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listing of all DDPS edits and applicability

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					DRUG DATA PROCESSING SYSTEM and DRUG BENEFIT CALCULATOR (DDPS/DBC) Transaction & Validation Edits
                                                                                                                                                                  Edit Applicable (Y/N)                                 Failure Outcome
                                                                                                                                                                                                                             (Reject,
                  Edit                                                                                                                                                       Bene-                                      Informational, or
 Error #        Category    Data Element to be Edited              Message to be Reported                      Comments/Rationale               Standard   X12   Paper     Submitted        PACE         Fallback           Update)

  603              M/I     Health Insurance Claim      The HICN is missing. Must not be blank.                                                     Y       Y      Y            Y              Y              Y                Reject
                           (HIC) Number
  604              M/I     Cardholder ID               The Cardholder ID is missing.                                                               Y       Y      Y            Y              Y              Y                Reject
  605              M/I     Patient Date of Birth (DOB) The DOB is an invalid date. Dates must DOB is optional. If Plans choose to                  Y       Y      Y            Y              Y              Y                Reject
                                                       be in CCYYMMDD format.                          report DOB, the format must be
                                                                                                       correct. Matching is done on Month
                                                                                                       and Year only, Day is disregarded.
                                                                                                       If no DOB is to be provided, zeroes or
                                                                                                       spaces should be used to populate this
                                                                                                       field.
  606              M/I     Patient Gender              The Gender is missing or invalid. The                                                       Y       Y      Y            Y              Y              Y                Reject
                                                       Gender must be either '1' or '2'.
  607              M/I     Date of Service (DOS)       The DOS is missing or invalid. DOS must                                                     Y       Y      Y            Y              Y              Y                Reject
                                                       be in CCYYMMDD format and be a valid
                                                       date.
  608              M/I     Date of Service (DOS)       The DOS must be on/after 1/1/2006                                                           Y       Y      Y            Y              Y              Y                Reject
  609              M/I     Date of Service (DOS)       DOS must be on or before today's date.                                                      Y       Y      Y            Y              Y              Y                Reject
  610              M/I     Paid Date                   The Paid Date is missing. Must not be           Paid Date is optional for non-Fallback      N       N      N            N              N              Y                Reject
                                                       blank for Fallback Plans.                       Plans. If Paid Date is not provided,
                                                                                                       zeroes or spaces should be used to
                                                                                                       populate this field.
  611              M/I     Paid Date                   The Paid Date is an invalid date in             If non-Fallback Plans choose to report      Y       Y      Y            Y              Y              Y                Reject
                                                       CCYYMMDD format.                                Paid Date, format must be correct.
                                                                                                       DDPS will reject all date fields with
                                                                                                       invalid date format.
  612              M/I     Prescription/ Service       The Prescription Number/Service                                                             Y       Y      Y            Y              Y              Y                Reject
                           Reference Number            Reference Number is missing or invalid.
                                                       Prescription Number/Service Reference
                                                       Number must be numeric.
  613              M/I     Product/ Service ID         The NDC code is missing.                                                                    Y       Y      Y            Y              Y              Y                Reject
  614              M/I     Service Provider ID         The Service Provider ID Qualifier is                                                        Y       Y      Y            Y              Y              Y                Reject
                           Qualifier                   missing or invalid. Service Provider ID
                                                       Qualifier must be equal to '01' - NPI or '06' -
                                                       UPIN or '07' - NCPDP or '08' - State
                                                       License or '11' - TIN or '99' - Other.

  615              M/I     Service Provider ID           The Service Provider ID is missing or    Both NPI and NCPDP numbers are                   Y       Y      Y            Y              Y              Y                Reject
                                                         invalid.                                 validated.
  616              M/I     Fill Number                   The Fill Number is missing or invalid.                                                    Y       Y      Y            Y              Y              Y                Reject
                                                         The Fill Number must be equal to a value
                                                         between 0 and 99.
  617              M/I     Dispensing Status             The Dispensing Status is invalid. The                                                     Y       Y      Y             Y             Y              Y                Reject
                                                         Dispensing Status must be either a blank
                                                         or 'P' or 'C'.
  618              M/I     Compound Code                 Compound Code is missing or invalid.                                                      Y       Y      Y            Y              Y              Y                Reject
                                                         The Compound Code must be equal to 0, 1
                                                         or 2.


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                                                                                                                                                            Edit Applicable (Y/N)                                 Failure Outcome
                                                                                                                                                                                                                       (Reject,
                 Edit                                                                                                                                                  Bene-                                      Informational, or
Error #        Category    Data Element to be Edited           Message to be Reported                      Comments/Rationale             Standard   X12   Paper     Submitted        PACE         Fallback           Update)
 619             M/I      DAW/Product Selection      The DAW/Product Selection Code is                                                       Y        Y      Y          Y              Y              Y                 Reject
                          Code                       missing or invalid. The DAW/Product
                                                     Selection Code must be equal to a value
                                                     between „0‟ and „9‟.
 620              M/I     Quantity Dispensed         The Quantity Dispensed is missing or                                                    Y       Y      Y            Y              Y              Y                Reject
                                                     invalid. The Quantity Dispensed must be
                                                     greater than or = 0.001.
 621              M/I     Days Supply                The Days Supply is missing or invalid.                                                  Y       Y      Y            Y              Y              Y                Reject
                                                     The value must be a value between 0 and
                                                     999 days.
 622              M/I     Prescriber ID Qualifier    Prescriber ID Qualifier is missing.          Applies only to standard claims.           Y       N      N            N              Y              Y                Reject
 623              M/I     Prescriber ID Qualifier    Prescriber ID Qualifier is invalid. The      If present, must be a valid value.         Y       Y      Y            Y              Y              Y                Reject
                                                     Prescriber ID Qualifier must be equal to
                                                     '01' - NPI or '06' - UPIN or '08' - State
                                                     License or '12' - DEA.
 624              M/I     Prescriber ID              The Prescriber ID is missing. Must not be    Applies on all standard claims and on      Y       Y      Y            Y              Y              Y                Reject
                                                     blank.                                       non-standard claims when Prescriber
                                                                                                  ID qualifier is present and valid
 625              M/I     Drug Coverage Status Code The Drug Coverage Status Code is                                                         Y       Y      Y            Y              Y              Y                Reject
                                                     missing or invalid. Valid values are „C‟,
                                                     „E‟ & „O‟.
 626              M/I     Adjustment/ Deletion Code The Adjustment Code is invalid. Valid                                                    Y       Y      Y            Y              Y              Y                Reject
                                                     Values are „A‟ for Adjustment and „D‟ for
                                                     Deletion, or 'blank'.
 627              M/I     Non-Standard Format Code The Non-Standard Format Code is invalid.                                                  Y       Y      Y            Y              Y              Y                Reject
                                                     Valid values are „blank‟, „B‟, „X‟, „P‟, 'S',
                                                     or 'C'
 628              M/I     Pricing Exception Code     The Pricing Exception Code is invalid.                                                  Y       Y      Y            Y              Y              Y                Reject
                                                     Valid values are „blank‟, „O‟, or „M‟.
 629              M/I     Catastrophic Coverage Code The Catastrophic Coverage Code is                                                       Y       Y      Y            Y              Y              Y                Reject
                                                     invalid. Must be Blank, „A‟, or „C‟.
 630              M/I     Ingredient Cost Paid       The Ingredient Cost Paid is missing or        This requirement also applies to OTC      Y       Y      Y            Y              Y              Y                Reject
                                                     invalid. The Ingredient Cost Paid must be drugs funded by administrative costs
                                                     >= zero.
 631              M/I     Dispensing Fee Paid        Dispensing Fee Paid is missing or invalid.                                              Y       Y      Y            Y              Y              Y                Reject
                                                     Must be >= zero.
 632              M/I     Total Amount Attributed to Sales Tax is missing or invalid. Must be                                                Y       Y      Y            Y              Y              Y                Reject
                          Sales Tax                  >= zero.
 633              M/I     Gross Drug Cost Below Out- GDCB is missing or invalid. Must be >=                                                  Y       Y      Y            Y              Y              Y                Reject
                          Of-Pocket Threshold        zero.
                          (GDCB)
 634              M/I     Gross Drug Cost Above Out- GDCA is missing or invalid, must be >=                                                  Y       Y      Y            Y              Y              Y                Reject
                          Of-Pocket Threshold        zero.
                          (GDCA)
 635              M/I     Patient Pay Amount         The Patient Pay Amount is missing or                                                    Y       Y      Y            Y              Y              Y                Reject
                                                     invalid. Must be >= zero.
 636              M/I     Other TrOOP Amount         Other TrOOP Amount is missing or                                                        Y       Y      Y            Y              Y              Y                Reject
                                                     invalid, must be >= zero.
 637              M/I     Low Income Cost-sharing    The LICS value is missing or invalid.                                                   Y       Y      Y            Y              Y              Y                Reject
                          Subsidy Amount (LICS)      Must be >= zero.

