rx_rejection_reason_type
Valid Values:
| Value | |
|---|---|
| "M/I IIN Number" | "M/I Version/Release Number" |
| "M/I Transaction Code" | "M/I Processor Control Number" |
| "M/I Service Provider Number" | "M/I Group ID" |
| "M/I Cardholder ID" | "M/I Person Code" |
| "M/I Date Of Birth" | "M/I Patient Gender Code" |
| "M/I Patient Relationship Code" | "M/I Place of Service" |
| "M/I Other Coverage Code" | "M/I Eligibility Clarification Code" |
| "M/I Date of Service" | "M/I Prescription/Service Reference Number" |
| "M/I Fill Number" | "M/I Days Supply" |
| "M/I Smoker/Non-Smoker Code" | "M/I Prescriber Location Code" |
| "M/I Patient Country Code" | "Version/Release Value Not Supported" |
| "Transaction Code/Type Value Not Supported" | "PCN Must Contain Processor/Payer Assigned Value" |
| "Transaction Count Does Not Match Number of Transactions" | "Multiple Transactions Not Supported" |
| "Multi-Ingredient Compound Must Be A Single Transaction" | "Vendor Not Certified For Processor/Payer" |
| "Claim Segment Required For Adjudication" | "Clinical Segment Required For Adjudication" |
| "M/I Medigap ID" | "M/I Medicaid Indicator" |
| "M/I Pregnancy Indicator" | "M/I Provider Accept Assignment Indicator" |
| "M/I Primary Care Provider ID Qualifier" | "M/I Compound Ingredient Modifier Code Count" |
| "M/I Compound Ingredient Modifier Code" | "M/I Prescriber First Name" |
| "M/I Prescriber Street Address" | "M/I Prescriber City Address" |
| "M/I Prescriber State/Province Address" | "M/I Prescriber Zip/Postal Zone" |
| "M/I Additional Documentation Type ID" | "M/I Length Of Need" |
| "M/I Length Of Need Qualifier" | "M/I Prescriber/Supplier Date Signed" |
| "M/I Request Status" | "M/I Request Period Begin Date" |
| "M/I Request Period Recert/Revised Date" | "M/I Supporting Documentation" |
| "M/I Question Number/Letter Count" | "M/I Compound Code" |
| "M/I Product/Service ID" | "M/I Dispense As Written (DAW)/Product Selection Code" |
| "M/I Ingredient Cost Submitted" | "M/I Prescriber ID" |
| "M/I Unit Of Measure" | "Product Identifier Not FDA/NSDE Listed" |
| "M/I Date Prescription Written" | "M/I Number Of Refills Authorized" |
| "Patient Segment Is Not Used For This Transaction Code" | "Insurance Segment Is Not Used For This Transaction Code" |
| "Claim Segment Is Not Used For This Transaction Code" | "Pharmacy Provider Segment Is Not Used For This Transaction Code" |
| "Prescriber Segment Is Not Used For This Transaction Code" | "COB/Other Payments Segment Is Not Used For This Tx Code" |
| "Workers' Comp Segment Is Not Used For This Tx Code" | "DUR/PPS Segment Is Not Used For This Transaction Code" |
| "Pricing Segment Is Not Used For This Transaction Code" | "Coupon Segment Is Not Used For This Transaction Code" |
| "Compound Segment Is Not Used For This Transaction Code" | "Prior Authorization Segment Is Not Used For This Tx Code" |
| "Clinical Segment Is Not Used For This Transaction Code" | "Additional Documentation Segment Is Not Used For This Tx Code" |
| "Facility Segment Is Not Used For This Transaction Code" | "Narrative Segment Is Not Used For This Transaction Code" |
| "Purchaser Segment Is Not Used For This Transaction Code" | "Service Provider Segment Is Not Used For This Transaction Code" |
| "Patient ID Qualifier Is Not Used For This Transaction Code" | "Patient ID Is Not Used For This Transaction Code" |
| "Date Of Birth Is Not Used For This Transaction Code" | "Patient Gender Code Is Not Used For This Transaction Code" |
| "Patient First Name Is Not Used For This Transaction Code" | "Patient Last Name Is Not Used For This Transaction Code" |
| "Patient Street Address Is Not Used For This Transaction Code" | "Patient City Address Is Not Used For This Transaction Code" |
| "Patient State/Province Address Is Not Used For This Tx Code" | "Patient ZIP/Postal Zone Is Not Used For This Transaction Code" |
| "Patient Phone Number Is Not Used For This Transaction Code" | "Place Of Service Is Not Used For This Transaction Code" |
| "Employer ID Is Not Used For This Transaction Code" | "Smoker/Non-Smoker Code Is Not Used For This Transaction Code" |
| "Pregnancy Indicator Is Not Used For This Transaction Code" | "Patient E-Mail Address Is Not Used For This Transaction Code" |
| "Patient Residence Is Not Used For This Transaction Code" | "Patient ID Associated State/Province Address Not Used For Tx" |
| "Cardholder First Name Is Not Used For This Transaction Code" | "Cardholder Last Name Is Not Used For This Transaction Code" |
| "Home Plan Is Not Used For This Transaction Code" | "Plan ID Is Not Used For This Transaction Code" |
| "Eligibility Clarification Code Is Not Used For This Tx Code" | "Group ID Is Not Used For This Transaction Code" |
| "Person Code Is Not Used For This Transaction Code" | "Patient Relationship Code Is Not Used For This Transaction Code" |
| "Other Payer BIN Number Is Not Used For This Transaction Code" | "Other Payer Processor Control Number Not Used For This Tx Code" |
| "Other Payer Cardholder ID Is Not Used For This Transaction Code" | "Other Payer Group ID Is Not Used For This Transaction Code" |
| "Medigap ID Is Not Used For This Transaction Code" | "Medicaid Indicator Is Not Used For This Transaction Code" |
| "Provider Accept Assignment Indicator Not Used For This Tx Code" | "CMS Part D Defined Qualified Facility Not Used For This Tx Code" |
| "Medicaid ID Number Is Not Used For This Transaction Code" | "Medicaid Agency Number Is Not Used For This Transaction Code" |
| "Associated Rx/Service Reference Number Not Used For Tx Code" | "Associated Rx/Service Date Is Not Used For This Tx Code" |
| "Procedure Modifier Code Count Is Not Used For This Tx Code" | "Procedure Modifier Code Is Not Used For This Transaction Code" |
| "Quantity Dispensed Is Not Used For This Transaction Code" | "Fill Number Is Not Used For This Transaction Code" |
| "Days Supply Is Not Used For This Transaction Code" | "Compound Code Is Not Used For This Transaction Code" |
| "DAW/Product Selection Code Is Not Used For This Tx Code" | "Date Prescription Written Is Not Used For This Transaction Code" |
| "Number Of Refills Authorized Is Not Used For This Tx Code" | "Prescription Origin Code Is Not Used For This Transaction Code" |
| "Submission Clarification Code Count Not Used For This Tx Code" | "Submission Clarification Code Is Not Used For This Tx Code" |
| "Quantity Prescribed Is Not Used For This Transaction Code" | "Other Coverage Code Is Not Used For This Transaction Code" |
| "Special Packaging Indicator Is Not Used For This Tx Code" | "Originally Prescribed Product/Service ID Qual Not Used For Tx" |
| "Originally Prescribed Product/Service Code Not Used For This Tx" | "Originally Prescribed Quantity Is Not Used For This Tx Code" |
| "Alternate ID Is Not Used For This Transaction Code" | "Scheduled Rx ID Number Is Not Used For This Tx Code" |
| "Unit Of Measure Is Not Used For This Transaction Code" | "Level Of Service Is Not Used For This Transaction Code" |
| "Prior Authorization Type Code Is Not Used For This Tx Code" | "Prior Authorization ID Submitted Is Not Used For This Tx Code" |
| "Intermediary Authorization Type ID Not Used For This Tx Code" | "Intermediary Authorization ID Is Not Used For This Tx Code" |
| "Dispensing Status Is Not Used For This Transaction Code" | "Quantity Intended To Be Dispensed Not Used For This Tx Code" |
| "Days Supply Intended To Be Dispensed Not Used For This Tx Code" | "Delay Reason Code Is Not Used For This Transaction Code" |
| "Transaction Reference Number Is Not Used For This Tx Code" | "Patient Assignment (Dir Member Reimb) Not Used For This Tx Code" |
| "Route of Administration Is Not Used For This Transaction Code" | "Compound Type Is Not Used For This Transaction Code" |
| "Medicaid Subrogation ICN/TCN Is Not Used For This Tx Code" | "Pharmacy Service Type Is Not Used For This Transaction Code" |
| "Associated Rx/Service Provider ID Qualifier Not Used For Tx" | "Associated Rx/Service Provider ID Is Not Used For This Tx Code" |
| "Associated Rx/Service Ref Number Qualifier Not Used For This Tx" | "Associated Rx/Service Ref Fill Number Not Used For This Tx Code" |
| "Time of Service Is Not Used For This Transaction Code" | "Sales Transaction ID Is Not Used For This Transaction Code" |
| "Reported Adjudicated Program Type Not Used For This Tx Code" | "M/I Request Type" |
| "M/I Request Period Date-Begin" | "M/I Request Period Date-End" |
| "M/I Basis Of Request" | "M/I Authorized Representative First Name" |
| "M/I Authorized Representative Last Name" | "M/I Authorized Representative Street Address" |
| "M/I Authorized Representative City Address" | "M/I Authorized Representative State/Province Address" |
| "M/I Authorized Representative Zip/Postal Zone" | "M/I Prescriber Phone Number" |
| "M/I Prior Authorization ID Assigned" | "M/I Authorization Number" |
| "M/I Facility Name" | "Prior Authorization Not Required" |
| "M/I Prior Authorization Supporting Documentation" | "Active Prior Authorization Exists; Resubmit At Its Expiration" |
