Table 5: SDMCD Duplicate Claim Response Format

Table 5: SDMCD Duplicate Claim Response Format
FROM CURRENT CLAIM	NCPDP DUPLICATE REJECT
Constant value ‘D’	NCPDP DUPLICATE REJECT
Constant value zero	DEDUCTIBLE, FIELD 505 INGR-COST-PD, FIELD 506 DISPENSING FEE, FIELD 507 SALES TAX, FIELD 508
Constant value ‘ORIGINAL CLAIM PAID’, SDMCD Reference Number, and date paid from the previously paid claim.	MESSAGE FIELD, 504
SDMCD Reference Number for the current rejected claim.	AUTHORIZATION NUMBER, FIELD 503
Reimbursement amount from previously paid claim	TOTAL AMOUNT PAID, FIELD 509
SDMCD amount to be paid by recipient (copayment) from the previously paid claim	MESSAGE FIELD, 504