Adjudication Details Response Mappings
This is a response to a query for retrieval of Adjudication Details. Though the PCS Query Response has been restructured from the existing CPHA3 message, many of the data elements are mappable, as shown in the table below.
| FIELD NAME | FIELD # | FHIR | Notes |
|---|---|---|---|
| E.01.03 | AdjudicationDate | parameter:DetailedRecordByDate | This is the date assigned by the processor. |
| E.02.03 | TraceNumber | Parameters.parameter:TraceNumber | 6N max in CPHA; unlimited in FHIR is this a mapping issue? |
| E.03.03 | Transaction Code | MessageHeader.event.code = 81 | |
| E.04.03 | Reference Number | Parameters.parameter:ReferenceNumber | This is the internal reference number assigned, by the processor to the request for adjudication results |
| E.05.03 | Response Status | Parameters.parameter:ResponseStatus | This indicates the status of the request transmitted Z=detailed record as requested R=request rejected |
| E.06.03 | Response Codes | Parameters.parameter:ResponseCodes | |
| H.65.03 | Number of Detail Records | parameter:NumberofDetailRecords AND Bundle.Total |
Total number of detail records included |
| H.66.03 | Current Rx Number | parameter:DetailedRecordByDate.part:CurrentRXNumber | Prescription Numbers (from Field D.55.03) of the first claim or reversal and all subsequent claims or reversals contained in this response |
| H.67.03 | Amount Payable/Reversed | parameter:DetailedRecordByDate.part:AmountPayableReversedPharmacy | Value of individual claims or reversals as identified by prescription numbers in Field H.66.03 |