| "M/I Facility Street Address" | "M/I Facility State/Province Address" |
| "Prior Authorization In Process" | "Authorization Number Not Found" |
| "Prior Authorization Denied" | "Reversal Request Outside Processor Reversal Window" |
| "No Matching Paid Claim Found For Reversal Request" | "M/I Level Of Service" |
| "M/I Prescription Origin Code" | "M/I Submission Clarification Code" |
| "M/I Primary Care Provider ID" | "M/I Basis Of Cost Determination" |
| "M/I Diagnosis Code" | "Provider ID Qualifier Is Not Used For This Transaction Code" |
| "Provider ID Is Not Used For This Transaction Code" | "Prescriber ID Qualifier Is Not Used For This Transaction Code" |
| "Prescriber ID Is Not Used For This Transaction Code" | "Prescriber ID Associated State/Province Address Not Used For Tx" |
| "Prescriber Last Name Is Not Used For This Transaction Code" | "Prescriber Phone Number Is Not Used For This Transaction Code" |
| "Primary Care Provider ID Qualifier Not Used For This Tx Code" | "Primary Care Provider ID Is Not Used For This Transaction Code" |
| "Primary Care Provider Last Name Is Not Used For This Tx Code" | "Prescriber First Name Is Not Used For This Transaction Code" |
| "Prescriber Street Address Is Not Used For This Transaction Code" | "Prescriber City Address Is Not Used For This Transaction Code" |
| "Prescriber State/Province Address Is Not Used For This Tx Code" | "Prescriber ZIP/Postal Zone Is Not Used For This Tx Code" |
| "Prescriber Alternate ID Qualifier Not Used For This Tx Code" | "Prescriber Alternate ID Is Not Used For This Transaction Code" |
| "Prescriber Alternate ID Associated State/Province Addr Not Used" | "Other Payer ID Qualifier Is Not Used For This Transaction Code" |
| "Other Payer ID Is Not Used For This Transaction Code" | "Other Payer Date Is Not Used For This Transaction Code" |
| "Internal Control Number Is Not Used For This Transaction Code" | "Other Payer Amount Paid Count Is Not Used For This Tx Code" |
| "Other Payer Amount Paid Qualifier Not Used For This Tx Code" | "Other Payer Amount Paid Is Not Used For This Transaction Code" |
| "Other Payer Reject Count Is Not Used For This Transaction Code" | "Other Payer Reject Code Is Not Used For This Transaction Code" |
| "Other Payer-Patient Resp Amount Count Not Used For This Tx Code" | "Other Payer-Patient Resp Amount Qualifier Not Used For This Tx" |
| "Other Payer-Patient Resp Amount Not Used For This Tx Code" | "Benefit Stage Count Is Not Used For This Transaction Code" |
| "Benefit Stage Qualifier Is Not Used For This Transaction Code" | "Benefit Stage Amount Is Not Used For This Transaction Code" |
| "Employer Name Is Not Used For This Transaction Code" | "Employer Street Address Is Not Used For This Transaction Code" |
| "Employer City Address Is Not Used For This Transaction Code" | "Employer State/Province Address Not Used For This Tx Code" |
| "Employer ZIP/Postal Code Is Not Used For This Transaction Code" | "Employer Phone Number Is Not Used For This Transaction Code" |
| "Employer Contact Name Is Not Used For This Transaction Code" | "Carrier ID Is Not Used For This Transaction Code" |
| "Claim/Reference ID Is Not Used For This Transaction Code" | "Billing Entity Type Indicator Not Used For This Tx Code" |
| "Pay To Qualifier Is Not Used For This Transaction Code" | "Pay To ID Is Not Used For This Transaction Code" |
| "Pay To Name Is Not Used For This Transaction Code" | "Pay To Street Address Is Not Used For This Transaction Code" |
| "Pay To City Address Is Not Used For This Transaction Code" | "Pay To State/Province Address Not Used For This Tx Code" |
| "Pay To ZIP/Postal Zone Is Not Used For This Transaction Code" | "Generic Equivalent Product ID Qual Not Used For This Tx Code" |
| "Generic Equivalent Product ID Not Used For This Tx Code" | "DUR/PPS Code Counter Is Not Used For This Transaction Code" |
| "Reason For Service Code Is Not Used For This Transaction Code" | "Professional Service Code Is Not Used For This Transaction Code" |
| "Result Of Service Code Is Not Used For This Transaction Code" | "DUR/PPS Level Of Effort Is Not Used For This Transaction Code" |
| "DUR Co-Agent ID Qualifier Is Not Used For This Transaction Code" | "DUR Co-Agent ID Is Not Used For This Transaction Code" |
| "Ingredient Cost Submitted Is Not Used For This Transaction Code" | "Dispensing Fee Submitted Is Not Used For This Transaction Code" |
| "Professional Service Fee Submitted Not Used For This Tx Code" | "Patient Pay Amount Reported Not Used For This Tx Code" |
| "Incentive Amount Submitted Not Used For This Tx Code" | "Other Amount Claimed Submitted Count Not Used For This Tx Code" |
| "Other Amount Claimed Submitted Qual Not Used For This Tx Code" | "Other Amount Claimed Submitted Not Used For This Tx Code" |
| "Regulatory Fee Amount Submitted Not Used For This Tx Code" | "Percentage Sales Tax Amount Submitted Not Used For This Tx Code" |
| "Percentage Sales Tax Rate Submitted Not Used For This Tx Code" | "Percentage Sales Tax Basis Submitted Not Used For This Tx Code" |
| "Usual And Customary Charge Not Used For This Tx Code" | "Gross Amount Due Is Not Used For This Transaction Code" |
| "Basis Of Cost Determination Not Used For This Tx Code" | "Medicaid Paid Amount Is Not Used For This Transaction Code" |
| "Coupon Value Amount Is Not Used For This Transaction Code" | "Compound Ingredient Drug Cost Not Used For This Tx Code" |
| "Compound Ingredient Basis Of Cost Determ. Not Used For Tx Code" | "Compound Ingredient Modifier Code Count Not Used For Tx Code" |
| "Compound Ingredient Modifier Code Not Used For This Tx Code" | "Authorized Representative First Name Not Used For This Tx Code" |
| "Authorized Rep. Last Name Is Not Used For This Transaction Code" | "Authorized Rep. Street Address Not Used For This Tx Code" |
| "Authorized Rep. City Is Not Used For This Transaction Code" | "Authorized Rep. State/Province Not Used For This Tx Code" |
| "Authorized Rep. ZIP/Postal Code Not Used For This Tx Code" | "Prior Authorization ID Assigned Not Used For This Tx Code" |
| "Authorization Number Is Not Used For This Transaction Code" | "Prior Authorization Supporting Doc Not Used For This Tx Code" |
| "Diagnosis Code Count Is Not Used For This Transaction Code" | "Diagnosis Code Qualifier Is Not Used For This Transaction Code" |
| "Diagnosis Code Is Not Used For This Transaction Code" | "Clinical Information Counter Not Used For This Tx Code" |
| "Measurement Date Is Not Used For This Transaction Code" | "Measurement Time Is Not Used For This Transaction Code" |
| "Measurement Dimension Is Not Used For This Transaction Code" | "Measurement Unit Is Not Used For This Transaction Code" |
| "Measurement Value Is Not Used For This Transaction Code" | "Request Period Begin Date Is Not Used For This Transaction Code" |
| "Request Period Recert/Revised Date Not Used For This Tx Code" | "M/I Question Number/Letter" |
| "M/I Coordination Of Benefits/Other Payments Count" | "M/I Question Percent Response" |
| "M/I Primary Care Provider Last Name" | "M/I Question Date Response" |
| "M/I Question Dollar Amount Response" | "M/I Question Numeric Response" |
| "M/I Question Alphanumeric Response" | "Compound Ingr Modifier Code Count != # Of Repetitions" |
| "Question Number/Letter Count Does Not Match Repetitions Number" | "Question Number/Letter Not Valid For Identified Document" |
| "Question Response Not Appropriate For Question Number/Letter" | "Required Question Num/Letter Response For Indicated Doc Missing" |
| "Compound Product ID Requires A Modifier Code" | "M/I Additional Documentation Segment" |
| "Must Dispense Through Specialty Pharmacy" | "M/I Patient Residence" |
| "Patient Residence Value Not Supported" | "Place of Service Not Supported By Plan" |
| "Pharmacy Not Contracted With Plan/Processor On Date Of Service" | "Submit Bill To Other Processor Or Primary Payer" |
| "Plan's Prescriber DB: Prescriber ID Submitted Inactive/Expired" | "Plan's Prescriber DB: Prescriber DEA Number Inactive/Expired" |
| "Plan's Prescriber DB: Prescriber DEA Number Not Found" | "Plan's Prescriber DB: DEA Num Does Not Allow Drug DEA Class" |
| "Request Status Is Not Used For This Transaction Code" | "Length Of Need Qualifier Is Not Used For This Transaction Code" |
| "Length Of Need Is Not Used For This Transaction Code" | "Prescriber/Supplier Date Signed Not Used For This Tx Code" |
| "Supporting Documentation Is Not Used For This Transaction Code" | "Question Number/Letter Count Not Used For This Tx Code" |
| "Question Number/Letter Is Not Used For This Transaction Code" | "Question Percent Response Is Not Used For This Transaction Code" |
| "Question Date Response Is Not Used For This Transaction Code" | "Question Dollar Amount Response Not Used For This Tx Code" |
| "Question Numeric Response Is Not Used For This Transaction Code" | "Question Alphanumeric Response Not Used For This Tx Code" |
| "Facility ID Is Not Used For This Transaction Code" | "Facility Name Is Not Used For This Transaction Code" |