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                                                                                                                                                               Edit Applicable (Y/N)                                 Failure Outcome
                                                                                                                                                                                                                          (Reject,
                 Edit                                                                                                                                                     Bene-                                      Informational, or
Error #        Category    Data Element to be Edited          Message to be Reported                         Comments/Rationale              Standard   X12   Paper     Submitted        PACE         Fallback           Update)
 638             M/I      Patient Liability Reduction PLRO is missing or invalid. Must be                                                       Y        Y      Y          Y              Y              Y                 Reject
                          due to Other Payers (PLRO) numeric.

 639              M/I     Covered D Plan Paid             CPP is missing or invalid. Must be >=                                                 Y       Y      Y            Y              Y              Y                Reject
                          Amount (CPP)                    zero.
 640              M/I     Non-covered Plan Paid           NPP is missing or invalid. Must be                                                    Y       Y      Y            Y              Y              Y                Reject
                          Amount (NPP)                    numeric.
 641              M/I     Filler Fields, positions 125-   Filler fields must be blank.              Change from 307-512 to 308-512              Y       Y      Y            Y              Y              Y                Reject
                          126 and 308-512.                                                          effective with December 2008 release
 642              M/I     Non-Standard Format Code,       State-to-Plan PDEs are not allowed with                                               Y       Y      Y            Y              Y              Y                Reject
                          Date of Service                 date of service after March 31, 2006
 643              M/I     Non-Standard Format Code,       State-to-Plan PDEs are not allowed with Only PDEs with "C" drugs may be               Y       Y      Y            Y              Y              Y                Reject
                          Drug Coverage Code              non-covered drugs                       considered for State-to-Plan
                                                                                                  Reconcilation.
                                                                                                  Applies only to State-to-Plan PDEs.
 644              M/I     Non-Standard Format Code, Service Provider ID Qualifier must be '07' The Service Provider ID must be an               Y       Y      Y            Y              Y              Y                Reject
                          Service Provider ID          for State-to-Plan PDEs                     NCPDP code for State-to-Plan PDEs.
                          Qualifier                                                               Applies only to State-to-Plan PDEs.
 645              M/I     Non-Standard Format Code, Service Provider ID '5300378' allowed         Service Provider code '5300378' is            Y       Y      Y            Y              Y              Y                Reject
                          Service Provider ID          only for State-to-Plan PDEs                reserved for use in State-to-Plan PDEs
                          Qualifier, Service Provider                                             only.
                          ID
 646              M/I     Estimated Rebate at Point of Estimated Rebate at Point of Sale amount                                                 Y       Y      Y            Y              Y              Y                Reject
                          Sale                         is missing or invalid. For service dates
                                                       effective January 1, 2008 forward, must be
                                                       >= zero. For service dates prior to 2008,
                                                       must be zero or spaces.

 647              M/I     Vaccine Administration Fee Vaccine Administration Fee Amount is                                                       Y       Y      Y            Y              Y              Y                Reject
                                                     missing or invalid. For service dates
                                                     effective January 1, 2008 forward, must be
                                                     >= zero. For service dates prior to 2008,
                                                     must be zero or spaces.
 648              M/I     Prescription Origin        The Prescription Origin Code is invalid.    New field captures Prescription Origin         Y       Y      Y            Y              Y              Y                Reject
                                                     Valid values are blank, “0”, “1”, “2”, “3”, (aka "e-prescribing").
                                                     and “4”.                                    Effective with December 2008 release.

