NCPDP D.0 Field Numbers with NRx Field Names and Locations

NCPDP D.0 Field #	NRx Field Name	NRx Field Location - Record Name
115-N5	Medicaid ID #	Patient Record
126-UA	Generic Equivalent (Send Worker's Compensation Generic Equivalent Product ID)	Price Plan and Transaction Record
128-UC	Spending Account Amount Remaining	Claim Payment Detail
129-UD	Amount Attributed to Health Plan Assistance	Transaction Record Copay Breakdown Window and Claim Payment Detail
130-UF 131-UG 132-UH	Additional Message Information Count Additional Message Information Continuity Additional Message Information Qualifier	Claim Payment Detail Internal Use Only
133-UJ	Amount from Provider Network Selection Amount Attributed to Provider Network Selection	Transaction Record Copay Breakdown and Claim Payment Detail
134-UK	Amount from Brand Drug Amount Attributed to Product Selected/Brand Drug	Transaction Record Copay Breakdown and Claim Payment Detail Type your drop-down text here.
135-UM	Amount from Non-Preferred Formulary Selection Amount Attributed to Product Selected/Non-Preferred Formulary	Transaction Record Copay Breakdown and Claim Payment Detail
136-UN	Amount from Brand Non-Preferred Formulary Selection Amount Attributed to Product Selected/Brand Non-Preferred Formulary	Transaction Record Copay Breakdown and Claim Payment Detail
137-UP	Amount from Coverage Gap Amount Attributed to Coverage Gap	Transaction Record Copay Breakdown and Claim Payment Detail
147-U7	Pharmacy Service Type	Price Plan
148-U8 149-U9	Ingredient Cost Contracted/Reimbursable Amount Dispensing Fee Contracted/Reimbursable Amount	Claim Payment Detail
202-B2	Provider Qualifier	Price Plan
301-C1 302-C2 304-C4	Group # from Resp Policy # from Resp Birth Date From Resp	Claim Rejection Detail
307-C7	Place of Service	Patient Record, Insurance Record, Prescription Record, Transaction Record and Patient Outcome Record (DUR)
308-C8	Other Coverage	Patient Insurance Record, Prescription Record and Transaction Record Type your drop-down text here.
309-C9	Eligibility Clarification Code	Patient Insurance Record
310-CA	Patient Name from Response	Claim Payment Detail
331-CX 332-CY	Patient ID Qualifier Patient ID	Patient Record and Price Plan
333-CZ	Employer ID	Patient Insurance Record
334-1C	Smoker/Non-Smoker Code	Price Plan
336-8C	Facility ID	Patient Insurance Record and Facility Record
339-6C	Other ID Qualifier	Patient Insurance Record
350-HN	Patient Email Address	Price Plan
357-NV	Delay Reason Code	Prescription Record, Transaction Record and Patient Outcome Record (DUR)
359-2A	Medigap ID	Patient Insurance Record
360-2B	Medicaid Indicator	Patient Record
361-2D	Provider Accept Assignment	Patient Insurance Record, Prescription Record and Transaction Record
384-4X	Patient Residence	Patient Insurance Record and Facility Record
390-BM	Narrative Message	Prescription Record
393-MV 394-MW	Benefit Qualifier Benefit Stage Amount	Claim Payment Detail
408-D8	Dispense As Written (NCPDP DAW Default)	Price Plan and Prescription Record
418-DI	Level of Service	Prescription Record and Transaction Record
419-DJ	Prescription Origin Code	Prescription Record, Transaction Record and Store Control/Store Level Options/Rx Filling Options
420-DK	Submission Clarification Code	Prescription Record and Transaction Record
423-DN	Misc Cost 1 & 2	Drug Record
423-DN	Cost Basis	Transaction Record
429-DT	Special Pkg Ind	Drug Record and Prescription Record
436-E1	State Code Qualifier	Drug Record
439-E4 440-E5 441-E6	Reason for Service (Conflict Code) Professional Service Code (Intervention Code) Result of Service Code (Outcome Code)	Patient Outcome Record (DUR)
461-EU	Prior Authorization Type	Patient Outcome Record (DUR), Price Plan and Prescription Record
462-EV 463-EW 464-EX	Prior Authorization Number Intermediary Authorization Type Intermediary Authorization ID	Patient Outcome Record (DUR)
466-EZ	Misc ID Qualifier (Prescriber ID Qualifier)	Prescriber Record
474-8E 475-J9	Level of Effort Code Co-Agent Qualifier	Patient Outcome Record (DUR)
483-E3	Incentive Amount Submitted	Price Plan, Prescription Record and Transaction Record
505-F5	Patient Pay Amount	Patient Outcome Record (DUR) and Claim Payment Detail
511-FB	Message Reject Codes	Claim Rejection Detail
518-FI	Amount of Copay	Claim Payment Detail
520-FK	Amount Exceeding Periodic Benefit Maximum	Transaction Record
522-FM	Basis of Reimbursement Determination	Transaction Record and Claim Payment Detail
523-FN	Amount from Sales Tax	Transaction Record Type your drop-down text here.
523-FW	Database Indicator	Patient Outcome Record (DUR) Type your drop-down text here.
526-FQ	Additional Message Information	Claim Payment Detail
528-FS 529-FT 533-FX	Clinical Significance Code (Severity) Other Pharmacy Indicator (Pharmacy) Other Prescriber Indicator (Prescriber)	Patient Outcome Record (DUR)
545-2F	Network Reimbursement ID	Claim Payment Detail
546-4F	Reject Field Occurrence Indicator	Claim Rejection Detail
548-6F	Approved Message Codes	Claim Payment Detail
553-AR 554-AS 555-AT 556-AU	Preferred Product ID Preferred Product Incentive Preferred Product Cost Share Incentive Preferred Product Description	Claim Rejection Detail and Claim Payment Detail
557-AV	Tax Exempt ID	Claim Payment Detail
558-AW	Flat Sales Tax Amount Paid	Claim Payment Detail
558-AW 559-AX 560-AY 562-J1	Flat Sales Tax Amount Paid Percentage Sales Tax Amount Percentage Sales Tax Rate Professional Service Fee	Patient Outcome Record (DUR)
570-NS	DUR Additional Text	Patient Outcome Record (DUR)
571-NZ	Amount Attributed to Processor Fee Amount from Processor Fee	Claim Payment Detail and Transaction Record
572-4U 573-4V	Amount of Coinsurance Basis of Calculation - Coinsurance	Claim Payment Detail
574-2Y	Plan Sales Tax Amount	Claim Payment Detail and Transaction Record
575-EQ	Patient Sales Tax Amount	Claim Payment Detail and Transaction Record
577-G3	Estimated Generic Savings	Claim Payment Detail
987-MA	URL	Claim Rejection Detail
995-E2	Route of Administration	Compound Template, Prescription Record and Transaction Record
996-G1	Compound Type	Compound Template
997-G2	CMS Part D Qualified Facility	Facility Record