400.SV107-1, SV107-2, SV107-3, or SV107-4 is \"10\" and  2300.HI10-1 is \"BF\" then 2300.HI10-2 must be a valid ICD-9-CM Diagnosis code on the date in 2400.DTP03 when DTP01 = \"472\", based on  the ICD-9-CM Diagnosis Code list.",null,"Accepted"]
["PAS2300.HI10-02.BF..0007","PAS2300","X222.226.2300.HI10-2.070",null,null,null,null,null,null,"If 2400.SV107-1, SV107-2, SV107-3 and SV107-4 are not \"10\" and 2300.HI10-1 is \"BF\",  2300.HI10-2 must be a valid ICD-9-CM Principal Diagnosis code for every date in the DOS range for this claim., based on  the ICD-9-CM Diag list.",null,"Accepted"]
["PAS2300.HI10-02.BF..0010","PAS2300","X222.226.2300.HI10-2.100",null,null,null,null,null,null,"2300.HI10-2 must not contain a \".\"",null,"Accepted",null,"\nPAS2300.HI10-02.BF..0002"]
["PAS2300.HI10-02.BG..0001","PAS2300","X222.242.2300.HI10-2.010",null,null,null,null,null,null,"2300.HI10-2 must be a valid Condition code.",null,"Accepted"]
["PAS2300.HI11.BF..0001","PAS2300","X222.226.2300.HI11.010",null,null,null,null,null,null,"2300.HI11 can only be present if 2300.HI10 is present.",null,"Accepted",null,"\nPAS2300.HI11-01.BF..0002"]
["PAS2300.HI11.BG..0001","PAS2300","X222.242.2300.HI11.010",null,null,null,null,null,null,"2300.HI11 can only be present if 2300.HI10 is present.",null,"Accepted",null,"\nPAS2300.HI11-01.BG..0001"]
["PAS2300.HI11-01.BF..0002","PAS2300","X222.226.2300.HI11-1.020",null,null,null,null,null,"1 Segment where HI11-1=BF","2300.HI11=-1 must = \"BF\"","HI11-1=BF","Accepted"]
["PAS2300.HI11-01.BG..0001","PAS2300","X222.242.2300.HI11-1.010",null,null,null,null,null,null,"2300.HI11-1 must be \"BG\".",null,"Accepted"]
["PAS2300.HI11-02.BF..0002","PAS2300","X222.226.2300.HI11-2.020",null,null,null,null,null,null,"If 2400.SV107-1, SV107-2, SV107-3, or SV107-4 is \"11\" and  2300.HI11-1 is \"BF\" then 2300.HI11-2 must be a valid ICD-9-CM Diagnosis code on the date in 2400.DTP03 when DTP01 = \"472\", based on  the ICD-9-CM Diagnosis Code list.",null,"Accepted"]
["PAS2300.HI11-02.BF..0007","PAS2300","X222.226.2300.HI11-2.070",null,null,null,null,null,null,"If 2400.SV107-1, SV107-2, SV107-3 and SV107-4 are not \"11\" and 2300.HI11-1 is \"BF\",  2300.HI11-2 must be a valid ICD-9-CM Principal Diagnosis code for every date in the DOS range for this claim., based on  the ICD-9-CM Diag list.",null,"Accepted"]
["PAS2300.HI11-02.BF..0010","PAS2300","X222.226.2300.HI11-2.100",null,null,null,null,null,null,"2300.HI11-2 must not contain a \".\"",null,"Accepted",null,"\nPAS2300.HI11-02.BF..0002"]
["PAS2300.HI11-02.BG..0001","PAS2300","X222.242.2300.HI11-2.010",null,null,null,null,null,null,"2300.HI11-2 must be a valid Condition code.",null,"Accepted"]
["PAS2300.HI12.BF..0001","PAS2300","X222.226.2300.HI12.010",null,null,null,null,null,null,"2300.HI12 can only be present if 2300.HI11 is present.",null,"Accepted",null,"\nPAS2300.HI12-01.BF..0002"]
["PAS2300.HI12.BG..0001","PAS2300","X222.242.2300.HI12.010",null,null,null,null,null,null,"2300.HI12 can only be present if 2300.HI11 is present.",null,"Accepted",null,"\nPAS2300.HI12-01.BG..0001"]
["PAS2300.HI12-01.BF..0002","PAS2300","X222.226.2300.HI12-1.020",null,null,null,null,null,"1 Segment where HI12-1=BF","2300.HI12=-1 must = \"BF\"","HI12-1=BF","Accepted"]
["PAS2300.HI12-01.BG..0001","PAS2300","X222.242.2300.HI12-1.010",null,null,null,null,null,null,"2300.HI12-1 must be \"BG\".",null,"Accepted"]
["PAS2300.HI12-02.BF..0002","PAS2300","X222.226.2300.HI12-2.020",null,null,null,null,null,null,"If 2400.SV107-1, SV107-2, SV107-3, or SV107-4 is \"12\" and  2300.HI12-1 is \"BF\" then 2300.HI12-2 must be a valid ICD-9-CM Diagnosis code on the date in 2400.DTP03 when DTP01 = \"472\", based on  the ICD-9-CM Diagnosis Code list.",null,"Accepted"]
["PAS2300.HI12-02.BF..0007","PAS2300","X222.226.2300.HI12-2.070",null,null,null,null,null,null,"If 2400.SV107-1, SV107-2, SV107-3 and SV107-4 are not \"12\" and 2300.HI12-1 is \"BF\",  2300.HI12-2 must be a valid ICD-9-CM Principal Diagnosis code for every date in the DOS range for this claim., based on  the ICD-9-CM Diag list.",null,"Accepted"]
["PAS2300.HI12-02.BF..0010","PAS2300","X222.226.2300.HI12-2.100",null,null,null,null,null,null,"2300.HI12-2 must not contain a \".\"",null,"Accepted",null,"\nPAS2300.HI12-02.BF..0002"]
["PAS2300.HI12-02.BG..0001","PAS2300","X222.242.2300.HI12-2.010",null,null,null,null,null,null,"2300.HI12-2 must be a valid Condition code.",null,"Accepted"]
["PAS2300.REF.1J..0001","PAS2300","X222.206.2300.REF.010",null,null,null,null,null,null,"Only one iteration of 2300.REF with REF01 = \"1J\" is allowed.",null,"Accepted",null,"\nPAS2300.REF01.1J..0001"]
["PAS2300.REF.4N..0001","PAS2300","X222.189.2300.REF.010",null,null,null,null,null,null,"Only one iteration of 2300.REF with REF01 = \"4N\" is allowed.",null,"Accepted",null,"\nPAS2300.REF01.4N..0001"]
["PAS2300.REF.9A..0001","PAS2300","X222.199.2300.REF.010",null,null,null,null,null,null,"Only one iteration of 2300.REF with REF01 = \"9A\" is allowed.",null,"Accepted",null,"\nPAS2300.REF01.9A..0001"]
["PAS2300.REF.9C..0001","PAS2300","X222.200.2300.REF.010",null,null,null,null,null,null,"Only one iteration of 2300.REF with REF01 = \"9C\" is allowed.",null,"Accepted",null,"\nPAS2300.REF01.9C..0001"]