 660           Adj/Del    Adjustment/ Deletion Code, The Adjustment/Deletion PDE does not           Please check the Contract No, PBP ID,       Y       Y      Y            Y              Y              Y                Reject
                          Contract Number, Plan      match the existing PDE record.                 HICN, Service Provider ID Qualifier,
                          Benefit Package ID, HIC                                                   Service Provider ID,
                          number, Service Provider                                                  Prescription/Service Reference
                          ID, Service Provider ID                                                   Number, DOS, Fill Number and
                          Qualifier, Prescription/                                                  Dispensing Status. All nine (9) fields
                          Service Reference Number,                                                 noted must match the existing PDE
                          Date of Service, Fill                                                     record.
                          Number, and Dispensing
                          Status




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                                                                                                                                                             Edit Applicable (Y/N)                                 Failure Outcome
                                                                                                                                                                                                                        (Reject,
                 Edit                                                                                                                                                   Bene-                                      Informational, or
Error #        Category     Data Element to be Edited            Message to be Reported                      Comments/Rationale            Standard   X12   Paper     Submitted        PACE         Fallback           Update)
 661           Adj/Del    Adjustment/ Deletion Code,     Cannot adjust a deleted record. Existing                                             Y        Y      Y          Y              Y              Y                 Reject
                          Contract Number, Plan          PDE has already been deleted.
                          Benefit Package ID, HIC
                          number, Service Provider
                          ID, Service Provider ID
                          Qualifier, Prescription/
                          Service Reference Number,
                          Date of Service, Fill
                          Number, and Dispensing
                          Status
 662           Adj/Del    Adjustment/ Deletion Code,     Existing PDE has already been deleted.                                               Y       Y      Y            Y              Y              Y                Reject
                          Contract Number, Plan
                          Benefit Package ID, HIC
                          number, Service Provider
                          ID, Service Provider ID
                          Qualifier, Prescription/
                          Service Reference Number,
                          Date of Service, Fill
                          Number, and Dispensing
                          Status
 663           Adj/Del    Adjustment/ Deletion Code,     Value of Dispensing Status on adjustment                                             Y       Y      Y            Y              Y              Y                Reject
                          Contract Number, Plan          record and the record to be adjusted must
                          Benefit Package ID, HIC        be the same.
                          number, Service Provider
                          ID, Service Provider ID
                          Qualifier, Prescription/
                          Service Reference Number,
                          Date of Service, Fill
                          Number, and Dispensing
                          Status
 670           Cat Cov    GDCB, Catastrophic             If Catastrophic Coverage is 'blank', GDCB   Applies to Covered Drugs only. Drug      Y       Y      Y            Y              N              Y                Reject
                          Coverage                       must be greater than zero.                  Coverage = 'C'
 671           Cat Cov    GDCA, Catastrophic             If Catastrophic Coverage is 'blank', GDCA   Applies to Covered Drugs only. Drug      Y       Y      Y            Y              N              Y                Reject
                          Coverage Code                  must be zero.                               Coverage = 'C'
 672           Cat Cov    GDCB, Catastrophic             If Catastrophic Coverage 'A', GDCB must     Applies to Covered Drugs only. Drug      Y       Y      Y            Y              N              Y                Reject
                          Coverage                       be greater than zero.                       Coverage = 'C'
 673           Cat Cov    GDCA, Catastrophic             If Catastrophic Coverage is 'C', GDCA       Applies to Covered Drugs only. Drug      Y       Y      Y            Y              N              Y                Reject
                          Coverage                       must be greater than zero.                  Coverage = 'C'
 674           Cat Cov    GDCB, Catastrophic             If Catastrophic Coverage is 'C', GDCB       Applies to Covered Drugs only. Drug      Y       Y      Y            Y              N              Y                Reject
                          Coverage                       must be zero.                               Coverage = 'C'
 690             Cost     Ingred Cost, Disp Fee, Sales   Sum of Cost Fields > Sum of Payment         System allows $.05 margin of error       Y       Y      Y            Y              N              Y                Reject
                          Tax, Pt Pay, LICS, TrOOP,      Fields +/- Rounding Error and Dispensing    because some fields are calculated
                          PLRO, CPP, NPP                 Status is 'blank' or 'P'.                   fields (i.e. CPP, NPP and LICS)
 691             Cost     GDCB, GDCA, Ingred Cost,       The sum of GDCB and GDCA is not equal       Applies to Covered Drugs only. Drug      Y       Y      Y            Y              N              Y                Reject
                          Disp Fee, Sales Tax            to the sum of Ingred Cost + Disp Fee +      Coverage = 'C'
                                                         Sales Tax+ Vaccine Administration Fee.




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                                                                                                                                                                      Edit Applicable (Y/N)                                 Failure Outcome
                                                                                                                                                                                                                                 (Reject,
                 Edit                                                                                                                                                            Bene-                                      Informational, or
Error #        Category     Data Element to be Edited          Message to be Reported                              Comments/Rationale               Standard   X12   Paper     Submitted        PACE         Fallback           Update)
 692             Cost     Ingred Cost, Disp Fee Paid, Sum of Cost Fields < Sum of Payment                                                              Y        Y      Y          Y              N              Y                 Reject
                          Sales Tax, Pt Pay, LICS,    Fields +/- Rounding Error and Dispensing
                          TrOOP, PLRO, CPP, NPP Status is 'blank' and CPP + NPP > 0.

 693             Cost     Ingred Cost, Disp Fee Paid,   Sum of Cost Fields < Sum of Payment                                                            Y       Y      Y            Y              N              Y                Reject
                          Sales Tax, Pt Pay, LICS,      Fields +/- Rounding Error and Dispensing
                          TrOOP, PLRO, CPP, NPP         Status is 'C'.

 694             Cost     Ingredient Cost, Dispensing The sum of Ingredient Cost, Dispensing   This requirement also applies to OTC                    Y       Y      Y            Y              N              Y                Reject
                          Fee, Vaccine Administration Fee, and Vaccine Administration Fee must drugs funded by adminstrative costs
                          Fee                         be > zero.
 700             Elig     HICN                        The HICN does not match an existing                                                              Y       Y      Y            Y              Y              Y                Reject
                                                      Beneficiary.
 701             Elig     Patient Date of Birth (DOB) The DOB provided does not match the                                                              Y       Y      Y            Y              Y              Y                Reject
                                                      DOB on MBD.
 702             Elig     Patient Gender              The Gender does not match the value on                                                           Y       Y      Y            Y              Y              Y                Reject
                                                      MBD.
 703             Elig     Date of Service (DOS)       The DOS cannot be less than the DOB.                                                             Y       Y      Y            Y              Y              Y                Reject
 704             Elig     Date of Service (DOS)       The DOS cannot be greater than the date                                                          Y       Y      Y            Y              Y              Y                Reject
                                                      of death (DOD) + 32 days.
 705             Elig     Date of Service (DOS)         The Beneficiary must be enrolled in Part D                                                     Y       Y      Y            Y              Y              Y                Reject
                                                        on the DOS.
 706             Elig     Date of Service (DOS)         This DOS does not fall in a valid P2P                                                          Y       Y      Y            Y              Y              Y                Reject
                                                        period. The Beneficiary must be enrolled
                                                        in this Contract on the DOS
 707             Elig     Date of Service (DOS)         The Beneficiary must be enrolled in this   If the contract on MBD matches the                  Y       Y      Y            Y              Y              Y                Reject
                          Contract                      Part D Plan Benefit Package on the DOS. contract on the PDE, then the PBP on
                          Plan Benefit Package                                                     MBD must match the PBP on the PDE.

