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ASAP R.5/95

 

Field Name Definition Values

R/O*

Field
Format

Field
Length

Positions
Identifier    

O

A/N

3

001-003
BIN    

O

N

6

004-009
Version Number    

O

N

2

010-011
Transaction Code    

O

N

2

012-013
NCPDP or DEA License Number Pharmacies report the NCPDP number. Dispensing practitioners use the DEA License #  

R

A/N

12

014-025
Customer ID Number Customer ID (Driver License, State ID,  Military ID, Passport)  

R

A/N

20

026-045
Zip Code 3 digit US Postal Code identifying the state code  

O

A/N

3

046-048
Birth Date Customer's birth date YYYYMMDD

R

N

8

049-056
Sex Code Sex / Gender of the patient 1=Male
2=Female
3=Animal

O

N

1

057-057
Date Filled Date the prescription was filled YYYYMMDD

R

N

8

058-065
Rx # Prescription number assigned by  the pharmacy  

R

A/N

7

066-072
New-Refill Code Code indicating whether the prescription is new or refill  

O

N

2

073-074
Metric Quantity Number of metric units of drug being dispensed  

R

N

5

075-079
Days Supply Estimated number of days the prescription will last  

O

N

3

080-082
Compound Code

Code indicating whether or not the prescription is a

compound medication

 

O

N

1

083-083
NDC Number National Drug Code of the drug dispensed (5-4-2) format

R

A/N

11

084-094
Prescriber ID DEA # of the prescribing physician  

R

A/N

10

095-104
DEA Suffix DEA Suffix  

O

A/N

4

105-108
Date Rx Written Date the Rx was written YYYYMMDD

O

N

8

109-116
Number of Refills Authorized Number of refills authorized by Prescriber  

O

N

2

117-118
Rx Origin Code Code indicating the origin of the prescription  

O

A/N

1

119-119
Customer Location Code indicating location of patient (customer)  

O

A/N

2

120-121
Diagnosis Code ICD-9 or CPT code provided by Prescriber  

O

A/N

7

122-128
Alternate Prescriber State license number or HIN.  To be included if DEA number field is for an institution rather than the prescriber.  

O

A/N

10

129-138
Patient Last Name Patient Last Name  

R

A/N

15

139-153
Patient First Name Includes middle initial and suffix  

R

A/N

15

154-168
Patient Address Street or PO Box #  

R

A/N

30

169-198
Patient State Standard 2-digit State abbreviation (example:  OK).  

R

A/N

2

199-200
Patient Zip Code Full zip code (including 4-digit suffix if available).  

R

A/N

9

201-209
Triplicate Serial #

# Assigned to triplicate Rx document by States with

triplicate programs.

 

O

A/N

12

210-221
Filler Filler  

O

A/N

1

222

*R = required    O = optional    A/N = Alphabet/Numeric

NOTE: 
1. Fixed length ASCII text files with one record (line) per prescription.
2. Carriage return at the end of each record.