| "Facility Street Address Is Not Used For This Transaction Code" | "Facility City Address Is Not Used For This Transaction Code" |
| "Facility State/Province Address Not Used For This Tx Code" | "Facility ZIP/Postal Zone Is Not Used For This Transaction Code" |
| "Purchaser ID Qualifier Is Not Used For This Transaction Code" | "Purchaser ID Is Not Used For This Transaction Code" |
| "Purchaser ID Associated State Code Not Used For This Tx Code" | "Purchaser Date Of Birth Is Not Used For This Transaction Code" |
| "Purchaser Gender Code Is Not Used For This Transaction Code" | "Purchaser First Name Is Not Used For This Transaction Code" |
| "Purchaser Last Name Is Not Used For This Transaction Code" | "Purchaser Street Address Is Not Used For This Transaction Code" |
| "Purchaser City Address Is Not Used For This Transaction Code" | "Purchaser State/Province Address Not Used For This Tx Code" |
| "Purchaser ZIP/Postal Zone Is Not Used For This Transaction Code" | "Purchaser Country Code Is Not Used For This Transaction Code" |
| "Purchaser Relationship Code Not Used For This Tx Code" | "Released Date Is Not Used For This Transaction Code" |
| "Released Time Is Not Used For This Transaction Code" | "Service Provider Name Is Not Used For This Transaction Code" |
| "Service Provider Street Address Not Used For This Tx Code" | "Service Provider City Address Not Used For This Tx Code" |
| "Service Provider State/Province Address Not Used For Tx Code" | "Service Provider ZIP/Postal Zone Not Used For This Tx Code" |
| "Seller ID Qualifier Is Not Used For This Transaction Code" | "Seller ID Is Not Used For This Transaction Code" |
| "Seller Initials Is Not Used For This Transaction Code" | "Other Amount Claimed Submitted Grouping Incorrect" |
| "Other Payer Amount Paid Grouping Incorrect" | "Other Payer-Patient Responsibility Amount Grouping Incorrect" |
| "Benefit Stage Amount Grouping Incorrect" | "Diagnosis Code Grouping Incorrect" |
| "COB/Other Payments Segment Incorrectly Formatted" | "Additional Documentation Segment Incorrectly Formatted" |
| "Clinical Segment Incorrectly Formatted" | "Patient Segment Incorrectly Formatted" |
| "Insurance Segment Incorrectly Formatted" | "Transaction Header Segment Incorrectly Formatted" |
| "Claim Segment Incorrectly Formatted" | "Pharmacy Provider Segment Incorrectly Formatted" |
| "Prescriber Segment Incorrectly Formatted" | "Workers' Compensation Segment Incorrectly Formatted" |
| "Pricing Segment Incorrectly Formatted" | "Coupon Segment Incorrectly Formatted" |
| "Prior Authorization Segment Incorrectly Formatted" | "Facility Segment Incorrectly Formatted" |
| "Narrative Segment Incorrectly Formatted" | "Purchaser Segment Incorrectly Formatted" |
| "Service Provider Segment Incorrectly Formatted" | "Pharmacy Not Contracted In Assisted Living Network" |
| "Svc Provider ID Qualifier Must Precede Svc Provider ID" | "Patient ID Qualifier Does Not Precede Patient ID" |
| "Rx/Service Ref Num Qualifier Must Precede Rx/Service Ref Num" | "Product/Service ID Qual Must Precede Product/Service ID" |
| "Procedure Modifier Code Count Must Precede Modifier Code" | "SCC Count Does Not Precede Submission Clarification Code" |
| "Orig Rx Product/Svc ID Qual Must Precede Product/Svc Code" | "Other Amount Claimed Count Must Precede Amount &/or Qualifier" |
| "Other Amt Claimed Qual Must Precede Other Amt Claimed Submitted" | "Provider ID Qualifier Does Not Precede Provider ID" |
| "Prescriber ID Qualifier Does Not Precede Prescriber ID" | "Primary Care Provider ID Qual Must Precede Primary Care Prov ID" |
| "COB/Other Payments Count Must Precede Other Payer Coverage Type" | "Other Payer ID Count Must Precede Other Payer ID Data Fields" |
| "Other Payer ID Qualifier Does Not Precede Other Payer ID" | "Other Payer Amount Paid Count Must Precede Amt Paid &/or Qual" |
| "Other Payer Amt Paid Qual Must Precede Other Payer Amount Paid" | "Other Payer Reject Count Must Precede Other Payer Reject Code" |
| "OP-Pt Resp Amt Count Must Precede OP-Pt Resp Amt &/or Qual" | "OP-Patient Resp Amt Qualifier Must Precede OP-Patient Resp Amt" |
| "Benefit Stage Count Must Precede Benefit Stage Amt &/or Qual" | "Benefit Stage Qualifier Does Not Precede Benefit Stage Amount" |
| "Pay To Qualifier Does Not Precede Pay To ID" | "Gen Equiv Product ID Qual Must Precede Gen Equiv Product ID" |
| "DUR/PPS Code Counter Does Not Precede DUR Data Fields" | "DUR Co-Agent ID Qualifier Does Not Precede DUR Co-Agent ID" |
| "Compound Ingr Component Count Must Precede Product ID &/or Qual" | "Compound Product ID Qualifier Must Precede Compound Product ID" |
| "Compound Ingr Modifier Code Count Must Precede Modifier Code" | "Diagnosis Code Count Must Precede Diagnosis Code &/or Qualifier" |
| "Diagnosis Code Qualifier Does Not Precede Diagnosis Code" | "Clinical Info Counter Must Precede Clinical Measurement Data" |
| "Length Of Need Qualifier Does Not Precede Length Of Need" | "Question Num/Letter Count Must Precede Question Num/Letter" |
| "Accumulator Month Count Does Not Precede Accumulator Month" | "M/I Other Payer Coverage Type" |
| "M/I Other Payer Reject Count" | "M/I Facility City Address" |
| "Non-Matched Pharmacy Number" | "Non-Matched Group ID" |
| "Non-Matched Cardholder ID" | "Non-Matched Person Code" |
| "Non-Matched Product/Service ID Number" | "Non-Matched Product Package Size" |
| "Non-Matched Prescriber ID" | "Non-Matched Primary Prescriber" |
| "Patient ID Count Does Not Precede Patient ID Data Fields" | "Benefit Stage Qualifier Value Not Supported" |
| "Other Payer Coverage Type Value Not Supported" | "Rx/Service Reference Number Qualifier Value Not Supported" |
| "Additional Documentation Type ID Value Not Supported" | "Authorized Rep State/Province Address Value Not Supported" |
| "Basis Of Request Value Not Supported" | "Billing Entity Type Indicator Value Not Supported" |
| "CMS Part D Defined Qualified Facility Value Not Supported" | "Compound Code Value Not Supported" |
| "Compound Dispensing Unit Form Indicator Value Not Supported" | "Compound Ingr Basis Of Cost Determination Value Not Supported" |
| "Compound Product ID Qualifier Value Not Supported" | "Compound Type Value Not Supported" |
| "Coupon Type Value Not Supported" | "DUR Co-Agent ID Qualifier Value Not Supported" |
| "DUR/PPS Level Of Effort Value Not Supported" | "Delay Reason Code Value Not Supported" |
| "Diagnosis Code Qualifier Value Not Supported" | "Dispensing Status Value Not Supported" |
| "Eligibility Clarification Code Value Not Supported" | "Employer State/Province Address Value Not Supported" |
| "Facility State/Province Address Value Not Supported" | "Header Response Status Value Not Supported" |
| "Intermediary Authorization Type ID Value Not Supported" | "Length of Need Qualifier Value Not Supported" |
| "Level Of Service Value Not Supported" | "Measurement Dimension Value Not Supported" |
| "Measurement Unit Value Not Supported" | "Medicaid Indicator Value Not Supported" |
| "Originally Prescribed Product/Svc ID Qual Value Not Supported" | "Other Amount Claimed Submitted Qualifier Value Not Supported" |
| "Other Coverage Code Value Not Supported" | "Other Payer-Patient Resp Amount Qualifier Value Not Supported" |
| "Patient Assignment (Direct Member Reimb) Value Not Supported" | "Patient Gender Code Value Not Supported" |
| "Patient State/Province Address Value Not Supported" | "Pay to State/Province Address Value Not Supported" |
| "Percentage Sales Tax Basis Submitted Value Not Supported" | "Pregnancy Indicator Value Not Supported" |
| "Prescriber ID Qualifier Value Not Supported" | "Prescriber State/Province Address Value Not Supported" |
| "Prescription Origin Code Value Not Supported" | "Primary Care Provider ID Qualifier Value Not Supported" |
| "Prior Authorization Type Code Value Not Supported" | "Provider Accept Assignment Indicator Value Not Supported" |
| "Provider ID Qualifier Value Not Supported" | "Request Status Value Not Supported" |
| "Request Type Value Not Supported" | "Route of Administration Value Not Supported" |
| "Smoker/Non-Smoker Code Value Not Supported" | "Special Packaging Indicator Value Not Supported" |
| "Transaction Count Value Not Supported" | "Unit Of Measure Value Not Supported" |
| "COB Segment Present On A Non-COB Claim" | "Part D Plan Cannot Coordinate Benefits With Another Part D Plan" |
| "ID Submitted Is Associated With An Excluded Pharmacy" | "Pharmacy Not Contracted In Retail Network" |
| "Pharmacy Not Contracted In Mail Order Network" | "Pharmacy Not Contracted In Hospice Network" |
| "Pharmacy Not Contracted In Veterans Administration Network" | "Pharmacy Not Contracted In Military Network" |
| "Patient Country Code Value Not Supported" | "Patient Country Code Not Used For This Transaction" |
| "M/I Veterinary Use Indicator" | "Veterinary Use Indicator Value Not Supported" |
| "Notice: Medicare Prescription Drug Coverage And Your Rights" | "Veterinary Use Indicator Not Used For This Transaction" |
| "Patient ID Assoc State/Province Address Value Not Supported" | "Medigap ID Not Covered" |
