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Version: v0.1.6

Read compounds, other payers, DUR, and prior authorization

Four views read the request segments beyond the claim, and a fifth reads the other-payer blocks of a response. Each takes a parsed transmission and an optional transaction index, and returns undefined when its segment is absent:

ViewSegmentWhat it returns
compound(t)Compound (10)the dosage form, the declared count, and every ingredient
cobOtherPayments(t)COB/Other Payments (05)each prior payer with its amount rows
requestDur(t)DUR/PPS (08)each submitted DUR interaction
priorAuthorization(t)Prior Authorization (12)that the segment was submitted, with its type and number
responseCob(t)Response COB (28)each other payer the PBM routes the claim on to
import {
  buildTelecomRequest,
  cobOtherPayments,
  compound,
  parseTelecom,
  priorAuthorization,
  requestDur,
  serializeTelecom,
} from "@cosyte/ncpdp/telecom";

const wire = serializeTelecom(
  buildTelecomRequest({
    header: { transactionCode: "B1", binNumber: "999999", dateOfService: "20260115" },
    segments: [
      {
        segmentId: "07",
        fields: [
          { id: "D2", value: "RX0000002" },
          { id: "E7", value: "120000" },
        ],
      },
      {
        segmentId: "10",
        fields: [
          { id: "EF", value: "13" },
          { id: "EC", value: "2" },
          { id: "RE", value: "03" },
          { id: "TE", value: "99999999991" },
          { id: "ED", value: "100000" },
          { id: "EE", value: "1250" },
          { id: "RE", value: "03" },
          { id: "TE", value: "99999999992" },
          { id: "ED", value: "20000" },
          { id: "EE", value: "750" },
        ],
      },
      {
        segmentId: "05",
        fields: [
          { id: "4C", value: "1" },
          { id: "5C", value: "01" },
          { id: "6C", value: "03" },
          { id: "7C", value: "999998" },
          { id: "HC", value: "07" },
          { id: "DV", value: "2000" },
        ],
      },
      {
        segmentId: "08",
        fields: [
          { id: "E4", value: "DD" },
          { id: "E5", value: "M0" },
          { id: "E6", value: "1B" },
        ],
      },
      {
        segmentId: "12",
        fields: [
          { id: "EU", value: "1" },
          { id: "EV", value: "PA0000001" },
        ],
      },
    ],
  }),
);

const t = parseTelecom(wire);

const c = compound(t);
c?.declaredIngredientCount; // => "2"
c?.ingredients.length; // => 2
c?.ingredients.map((i) => i.productId); // => ["99999999991", "99999999992"]
c?.ingredients[0]?.quantity?.impliedDecimal; // => "100.000"
c?.ingredients[1]?.drugCost?.amount; // => "7.50"

const payer = cobOtherPayments(t)?.[0];
payer?.payerId; // => "999998"
payer?.amountsPaid[0]?.qualifier; // => "07"
payer?.amountsPaid[0]?.amount.amount; // => "20.00"

const interaction = requestDur(t)?.[0];
interaction?.reasonForServiceCode; // => "DD"
interaction?.professionalServiceCode; // => "M0"
interaction?.resultOfServiceCode; // => "1B"

priorAuthorization(t); // => { present: true, typeCode: "1", numberSubmitted: "PA0000001" }
t.warnings.length; // => 0

What each view guarantees:

  • Every compound ingredient is kept. A new ingredient starts at each product id qualifier (RE) or product id (TE), so one is found even when a sender leaves the qualifier out. When the declared count disagrees with the ingredients decoded, every decoded ingredient is kept and the transmission carries NCPDP_TELECOM_COMPOUND_COUNT_MISMATCH.
  • Every other-payer amount row is kept with its amount. A new payer block starts at each Other Payer Coverage Type (5C), and each amount pairs with the qualifier before it, so two payments are never merged. A declared payer count that disagrees warns with NCPDP_TELECOM_COB_COUNT_MISMATCH.
  • Money and quantities are exact strings, read the same way as the response pricing.
  • An unknown DUR reason is kept. A Reason For Service code outside the labeled set is kept with reasonKnown: false and warned with NCPDP_TELECOM_UNKNOWN_DUR_REASON. Professional service, result, and level-of-effort codes are verbatim, with no descriptions.
  • Prior authorization is presence, not adjudication. The view says the segment was submitted and echoes its type and number. Whether an authorization is valid is the PBM's decision, returned in the response.

Read the other payers in a response​

import { parseTelecom, responseCob } from "@cosyte/ncpdp/telecom";

const FS = "\x1c";
const GS = "\x1d";
const RS = "\x1e";

const header = "D0" + "B1" + "1" + "A" + "01" + "1234567890".padEnd(15);
const status = ["AM21", "ANP"].join(FS);
const cob = [
  "AM28",
  "NT1",
  "5C02",
  "6C03",
  "7C999997",
  "MHPCN0000002",
  "NUSYNTHCARD10",
  "MJGRP0000001",
].join(FS);

const next = responseCob(parseTelecom(header + GS + status + RS + cob))?.[0];

next?.coverageType; // => "02"
next?.payerId; // => "999997"
next?.processorControlNumber; // => "PCN0000002"
next?.cardholderId; // => "SYNTHCARD10"
next?.groupId; // => "GRP0000001"

Reference: compound, cobOtherPayments, requestDur, priorAuthorization, and responseCob.

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