["PAS2300.REF.9F..0001","PAS2300","X222.193.2300.REF.010",null,null,null,null,null,null,"Only one iteration of 2300.REF with REF01 = \"9F\" is allowed.",null,"Accepted",null,"\nPAS2300.REF01.9F..0001"]
["PAS2300.REF.D9..0001","PAS2300","X222.202.2300.REF.010",null,null,null,null,null,null,"Only one iteration of 2300.REF with REF01 = \"D9\" is allowed.",null,"Accepted",null,"\nPAS2300.REF01.D9..0001"]
["PAS2300.REF.EA..0001","PAS2300","X222.204.2300.REF.010",null,null,null,null,null,null,"Only one iteration of 2300.REF with REF01 = \"EA\" is allowed.",null,"Accepted",null,"\nPAS2300.REF01.EA..0001"]
["PAS2300.REF.EW..0001","PAS2300","X222.192.2300.REF.010",null,null,null,null,null,null,"Only one iteration of 2300.REF with REF01 = \"EW\" is allowed.",null,"Accepted",null,"\nPAS2300.REF01.EW..0001"]
["PAS2300.REF.G1..0001","PAS2300","X222.194.2300.REF.010",null,null,null,null,null,null,"Only one iteration of 2300.REF with REF01 = \"G1\" is allowed.",null,"Accepted",null,"\nPAS2300.REF01.G1..0001"]
["PAS2300.REF.LX..0001","PAS2300","X222.201.2300.REF.010",null,null,null,null,null,null,"Only one iteration of 2300.REF with REF01 = \"LX\" is allowed.",null,"Accepted",null,"\nPAS2300.REF01.LX..0001"]
["PAS2300.REF.P4..0001","PAS2300","X222.205.2300.REF.010",null,null,null,null,null,null,"Only one iteration of 2300.REF with REF01 = \"P4\" is allowed.",null,"Accepted",null,"\nPAS2300.REF01.P4..0001"]
["PAS2300.REF.X4..0001","PAS2300","X222.197.2300.REF.010",null,null,null,null,null,null,"Only one iteration of 2300.REF with REF01 = \"X4\" is allowed.",null,"Accepted",null,"\nPAS2300.REF01.X4..0001"]
["PAS2300.REF01.1J..0001","PAS2300","X222.206.2300.REF01.010  X222.206.2300.REF01.020",null,null,null,null,null,"1 Segment RE01=1J","2300.REF01 must be \"1J\".  2300.REF02 must be present.","REF01=1J","Accepted"]
["PAS2300.REF01.4N..0001","PAS2300","X222.189.2300.REF01.010  X222.189.2300.REF01.020",null,null,null,null,null,"1 Segment REF01=4N","2300.REF01 must be present. 2300.REF01 must be \"4N\".","REF01=4N","Accepted"]
["PAS2300.REF01.9A..0001","PAS2300","X222.199.2300.REF01.010",null,null,null,null,null,"1 Segment RE01=9A","To ensure that when REF01=9A is submitted and remainder of claim is valid, claim will be accepted without errors.","REF01=9A","Accepted"]
["PAS2300.REF01.9C..0001","PAS2300","X222.200.2300.REF01.010  X222.200.2300.REF01.020",null,null,null,null,null,"1 Segment RE01=9C","2300.REF01 must be present and be 9C","REF01=9C","Accepted"]
["PAS2300.REF01.9F..0001","PAS2300","X222.193.2300.REF01.010  X222.193.2300.REF01.020",null,null,null,null,null,"1 Segment RE01=9F","2300.REF01 must be present.  2300.REF01 must be\"9F\".","REF01=9F","Accepted"]
["PAS2300.REF01.D9..0001","PAS2300","X222.202.2300.REF01.010  X222.202.2300.REF01.020",null,null,null,null,null,"1 Segment RE01=D9","2300.REF01 must be present. 2300.REF01 must be \"D9\".","REF01=D9","Accepted"]
["PAS2300.REF01.EA..0001","PAS2300","X222.204.2300.REF01.010  X222.204.2300.REF01.020",null,null,null,null,null,"1 Segment RE01=EA","2300.REF01 must be present. 2300.REF01 must be \"EA\".","REF01=EA","Accepted"]
["PAS2300.REF01.EW..0001","PAS2300","X222.192.2300.REF01.010  X222.192.2300.REF01.020",null,null,null,null,null,"1 Segment RE01=EW","REF01 must be present and be EW ","REF01=EW","Accepted"]
["PAS2300.REF01.G1..0001","PAS2300","X222.194.2300.REF01.010 ",null,null,null,null,null,"1 Segment RE01=G1","2300.REF01 must be present.  2300.REF01 must be \"G1\".","REF01=G1","Accepted"]
["PAS2300.REF01.LX..0001","PAS2300","X222.201.2300.REF01.010  X222.201.2300.REF01.020",null,null,null,null,null,"1 Segment RE01=LX","2300.REF01 must be present. 2300.REF01 must be \"LX\".","REF01=LX","Accepted"]
["PAS2300.REF01.P4..0001","PAS2300","X222.205.2300.REF01.010  X222.205.2300.REF01.020",null,null,null,null,null,"1 Segment RE01=P4","2300.REF01 must be present. 2300.REF01 must be \"P4\".","REF01=P4","Accepted"]
["PAS2300.REF01.X4..0001","PAS2300","X222.197.2300.REF01.010 X222.197.2300.REF01.020",null,null,null,null,null,"1 Segment RE01=X4","2300.REF01 must be present. 2300.REF01 must be \"X4\".","REF01=X4","Accepted"]
["PAS2300.REF02.1J..0001","PAS2300","X222.206.2300.REF02.010  X222.206.2300.REF02.020  X222.206.2300.REF02.030",null,null,null,null,null,"1 Segment REF01=1J, REF02=valid NPI value ","2300.REF02 must be present, must be valid according to the NPI algorithm and the first position must be a \"1\".","REF01=1J; REF02=valid NPI","Accepted",null,"\nPAS2300.REF02.D9..0001"]
["PAS2300.REF02.4N..0001","PAS2300","X222.189.2300.REF02.010  X222.189.2300.REF02.020",null,null,null,null,null,null,"2300.REF02 must be present. 2300.REF02 must be valid values of 1, 2, 3, 4, 5, 6 or 7","REF01=4N","Accepted"]
["PAS2300.REF02.9A..0001","PAS2300","X222.199.2300.REF02.010  X222.199.2300.REF02.020  X222.199.2300.REF02.030  X222.199.2300.REF02.050",null,null,null,null,null,"1 Segment REF01=9A, REF02=valid value (alphanumeric <51 characters >0 characters) ","2300.REF02 must be present, must be 1 - 50 accepted AN characters and must contain at least one non-space character.","REF01=9A; REF02=123456","Accepted"]