| "Prescriber Alt ID State/Province Addr Value Not Supported" | "Compound Ingredient Modifier Code Not Covered" |
| "Purchaser State/Province Address Value Not Supported" | "Service Provider State/Province Address Value Not Supported" |
| "M/I Other Payer ID" | "Other Payer ID Count Does Not Match Number of Repetitions" |
| "Other Payer ID Count Exceeds Number Of Occurrences Supported" | "Other Payer ID Count Grouping Incorrect" |
| "Other Payer ID Count Is Not Used For This Transaction Code" | "Provider ID Not Covered" |
| "Purchaser ID Associated State/Province Code Value Not Supported" | "Fill Number Value Not Supported" |
| "Facility ID Not Covered" | "Carrier ID Not Covered" |
| "Alternate ID Not Covered" | "Patient ID Not Covered" |
| "Compound Dosage Form Not Covered" | "Plan ID Not Covered" |
| "DUR Co-Agent ID Not Covered" | "M/I Date Of Service" |
| "Pay To ID Not Covered" | "Associated Prescription/Service Provider ID Not Covered" |
| "Compound Preparation Time Not Used For This Transaction Code" | "LTC Dispensing Type Does Not Support The Packaging Type" |
| "More Than One Patient Found" | "Cardholder ID Matched But Last Name Did Not" |
| "M/I Other Payer ID Qualifier" | "M/I Facility ZIP/Postal Zone" |
| "M/I Other Payer Reject Code" | "COB/Other Payments Segment Required For Adjudication" |
| "Coupon Segment Required For Adjudication" | "Insurance Segment Required For Adjudication" |
| "Patient Segment Required For Adjudication" | "Pharmacy Provider Segment Required For Adjudication" |
| "Prescriber Segment Required For Adjudication" | "Pricing Segment Required For Adjudication" |
| "Prior Authorization Segment Required For Adjudication" | "Worker's Compensation Segment Required For Adjudication" |
| "Transaction Segment Required For Adjudication" | "Compound Segment Required For Adjudication" |
| "Compound Segment Incorrectly Formatted" | "Multi-ingredient Compounds Not Supported" |
| "DUR/PPS Segment Required For Adjudication" | "DUR/PPS Segment Incorrectly Formatted" |
| "Not Authorized To Submit Electronically" | "Provider Not Eligible To Perform Service/Dispense Product" |
| "Product/Service Not Covered For Patient Age" | "Product/Service Not Covered For Patient Gender" |
| "Patient/Card Holder ID Name Mismatch" | "Product/Service ID Not Covered For Institutionalized Patient" |
| "Claim Submitted Does Not Match Prior Authorization" | "Patient Is Not Covered" |
| "Patient Age Exceeds Maximum Age" | "Date Of Service Before Coverage Effective" |
| "Date Of Service After Coverage Expired" | "Date Of Service After Coverage Terminated" |
| "Coverage Outside Submitted Date Of Service" | "Intermediary Auth Type ID Must Precede Intermediary Auth ID" |
| "Associated Rx/Service Provider ID Qual Must Precede Provider ID" | "Prescriber Alt ID Qualifier Must Precede Prescriber Alt ID" |
| "Purchaser ID Qualifier Does Not Precede Purchaser ID" | "Seller ID Qualifier Does Not Precede Seller ID" |
| "Brand Drug/Specific Labeler Code Required" | "Info Reporting (N1/N3) Tx Cannot Be Matched To A Claim (B1/B3)" |
| "Step Therapy/Alt Drug Req Before Submitted Product Service ID" | "COB Claim Not Required, Pt Liability Amount Submitted Was Zero" |
| "Info Rpt N1/N3 Matched Reversed/Rejected Claim Under Part D IIN" | "Info Rpt N1/N3 Matched Part D Claim Paid As Non-Part D" |
| "LTC Appropriate Dispensing Invalid SCC Combination" | "Packaging Method/Disp Freq Missing/Wrong For LTC Short Cycle" |
| "Uppercase Character(s) Required" | "Cmp Ingr Cost Basis Value 14 Req When Qty=0 But Cost>$0" |
| "SCC 8 Required When Compound Ingredient Quantity Is 0" | "Compound Ingredient Drug Cost Cannot Be Negative Amount" |
| "Plan's Prescriber DB: Submitted DEA Disallows Drug DEA Schedule" | "Prescriber Type 1 NPI Required" |
| "This Product/Service May Be Covered Under Medicare Part D" | "This Medicaid Patient Is Medicare Eligible" |
| "M/I Authorized Representative Country Code" | "M/I Employer Country Code" |
| "M/I Entity Country Code" | "M/I Facility Country Code" |
| "M/I Patient ID Associated Country Code" | "M/I Pay To Country Code" |
| "M/I Prescriber Alternate ID Associated Country Code" | "M/I Prescriber ID Associated Country Code" |
| "M/I Prescriber Country Code" | "M/I Purchaser ID Associated Country Code" |
| "Authorized Representative Country Code Value Not Supported" | "Employer Country Code Value Not Supported" |
| "Entity Country Code Value Not Supported" | "Facility Country Code Value Not Supported" |
| "Patient ID Associated Country Code Value Not Supported" | "Pay To Country Code Value Not Supported" |
| "Prescriber Alternate ID Associated Country Code Not Supported" | "Prescriber ID Associated Country Code Value Not Supported" |
| "Prescriber Country Code Value Not Supported" | "Purchaser ID Associated Country Code Value Not Supported" |
| "Repackaged Product Is Not Covered By The Contract" | "Pt Not Eligible Due To Non Payment Of Premium; Contact Plan" |
| "Quantity Prescribed Required For CII Prescription" | "Quantity Prescribed Does Not Match Original Dispensing Quantity" |
| "Cumulative Qty For This Rx Number Exceeds Total Prescribed Qty" | "DOS >60 Days From CII Rx Written Date For LTC/Terminally Ill Pt" |
| "REMS: Mandatory Data Element(s) Missing" | "REMS: Prescriber Not Matched Or May Not Be Enrolled" |
| "REMS: Patient Not Matched Or May Not Be Enrolled" | "REMS: Pharmacy Not Matched Or May Not Be Enrolled" |
| "REMS: Multiple Patient Matches" | "REMS: Patient Age Not Matched" |
| "REMS: Patient Gender Not Matched" | "REMS: Pharmacy Has Not Enrolled" |
| "REMS: Pharmacy Has Not Renewed Enrollment" | "REMS: Pharmacy Has Not Submitted Agreement Form" |
| "REMS: Pharmacy Has Been Suspended Due To Non-compliance" | "REMS: Prescriber Has Not Enrolled" |
| "REMS: Prescriber Has Not Completed A Knowledge Assessment" | "REMS: Prescriber Has Been Suspended Due To Non-compliance" |
| "REMS: Excessive Days Supply" | "REMS: Insufficient Days Supply" |
| "REMS: Excessive Dosage" | "REMS: Insufficient Dosage" |
| "REMS: Additional Fills Not Permitted" | "REMS: Laboratory Test Results Not Documented" |
| "REMS: Lab Test Not Conducted Within Specified Time Period" | "REMS: Dispensing Not Authorized Due To Laboratory Test Results" |
| "REMS: Prescriber Counseling Of Patient Not Documented" | "REMS: Prescriber Has Not Documented Safe Use Conditions" |
| "REMS: Prescriber Has Not Documented Patient Opioid Tolerance" | "REMS: Prescriber Has Not Documented Patient Contraceptive Use" |
| "REMS: Lack Of Contraindicated Therapy Not Documented" | "REMS: Step Therapy Not Documented" |
| "REMS: Prescriber Has Not Enrolled Patient" | "REMS: Prescriber Must Renew Patient Enrollment" |
| "REMS: Patient Enrollment Requirements Have Not Been Met" | "REMS: Prescriber Has Not Submitted Patient Agreement" |
| "REMS: Prescriber Has Not Verified Pt's Reproductive Potential" | "REMS: Patient Has Not Documented Safe Use Conditions" |
| "REMS: Patient Has Not Documented Completed Education" | "REMS: Patient Has Not Documented Contraceptive Use" |
| "REMS: Administrator Denied" | "REMS: Service Billing Denied" |
| "PDMP: Administrator Denied" | "PDMP: Pharmacy Not Contracted" |
| "PDMP: Pharmacy Contract Not Renewed" | "PDMP: M/I Patient First Name" |
| "PDMP: M/I Patient Last Name" | "PDMP: M/I Patient Street Address" |
| "PDMP: M/I Patient City" | "PDMP: M/I Patient State Or Province" |
| "PDMP: M/I Patient ZIP/Postal Code" | "PDMP: M/I Prescriber ID" |
| "PDMP: M/I Prescriber Last Name" | "Provider Does Not Match Authorization On File" |
| "Service Provider ID Qualifier Not Supported For Processor/Payer" | "Non-Matched DOB" |
| "M/I DUR/PPS Code Counter" | "Future Date Not Allowed For Date Of Birth" |
| "Future Date Not Allowed For DOB" | "Non-Matched Gender Code" |
| "Patient Relationship Code Value Not Supported" | "Discrepancy Between Other Coverage Code And Other Payer Amount" |
| "Discrepancy Between Other Coverage Code And Other Coverage Info" | "Patient ID Qualifier Value Not Supported" |
| "COB/Other Payments Count Exceeds Number Of Supported Payers" | "Other Payer ID Qualifier Value Not Supported" |
| "Other Payer Amount Paid Count Exceeds Supported Groupings" | "Other Payer Amount Paid Qualifier Value Not Supported" |
| "Quantity Intended To Be Dispensed Required For Partial Fill Tx" | "Days Supply Intended To Be Dispensed Req For Partial Fill Tx" |
| "Duplicate Fill Number" | "Number Of Refills Authorized Exceed Allowable Refills" |
| "Days Supply Exceeds Plan Limitation" | "Compounds Not Covered" |
| "Compound Requires Two Or More Ingredients" | "Product/Service Not Covered - Plan/Benefit Exclusion" |
| "Prescriber ID Is Not Covered" | "Primary Prescriber Is Not Covered" |
| "Additional Fills Are Not Covered" | "Other Carrier Payment Meets Or Exceeds Payable" |
| "Prior Authorization Required" | "Plan Limitations Exceeded" |
| "Discontinued Product/Service ID Number" | "Cost Exceeds Maximum" |
| "Fill Too Soon" | "PDMP: M/I Patient ID" |
| "PDMP: M/I Patient Date Of Birth" | "PDMP: M/I Patient Gender" |
