Payer Specification Sheet

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Field# NCPDP Field Name Value Payer Usage Payer Situation 3Ø4-C4 DATE OF BIRTH R 3Ø5-C5 PATIENT GENDER CODE R 31Ø-CA PATIENT FIRST NAME RW Payer Requirement Required for: BCBS of IL, BIN Ø11552, PCN ILSC This is required for all other BCBS plans when DOB and gender are identical 311-CB PATIENT LAST NAME R

  Name