 708             Elig     Date of Service (DOS)         Submitter contract differs from contract of       Applies to Covered drugs.                    Y       Y      Y            Y              Y              Y            Informational
                          Contract                      record; this PDE is subject to plan to plan
                          Drug Coverage Status Code     reconciliation
 709             Elig     Date of Service (DOS)         Even though the submitting contract does          Applies to non-covered drugs                 Y       Y      Y            Y              Y              Y            Informational
                          Contract                      not equal the contract of record, this PDE        (enhanced and over-the-counter).
                          Drug Coverage Status Code     is not subject to plan-to-plan
                                                        reconciliation. PDEs with drug coverage
                                                        status of 'E' or 'O' are not eligible for plan-
                                                        to-plan reconciliation.
 710             Elig     HICN                          The beneficiary HICN has changed                  The beneficiary HIC number had               Y       Y      Y            Y              Y              Y            Informational
                                                        according to CMS records; use the                 changed according to CMS records --
                                                        corrected HICN for future submissions.            use the correct HIC number for future
                                                                                                          submissions. See the Corrected HICN
                                                                                                          field (positions 446-465) in the return
                                                                                                          file for the correct HICN.
 711             Elig     Submitting Contract           PACE plans cannot submit plan-to-plan                                                          Y       Y      Y            Y              Y              Y                Reject
                          Contract of Record            PDEs.
 712             Elig     Date of Service (DOS),        Submitting contract was not prior Contract Submitting plan should check their                  Y       Y      Y            Y              Y              Y            Informational
                          Submitting Contract           of Record for this P2P period.             records to ensure the beneficiary was
                                                                                                   enrolled in that plan at some time
                                                                                                   during the Benefit Year.

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                                                                                                                                                                Edit Applicable (Y/N)                                 Failure Outcome
                                                                                                                                                                                                                           (Reject,
                 Edit                                                                                                                                                      Bene-                                      Informational, or
Error #        Category    Data Element to be Edited           Message to be Reported                      Comments/Rationale                 Standard   X12   Paper     Submitted        PACE         Fallback           Update)
 713             Elig     Submitting Contract and    The Submitting Contract/PBP does not           Compared to the HPMS extract data            Y        Y      Y          Y              Y              Y                 Reject
                          PBP, Date of Service       offer Part D on Date of Service
 714             Elig     Date of Service (DOS)      The DOS is greater than the date of death                                                   Y       Y      Y            Y              Y              Y            Informational
                                                     (DOD), but is within the 32 day allowable
                                                     margin.
 715             LICS     Low Income Cost-sharing    Dollars reported in LICS are greater than      Applies to Covered Drugs only. Drug          Y       Y      Y            Y              N              Y                Reject
                          Subsidy Amount (LICS)      zero. However, Beneficiary is not eligible     Coverage = 'C'
                                                     for LICS subsidy.                              This edit is bypassed for 2006 Dates of
                                                                                                    Service.
 716             LICS     Patient Pay Amount, Other    Pat Liab exceeds the statutorially defined   Applies to Covered Drugs only.               Y       Y      Y            Y              N              Y                Reject
                          TrOOP Amount, PLRO           maximum for Institutionalized Low            Institutionalized Low-Income
                                                       Income beneficiary.                          beneficiaries have zero cost-sharing.
                                                                                                    This edit is bypassed for POS plans.
 717             LICS     Patient Pay Amount, Other    Patient liability exceeds the statutorily    Applies to Covered Drugs only.               Y       Y      Y            Y              N              Y                Reject
                          TrOOP Amount                 defined pre-catastrophic maximum for         Non-catastrophic cost-sharing
                                                       Category 2 Low Income beneficiary.           maximum is determined by benefit
                                                                                                    year.
 718             LICS     Patient Pay Amount, Other    Patient liability exceeds the statutorily    Applies to Covered Drugs only.               Y       Y      Y            Y              N              Y                Reject
                          TrOOP Amount, PLRO           defined pre-catastrophic maximum for         Non-catastrophic cost-sharing
                                                       Category 1 Low Income beneficiary.           maximum is determined by benefit
                                                                                                    year.
 719             LICS     Patient Pay Amount, Other    Patient liability exceeds the statutorily    Applies to Covered Drugs only.               Y       Y      Y            Y              N              Y            Informational
                          TrOOP Amount, PLRO           defined pre-catastrophic maximum for         Non-catastrophic cost-sharing
                                                       Category 4 Low Income beneficiary who        maximum is determined by benefit
                                                       has met deductible.                          year.
 720             LICS     Patient Pay Amount, Other    Patient Liability exceeds the statutorily    Applies to Covered Drugs only.               Y       Y      Y            Y              N              Y                Reject
                          TrOOP Amount, PLRO           defined catastrophic maximum for             Applies to beneficiaries who have
                                                       Category 1 or Category 2 Low Income          reached the out-of-pocket threshold.
                                                       beneficiary.
 721             LICS     Patient Pay Amount, Other    Patient liability exceeds the statutorily    Applies to Covered Drugs only.               Y       Y      Y            Y              N              Y                Reject
                          TrOOP Amount, PLRO           defined catastrophic maximum for             Catastrophic cost-sharing maximum is
                                                       Category 4 Low Income beneficiary who        determined by benefit year.
                                                       has reached the out-of-pocket threshold.
 722             LICS     Low Income Cost-sharing      Dollars reported in LICS are greater than    Applies to Dates of Service in 2006.         Y       Y      Y            Y              N              Y            Informational
                          Subsidy Amount (LICS),       zero. However, beneficiary is not eligible   Applies to Covered Drugs only.
                          Drug Coverage Status Code,   for LICS subsidy in CMS systems. Plans
                          Date of Service              must have documented evidence to
                                                       substantiate LICS.
 735             NDC      Product/ Service ID          The NDC Code does not match a valid                                                       Y       Y      Y            Y              Y              Y                Reject
                                                       code on the NDC database.
 736             NDC      Product/ Service ID          DOS < NDC effective date.                    This edit code is disabled.                  N       N      N            N              N              N                Reject
 737             NDC      Drug Coverage Status Code    Inappropriate Drug coverage status code.     This edit code is disabled effective         N       N      N            N              N              N                Reject
                                                       Drug Coverage is not 'O' although the drug   02/01/09.
                                                       is on the OTC list.
 738             NDC      Drug Coverage Status Code    The NDC identifies a Part D Non-                                                          Y       Y      Y            Y              Y              Y                Reject
                                                       coverable Drug.
 739             NDC      Drug Coverage Status Code,   This NDC is for a drug that is usually       This edit code is disabled effective         N       N      N            N              N              N            Informational
                          NDC                          covered under Part B. If Plan determines     02/01/09.
                                                       that this drug is Part B covered, submit
                                                       deletion record.

