5.3.2. NCPDP Transaction Segments
Data in the NCPDP standard is grouped together in segments. The current program segment requirements are outlined below.
| NCPDP Segment | B1 | B2 | E1 | Segment Support Requirements |
|---|---|---|---|---|
|
Header |
Mandatory |
Mandatory |
Mandatory |
Required for all transactions |
|
Patient |
Required | Not Used | Required |
Required for B1 and E1, not used for B2 |
|
Insurance |
Mandatory |
Not Used | Mandatory | Required for B1 and E1, not used for B2 |
|
Claim |
Mandatory | Mandatory | Not Used | Required for B1 and B2, not used for E1 |
|
Pharmacy Provider |
Not Used | Not Used | Not Used |
Not used |
|
Prescriber |
Required | Not Used | Not Used |
Required for B1 only |
|
COB/Other Payments |
Optional | Not Used | Not Used |
Required for B1 when other payer exists |
|
Worker’s Comp |
Not Used | Not Used | Not Used |
Not Used |
|
DUR/PPS |
Optional | Optional | Not Used |
Optional |
|
Pricing |
Mandatory | Not Used | Not Used |
Required for B1 only |
|
Coupon |
Not Used | Not Used | Not Used |
Not Used |
|
Compound |
Optional | Not Used | Not Used |
Required for B1 when claim is for a compound |
|
Prior Authorization |
Not Used | Not Used | Not Used |
Not Used |
|
Clinical |
Not Used | Not Used | Not Used |
Not Used |
|
Additional Documentation |
Not Used | Not Used | Not Used |
Not Used |
|
Facility |
Not Used | Not Used | Not Used |
Not Used |
| Narrative | Not Used | Not Used | Not Used | Not Used |