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Pricing Segment

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***For fields with the number one (1) appended, the segment will display additional fields for sequential fields (ingredient 2, 3, etc).

Field #

Field Name

Possible Value or Explanation of Field

409-D9

Ingredient Cost

Refers to the cost field on the main Processing Screen

412-DC

Dispensing Fee

Refers to the fee field on the main Processing Screen

433-DX

Patient Paid Amount

Refers to the copay fee field on the main Processing Screen

438-E3

Incentive Fee

Refers to the incentive fee field (expand other with + button) on the main Processing Screen

482-GE

Percentage Sales Tax Amount

Sales tax amount as calculated based on the percentage rate below

483-HE

Percentage Sales Tax Rate

Sales tax rate as indicated on the pricing segment of the Insurance Plan File (F5)

484-JE

Percentage Sales Tax Basis

Code indicating the basis for the percentage cost; blank - not specified, 02 - ingredient cost, 03 - Ingredient cost plus dispensing fee, 04 - professional service fee

481-HA

Flat Sales Tax Amount

Sales tax amount based on the flat fee as indicated on the pricing segment of the Insurance Plan File (F5)

477-BE

Professional Service Fee

This professional service fee gets transmitted when the Drug is switched to Service Billing from RX Billing in the Drug file.

426-DQ

Usual & Customary Charge

Refers to the U&C charges field on the main Processing Screen

430-DU

Gross Amount Due

This refers to the total field on the main processing screen

423-DN

Basis of Cost

Refers to the Basis of Cost field on the main Processing Screen

478-H7

Other Amount Submitted Count

Indicates how many other amounts were submitted; this is calculated by adding the lines of the "Other" pricing segment accessed by the "+" sign on the main processing screen

479-H8

Other Amount Submitted Qualifier 1

Indicates the qualifier for the other amount specified; located in the "Other" pricing segment accessed by the "+" sign on the main processing screen

480-H9

Other Amount Submitted 1

Indicates the total amount for the other amount specified based on the qualifier above; located in the "Other" pricing segment accessed by the "+" sign on the main processing screen

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