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                                                                                                                                                               Edit Applicable (Y/N)                                 Failure Outcome
                                                                                                                                                                                                                          (Reject,
                 Edit                                                                                                                                                     Bene-                                      Informational, or
Error #        Category    Data Element to be Edited         Message to be Reported                           Comments/Rationale             Standard   X12   Paper     Submitted        PACE         Fallback           Update)
 740            NDC       NDC                        NDC is DESI drug.                              This edit code is disabled effective        N        N      N          N              N              N                 Reject
                                                                                                    02/01/09.
 741             NDC      NDC                           The drug is always excluded from Part D; This edit code is disabled effective           N       N      N            N              N              N                Reject
                                                        the drug is always covered by Part B.       02/01/09.
 742             NDC      Product Service ID, Vaccine   If the amount in the Vaccine                                                            Y       Y      Y            Y              Y              Y                Reject
                          Administration Fee            Administration Fee field is >0, then the
                                                        NDC Code must qualify as a valid Part D
                                                        vaccine.
 755           Non Cov    Drug Coverage Status Code,    If Drug Coverage Status Code equals 'E' or                                              Y       Y      Y            Y              N              Y                Reject
                Drug      Catastrophic Coverage Code    'O', Catastrophic Coverage Code must not
                                                        equal 'A' or 'C'.
 756           Non Cov    Drug Coverage Status Code,    If Drug Coverage Status Code is 'E' or 'O',                                             Y       Y      Y            Y              Y              Y                Reject
                Drug      CPP                           then the Covered D Plan Paid Amount
                                                        must be zero.
 757           Non Cov    Drug Coverage Status Code,    If Drug Coverage Status Code is 'E' or 'O',                                             Y       Y      Y            Y              N              Y                Reject
                Drug      Other TrOOP Amount            then Other TrOOP Amount must be zero.

 758           Non Cov    Drug Coverage Status Code, If Drug Coverage Status Code is 'E' or 'O',                                                Y       Y      Y            Y              N              Y                Reject
                Drug      LICS                       then LICS must be zero.
 759           Non Cov    Drug Coverage Status Code, If Drug Coverage Status Code is 'E' or 'O',                                                Y       Y      Y            Y              N              Y                Reject
                Drug      GDCB                       then GDCB must be zero.
 760           Non Cov    Drug Coverage Status Code, If Drug Coverage Status Code is 'E' or 'O',                                                Y       Y      Y            Y              N              Y                Reject
                Drug      GDCA                       then GDCA must be zero
 761           Non Cov    Drug Coverage Status Code, If Drug Coverage is 'O', then Patient Pay OTC Costs are included in                        Y       Y      Y            Y              N              Y                Reject
                Drug      GDCA                       Amount, LICS, Other TrOOP, and PLRO Administrative Costs. Plans cannot
                                                     must equal zero.                              charge beneficiaries for OTC drugs.
                                                                                                   Patient liability can be reported in as
                                                                                                   many as 4 fields: Patient Pay Amount,
                                                                                                   LICS, Other TrOOP Amount and/or
                                                                                                   PLRO.
 762           Non Cov    Drug Coverage Status Code, If drug coverage status code is "E", the                                                   Y       Y      Y            Y              N              Y                Reject
                Drug      Part D Benefit Type Code   contract type must be Enhanced
                                                     Alternative.
 763           Non Cov    Drug Coverage Status Code, If Drug Coverage Status Code is „E‟ or                                                     Y       Y      Y            Y              Y              Y                Reject
                Drug      Vaccine Administration Fee „O‟ then the Vaccine Administration Fee
                                                     must be zero
 775             Misc     Dispensing Status - record Incompatible Dispensing Status (blank                                                      Y       Y      Y            Y              Y              Y                Reject
                          incompatibility            cannot follow 'C' or 'P'). Record for a Partl
                                                     ('P') or Compl ('C') fill is on file for this
                                                     disp event. DDPS cannot accept another
                                                     record with Disp Status = blank for the
                                                     same dispensing event.




          Page 7 of 15                                                                                             1/31/2012                                       C:\Docstoc\Working\pdf\42008d2b-fb37-4c9d-8647-5c01217e0313.xls
                                                                                                                                                                 Edit Applicable (Y/N)                                 Failure Outcome
                                                                                                                                                                                                                            (Reject,
                 Edit                                                                                                                                                       Bene-                                      Informational, or
Error #        Category     Data Element to be Edited          Message to be Reported                           Comments/Rationale             Standard   X12   Paper     Submitted        PACE         Fallback           Update)
 776            Misc      Dispensing Status - record Incompatible Dispensing Status ('C' or 'P'                                                   Y        Y      Y          Y              Y              Y                 Reject
                          incompatibility             cannot follow 'blank' ). Record with
                                                      unspecified fill status (blank) is on file for
                                                      this same dispensing event. DDPS cannot
                                                      accept another record with Partl ('P') or
                                                      Compl ('C') fill for the same dispensing
                                                      event.


 777             Misc     Service Provider,           Duplicate PDE record.Duplicate PDE               Applies only if adjustment/deletion        Y       Y      Y            Y              Y              Y                Reject
                          Prescription/Service        record exists in DDPS data warehouse.            code is blank on the PDE record.
                          Reference Number, Date of                                                    Added match against the PDE file for
                          Service, Fill Number,                                                        duplicates and incompatible status.
                          Dispensing Status, Contract
                          Number, PBP Number,                                                          See edit 784 for associated edit.
                          Adjustment/Deletion Code


 778             Misc     Paid Date                     Paid Date < DOS.                            Applies only if paid date is present.         Y       Y      Y            Y              Y              Y                Reject
                                                                                                    Zeroes or spaces are allowed
 779             Misc     Covered D Plan Paid          Submitting Plan cannot report NPP for        The following Plan types are excluded:        Y       Y      Y            Y              Y              Y                Reject
                          Amount                       Covered Part D Drug.                         EA, Employer-only, Flexible Capitated
                                                                                                    Payment Demo, Fixed Capitated
                                                                                                    Payment Demo
 780             Misc     Service Provider ID Quaifier Service Provider ID Qualifier must be '01' - Does not apply to X12, Paper, or              Y       N      N            N              Y              Y                Reject
                                                       NPI or '07' - NCPDP on standard claim.       Beneficiary Submitted claims

 781             Misc     Service Provider ID           Service Provider ID is not on master           If Service Provider ID = "01", then        Y       Y      Y            Y              Y              Y                Reject
                                                        provider file.                                 validate as an NPI number.
                                                                                                       If Service Provider ID = "07", then
                                                                                                       validate as an NCPDP number.
 782             Misc     N/A                           Record had no error, but was submitted as                                                 Y       Y      Y            Y              Y              Y                Reject
                                                        part of a rejected batch. DDPS rejects
                                                        batches with error rates exceeding 50%.