["PAS2300.REF02.9C..0001","PAS2300","X222.200.2300.REF02.010  X222.200.2300.REF02.020  X222.200.2300.REF02.030  X222.200.2300.REF02.050",null,null,null,null,null,"1 Segment REF01=9C, REF02=valid value (alphanumeric <51 characters >0 characters) ","2300.REF02 must be present, must be 1 - 50 accepted AN characters and must contain at least one non-space character.","REF01=9C; REF02=123456","Accepted"]
["PAS2300.REF02.9F..0001","PAS2300","X222.193.2300.REF02.010  X222.193.2300.REF02.020    X222.193.2300.REF02.030  X222.193.2300.REF02.050",null,null,null,null,null,"1 Segment REF01=9F, REF02=valid value (alphanumeric <51 characters >0 characters) ","2300.REF02 must be present.  2300.REF02 must contain at least one non-space character.  2300.REF02 must be 1 - 50 characters.  2300.REF02 must be populated with accepted AN characters.","REF01=9F; REF02=123456","Accepted"]
["PAS2300.REF02.D9..0001","PAS2300","X222.202.2300.REF02.010  X222.202.2300.REF02.020  X222.202.2300.REF02.030  X222.202.2300.REF02.050",null,null,null,null,null,"1 Segment REF01=D9, REF02=valid value (alphanumeric <51 characters >0 characters) ","2300.REF02 must be present, must be 1 - 50 accepted AN characters and must contain at least one non-space character.","REF01=D9; REF02=123456","Accepted"]
["PAS2300.REF02.EA..0001","PAS2300","X222.204.2300.REF02.010  X222.204.2300.REF02.020  X222.204.2300.REF02.030  X222.204.2300.REF02.050",null,null,null,null,null,"1 Segment REF01=EA, REF02=valid value (alphanumeric <51 characters >0 characters) ","2300.REF02 must be present, must be 1 - 50 accepted AN characters and must contain at least one non-space character.","REF01=EA; REF02=123456","Accepted",null,"\nPAS2300.REF02.D9..0001"]
["PAS2300.REF02.EW..0001","PAS2300","X222.192.2300.REF02.010  X222.192.2300.REF02.060",null,null,null,null,null,"1 Segment REF01=EW","2300.REF02 must be present.  2300.REF02 must be a valid Mammography Certification Number.","REF01=EW","Accepted"]
["PAS2300.REF02.G1..0001","PAS2300","X222.194.2300.REF02.010  X222.194.2300.REF02.020  X222.194.2300.REF02.030  X222.194.2300.REF02.050",null,null,null,null,null,"1 Segment REF01=G1, REF02=valid value (alphanumeric <51 characters >0 characters) ","2300.REF02 must be present must contain at least one non-space character, must be 1 - 50, and populated with an accepted AN characters.","REF01=G1; REF02=123456","Accepted"]
["PAS2300.REF02.LX..0001","PAS2300","X222.201.2300.REF02.010  X222.201.2300.REF02.020  X222.201.2300.REF02.030  X222.201.2300.REF02.050",null,null,null,null,null,"1 Segment REF01=LX, REF02=valid value (alphanumeric <51 characters >0 characters) ","2300.REF02 must be present, must be 1 - 50 accepted AN characters and must contain at least one non-space character.","REF01=LX; REF02=123456","Accepted",null,"\nPAS2300.REF02.D9..0001"]
["PAS2300.REF02.P4..0001","PAS2300","X222.205.2300.REF02.010  X222.205.2300.REF02.020  X222.205.2300.REF02.030  X222.205.2300.REF02.050",null,null,null,null,null,"1 Segment REF01=P4, REF02=valid value (alphanumeric <51 characters >0 characters) ","2300.REF02 must be present, must be 1 - 50 accepted AN characters and must contain at least one non-space character.","REF01=P4; REF02=THJ122 and 1000B.NM109 must be a number identifying the current contractor for processing VA MRA project claims.","Accepted"]
["PAS2300.REF02.X4..0001","PAS2300","X222.197.2300.REF02.010",null,null,null,null,null,"1 Segment REF01=X4, REF02=valid CLIA value ","To ensure that when REF01=X4 and REF02 is a valid CLIA value is submitted and remainder of claim is valid, claim will be accepted without errors.","REF01=X4; REF02=12D3456789","Accepted"]
["PAS2310A.NM1...0001","PAS2310A","X222.257.2310A.NM1.010",null,null,null,null,null,null,"Only two iterations of 2310A are allowed.",null,"Accepted",null,"PAS2310A.NM101.P3..0004"]
["PAS2310A.NM1...0002","PAS2310A","X222.257.2310A.NM1.020",null,null,null,null,null,null,"Only one iteration of 2310A.NM1 is allowed. ",null,"Accepted",null,"PAS2310A.NM101.DN..0001"]
["PAS2310A.NM105...0007","PAS2310A","X222.257.2310A.NM105.045","NM105",null,null,null,null,null,"2310A.NM105 must be populated with The first position of 2310A.NM105 must be alphabetic (A…Z).","NM105 = A","Accepted",null,"PAS2310A.NM105...0004"]
["PAS2310B.NM105...0007","PAS2310B","X222.262.2310B.NM105.055","NM105",null,null,null,null,null,"2310B.NM105 must be populated with The first position of 2310B.NM105 must be alphabetic (A…Z).","NM105 = A","Accepted",null,"PAS2310B.NM105...0004"]
["PAS2310C.PER04...0001","PAS2310C","X222.277.2310C.PER04.010 X222.277.2310C.PER04.020 X222.277.2310C.PER04.050",null,null,null,null,null,"Required when the location of health care service is different than that carried in Loop ID-2010AA (Billing Provider)","2310C.PER04 must be present must be at least one non-space character, and be 1 - 256 accepted AN characters."," Submit a 5010 claim with a Communication number in the 2310C.PER04 element <= 256 AN characters. (1111111111)","Accepted"]
["PAS2310C.PER05...0001","PAS2310C","X222.277.2310C.PER05.010  ",null,null,null,null,null,"Required when the location of health care service is different than that carried in Loop ID-2010AA (Billing Provider)","2310C.PER05 must valid values and be \"EX\".","Submit a 5010 claim with a valid Communication Number Qualifier  in the 2310C.PER05 element (EX)","Accepted"]
