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25901 This record was superseded by another input record.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