 783             Misc     Service Provider ID           Service Provider was not an active             This edit has been disabled.               N       N      N            N              N              N                Reject
                                                        pharmacy on DOS.
 784             Misc     Service Provider,             Duplicate PDE record, originally               Applies only if adjustment/deletion        Y       Y      Y            Y              Y              Y                Reject
                          Prescription/Service          submitted by different contract.               code is blank on the PDE record.
                          Reference Number, Date of
                          Service, Fill Number,                                                        Replaces Edit# 777 when Contract
                          Dispensing Status, Contract                                                  Number is different from the original
                          Number, PBP Number,                                                          PDE that this record is duplicating.
                          Adjustment/Deletion Code                                                     Original Submitting Contract is
                                                                                                       indicated in Return File.
 785             Misc     Service Provider ID           Duplicate PDE record exists on this file.      Applies only if a duplicate PDE is         Y       Y      Y            Y              Y              Y                Reject
                          Qualifier, Service Provider   This PDE is not saved.                         found on the same submitter file.
                          ID, Prescription/Service
                          Reference Number, Date of
                          Service, Fill Number



          Page 8 of 15                                                                                                1/31/2012                                      C:\Docstoc\Working\pdf\42008d2b-fb37-4c9d-8647-5c01217e0313.xls
                                                                                                                                                         Edit Applicable (Y/N)                                 Failure Outcome
                                                                                                                                                                                                                    (Reject,
                 Edit                                                                                                                                               Bene-                                      Informational, or
Error #        Category    Data Element to be Edited           Message to be Reported                    Comments/Rationale            Standard   X12   Paper     Submitted        PACE         Fallback           Update)
 800            PACE      Catastrophic Coverage Code The Catastrophic Coverage Code is                                                    N        N      N          N              Y              N                 Reject
                                                      invalid. Must be Blank in PDEs submitted
                                                      by PACE Programs.
 801            PACE      Patient Pay Amount          The Patient Pay Amount is invalid. Must                                             N       N      N            N              Y              N                Reject
                                                      equal zero in PDEs submitted by PACE
                                                      Programs.
 802            PACE      Other TrOOP Amount          Other TrOOP Amount is invalid. Must                                                 N       N      N            N              Y              N                Reject
                                                      equal zero in PDEs submitted by PACE
                                                      Programs.
 803            PACE      Low Income Cost-sharing     The LICS value is not a valid value. Must                                           N       N      N            N              Y              N                Reject
                          Subsidy Amount (LICS)       equal zero in PDEs submitted by PACE
                                                      Programs.
 804            PACE      Patient Liability Reduction The PLRO must equal zero in PDEs                                                    N       N      N            N              Y              N                Reject
                          due to Other Payers (PLRO) submitted by PACE Programs.

 805            PACE      Non-covered Plan Paid    When Drug Coverage Status Code = 'C'                                                   N       N      N            N              Y              N                Reject
                          Amount (NPP), Drug       the Non-covered Plan Paid Amount must
                          Coverage Status Code     equal zero in PDEs submitted by PACE
                                                   Programs.
 806           PACE     Gross Drug Cost Below Out- GDCB is invalid; must equal zero in PDEs                                               N       N      N            N              Y              N                Reject
                        Of-Pocket Threshold        submitted by PACE Programs.
                        (GDCB)
 807           PACE     Gross Drug Cost Above Out- GDCA is invalid; must equal zero in PDEs                                               N       N      N            N              Y              N                Reject
                        Of-Pocket Threshold        submitted by PACE Programs.
                        (GDCA)
 808           PACE     Drug Coverage Status Code, For a Covered Drug, Sum of Ingredient                                                  N       N      N            N              Y              N                Reject
                        Ingredient Cost Paid,      Cost Paid, Dispensing Fee Paid, Total
                        Dispensing Fee Paid, Total Amount Attributed to Sales Tax and
                        Amount Attributed to Sales Vaccine Administration Fee must equal
                        Tax, Non-covered Plan Paid Covered D Plan Paid Amount in PDE
                        Amount                     submitted by a PACE Program.
 809           PACE     Drug Coverage Status Code, For a Non-Covered Drug, Sum of                                                         N       N      N             N             Y              N                Reject
                        Ingredient Cost Paid,      Ingredient Cost Paid, Dispensing Fee Paid,
                        Dispensing Fee Paid, Total Total Amount Attributed to Sales Tax and
                        Amount Attributed to Sales Vaccine Administration Fee must equal
                        Tax, Non-covered Plan Paid Non-Covered Plan Paid Amount in PDE
                        Amount                     submitted by a PACE Program.
 810           PACE     Rebate Pass Through at POS The Estimated Rebate at Point of Sale                                                  N       N      N             N             Y              N                Reject
                                                   amount is invalid. Must equal zero in
                                                   PDEs submitted by PACE Programs.
 851           Retro    Submitting Contract/PBP,   The Contract of Record has been updated; Identifies P2P Phase III condition # 1        Y       Y      Y            Y              Y              Y               Update
             Enrollment Original Contract/PBP,     a P2P condition now exists.
                        Updated Contract/PBP
 852           Retro    Submitting Contract/PBP,   Submitting Contract/PBP is now the         Identifies P2P Phase III condition # 2      Y       Y      Y            Y              Y              Y               Update
             Enrollment Original Contract/PBP,     Contract/PBP of Record; a P2P condition
                        Updated Contract/PBP       no longer exists.
 853           Retro    Submitting Contract/PBP,   PBP of Record has been updated. This       Identifies P2P Phase III condition # 3      Y       Y      Y            Y              Y              Y               Update
             Enrollment Original Contract/PBP,     PDE continues to be a non-P2P PDE.
                        Updated Contract/PBP