["PAS2310D.NM105...0007","PAS2310D","X222.280.2310D.NM105.045","NM105",null,null,null,null,null,"2310D.NM105 must be populated with The first position of 2310D.NM105 must be alphabetic (A…Z).","NM105 = A","Accepted",null,"PAS2310D.NM105...0004"]
["PAS2320...0001","PAS2320","X222.295.2320..010",2320,1,null,null,null,null,"Only ten iterations of the 2320 loop are allowed.",null,"Accepted",null,"PAS2330A.N3...0002"]
["PAS2320.AMT.D..0002","PAS2320","X222.305.2320.AMT.020\nX222.305.2320.AMT.040",null,null,null,null,null,"MSP Claim ","Only one iteration of 2320.AMT with AMT01 = \"D\" is allowed.",null,"Accepted",null,"PAS2320.AMT01.D..0001"]
["PAS2320.AMT01...0001","PAS2320","X222.305.2320.AMT01.030","AMT01",null,null,null,null,null,"2320.AMT01 = \"D\" not present","Enter an MSP claim with AMT01 blank ","Accepted"]
["PAS2320.SBR...0001","PAS2320","X222.295.2320.SBR.010","SBR",2,null,null,null,null,"Only one iteration of 2320.SBR is allowed.","Submit a claim with a one 2320.SBR segment. ","Accepted"]
["PAS2320.SBR01..A.0001","PAS2320","X222.295.2320.SBR01.010",null,null,null,null,null,"MSP Claim ","To validate the SBR01 will be accepted and mapped to the CMS flat file","Enter an MSP claim with SBR01=A in the applicable sequence order ","Accepted"]
["PAS2320.SBR01..B.0001","PAS2320","X222.295.2320.SBR01.010",null,null,null,null,null,"MSP Claim ","To validate the SBR01 will be accepted and mapped to the CMS flat file","Enter an MSP claim with SBR01=B in the applicable sequence order ","Accepted",null,"PAS2320.SBR01..A.0001"]
["PAS2320.SBR01..C.0001","PAS2320","X222.295.2320.SBR01.010",null,null,null,null,null,"MSP Claim ","To validate the SBR01 will be accepted and mapped to the CMS flat file","Enter an MSP claim with SBR01=C in the applicable sequence order ","Accepted",null,"PAS2320.SBR01..A.0001"]
["PAS2320.SBR01..D.0001","PAS2320","X222.295.2320.SBR01.010",null,null,null,null,null,"MSP Claim ","To validate the SBR01 will be accepted and mapped to the CMS flat file","Enter an MSP claim with SBR01=D in the applicable sequence order ","Accepted",null,"PAS2320.SBR01..A.0001"]
["PAS2320.SBR01..E.0001","PAS2320","X222.295.2320.SBR01.010",null,null,null,null,null,"MSP Claim ","To validate the SBR01 will be accepted and mapped to the CMS flat file","Enter an MSP claim with SBR01=E in the applicable sequence order ","Accepted",null,"PAS2320.SBR01..A.0001"]
["PAS2320.SBR01..F.0001","PAS2320","X222.295.2320.SBR01.010",null,null,null,null,null,"MSP Claim ","To validate the SBR01 will be accepted and mapped to the CMS flat file","Enter an MSP claim with SBR01=F in the applicable sequence order ","Accepted",null,"PAS2320.SBR01..A.0001"]
["PAS2320.SBR01..G.0001","PAS2320","X222.295.2320.SBR01.010",null,null,null,null,null,"MSP Claim ","To validate the SBR01 will be accepted and mapped to the CMS flat file","Enter an MSP claim with SBR01=G in the applicable sequence order ","Accepted",null,"PAS2320.SBR01..A.0001"]
["PAS2320.SBR01..H.0001","PAS2320","X222.295.2320.SBR01.010",null,null,null,null,null,"MSP Claim ","To validate the SBR01 will be accepted and mapped to the CMS flat file","Enter an MSP claim with SBR01=H in the applicable sequence order ","Accepted",null,"PAS2320.SBR01..A.0001"]
["PAS2320.SBR01..P.0001","PAS2320","X222.295.2320.SBR01.010",null,null,null,null,null,"MSP Claim ","To validate the 2320 SBR01 will be accepted and mapped to the CMS flat file","Enter an MSP claim with SBR01=P in the applicable sequence order","Accepted",null,"PAS2320.SBR01..A.0001"]
["PAS2320.SBR01..S.0001","PAS2320","X222.295.2320.SBR01.010",null,null,null,null,null,"MSP Claim ","To validate the SBR01 will be accepted and mapped to the CMS flat file","Enter an MSP claim with SBR01=S in the applicable sequence order ","Accepted"]
["PAS2320.SBR01..T.0001","PAS2320","X222.295.2320.SBR01.010",null,null,null,null,null,"MSP Claim ","To validate the SBR01 will be accepted and mapped to the CMS flat file","Enter an MSP claim with SBR01=T in the applicable sequence order ","Accepted",null,"PAS2320.SBR01..A.0001"]
["PAS2330A.NM105...0007","PAS2330A","X222.313.2330A.NM105.055","NM105",null,null,null,null,null,"2330A.NM105 must be populated with The first position of 2330A.NM105 must be alphabetic (A…Z).","NM105 = A","Accepted",null,"PAS2330A.NM105...0004"]
["PAS2410.LIN02.N4..0001","PAS2410","X222A1.023.2410.LIN02.010",null,null,null,null,null,null,"To ensure a 999 Accept is created for the 5010 edit that says 2410.LIN02 must be present.","Create data file to meet the following 5010 criteria: 2410.LIN02 must be present.","Accepted"]
["PAS2410.REF...0002","PAS2410","X222.428.2410.REF.020",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following edit: 2410. CTP05-1 must be present.Only one iteration of 2410.REF is allowed.","Only one iteration of 2410.REF is allowed.","Accepted"]
["PAS2410.REF...0003","PAS2410","X222.428.2410.REF.030",null,null,null,null,null,null,"To ensure that a 999/277CA is not are not created to meet the following edit: If SV101-3, SV101-4,SV101-5 or SV101-6 are = \"J1\", 2410.REF with REF01 = \"XZ\" must be present. ","If SV101-3, SV101-4,SV101-5 or SV101-6 are = \"J1\", 2410.REF with REF01 = \"XZ\" must be present.","Accepted"]