| "PDMP: M/I Prescription Origin Code" | "PDMP: M/I Scheduled Rx Serial Number" |
| "PDMP: M/I Product/Service ID" | "PDMP: M/I Compound Code" |
| "PDMP: M/I Patient Phone Number" | "PDMP: M/I Reported Adjudicated Program Type" |
| "M/I Record Type" | "Date Received After Requested Response Date" |
| "M/I Transmission Date" | "M/I Sending Entity Identifier" |
| "M/I Receiver ID" | "M/I Transmission File Type" |
| "M/I Transmission Type" | "Transmission File Type Not Supported" |
| "M/I Submission Number" | "M/I Audit Request Type" |
| "Audit Request Type Not Supported" | "M/I Service Provider Chain Code" |
| "M/I Entity Name" | "M/I Entity Contact First Name" |
| "M/I Entity Contact Last Name" | "M/I Entity Address Line 1" |
| "M/I Entity Address Line 2" | "M/I Entity City" |
| "M/I Entity State/Province Address" | "M/I Entity ZIP/Postal Code" |
| "M/I Entity Fax Number" | "M/I Entity Email" |
| "Header Response Status Not Supported For This Transmission Type" | "Reject Code Not Supported For This Transmission File Type" |
| "M/I Claim Sequence Number" | "M/I Audit Control Identification" |
| "M/I Audit Range Qualifier" | "Audit Range Qualifier Not Supported For This Audit Request Type" |
| "M/I Audit Range Start" | "Audit Range Start Not Supported For This Audit Request Type" |
| "M/I Audit Range End" | "Audit Range End Not Supported For This Audit Request Type" |
| "Exceeds Range Start Limitations" | "Exceeds Range End Limitations" |
| "M/I Requested Response Date" | "Response Date Requires Rescheduling" |
| "M/I Estimated Arrival Time Description" | "Estimated Arrival Time Requires Rescheduling" |
| "M/I Audit Sponsor" | "Non-Matched Processor Control Number" |
| "M/I Audit Element Type 1" | "M/I Audit Element Type 2" |
| "M/I Audit Element Type 3" | "M/I Audit Element Type 4" |
| "M/I Audit Element Type 5" | "Audit Element Type Not Allowable Per State Regulation" |
| "Audit Element Type Not Required For Dispensing" | "M/I Audit Element Response Type 1" |
| "M/I Audit Element Response Type 2" | "M/I Audit Element Response Type 3" |
| "M/I Audit Element Response Type 4" | "M/I Audit Element Response Type 5" |
| "M/I Discrepancy Code 1" | "M/I Discrepancy Code 2" |
| "M/I Discrepancy Code 3" | "M/I Discrepancy Message" |
| "M/I Discrepancy Amount" | "Discrepancy Amount In Excess Of Claimed Amount" |
| "M/I Record Count" | "Pharmacy Location Has Closed" |
| "Paid B1/B3 Under Part D Found; N2 No Match Approved N1/N3 Tx" | "Paid B1/B3 Not Under Part D; N2 No Match Approved N1/N3 Tx" |
| "Compound Unidentified Ingredient(s); SCC Override Not Allowed" | "Compound Non-covered Ingredient(s); SCC Override Not Allowed" |
| "Prescriber Is Not Listed On Medicare Enrollment File" | "Prescriber Medicare Enrollment Period Is Outside Of Claim DOS" |
| "Pharmacy Not Listed In Medicare FFS Active Enrollment File" | "Pharmacy Enrollment With Medicare FFS Has Terminated" |
| "Plan's Prescriber DB: No Active State License w/ Rx Auth" | "Invalid Transmission File Type" |
| "Invalid Document Reference Number" | "M/I Transmission Time" |
| "Corrupted Transmission Control Number" | "M/I Sender ID" |
| "M/I File Type" | "M/I Accumulator Balance Count" |
| "M/I Accumulator Network Indicator" | "M/I Accumulator Action Code" |
| "M/I Benefit Type" | "M/I In Network Status" |
| "Duplicate Record" | "Retry Limit Exceeded" |
| "Deductible Over Accumulated" | "Out Of Pocket Over Accumulated" |
| "Maximum Benefit Amount (CAP) Over Accumulated" | "SA Over Accumulated" |
| "LTC Over Accumulated" | "Compound Requires At Least One Covered Ingredient" |
| "Compound Segment Missing On A Compound Claim" | "M/I Facility ID" |
| "Compound Segment Present On A Non-Compound Claim" | "M/I DUR/PPS Level Of Effort" |
| "Product/Service ID (407-D7) Must Be A Single Zero For Compounds" | "Product/Service Only Covered On Compound Claim" |
| "Incorrect Product/Service ID For Processor/Payer" | "DAW Code Value Not Supported" |
| "Sum Of Compound Ingredient Costs Does Not Equal Ingredient Cost" | "Future Date Prescription Written Not Allowed" |
| "Date Written Different On Previous Fill" | "Excessive Refills Authorized" |
| "Submission Clarification Code Value Not Supported" | "Basis Of Cost Determination Value Not Supported" |
| "U&C Must Be Greater Than Zero" | "GAD Must Be Greater Than Zero" |
| "Negative Dollar Amount Not Supported In Other Payer Amount Paid" | "Discrepancy Between Other Coverage Code And Other Payer Amt Pd" |
| "Collection From Cardholder Not Allowed" | "Excessive Amount Collected" |
| "Product/Service ID Qualifier Value Not Supported" | "Diagnosis Code Submitted Does Not Meet Drug Coverage Criteria" |
| "Claim Too Old" | "Claim Is Post-Dated" |
| "Duplicate Paid/Captured Claim" | "Claim Has Not Been Paid/Captured" |
| "Claim Not Processed" | "Submit Manual Reversal" |
| "Reversal Not Processed" | "DUR Reject Error" |
| "Rejected Claim Fees Paid" | "RXC Over Accumulated" |
| "M/I Total Amount Paid" | "M/I Amount Of Copay" |
| "M/I Patient Pay Amount" | "M/I Amount Attributed To Product Selection/Brand" |
| "M/I Amount Attributed To Sales Tax" | "M/I Amount Attributed To Process Fee" |
| "M/I Invoiced Amount" | "M/I Penalty Amount" |
| "Mismatched Original Authorization" | "M/I Partner Eligibility Data" |
| "Partner Eligibility Mismatch" | "M/I Record Length" |
| "M/I Action Code" | "Not Supported Accumulator Action Code" |
| "Balance Mismatch" | "Pharmacy Benefit Exclusion; May Be Under Pt's Medical Benefit" |
| "Pharmacy Benefit Exclusion, Covered Under Pt's Medical Benefit" | "Medication Administration Not Covered, Plan Benefit Exclusion" |
| "Plan Enrollment File Indicates Medicare As Primary Coverage" | "N1/N3 Matched Reversed/Rejected Claim Not Under Part D IIN PCN" |
| "N1/N3 Tx Matched Paid Claim Not Submitted Under Part D IIN PCN" | "Drug Unrelated To Terminal Illness; Not Covered By Hospice" |
| "Beneficiary Liability; Hospice Non-Formulary; Check Other Cov" | "Multi-transaction Transmission Not Allowed In Current NCPDP Std" |
| "Claim DOS Is Outside Of Product's FDA/NSDE Marketing Dates" | "Prescriber NPI Submitted Not Found Within Processor's NPI File" |
| "Pharmacy Service Provider Temp Suspended By Payer/Processor" | "Plan/Beneficiary Case Management Restriction In Place" |
| "Pharmacy Notify Beneficiary: Failed Part D Prescriber NPI Reqs" | "Workers' Comp/P&C Adjuster Auth Required - Pt Contact Adjuster" |
| "Product Service ID Carve-Out, Bill Medicaid Fee For Service" | "Prescriber NPI Not Found; Status/Medicare/Rx Auth Not Validated" |
| "Accumulator Year Is Not Within ATBT Timeframe" | "M/I Provider First Name" |
| "M/I Provider Last Name" | "M/I Facility ID Qualifier" |
| "Facility ID Qualifier Value Not Supported" | "M/I Original Manufacturer Product ID" |
| "M/I Original Manufacturer Product ID Qualifier" | "Original Manufacturer Product ID Qualifier Value Not Supported" |
| "Record Is Locked." | "Record Is Not Locked." |
| "M/I Transmission ID" | "M/I Other Payer Adjudicated Program Type" |
| "Other Payer Reconciliation ID Not Used For This Tx Code" | "Benefit Stage Indicator Count Not Used For This Tx Code" |
| "Benefit Stage Indicator Count Does Not Precede Benefit Stage" | "M/I Benefit Stage Indicator Count" |
| "Benefit Stage Indicator Count Does Not Match # Of Repetitions" | "Benefit Stage Indicator Is Not Used For This Transaction Code" |
| "Benefit Stage Indicator Value Not Supported" | "M/I Benefit Stage Indicator" |
| "N Payer IIN Is Not Used For This Transaction Code" | "M/I N Payer IIN" |
| "Non-Matched N Payer IIN" | "N Payer Processor Control Number Not Used For This Tx Code" |
| "M/I N Payer Processor Control Number" | "Non-Matched N Payer Processor Control Number" |
| "N Payer Group ID Is Not Used For This Transaction Code" | "M/I N Payer Group ID" |
| "Non-Matched N Payer Group ID" | "N Payer Cardholder ID Is Not Used For This Transaction Code" |
| "M/I N Payer Cardholder ID" | "N Payer Cardholder ID Is Not Covered" |
| "N Payer Adjudicated Program Type Not Used For This Tx Code" | "M/I N Payer Adjudicated Program Type" |
| "N Payer Adjudicated Program Type Value Not Supported" | "M/I N Transaction Reconciliation ID" |
| "M/I N Transaction Source Type" | "M/I Prescriber DEA Number" |
| "M/I Compound Level Of Complexity" | "Compound Complexity/Preparation Environment Type Mismatch" |
| "M/I Preparation Environment Type" | "M/I Preparation Environment Event Code" |
| "M/I Total Prescribed Quantity Remaining" | "Prescriptive Authority Restrictions Apply, Criteria Not Met" |
| "Service Provider ID Terminated On NPPES File" | "Service Provider ID Not Found On NPPES File" |
| "Service Provider ID Excluded From Receiving CMS Enrollment Data" | "M/I Submission Type Code" |
| "M/I Submission Type Code Count" | "M/I Do Not Dispense Before Date" |
| "Date of Service Prior To Do Not Dispense Before Date" | "M/I Multiple RX Order Group Reason Code" |
| "M/I Multiple RX Order Group ID" | "M/I Prescriber Place of Service" |
