NCPDP Version D.0 Payer Sheet - EHO Rx

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Patient Segment Segment Identification (111-AM) = “Ø1”Claim Billing/Claim Rebill Field NCPDP Field Name Value Payer Usage Payer Situation 331 -CX PATIENT ID QUALIFIER R

  Sheet, Claim, Version, Billing, Payer, Ncpdp version d, Ncpdp, 0 payer sheet, Claim billing