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Days Supply

PC034, APCD Council



Name:Days Supply
Data Element ID:PC034
Description:Not Provided
State:APCD Council
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File Specification for Pharmacy Claims File Submission

Data Element ID Data Element
PC001 Payer
PC002 Plan ID
PC003 Insurance Type/Product Code
PC004 Payer Claim Control Number
PC005 Line Counter
PC006 Insured Group Number
PC007 Encrypted Subscriber Social Security Number
PC008 Plan Specific Contract Number
PC009 Member Suffix or Sequence Number
PC010 Member Identification Code
PC011 Individual Relationship Code
PC012 Member Gender
PC013 Member Date of Birth
PC014 Member City Name of Residence
PC015 Member State or Province
PC016 Member ZIP Code
PC017 Date Service Approved (AP Date)
PC018 Pharmacy Number
PC019 Pharmacy Tax ID Number
PC020 Pharmacy Name
PC021 National Pharmacy ID Number
PC022 Pharmacy Location City
PC023 Pharmacy Location State
PC024 Pharmacy ZIP Code
PC024A Pharmacy Country Name
PC025 Claim Status
PC026 Drug Code
PC027 Drug Name
PC028 New Prescription or Refill
PC029 Generic Drug Indicator
PC030 Dispense as Written Code
PC031 Compound Drug Indicator
PC032 Date Prescription Filled
PC033 Quantity Dispensed
PC034 Days Supply
PC035 Charge Amount
PC036 Paid Amount
PC036A Other Amount Paid
PC036B Other Payer Amount Recognized
PC037 Ingredient Cost/List Price
PC038 Postage Amount Claimed
PC039 Dispensing Fee
PC040 Co-pay Amount
PC041 Coinsurance Amount
PC042 Deductible Amount
PC043 Unassigned
PC044 Prescribing Physician First Name
PC045 Prescribing Physician Middle Name
PC046 Prescribing Physician Last Name
PC047 Prescribing Physician Number
PC048 Prescribing Physician Number
PC049 Prescribing Physician Plan Number
PC050 Prescribing Physician License Number
PC051 Prescribing Physician Street Address
PC052 Prescribing Physician Street Address 2
PC053 Prescribing Physician City
PC054 Prescribing Physician State
PC055 Prescribing Physician Zip
PC056 Product ID Number
PC057 Mail Order pharmacy
PC058 Script number
PC059 Recipient PCP ID
PC060 Single/Multiple Source Indicator
PC061 Member Street Address
PC062 Billing Provider Tax ID Number
PC063 Date of Payment
PC101 Encrypted Subscriber Last Name
PC102 Encrypted Subscriber First Name
PC103 Encrypted Subscriber Middle Initial
PC104 Encrypted Member Last Name
PC105 Encrypted Member First Name
PC106 Encrypted Member Middle Initial
PC899 Record Type

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