| "Prior Payer Excluded Fed Health Prog; Copay Assist Not Allowed" | "Beneficiary Is Enrolled In Excluded Federal Health Care Program" |
| "Prescriber Not Enrolled in State Medicaid Program" | "Pharmacy Not Enrolled in State Medicaid Program" |
| "Days Supply Is Less Than Plan Minimum" | "Pharmacy Must Attest FDA REMS Requirements Have Been Met" |
| "Pharmacy Must Attest Required Patient Form Is On File" | "Pharmacy Must Attest Plan Medical Necessity Criteria Met" |
| "Allowed Number of Overrides Exhausted" | "Other Payer Adjudicated Program Type Of Unknown Is Not Covered" |
| "M/I Regulatory Fee Count" | "M/I Regulatory Fee Type Code" |
| "M/I Other Payer Percentage Tax Exempt Indicator" | "Reason For Service Code Value Not Supported" |
| "Professional Service Code Value Not Supported" | "Result Of Service Code Value Not Supported" |
| "Quantity Does Not Match Dispensing Unit" | "Quantity Dispensed Exceeds Maximum Allowed" |
| "Quantity Not Valid For Product/Service ID Submitted" | "Future Other Payer Date Not Allowed" |
| "Compound Ingredient Component Count Exceeds Supported Number" | "Minimum Of Two Ingredients Required" |
| "Compound Ingredient Quantity Exceeds Maximum Allowed" | "Compound Ingredient Drug Cost Must Be Greater Than Zero" |
| "Route Of Administration Submitted Not Covered" | "Rx/Service Reference Number Qualifier Submitted Not Covered" |
| "Future Associated Prescription/Service Date Not Allowed" | "Prior Authorization Type Code Submitted Not Covered" |
| "Provider ID Qualifier Submitted Not Covered" | "Prescriber ID Qualifier Submitted Not Covered" |
| "DUR/PPS Code Counter Exceeds Number Of Occurrences Supported" | "Coupon Type Submitted Not Covered" |
| "Compound Product ID Qualifier Submitted Not Covered" | "Duplicate Product ID In Compound" |
| "Host Hung Up" | "Host Response Error" |
| "System Unavailable/Host Unavailable" | "Time Out" |
| "Scheduled Downtime" | "Payer Unavailable" |
| "Connection To Payer Is Down" | "Host Processing Error" |
| "M/I Other Payer Regulatory Fee Type Count" | "M/I Other Payer Regulatory Fee Type Code" |
| "M/I Other Payer Regulatory Fee Exempt Indicator" | "Regulatory Fee Count Not Used For This Transaction Code" |
| "Regulatory Fee Type Code Not Used For This Transaction Code" | "Other Payer % Tax Exempt Indicator Not Used For This Tx Code" |
| "Other Payer Regulatory Fee Type Count Not Used For This Tx Code" | "Other Payer Regulatory Fee Type Code Not Used For This Tx Code" |
| "OP Regulatory Fee Exempt Indicator Not Used For This Tx Code" | "Regulatory Fee Grouping Not Correct" |
| "Other Payer Regulatory Fee Grouping Not Correct" | "Regulatory Fee Count Does Not Match Number of Repetitions" |
| "OP Regulatory Fee Type Count Does Not Match Repetition Count" | "Regulatory Fee Count Exceeds Number Of Occurrences Supported" |
| "OP Regulatory Fee Type Count Exceeds Occurrences Supported" | "Regulatory Fee Type Code Must Precede Reg Fee Amount Submitted" |
| "OP Reg Fee Type Code Must Precede OP Reg Fee Exempt Indicator" | "Regulatory Fee Count Does Not Precede Regulatory Fee Type Code" |
| "OP Reg Fee Type Count Must Precede OP Reg Fee Type Code" | "Regulatory Fee Type Code Value Not Supported" |
| "Other Payer Regulatory Fee Type Code Value Not Supported" | "Other Payer Regulatory Fee Exempt Indicator Value Not Supported" |
| "Morphine Milligram Equivalency (MME) Exceeds Limits" | "Morphine Milligram Equivalency (MME) Exceeds Limits For Pt Age" |
| "Cumulative Dose Exceeded Across Multiple Prescriptions" | "Initial Fill Days Supply Exceeds Limits" |
| "Initial Fill Days Supply Exceeds Limits For Patient Age" | "Days Supply Limitation For Product/Service For Patient Age" |
| "Cumulative Fills Exceed Limits" | "ID Submitted Is Associated With A Precluded Prescriber" |
| "ID Submitted Is Associated To A Precluded Pharmacy" | "M/I Sending Entity Name" |
| "M/I Patient Middle Name" | "M/I Patient Name Suffix" |
| "M/I Patient Name Prefix" | "M/I Electronic Prescription Message ID" |
| "M/I Electronic Prescriber Order Number" | "M/I State Issuing Scheduled Prescription ID Number" |
| "M/I Prescriber Middle Name" | "M/I Service Provider Contact First Name" |
| "M/I Service Provider Contact Last Name" | "M/I Service Provider Telephone Number" |
| "M/I Species" | "DUR Reject - Pharmacy Override Using DUR/PPS Not Allowed" |
| "All Lots Of Drug/Product Recalled" | "High Dollar Amount Is Not Supported" |
| "Last Known 4RX Claim Date Submitted Too Old" | "Patient Locked Into Specific Prescriber(s)" |
| "Patient Locked Into Specific Pharmacy(s)" | "DOS Of Remaining Inc Fill Exceeds Reg Disp Timeframe" |
| "Notify Patient: Care Delayed By Rejection/Benefit Restriction" | "Bill Dual Eligible Medicare Part B Cost Share To Alt Medicaid" |
| "Workers' Comp Medicare Set-Aside (WCMSA) Is Primary Payer" | "M/I Sex Assigned at Birth" |
| "Sex Assigned at Birth Value Not Supported" | "Associated Rx/Service Ref Num Qualifier Must Precede Ref Num" |
| "Benefit Stage Indicator Count Exceeds Occurrences Supported" | "M/I Employer Contact First Name" |
| "Patient Spenddown Not Met" | "Date Written Is After Date Of Service" |
| "Product Not Covered Non-Participating Manufacturer" | "Billing Provider Not Eligible To Bill This Claim Type" |
| "QMB (Qualified Medicare Beneficiary)-Bill Medicare" | "Patient Enrolled Under Managed Care" |
| "Days Supply Limitation For Product/Service" | "Unit Dose Packaging Only Payable For Nursing Home Recipients" |
| "Generic Drug Required" | "M/I Software Vendor/Certification ID" |
| "M/I Segment Identification" | "M/I Facility Segment" |
| "ID Submitted Is Associated With An Excluded Prescriber" | "ID Submitted Is Associated To A Deceased Prescriber" |
| "This Product May Be Covered Under Hospice - Medicare A" | "Product May Be Under Medicare-B Bundled Pmt To ESRD Dialysis" |
| "Not Covered Under Part D Law" | "This Product/Service May Be Covered Under Medicare Part B" |
| "M/I Internal Control Number" | "M/I Transaction Count" |
| "Compound Basis Of Cost Determination Submitted Not Covered" | "Diagnosis Code Qualifier Submitted Not Covered" |
| "Future Measurement Date Not Allowed" | "M/I Professional Service Fee Submitted" |
| "M/I Narrative Message" | "M/I Service Provider ID Qualifier" |
| "M/I Patient First Name" | "M/I Patient Last Name" |
| "M/I Cardholder First Name" | "M/I Cardholder Last Name" |
| "M/I Home Plan" | "M/I Employer Name" |
| "M/I Employer Street Address" | "M/I Employer City Address" |
| "M/I Employer State/Province Address" | "M/I Employer ZIP Postal Zone" |
| "M/I Employer Phone Number" | "M/I Employer Contact Name" |
| "M/I Patient Street Address" | "M/I Patient City Address" |
| "M/I Patient State/Province Address" | "M/I Patient ZIP/Postal Zone" |
| "M/I Patient Phone Number" | "M/I Carrier ID" |
| "M/I Alternate ID" | "M/I Patient ID Qualifier" |
| "M/I Patient ID" | "M/I Employer ID" |
| "M/I Employer Contact Last Name" | "M/I Employer Street Address Line 1" |
| "M/I Employer Street Address Line 2" | "M/I Employer Telephone Number Extension" |
| "M/I Facility Street Address Line 1" | "M/I Facility Street Address Line 2" |
| "M/I Number of LTPAC Dispensing Events" | "M/I Patient Street Address Line 1" |
| "M/I Patient Street Address Line 2" | "M/I Reconciliation ID" |
| "M/I Subrogation Amount Requested" | "M/I Pay To Street Address Line 1" |
| "M/I Pay To Street Address Line 2" | "Facility ID Qualifier Does Not Precede Facility ID" |
| "M/I LTPAC Billing Methodology" | "LTPAC Billing Methodology Value Not Supported" |
| "M/I LTPAC Dispense Frequency" | "LTPAC Dispense Frequency Value Not Supported" |
| "M/I Dispensing Fee Submitted" | "Original Mfr Product ID Qualifier Must Precede Product ID" |
| "Patient ID Associated Country Code Not Used For This Tx Code" | "Patient Name Prefix is Not Used for this Transaction Code" |
| "Patient Name Suffix is Not Used for this Transaction Code" | "Prescriber Alt ID Associated Country Code Not Used For This Tx" |
| "Prescriber ID Associated Country Code Not Used For This Tx Code" | "Reconciliation ID is Not Used for this Transaction Code" |
| "Submission Type Code Count Not Used For This Tx Code" | "Submission Type Code Count Must Precede Submission Type Code" |
| "Submission Type Code Count Exceeds Occurrences Supported" | "Submission Type Code Count Does Not Match Number of Repetitions" |
| "Patient ID Count Is Not Used for This Transaction Code" | "Patient ID Count Exceeds Number of Occurrences Supported" |
| "Patient ID Grouping is Incorrect" | "Patient Middle Name Is Not Used for This Transaction Code" |
| "Prescriber Middle Name Is Not Used for This Transaction Code" | "M/I Prescriber Street Address Line 1" |
| "M/I Prescriber Street Address Line 2" | "M/I Prescriber Telephone Number Extension" |
| "COB Conflict - OP Info: financial fields or rejects, not both" | "Professional Service Not Covered - Plan/Benefit Exclusion" |
| "Professional Service Code Req When Incentive Fee On Non-Vaccine" | "Hospice Nx Not Supported" |
| "Hospice Clinical Info Counter Does Not Match Submitted Tx Code" | "No Hospice Enrollment Found For This NPI" |