          Page 9 of 15                                                                                        1/31/2012                                      C:\Docstoc\Working\pdf\42008d2b-fb37-4c9d-8647-5c01217e0313.xls
                                                                                                                                                             Edit Applicable (Y/N)                                 Failure Outcome
                                                                                                                                                                                                                        (Reject,
                Edit                                                                                                                                                    Bene-                                      Informational, or
Error #       Category   Data Element to be Edited             Message to be Reported                       Comments/Rationale             Standard   X12   Paper     Submitted        PACE         Fallback           Update)
 854           Retro    Submitting Contract/PBP,     The Contract of Record and PBP of            Identifies P2P Phase III condition # 4      Y        Y      Y          Y              Y              Y                Update
             Enrollment Original Contract/PBP,       Record have been updated. A new P2P
                        Updated Contract/PBP         condition is established.
 855           Retro    Submitting Contract/PBP,     The Submitting Contract is now the           Identifies P2P Phase III condition # 5      Y       Y      Y            Y              Y              Y               Update
             Enrollment Original Contract/PBP,       Contract of Record but the Updated PBP
                        Updated Contract/PBP         of Record is different from the Submitting
                                                     PBP. A P2P condition no longer exists.
 998             Misc     Contract/PBP of Record     Internal CMS issue regarding                 Compares data returned from MBD             Y       Y      Y            Y              Y              Y                Reject
                                                     Contract/PBP of Record encountered           against the HPMS extract.
 999             Misc     Various                    Internal CMS system issue encountered        This is the system error edit code we       Y       Y      Y             Y             Y              Y                Reject
                                                                                                  will default to when we experience
                                                                                                  MBD issues where data is not returned
                                                                                                  for us to properly continue editing.




          Page 10 of 15                                                                                         1/31/2012                                        C:\Docstoc\Working\pdf\42008d2b-fb37-4c9d-8647-5c01217e0313.xls
                                         Change Log
Date of Change Edit Changed                               Description of Change
        8/1/2005    623           Changed Edits Applicable to Y for non-standard submission types
        8/1/2005    624           Changed Edits Applicable to Y for non-standard submission types
      9/15/2005     N/A           Added Pseudo Code column for CMS Review
      9/30/2005     783           New Edit added
     10/27/2005     628           Changed name of field to Pricing Exception Code and added valid
                                  value of 'M'.
      10/27/2005        605       Revised Comments/Rationale to include "if date is not provided,
                                  zeroes or spaces should be used to populate this field."
      10/27/2005        610       Revised Comments/Rationale to include "if date is not provided,
                                  zeroes or spaces should be used to populate this field."
       11/7/2005        ALL       Based on Sandra Anderson's review of Pseudo Code, highlighted in
                                  RED the Edits that require action or response from ViPS and
                                  highlighted in GREEN the Edits that have been reviewed and
                                  accepted by CMS
       11/9/2005       NEW        Combined Edits 673 & 674 into one Edit.
      11/11/2005       NEW        Removed combined Edit from above per Janice Martin & Jeff
                                  Collier. This was not what CBC was looking for.
      11/21/2005        605       Changed to yellow. The code is correct. Additional test records will
                                  be created to validate.
      11/21/2005        610       Changed to yellow. The code is correct. Additional test records will
                                  be created to validate.
      11/21/2005        628       Changed to green. The field accepts M, was tested and verified, all
                                  the ay through to Report 21.
      11/21/2005     660 - 663 Changed to yellow. The code is correct and uses Provider ID
                                  Qualifier. Additional test records will be created to validate
      11/21/2005        701       Changed to green. The code is correct. Additional testing
                                  completed on 11/04
      11/21/2005     704 - 707 Yellow. See questions in pseudo code review
      11/21/2005   716, 720, 761 Requires coding change. If any payment field > 0 then error,
                                  instead of checking the sum of the payment fields > 0
12/9/2005 - lg     605, 704, 705, Pseudo Code changed to reflect program edit code
                   737, 738, 739
12/9/2005 - lg     716, 740, 777 Comments/Rationale and Pseudo Code changed to reflect program
                                  edit code
12/9/2005 - lg          761       Message to be Reported and Pseudo Code changed to reflect
                                  program edit code
12/9/2005 - lg          776       Message to be Reported changed to reflect program edit code
      12/20/2005   605, 610, 704- Changed to green. ----Brandon
                   707, 716, 720,
                   761, 737-740,
                        783



                                             Page 11 of 15                                    1/31/2012
                                       Change Log
Date of Change Edit Changed                           Description of Change
     12/21/2005    660-663      Added Service Provider ID Qualifier and changed to green. ----
                                Brandon
     12/23/2005    775-777      Added to Pseudo Code to reflect that incompatible dispensing
                                status is being checked in the same file and the ODS, changed to
                                green. ----Brandon
        1/2/2006 716, 720, 761 Pseudo Code changed to reflect program edit code - JSM
        1/2/2006      779       Changed to green - extensive testing completed - JSm
      3/22/2006       999       Added per emails from Don and Jeff C
      5/11/2006 605, 641, 660, Added 641, 708, 709, 710
                 707, 708, 709, Changed Message for 660, 717, 718, 719, 721
                 710, 717, 718, Changed Comments/Rationale for 605, 707 (also changed pseudo
                   719, 721     code for 707) -- Suzanne

      9/26/2006 690, 692, 709, Made minor corrections to construct of "message" to match what is
                716, 738, 776 in production. -- Suzanne

      9/26/2006       711       Added information in "Edit Applicable"; had been blank before.
                                Added Comments/Rationale to indicate that this is applicable to
                                Phase 1 of P2P. -- Suzanne
      9/26/2006        779      Added "employer-only plans" to the list of excluded plan types in
                                the Comments/Rationale. -- Suzanne
      9/26/2006        641      Marked as "effective October 2006" -- Suzanne
      9/26/2006                 Added column for "State-to-Plan" under "Edit Applicable". This
                                will become effective in December 2006. -- Suzanne
     10/3/20063        762      Added this edit, which is going into production with the October
                                release. -- Suzanne
    10/18/20063        743      Added this edit, which is going into production with the December
                                release. -- Suzanne
    10/18/20063        722      Added this edit, which is going into production with the October
                                release. -- Suzanne
    10/18/20063        784      Added this edit, which is going into production with the October
                                release. -- Suzanne
    10/18/20063   706, 715, 716 Made note that these edits are bypassed for POS plans. -- Suzanne

    10/18/20063       777       Added comment to see 784 for associated edit. -- Suzanne
    10/18/20063     708, 709    Removed "Effective August 2006" -- Suzanne
     10/19/2006       711       Corrected spelling of "Plan-to-Plan" (was "Plant-to-Plan") --
                                Suzanne
     10/19/2006    716 - 721    Removed pseudo-code. Replaced with informational text. --
                                Suzanne
     10/19/2006       743       Removed pseudo-code. Replaced with "applies only to covered
                                drugs". -- Suzanne