["PAS2410.REF01.VY..0001","PAS2410","X222.428.2410.REF01.010",null,null,null,null,null,null,"To ensure that a 999/277Ca are not created to meet the following edit: 2410.REF01  must be present.","2410.REF01  must be present. \r\n2410.REF01 must= VY","Accepted"]
["PAS2410.REF01.VY..0002","PAS2410","X222.428.2410.REF01.020",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following edit: 2410.REF01  must be valid values.","2410.REF01  must be valid values.","Accepted",null,"PAS2410.REF01.VY..0001"]
["PAS2410.REF01.XZ..0001","PAS2410","X222.428.2410.REF01.010",null,null,null,null,null,null,"To ensure that a 999/277Ca are not created to meet the following edit: 2410.REF01  must be present.","2410.REF01  must be present.\r\n2410.REF01 must= XZ","Accepted"]
["PAS2410.REF01.XZ..0002","PAS2410","X222.428.2410.REF01.020",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following edit: 2410.REF01  must be valid values.","2410.REF01  must be valid values.","Accepted",null,"PAS2410.REF01.XZ..0001"]
["PAS2410.REF02.VY..0001","PAS2410","X222.428.2410.REF02.010",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following edit: 2410.REF01  must be present.","2410.REF02 must be present.","Accepted",null,"PAS2410.REF02.VY..0004"]
["PAS2410.REF02.VY..0002","PAS2410","X222.428.2410.REF02.020",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following edit: 2410.REF02 must be at least one non-space character","2410.REF02 must be at least one non-space character","Accepted",null,"PAS2410.REF02.VY..0004"]
["PAS2410.REF02.VY..0003","PAS2410","X222.428.2410.REF02.030\r",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following 5010 edit: 2410.REF02 must be 1 - 50 characters.","2410.REF02 must be 1 - 50 characters.","Accepted",null,"PAS2410.REF02.VY..0004"]
["PAS2410.REF02.VY..0004","PAS2410","X222.428.2410.REF02.040",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following 5010 edit: 2410.REF02 must be populated with accepted AN characters.","2410.REF02 must be populated with accepted AN characters.","Accepted"]
["PAS2410.REF02.XZ..0001","PAS2410","X222.428.2410.REF02.010",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following edit: 2410.REF01  must be present.","2410.REF02 must be present.","Accepted",null,"PAS2410.REF02.XZ..0004"]
["PAS2410.REF02.XZ..0002","PAS2410","X222.428.2410.REF02.020",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following edit: 2410.REF02 must be at least one non-space character","2410.REF02 must be at least one non-space character","Accepted",null,"PAS2410.REF02.XZ..0004"]
["PAS2410.REF02.XZ..0003","PAS2410","X222.428.2410.REF02.030\r",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following 5010 edit: 2410.REF02 must be 1 - 50 characters.","2410.REF02 must be 1 - 50 characters.","Accepted",null,"PAS2410.REF02.XZ..0004"]
["PAS2410.REF02.XZ..0004","PAS2410","X222.428.2410.REF02.040",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following 5010 edit: 2410.REF02 must be populated with accepted AN characters.","2410.REF02 must be populated with accepted AN characters.","Accepted"]
["PAS2420A.NM1...0001","PAS2420A","X222.430.2420A.NM1.010",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following 5010 edit: Only one iteration of 2420A.NM1 is allowed.","Create data file to meet the following 5010 criteria Only one iteration of 2420A.NM1 is allowed.","Accepted"]
["PAS2420A.NM101...0001","PAS2420A","X222.430.2420A.NM101.010",null,null,null,null,null,null,"To ensure that a 999/277Ca are not created to meet the following 5010 edit: 2420A.NM101 must be present","Create data file to meet the following 5010 criteria  2420A.NM101 must be present","Accepted",null,"PAS2420A.NM1...0001"]
["PAS2420A.NM101...0002","PAS2420A","X222.430.2420A.NM101.020",null,null,null,null,null,null,"To ensure that a 999/277Ca are not created to meet the following 5010 edit: 2420A.NM101 must be \"82\".","Create data file to meet the following 5010 criteria  2420A.NM101 must be \"82\".","Accepted",null,"\nPAS2420A.NM1...0001"]
["PAS2420A.NM102...0001","PAS2420A","X222.430.2420A.NM102.010",null,null,null,null,null,null,"To ensure that a 999/277Ca are not created to meet the following 5010 edit: 2420A.NM102 must be present","Create data file to meet the following 5010 criteria  2420A.NM102 must be present.","Accepted"]
["PAS2420A.NM102..1.0001","PAS2420A","X222.430.2420A.NM102.020",null,null,null,null,null,null,"To ensure that a 999/277Ca are not created to meet the following 5010 edit: 2420A.NM102 must be valid values","Create data file to meet the following 5010 criteria  2420A.NM102 must be valid values","Accepted",null,"PAS2420A.NM102...0001"]
["PAS2420A.NM102..2.0001","PAS2420A","X222.430.2420A.NM102.020",null,null,null,null,null,null,"To ensure that a 999/277Ca are not created to meet the following 5010 edit: 2420A.NM102 must be valid values","Create data file to meet the following 5010 criteria  2420A.NM102 must be valid values","Accepted"]
["PAS2420A.NM103...0002","PAS2420A","X222.430.2420A.NM103.020",null,null,null,null,null,null,"To ensure that a 999/277Ca are not created to meet the following 5010 edit: 2420A.NM103 must contain at least one non-space character.","Create data file to meet the following 5010 criteria  2420A.NM103 must contain at least one non-space character.","Accepted",null,"PAS2420A.NM103...0005"]