| "Hospice Rx/Service Ref Number Does Not Match Submitted Tx Code" | "Member refusal of product - Contact plan only" |
| "Pharmacy locked out at member request - Contact plan only" | "Prescriber locked out at member request - Contact plan only" |
| "Reversal Request Submitted Out of Order for Coordinated Benefit" | "Invalid LTPAC Dispense Frequency and SCC Combination" |
| "Benefit Stage Indicator Grouping Incorrect" | "Clinical Information Grouping Incorrect" |
| "Compound Ingredient Grouping Incorrect" | "Compound Ingredient Modifier Grouping Incorrect" |
| "Coordination of Benefits Grouping Incorrect" | "DUR Grouping Incorrect" |
| "Intermediary Grouping Incorrect" | "Other Payer Reject Grouping Incorrect" |
| "Procedure Modifier Grouping Incorrect" | "Additional Documentation Question Grouping Incorrect" |
| "Submission Clarification Code Grouping Incorrect" | "Submission Type Code Grouping Incorrect" |
| "M/I Intermediary ID" | "M/I Intermediary ID Count" |
| "M/I Intermediary ID Country Code" | "M/I Intermediary ID State Province Address" |
| "M/I Intermediary ID Qualifier" | "M/I Intermediary ID Type Code" |
| "M/I Intermediary ID Type Entity" | "M/I Other Payer Reconciliation ID" |
| "Intermediary ID Count Does Not Match Number of Repetitions" | "Intermediary ID Count Does Not Precede Intermediary ID" |
| "Intermediary ID Qualifier Does Not Precede Intermediary ID" | "Intermediary Segment Incorrectly Formatted" |
| "Product/Service ID Qualifier (436-E1) Must Be 00 For Compounds." | "Group Separator Is Not Used For This Version/Release" |
| "Submission Type Code Value Not Supported" | "Place of Service Value Not Supported" |
| "Species Value Not Supported" | "Prescriber Place of Service Value Not Supported" |
| "Other Payer Adjudicated Program Type Value Not Supported" | "Other Payer Percentage Tax Exempt Indicator Value Not Supported" |
| "Procedure Modifier Code Value Not Supported" | "Multiple Rx/Service Order Group Reason Code Value Not Supported" |
| "Preparation Environment Type Value Not Supported" | "Preparation Environment Event Code Value Not Supported" |
| "Compound Dosage Form Description Code Value Not Supported" | "Compound Ingredient Modifier Code Value Not Supported" |
| "Compound Level of Complexity Value Not Supported" | "Intermediary ID Type Code Value Not Supported" |
| "Intermediary ID Type Entity Value Not Supported" | "Intermediary ID Qualifier Value Not Supported" |
| "Intermediary ID State/Province Address Value Not Supported" | "Intermediary ID Country Code Value Not Supported" |
| "Submission Type Code is Not Used for this Transaction Code" | "LTPAC Dispense Frequency is Not Used for this Transaction Code" |
| "LTPAC Billing Methodology is Not Used for this Transaction Code" | "Number of LTPAC Dispensing Events Not Used For This Tx Code" |
| "Multi Rx/Service Order Group Reason Code Not Used For This Tx" | "Total Prescribed Quantity Remaining Not Used For This Tx Code" |
| "Preparation Environment Type Not Used for This Transaction Code" | "Preparation Environment Event Code Not Used For This Tx Code" |
| "Original Mfr Product ID Qualifier Not Used For This Tx Code" | "Original Mfr Product ID Not Used For This Tx Code" |
| "LTPAC Dispense Frequency Not Used for This Transaction Code" | "LTPAC Billing Methodology Not Used for This Transaction Code" |
| "Do Not Dispense Before Date Not Used for This Transaction Code" | "Subrogation Amount Requested Not Used for This Transaction Code" |
| "Other Payer Adjudicated Program Type Not Used For This Tx Code" | "Intermediary Segment Not Used for This Transaction Code" |
| "Last Known 4Rx Segment Not Used for This Transaction Code" | "N Tx Payer Identification Segment Not Used For This Tx Code" |
| "Minimum Quantity Limit Not Met" | "Claim for Non-Humans Not Covered - Plan/Benefit Exclusion" |
| "Non-Matched Hospice Prescription/Service Reference Number" | "PGx: Dispensing Not Authorized Due to PGx Lab Test Results." |
| "Multi Rx/Service Order Group ID Not Used For This Tx Code" | "M/I N Transaction Payer Identification Segment" |
| "N Tx Payer Identification Segment Incorrectly Formatted" | "N Tx Payer Identification Segment Required For Adjudication" |
| "Invalid Submission Clarification Code Combination" | "Beneficiary Not A Participant In This Medicare Rx Payment Plan" |
| "No Matching Medicare Part D Claim For Medicare Rx Payment Plan" | "Claim Not Eligible For Medicare Rx Payment Plan" |
| "OP-Patient Resp Amt Not Supported, Plan Only Needs OP Amt Paid" | "DUR Conflict. Pharmacy override allowed; prior auth may be req" |
| "Rx Required. Claim without associated Rx is not covered." | "This product may be covered under Workers Compensation." |
| "Plan Does Not Request Brand or Reference Product" | "NPI Submitted in Provider ID Not Found in Processor's NPI File" |
| "ID Submitted Is Associated With A Precluded Provider ID" | "Patient Locked Into Specific Provider ID" |
| "Provider ID Submitted Associated With Excluded Provider ID" | "Provider ID Submitted Associated With Deceased Provider ID" |
| "Plan's DB Cannot Verify Active State License for Provider ID" | "Plan's DB: Provider ID Submitted Is Inactive Or Expired" |
| "Non-Matched Provider ID" | "Type 1 NPI Required for Provider ID" |
| "M/I Usual And Customary Charge" | "Plan Requires Prescription-Only Formulation" |
| "Product Is Included In Facility Rate. Bill the LTC Facility" | "Pharmacy Benefit Exclusion, Submit Under DME Benefit" |
| "M/I Prescriber Last Name" | "M/I Special Packaging Indicator" |
| "M/I Gross Amount Due" | "M/I Other Payer Amount Paid" |
| "M/I Patient Pay Amount Reported" | "M/I Date Of Injury" |
| "M/I Claim/Reference ID" | "M/I Originally Prescribed Product/Service Code" |
| "M/I Originally Prescribed Quantity" | "M/I Compound Ingredient Component Count" |
| "M/I Compound Ingredient Quantity" | "M/I Compound Ingredient Drug Cost" |
| "M/I Compound Dosage Form Description Code" | "M/I Compound Dispensing Unit Form Indicator" |
| "M/I Originally Prescribed Product/Service ID Qualifier" | "M/I Scheduled Prescription ID Number" |
| "M/I Prescription/Service Reference Number Qualifier" | "M/I Associated Prescription/Service Reference Number" |
| "M/I Associated Prescription/Service Date" | "M/I Procedure Modifier Code" |
| "M/I Quantity Prescribed" | "M/I Prior Authorization Type Code" |
| "M/I Prior Authorization ID Submitted" | "M/I Intermediary Authorization Type ID" |
| "M/I Intermediary Authorization ID" | "M/I Provider ID Qualifier" |
| "M/I Prescriber ID Qualifier" | "M/I Product/Service ID Qualifier" |
| "M/I Route Of Administration" | "M/I Incentive Amount Submitted" |
| "M/I Reason For Service Code" | "M/I Professional Service Code" |
| "M/I Result Of Service Code" | "M/I Quantity Dispensed" |
| "M/I Other Payer Date" | "M/I Provider ID" |
| "M/I Plan ID" | "M/I Percentage Sales Tax Amount Submitted" |
| "M/I Compound Type" | "M/I CMS Part D Defined Qualified Facility" |
| "Prescriber Must Contact Plan" | "Pharmacist Must Contact Plan" |
| "Pharmacy Not Contracted In Specialty Network" | "Pharmacy Not Contracted In Home Infusion Network" |
| "Pharmacy Not Contracted In Long Term Care Network" | "Pharmacy Not Contracted In 90 Day Retail Network" |
| "M/I Regulatory Fee Amount Submitted" | "M/I Other Payer Amount Paid Count" |
| "M/I Other Payer Amount Paid Qualifier" | "M/I Dispensing Status" |
| "M/I Percentage Sales Tax Rate Submitted" | "M/I Quantity Intended To Be Dispensed" |
| "M/I Days Supply Intended To Be Dispensed" | "M/I Patient E-Mail Address" |
| "M/I Measurement Time" | "M/I Measurement Dimension" |
| "M/I Measurement Unit" | "M/I Measurement Value" |
| "M/I Primary Care Provider Location Code" | "M/I DUR Co-Agent ID" |
| "M/I Other Amount Claimed Submitted Count" | "M/I Other Amount Claimed Submitted Qualifier" |
| "M/I Other Amount Claimed Submitted" | "M/I Percentage Sales Tax Basis Submitted" |
| "M/I DUR Co-Agent ID Qualifier" | "M/I Coupon Type" |
| "M/I Transaction Reference Number" | "Patient Not Covered In This Aid Category" |
| "Recipient Locked In" | "Host PA/MC Error" |
| "Prescription/Service Reference Number/Time Limit Exceeded" | "Requires Manual Claim" |
| "Host Eligibility Error" | "Host Drug File Error" |
| "Host Provider File Error" | "M/I Coupon Number" |
| "M/I Other Payer BIN Number" | "M/I Other Payer Processor Control Number" |
| "M/I Other Payer Group ID" | "Non-Matched Other Payer BIN Number" |
| "Non-Matched Other Payer Processor Control Number" | "Non-Matched Other Payer Group ID" |
| "Other Payer Cardholder ID Not Covered" | "Product Not On Formulary" |
| "More than 1 Cardholder Found -- Narrow Search Criteria" | "M/I Patient Assignment Indicator (Direct Member Reimb Ind)" |
| "M/I Benefit Stage Count" | "M/I Benefit Stage Qualifier" |
| "M/I Benefit Stage Amount" | "Benefit Stage Count Does Not Match Number Of Repetitions" |
| "Error Overflow" | "M/I Coupon Value Amount" |
| "Transaction Rejected At Switch Or Intermediary" | "M/I Other Payer-Patient Responsibility Amount Qualifier" |
