United States Health Information Knowledgebase

 

Prescription/Service Reference Number Qualifier

Name:Prescription/Service Reference Number Qualifier
Field:455-EM
Definition:Indicates the type of billing submitted.
Type:Data Element
Example:Comments: Qualifies 'Prescription/Service Reference Number' (402-D2).
$attribute_name$:$attribute_value$
Version:04-2014
Registration Authority:National Council for Prescription Drug Programs
Source:National Council for Prescription Drug Programs
Values for: Prescription/Service Reference Number Qualifier
Standards Format: T
Value Value Meaning
1 Rx Billing - Transaction is a billing for a prescription or OTC drug product
2 Service Billing - Transaction is a billing for a professional service performed.
 
Standards Format: A
Value Value Meaning
1 Rx Billing - Transaction is a billing for a prescription or OTC drug product
2 Service Billing - Transaction is a billing for a professional service performed.
 
Standards Format: Z
Value Value Meaning
1 Rx Billing - Transaction is a billing for a prescription or OTC drug product
2 Service Billing - Transaction is a billing for a professional service performed.
 
Standards Format: W
Value Value Meaning
1 Rx Billing - Transaction is a billing for a prescription or OTC drug product
2 Service Billing - Transaction is a billing for a professional service performed.
 
Standards Format: X
Value Value Meaning
1 Rx Billing - Transaction is a billing for a prescription or OTC drug product
2 Service Billing - Transaction is a billing for a professional service performed.
 
Standards Format: J
Value Value Meaning
1 Rx Billing - Transaction is a billing for a prescription or OTC drug product
2 Service Billing - Transaction is a billing for a professional service performed.
 
Standards Format: E
Value Value Meaning
1 Rx Billing - Transaction is a billing for a prescription or OTC drug product
2 Service Billing - Transaction is a billing for a professional service performed.
 
Standards Format: R
Value Value Meaning
1 Telecommunication v 5.1-6.0 Rx- 7 bytes
2 Telecommunication v 7.0-C.4 Rx- 9 bytes
3 Telecommunication v D0 or higher Rx-12 bytes
Z Trading Partner Defined - Mutually agreed upon
 
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