Table 4: SDMCD Claim Rejected Response Format
FROM CURRENT CLAIM NCPDP CLAIM REJECTED RESPONSE OUTPUT

NCPDP FIELD NUMBER

Constant value ‘32' or ‘3C’ VERSION NUMBER

102

The NCPDP TRANS CODE submitted for the claim being rejected. TRANS CODE

103

Constant value ‘A’ HEADER STATUS

501

Constant value SPACES PLAN ID

524

Constant value ‘R’ RESPONSE STATUS

501

Up to 20 NCPDP reject codes can be returned for a single claim. REJECT CODE 01 through REJECT CODE 20

511

DUR messages pertaining to the claim (See Table 9) DUR RESPONSE

525

SDMCD Reference Number for the rejected claim REJECTED REFERENCE NUMBER

504

‘NOT PAID’ or a single specific SDMCD reject message that does not convert to a NCPDP reject code REJECT MESSAGE

504

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