["PAS2420A.NM103...0003","PAS2420A","X222.430.2420A.NM103.030",null,null,null,null,null,null,"To ensure that a 999/277Ca are not created to meet the following 5010 edit:","Create data file to meet the following 5010 criteria  2420A.NM103 must be 1 - 60 characters.","Accepted"]
["PAS2420A.NM103...0005","PAS2420A","X222.430.2420A.NM103.050",null,null,null,null,null,null,"To ensure that a 999/277Ca are not created to meet the following 5010 edit: 2420A.NM103 must be 1 - 60 characters.","Create data file to meet the following 5010 criteria  2420A.NM103 must be populated with accepted AN characters.","Accepted"]
["PAS2420A.NM104...0001","PAS2420A","X222.430.2420A.NM104.010",null,null,null,null,null,null,"To ensure that a 999/277Ca are not created to meet the following 5010 Edit:  If 2420A.NM102 is \"2\", 2420A.NM104 must not be present.","Create data file to meet the following 5010 criteria: If 2420A.NM102 is \"2\", 2420A.NM104 must not be present.","Accepted",null,"PAS2420A.NM102..2.0001"]
["PAS2420A.NM104...0002","PAS2420A","X222.430.2420A.NM104.020",null,null,null,null,null,null,"To ensure that a 999/277Ca are not created to meet the following 5010 Edit: 2420A.NM104 must contain at least one non-space character.","Create data file to meet the following 5010 criteria: 2420A.NM104 must contain at least one non-space character.","Accepted",null,"PAS2420A.NM104...0005"]
["PAS2420A.NM104...0003","PAS2420A","X222.430.2420A.NM104.030\r",null,null,null,null,null,null,"To ensure that a 999/277Ca are not created to meet the following 5010 Edit: 2420A.NM104 must be 1 - 35 characters.","Create data file to meet the following 5010 criteria: 2420A.NM104 must be 1 - 35 characters.","Accepted",null,"PAS2420A.NM104...0005"]
["PAS2420A.NM104...0005","PAS2420A","X222.430.2420A.NM104.050",null,null,null,null,null,null,"To ensure that a 999/277Ca are not created to meet the following 5010 Edit: IK403 = 6: \"Invalid Character in Data Element\"","Create data file to meet the following 5010 criteria: 2420A.NM104 must be populated with accepted AN characters.\r\n","Accepted"]
["PAS2420A.NM105...0001","PAS2420A","X222.430.2420A.NM105.010",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet t he following 5010 edit: If 2420A.NM102 is \"2\", 2420A.NM105 must not be present.","Create data file to meet the following 5010 criteria: If 2420A.NM102 is \"2\", 2420A.NM105 must not be present.","Accepted",null,"PAS2420A.NM105...0002"]
["PAS2420A.NM105...0002","PAS2420A","X222.430.2420A.NM105.020",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet t he following 5010 edit: 2420A.NM105 must contain at least one non-space character.","Creat data file to meet the following 5010 criteria: 2420A.NM105 must contain at least one non-space character.","Accepted"]
["PAS2420A.NM105...0003","PAS2420A","X222.430.2420A.NM105.030\r",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet t he following 5010 edit: 2420A.NM105 must be 1 - 25 characters.","Create data file to meet the following 5010 criteria: 2420A.NM105 must be 1 - 25 characters.","Accepted",null,"PAS2420A.NM105...0002"]
["PAS2420A.NM105...0005","PAS2420A","X222.430.2420A.NM105.050",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following 5010 edit: 2420A.NM105 must be populated with accepted AN characters.","Create data file to meet the following 5010 criteria: 2420A.NM105 must be populated with accepted AN characters.","Accepted",null,"PAS2420A.NM105...0002"]
["PAS2420A.NM105...0007","PAS2420A","X222.430.2420A.NM105.055","NM105",null,null,null,null,null,"2420A.NM105 must be populated with The first position of 2420A.NM105 must be alphabetic (A…Z).","NM105 = A","Accepted",null,"PAS2420A.NM105...0004"]
["PAS2420A.NM107...0001","PAS2420A","X222.430.2420A.NM107.010",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following 5010 edit: If 2420A.NM102 is \"2\", 2420A.NM107 must not be present.","Create data file to meet the following 5010 criteria: If 2420A.NM102 is \"2\", 2420A.NM107 must not be present.","Accepted",null,"PAS2420A.NM107...0002"]
["PAS2420A.NM107...0002","PAS2420A","X222.430.2420A.NM107.020",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following 5010 edit: If 2420A.NM102 is \"2\", 2420A.NM107 must not be present.","Create data file to meet the following 5010 criteria: If 2420A.NM102 is \"2\", 2420A.NM107 must not be present.","Accepted"]
["PAS2420A.NM107..0001","PAS2420A","X222.430.2420A.NM107.010",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following 5010 edit: If 2420A.NM102 is \"2\", 2420A.NM107 must not be present.","Create data file to meet the following 5010 criteria: If 2420A.NM102 is \"2\", 2420A.NM107 must not be present.","Accepted"]
["PAS2420A.NM107..0003","PAS2420A","X222.430.2420A.NM107.030\r\n",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following 5010 edit: If 2420A.NM102 is \"2\", 2420A.NM107 must not be present.","Create data file to meet the following 5010 criteria: If 2420A.NM102 is \"1\", 2420A.NM107 must be 1 - 10 characters.","Accepted"]