                                           Page 12 of 15                                   1/31/2012
                                        Change Log
Date of Change Edit Changed                           Description of Change
     12/12/2006   642-645      Added these edits for State-to-Plan Reconciliation (CR 199) --
                               Suzanne
     12/12/2006      627       Added "S" to the valid non-standard codes in the edit message (for
                               CR 199) -- Suzanne
     12/12/2006                Removed column for "State-to-Plan" under "Edit Applicable" as
                               this non-standard format is only applicable to dates of service from
                               1/1/06 - 3/31/06 and this column shouldn't be carried into
                               perpetuity.
     12/12/2006 641, 722, 762, Removed "Effective October 2006" -- Suzanne
                     784
     12/12/2006      784       Added to Comments/Rationale: "Original Submitting Contract is
                               indicated in Return File." -- Suzanne
     12/12/2006      720       Changed "I" and "II" to "1" and "2" in error message (taken from
                               Sandra's email of 10/26/06) -- Suzanne
     12/12/2006   717-721      In edit message, removed reference to actual annual maximums.
                               (CR 172) -- Suzanne
     12/12/2006   713, 998     Added these edits for CR 271 -- Suzanne
     12/14/2006      783       Changed Failure Outcome from "Informational" to "Reject" --
                               Suzanne
     12/19/2006      722       Removed wording in Comment "from POS plans only" as this edit
                               will apply to all PDEs for benefit year 2006. After 2006, this edit
                               will not apply at all. Added "Drug Coverage Status Code" to Data
                               Element to be Edited. -- Suzanne
        3/6/2007  717-721      Changed "Level" to "Category" for LICS edits, per CBC. --
                               Suzanne
      3/19/2007      704       Added "+ 32 days" to edit message (CR 291) -- Suzanne
      3/19/2007      714       Added this edit for CR 291 -- Suzanne
      3/19/2007      712       Added this edit for CR 202b -- Suzanne
      3/26/2007 738 & 739 Removed comments -- Suzanne (per conversation w/ Merri-Ellen)
      3/26/2007        781       Updated comments to indicate which table is checked based on
                                 Qualifier -- Suzanne
      3/26/2007        641       Changed from Informational to Reject -- Suzanne
      3/26/2007        783       Indicated that this edit is turned off for 2006 DOS (CR 293) --
                                 Suzanne
      3/26/2007        736       Indicated that this edit is permanently turned off (CR 318) --
                                 Suzanne
      3/27/2007        722       Added DOS to Data Elements to be Edited; changed Message to
                                 include "Plans must have documented evidence…"; and added
                                 "Applies to DOS in 2006" to Comments. -- Suzanne
      3/27/2007        615       Added "or invalid" to Message (CR 249). Indicated that both NPI
                                 and NCPDP numbers are validated. -- Suzanne



                                           Page 13 of 15                                    1/31/2012
                                       Change Log
Date of Change Edit Changed                   Description of Change
        4/2/2007            Removed "pseudo-code" and "Sandra's comments" tabs -- Suzanne

      4/10/2007       715       Changed "This edit is bypassed for POS plans." to "This edit is
                                bypassed for 2006 Dates of Service." -- Suzanne
      4/10/2007       762       Changed Edit Applicable flag for PACE from "Y" to "N" (to reflect
                                what is in production and on the CSSC website) -- Suzanne

      7/5/2007   851-855      Added P2P Phase III edit codes (CR 203) -- Suzanne
     9/21/2007 646, 647, 694, Added, based on information received from Chris R -- Suzanne
                 763, 810
     9/21/2007      630       Modified wording of edit and removed comment, based on
                              information received from Chris R -- Suzanne
     10/1/2007      641       Positions of filler fields changed, per CR 359/361. --Suzanne
     10/1/2007      742       Added, based on information received from Chris R -- Suzanne
     10/2/2007      783       Changed to reflect that this edit is bypassed for all dates, effective
                              with CR 293C-- Suzanne
     10/2/2007   777, 784     Removed HICN as a key field; this was removed from the
                              duplicate key with CR 145. -- Suzanne
    11/13/2007      777       Changed wording of error message. -- Suzanne
    11/13/2007      785       Added edit for CR 371. -- Suzanne
    12/20/2007      630       Reinstated the Comments that had been replaced by "Wording
                              change effective with the November release."
    12/20/2007      646       Changed edit message to match production (from "Rebate Pass
                              Through Amount" to "Estimated Rebate at Point of Sale amount").
                              Changed PACE switch from "Y" to "N". Removed "Effective with
                              November 2007 release" from Comments.
    12/20/2007 691, 808, 809 Changed edit message to include Vaccine Administration Fee.
    12/20/2007      810       Changed edit message to match production (from "Rebate Pass
                              Through Amount at POS" to "Estimated Rebate at Point of Sale
                              amount"). Removed "Effective with November 2007 release" from
                              Comments.
    12/20/2007 647, 694, 742, Removed "Effective with November 2007 release" from
                    763       Comments.
     2/18/2008 642, 643, 644 Changed all switches from "N" to "Y", to agree with what is in
                              Production
     2/18/2008      646       Changed PACE switch from "N" to "Y", to agree with what is in
                              Production
     2/18/2008      783       Changed all switches from "Y" to "N", to agree with what is in
                              Production
      5/1/2008      648       Added edit for new field on PDE to capture Prescription Origin
                              (CR 535)
      5/2/2008      648       Added Message for this new edit code (CR 535)


                                           Page 14 of 15                                     1/31/2012
                                       Change Log
Date of Change Edit Changed                          Description of Change
        5/2/2008     641       Changed range of positions from 307-512 to 308-512 (CR 535)
        5/2/2008     627       Added "C" as a valid non-standard format code (CR 536)
      6/23/2008 735, 738, 742 Wording changed per NDC Redesign project.
      6/23/2008 736, 737, 739, All switches set to "N" per NDC Redesign project.
                  740, 741
      6/23/2008      648       Removed "Effective with Dates of Service after 12/31/2008." from
                               Comments/Rationale.
      6/23/2008      785       Data Element to be Edited:
                               Changed "Service Provider" to read "Service Provider ID Qualifier,
                               Service Provider ID"
                               Removed "Dispensing Status, Contract Number, PBP Number,
                               Adjustment/Deletion Code"
                               (per email conversation with Chris Reinartz on 5/20/2008)
      6/23/2008      711       Removed "Applicable to Phase 1 of Plan-to-Plan Reconciliation."
                               from Comments/Rationale -- this edit is still in place during P2P
                               Phase 2 (on-going P2P processing)
      6/23/2008   777, 785     Removed references to April 2008 release.
      1/29/2009 737, 739, 740, Set Comments/Rationale to "This edit code is disabled effective
                     741       02/01/09". Per NDC Redesign project.
      2/16/2009      660       added Dispensing Status to 'Data Element to be Edited'. This was a
                               discrepany with the comments/rationale column
      2/17/2009    661,662     added Dispensing Status to 'Data Element to be Edited'.




                                          Page 15 of 15                                   1/31/2012

				
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