| "M/I Other Payer-Patient Responsibility Amount" | "M/I Other Payer-Patient Responsibility Amount Count" |
| "M/I Other Payer Cardholder ID" | "M/I Delay Reason Code" |
| "M/I Submission Clarification Code Count" | "No Patient Match Found" |
| "M/I Medicaid Paid Amount" | "M/I Medicaid Subrogation ICN/TCN" |
| "M/I Medicaid ID Number" | "M/I Medicaid Agency Number" |
| "Use Prior Authorization ID Provided During Transition Period" | "Use Prior Authorization ID Provided For Emergency Supply" |
| "Use Prior Authorization ID Provided For Level of Care Change" | "PA Exhausted/Not Renewable" |
| "Invalid Transaction Count For This Transaction Code" | "M/I Request Claim Segment" |
| "M/I Request Clinical Segment" | "M/I Request Coordination Of Benefits/Other Payments Segment" |
| "M/I Request Compound Segment" | "M/I Request Coupon Segment" |
| "M/I Request DUR/PPS Segment" | "M/I Request Insurance Segment" |
| "M/I Request Patient Segment" | "M/I Request Pharmacy Provider Segment" |
| "M/I Request Prescriber Segment" | "M/I Request Pricing Segment" |
| "M/I Narrative Segment" | "M/I Request Prior Authorization Segment" |
| "M/I Transaction Header Segment" | "M/I Request Workers Compensation Segment" |
| "Non-Matched Associated Prescription/Service Date" | "Employer ID Not Covered" |
| "Other Payer ID Not Covered" | "Non-Matched Unit Form/Route of Administration" |
| "Non-Matched Unit Of Measure To Product/Service ID" | "Non-zero Value Required for Vaccine Administration" |
| "Associated Prescription/Service Reference Number Not Found" | "Clinical Information Counter Out Of Sequence" |
| "Compound Ingr Component Count Does Not Match # Of Repetitions" | "COB/Other Payments Count Does Not Match Number Of Repetitions" |
| "Coupon Expired" | "Date Of Service Prior To Date Of Birth" |
| "Diagnosis Code Count Does Not Match Number Of Repetitions" | "DUR/PPS Code Counter Out Of Sequence" |
| "Field Is Non-Repeatable" | "PA Reversal Out Of Order" |
| "Multiple Partials Not Allowed" | "Different Drug Entity Between Partial & Completion" |
| "Mismatched Cardholder/Group ID-Partial To Completion" | "M/I Compound Product ID Qualifier" |
| "Improper Order Of Dispensing Status Code On Partial Fill Tx" | "M/I Associated Rx/Service Reference Number On Completion Tx" |
| "M/I Associated Rx/Service Date On Completion Tx" | "Associated Partial Fill Transaction Not On File" |
| "Partial Fill Transaction Not Supported" | "Transitional Benefit/Resubmit Claim" |
| "Completion Tx Not Permitted With Same DOS As Partial Tx" | "Plan Limits Exceeded On Intended Partial Fill Field Limitations" |
| "Out Of Sequence P Reversal On Partial Fill Transaction" | "M/I Patient ID Count" |
| "M/I Associated Prescription/Service Date On Partial Transaction" | "M/I Associated Rx/Service Reference Number On Partial Tx" |
| "Mandatory Data Elements Must Occur Before Optional In A Segment" | "Multiple Reversals Per Transmission Not Supported" |
| "Professional Service Code MA required for Vaccine Incentive Fee" | "Other Amount Claimed Count Does Not Match Number Of Repetitions" |
| "Other Payer Reject Count Does Not Match Number Of Repetitions" | "Procedure Modifier Count Does Not Match Number Of Repetitions" |
| "Procedure Modifier Code Invalid For Product/Service ID" | "Product/Service ID Must Be 0 When Product/Service ID Qual = 06" |
| "Product/Service Not Appropriate For This Location" | "Repeating Segment Not Allowed In Same Transaction" |
| "Syntax Error" | "Value In Gross Amount Due Does Not Follow Pricing Formulae" |
| "Accumulator Month Count Does Not Match Number of Repetitions" | "M/I Accumulator Year" |
| "M/I Transaction Identifier" | "M/I Accumulated Patient True Out Of Pocket Amount" |
| "M/I Accumulated Gross Covered Drug Cost Amount" | "M/I DateTime" |
| "M/I Accumulator Month" | "M/I Accumulator Month Count" |
| "Non-Matched Transaction Identifier" | "M/I Financial Information Reporting Transaction Header Segment" |
| "M/I Procedure Modifier Code Count" | "Other Payer Amount Paid Count Does Not Match Num Of Repetitions" |
| "SCC Count Does Not Match Number Of Repetitions" | "OP-Patient Resp Amt Count Does Not Match Number of Repetitions" |
| "Accumulated Patient True Out Of Pocket Must Be >= Zero" | "Missing/Invalid Compound Product ID" |
| "Patient ID Count Does Not Match Number Of Repetitions" | "Emergency Supply/Resubmit Claim" |
| "Level Of Care Change/Resubmit Claim" | "Dosage Exceeds Product Labeling Limit" |
| "M/I Billing Entity Type Indicator" | "M/I Pay To Qualifier" |
| "M/I Pay To ID" | "M/I Pay To Name" |
| "M/I Pay To Street Address" | "M/I Pay To City Address" |
| "M/I Pay To State/ Province Address" | "M/I Pay To ZIP/Postal Zone" |
| "M/I Generic Equivalent Product ID Qualifier" | "Accumulator Month Count Exceeds Number Of Occurrences Supported" |
| "Request Financial Segment Required For Financial Info Reporting" | "M/I Request Reference Segment" |
| "Out Of Order DateTime" | "Duplicate DateTime" |
| "M/I Generic Equivalent Product ID" | "M/I Compound Ingredient Basis Of Cost Determination" |
| "DAW 0 Not Allowed On Multi-source Drug With Available Generics" | "OP Coverage Type Req On Reversals; Resubmit Reversal w/ Field" |
| "M/I Pharmacy Service Type" | "Pay To Qualifier Value Not Supported" |
| "Generic Equivalent Product ID Qualifier Value Not Supported" | "Pharmacy Service Type Value Not Supported" |
| "Eligibility Search Time Frame Exceeded" | "M/I Diagnosis Code Count" |
| "M/I Diagnosis Code Qualifier" | "Accumulated Gross Covered Drug Cost Amount Must Be >= Zero" |
| "M/I Clinical Information Counter" | "M/I Associated Prescription/Service Reference Number Qualifier" |
| "M/I Associated Prescription/Service Fill Number" | "Accumulated Patient True Out Of Pocket Exceeds Maximum" |
| "Accumulated Gross Covered Drug Cost Exceeds Maximum" | "Out Of Order Accumulator Months" |
| "M/I Financial Information Reporting Request Insurance Segment" | "M/I Request Financial Segment" |
| "Financial Info Reporting Request Insurance Segment Required" | "Procedure Modifier Code Count Exceeds Occurrences Supported" |
| "Diagnosis Code Count Exceeds Number Of Occurrences Supported" | "Cmp Ingredient Modifier Count Exceeds Occurrences Supported" |
| "Other Amount Claimed Count Exceeds Occurrences Supported" | "Other Payer Reject Count Exceeds Occurrences Supported" |
| "OP-Patient Resp Amt Count Exceeds Occurrences Supported" | "SCC Count Exceeds Number of Occurrences Supported" |
| "Question Number/Letter Count Exceeds Occurrences Supported" | "Benefit Stage Count Exceeds Number Of Occurrences Supported" |
| "Clinical Information Counter Exceeds Occurrences Supported" | "Medicaid Agency Number Not Supported" |
| "M/I Service Provider Name" | "M/I Service Provider Street Address" |
| "M/I Service Provider City Address" | "M/I Service Provider State/Province Code Address" |
| "M/I Service Provider ZIP/Postal Code" | "M/I Patient ID Associated State/Province Address" |
| "M/I Purchaser Relationship Code" | "M/I Seller Initials" |
| "M/I Purchaser ID Qualifier" | "M/I Purchaser ID" |
| "M/I Purchaser ID Associated State/Province Code" | "M/I Purchaser Date of Birth" |
| "M/I Purchaser Gender Code" | "M/I Purchaser First Name" |
| "M/I Purchaser Last Name" | "M/I Purchaser Street Address" |
| "M/I Purchaser City Address" | "M/I Purchaser State/Province Code" |
| "M/I Purchaser ZIP/Postal Code" | "M/I Purchaser Country Code" |
| "M/I Time Of Service" | "M/I Associated Prescription/Service Provider ID Qualifier" |
| "M/I Associated Prescription/Service Provider ID" | "M/I Seller ID" |
| "Purchaser Country Code Value Not Supported For Processor/Payer" | "Prescriber Alternate ID Qualifier Value Not Supported" |
| "M/I Purchaser Segment" | "Purchaser Segment Present On Non-Controlled Substance Report Tx" |
| "Purchaser Segment Required On Controlled Substance Reporting Tx" | "M/I Service Provider Segment" |
| "Service Provider Seg Present On Non-Controlled Substance Rpt Tx" | "Service Provider Seg Required On Controlled Substance Rpt Tx" |
| "Purchaser Relationship Code Value Not Supported" | "Prescriber Alternate ID Not Covered" |
| "COB/Other Payments Segment Is Mandatory To A Downstream Payer" | "M/I Seller ID Qualifier" |
| "Associated Rx/Service Provider ID Qualifier Not Supported" | "Associated Rx/Service Reference Number Qualifier Not Supported" |
| "M/I Measurement Date" | "M/I Sales Transaction ID" |
| "M/I Prescriber ID Associated State/Province Address" | "M/I Prescriber Alternate ID Qualifier" |
| "Purchaser ID Qualifier Value Not Supported For Processor/Payer" | "M/I Prescriber Alternate ID" |
| "M/I Prescriber Alternate ID Associated State/Province Address" | "M/I Reported Adjudicated Program Type" |
| "M/I Released Date" | "M/I Released Time" |
| "Reported Adjudicated ProgramType Value Not Supported" | "M/I Compound Preparation Time" |
| "M/I CMS Part D Contract ID" | "M/I Medicare Part D Plan Benefit Package (PBP)" |
| "Cardholder ID Submitted Is Inactive. New Cardholder ID On File." | |