["PAS2420A.NM108...0002","PAS2420A","X222.430.2420A.NM108.020",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following 5010 edit: 2420A.NM108 must be present.","Create data file to meet the following 5010 criteria:  2420A.NM108 must be present.","Accepted"]
["PAS2420A.NM108...0003","PAS2420A","X222.430.2420A.NM108.030",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following 5010 edit: 2420A.NM108 must be present.","Create data file to meet the following 5010 criteria:  2420A.NM108 must be present.","Accepted",null,"PAS2420A.NM108...0002"]
["PAS2420A.NM108..0002","PAS2420A","X222.430.2420A.NM108.020",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following 5010 edit: 2420A.NM108 must be present.","Create data file to meet the following 5010 criteria:  2420A.NM108 must be present.","Accepted"]
["PAS2420A.NM108..0003","PAS2420A","X222.430.2420A.NM108.030",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following 5010 edit: 2420A.NM108 must be present.","Create data file to meet the following 5010 criteria:  2420A.NM108 must be present.","Accepted"]
["PAS2420A.NM109...0001","PAS2420A","X222.430.2420A.NM109.010",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following 5010 edit: If 2420A.NM108 is present, 2420A.NM109 must be present.","Create data file to meet the following 5010 criteria: If 2420A.NM108 is present, 2420A.NM109 must be present.","Accepted",null,"PAS2420A.NM108...0002"]
["PAS2420A.NM109...0002","PAS2420A","X222.430.2420A.NM109.020",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following 5010 edit: 2420A.NM109 must be valid according to the NPI algorithm.","Create data file to meet the following 5010 criteria: 2420A.NM109 must be valid according to the NPI algorithm.","Accepted",null,"PAS2420A.NM108...0002"]
["PAS2420A.NM109...0003","PAS2420A","X222.430.2420A.NM109.030",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following 5010 edit: 2420A.NM109 must be valid according to the NPI algorithm.","Create data file to meet the following 5010 criteria: 2420A.NM109 must be a valid NPI on the Crosswalk when evaluated with 1000B.NM109.","Accepted",null," \r\nPAS2420A.NM108...0002"]
["PAS2420A.NM109...0004","PAS2420A","X222.430.2420A.NM109.040",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following 5010 edit: 2420A.NM109 must be valid according to the NPI algorithm.","Create data file to meet the following 5010 criteria:  The first position of 2420A.NM109 must be a \"1\".","Accepted",null," \r\nPAS2420A.NM108...0002"]
["PAS2420A.PRV...0002","PAS2420A","X222.433.2420A.PRV.020",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following 5010 edit: Only one iteration of 2420A.PRV is allowed.","Create data file to meet the following 5010 criteria: Only one iteration of 2420A.PRV is allowed.","Accepted"]
["PAS2420A.PRV01...0001","PAS2420A","X222.433.2420A.PRV01.010",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following 5010 edit: 2420A.PRV01 must be present","Create data file to meet the following 5010 criteria: 2420A.PRV01 must be present","Accepted",null,"PAS2420A.PRV...0002"]
["PAS2420A.PRV01...0002","PAS2420A","X222.433.2420A.PRV01.020",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following 5010 edit: 2420A.PRV01 must be \"PE\".","Create data file to meet the following 5010 criteria: 2420A.PRV01 must be \"PE\".","Accepted",null,"PAS2420A.PRV...0002"]
["PAS2420A.PRV02...0001","PAS2420A","X222.433.2420A.PRV02.010",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following 5010 edit: 2420A.PRV02 must be present.","Create data file to meet the following 5010 criteria: 2420A.PRV02 must be present.","Accepted",null,"PAS2420A.PRV...0002"]
["PAS2420A.PRV02...0002","PAS2420A","X222.433.2420A.PRV02.020",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following 5010 edit: 2420A.PRV02 must be \"PXC\".","Create data file to meet the following 5010 criteria: 2420A.PRV02 must be \"PXC\".","Accepted",null,"PAS2420A.PRV...0002"]
["PAS2420A.PRV03...0001","PAS2420A","X222.433.2420A.PRV03.010",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following 5010 edit: 2420A.PRV03 must be present.","Create data file to meet the following 5010 criteria: 2420A.PRV03 must be present.","Accepted",null,"PAS2420A.PRV...0002"]
["PAS2420A.PRV03...0002","PAS2420A","X222.433.2420A.PRV03.020",null,null,null,null,null,null,"To ensure that a 999/277CA are not created to meet the following 5010 edit: 2420A.PRV03 must be valid Taxonomy Code","Create data file to meet the following 5010 criteria: 2420A.PRV03 must be valid Taxonomy Code","Accepted",null,"PAS2420A.PRV...0002"]
["PAS2420D.NM105...0007","PAS2420D","X222.449.2420D.NM105.045","NM105",null,null,null,null,null,"2420D.NM105 must be populated with The first position of 2420D.NM105 must be alphabetic (A…Z).","NM105 = A","Accepted",null,"PAS2420D.NM105...0004"]
["PAS2420E.NM105...0007","PAS2420E","X222.454.2420E.NM105.045","NM105",null,null,null,null,null,"2420E.NM105 must be populated with The first position of 2420E.NM105 must be alphabetic (A…Z).","NM105 = A","Accepted",null,"PAS2420E.NM105...0004"]
["PAS2420F.NM105...0007","PAS2420F","X222.465.2420F.NM105.045","NM105",null,null,null,null,null,"2420F.NM105 must be populated with The first position of 2420F.NM105 must be alphabetic (A…Z).","NM105 = A","Accepted",null,"PAS2420F.NM105...0004"]
