Table 7: SDMCD Reversal Response - Accepted - Format

The following data elements are moved from the current claim to the NCPDP accepted reversal response format for return to the pharmacist through POS when a claim is reversed.

From Current Claim NCPDP Claim Accepted Reversal Output

NCPDP Field Number

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

102

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

103

Constant value ‘A’ HEADER STATUS

501

SDMCD Reference Number of the reversed claim AUTHORIZATION NUMBER

503

Constant value ‘CLAIM REVERSED’ MESSAGE

504

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