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Related article: Service Provider ID Qualifier 07 � NCPDP ID Number M 2?1-B1 Service Provider ID NABP / NCPDP Provider number M 4?1-D1 Date of Service CCYYMMDD M 11?-AK Software Vendor/Certification ID ?????????? (zeros) or current certification number M Zero fill or use current Certification number Patient Segment: Required Field NCPDP Field Name Value M/R/RW Comment 111-AM Segment Identification ?1 M Patient Segment 304-C4 Date of Birth CCYYMMDD R 305-C5 Patient Gender Code ? =Not specified 1=Male 2=Female R 310 �CA Patient First Name R First 3 characters � verify Purchase Clonazepam Online what should be submitted 311 � CB Patient Last Name R First 5 characters verify what should be submitted 307-C7 Patient Location 0=Not specified 1=Home 2=Inter-Care 3=Nursing Home 4=Long Term/Extended Care 5=Rest Home 6=Boarding Home 7=Skilled Care Facility 8=Sub-Acute care Facility 9=Acute Care Facility 10=Outpatient 11=Hospice RW Use location Code 4 or 11 when the patient is in a LTC setting or hospice Bolded values are the current accepted values Insurance Segment: Mandatory Field # NCPDP Field Name Value M/R/RW Comment 111-AM Segment Identification ?4
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