["PAS2430.AMT...0002","PAS2430","X222.491.2430.AMT.020  X222.491.2430.AMT.030",null,null,null,null,null,null,"Only one iteration of 2430.AMT is allowed.  If 2320 AMT (EAF) is present for the same payer, the 2430 AMT (EAF) must not be present","Submit a claim with only one iteration of 2430.AMT where 2320.AMT (EAF) is present for the same payer, the 2430.AMT (EAF) is not present","Accepted"]
["PAS2430.AMT01...0001","PAS2430","X222.491.2430.AMT01.010  X222.491.2430.AMT01.020",null,null,null,null,null,null,"2430.AMT01 must be present and must be \"EAF\".","Submit a claim with 2430.AMT01 present and \"EAF\".","Accepted"]
["PAS2430.AMT02...0005","PAS2430","X222.491.2430.AMT02.005  X222.491.2430.AMT02.010  X222.491.2430.AMT02.020 ",null,null,null,null,null,null,"2430.AMT02 must be present, must be numeric, and must be < = 99,999.99.","Submit a claim with 2430.AMT02 present, numeric, and < = 99,999.99.","Accepted",null,"PAS2430.AMT...0002"]
["PAS2430.SVD02..0004","PAS2430","X222.480.2430.SVD02.040","SVD02",4,null,null,null,null,"To verify that an accepted 999 is generated","Create a claim where 2430.SVD02 is < = 99,999.99","Accepted",null,"PAS2430.CAS01.CO..0001"]

{"sheet":"Percent Complete","index":1,"n_rows":22,"n_cols":2,"rows_kept":22,"cut":false,"hidden":false,"merged":[]}
["Day","Percent Complete"]
["2013-08-05",{"$f":"Formulas!B1700/Formulas!$A$1700","v":0}]
["2013-08-06",{"$f":"Formulas!C1701/Formulas!$A$1700","v":0}]
["2013-08-07",{"$f":"Formulas!D1702/Formulas!$A$1700","v":0}]
["2013-08-08",{"$f":"Formulas!E1703/Formulas!$A$1700","v":0}]
["2013-08-09",{"$f":"Formulas!F1704/Formulas!$A$1700","v":0}]
["2013-08-12",{"$f":"Formulas!G1705/Formulas!$A$1700","v":0}]
["2013-08-13",{"$f":"Formulas!H1706/Formulas!$A$1700","v":0}]
["2013-08-14",{"$f":"Formulas!I1707/Formulas!$A$1700","v":0}]
["2013-08-15",{"$f":"Formulas!J1708/Formulas!$A$1700","v":0}]
["2013-08-16",{"$f":"Formulas!K1709/Formulas!$A$1700","v":0}]
["2013-08-19",{"$f":"Formulas!L1710/Formulas!$A$1700","v":0}]
["2013-08-20",{"$f":"Formulas!M1711/Formulas!$A$1700","v":0}]
["2013-08-21",{"$f":"Formulas!N1712/Formulas!$A$1700","v":0}]
["2013-08-22",{"$f":"Formulas!O1713/Formulas!$A$1700","v":0}]
["2013-08-23",{"$f":"Formulas!P1714/Formulas!$A$1700","v":0}]
["2013-08-26",{"$f":"Formulas!Q1715/Formulas!$A$1700","v":0}]
["2013-08-27",{"$f":"Formulas!R1716/Formulas!$A$1700","v":0}]
["2013-08-28",{"$f":"Formulas!S1717/Formulas!$A$1700","v":0}]
["2013-08-29",{"$f":"Formulas!T1718/Formulas!$A$1700","v":0}]
["2013-08-30",{"$f":"Formulas!U1719/Formulas!$A$1700","v":0}]
["2013-09-02",{"$f":"Formulas!V1720/Formulas!$A$1700","v":0}]

{"sheet":"Formulas","index":2,"n_rows":1700,"n_cols":29,"rows_kept":1700,"cut":false,"hidden":true,"merged":[]}
["Total #",{"$f":"'Percent Complete'!$A2","v":"2013-08-05"},{"$f":"'Percent Complete'!$A3","v":"2013-08-06"},{"$f":"'Percent Complete'!$A4","v":"2013-08-07"},{"$f":"'Percent Complete'!$A5","v":"2013-08-08"},{"$f":"'Percent Complete'!$A6","v":"2013-08-09"},{"$f":"'Percent Complete'!$A7","v":"2013-08-12"},"2013-08-13","2013-08-14","2013-08-15","2013-08-16","2013-08-19","2013-08-20","2013-08-21","2013-08-22","2013-08-23","2013-08-26","2013-08-27","2013-08-28","2013-08-29","2013-08-30","2013-09-02",null,"Received Expected Result Plus Other","Received Results Other Than Expected","Translator Error",null,"Pass","Fail"]
[{"$f":"IF('Test Cases'!A2=\"\",0,1)","v":1},{"$f":"IF(AND('Test Cases'!$S2<=Formulas!B$1,'Test Cases'!$S2<>\"\"),1,0)","v":0},{"$f":"IF(AND('Test Cases'!$S2<=Formulas!C$1,'Test Cases'!$S2<>\"\"),1,0)","v":0},{"$f":"IF(AND('Test Cases'!$S2<=Formulas!D$1,'Test Cases'!$S2<>\"\"),1,0)","v":0},{"$f":"IF(AND('Test Cases'!$S2<=Formulas!E$1,'Test Cases'!$S2<>\"\"),1,0)","v":0},{"$f":"IF(AND('Test Cases'!$S2<=Formulas!F$1,'Test Cases'!$S2<>\"\"),1,0)","v":0},{"$f":"IF(AND('Test Cases'!$S2<=Formulas!G$1,'Test Cases'!$S2<>\"\"),1,0)","v":0},{"$f":"IF(AND('Test Cases'!$S2<=Formulas!H$1,'Test Cases'!$S2<>\"\"),1,0)","v":0},{"$f":"IF(AND('Test Cases'!$S2<=Formulas!I$1,'Test Cases'!$S2<>\"\"),1,0)","v":0},{"$f":"IF(AND('Test Cases'!$S2<=Formulas!J$1,'Test Cases'!$S2<>\"\"),1,0)","v":0},{"$f":"IF(AND('Test Cases'!$S2<=Formulas!K$1,'Test Cases'!$S2<>\"\"),1,0)","v":0},{"$f":"IF(AND('Test Cases'!$S2<=Formulas!L$1,'Test Cases'!$S2<>\"\"),1,0)","v":0},{"$f":"IF(AND('Test Cases'!$S2<=Formulas!M$1,'Test Cases'!$S2<>\"\"),1,0)","v":0},{"$f":"IF(AND('Test Cases'!$S2<=Formulas!N$1,'Test Cases'!$S2<>\"\"),1,0)","v":0},{"$f":"IF(AND('Test Cases'!$S2<=Formulas!O$1,'Test Cases'!$S2<>\"\"),1,0)","v":0},{"$f":"IF(AND('Test Cases'!$S2<=Formulas!P$1,'Test Cases'!$S2<>\"\"),1,0)","v":0},{"$f":"IF(AND('Test Cases'!$S2<=Formulas!Q$1,'Test Cases'!$S2<>\"\"),1,0)","v":0},{"$f":"IF(AND('Test Cases'!$S2<=Formulas!R$1,'Test Cases'!$S2<>\"\"),1,0)","v":0},{"$f":"IF(AND('Test Cases'!$S2<=Formulas!S$1,'Test Cases'!$S2<>\"\"),1,0)","v":0},{"$f":"IF(AND('Test Cases'!$S2<=Formulas!T$1,'Test Cases'!$S2<>\"\"),1,0)","v":0},{"$f":"IF(AND('Test Cases'!$S2<=Formulas!U$1,'Test Cases'!$S2<>\"\"),1,0)","v":0},{"$f":"IF(AND('Test Cases'!$S2<=Formulas!V$1,'Test Cases'!$S2<>\"\"),1,0)","v":0}]
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