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