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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