Minimum Data Elements Sample Clauses

Minimum Data Elements. The minimum data elements are:

Minimum Data Elements. The following data elements must be retained for each Electronic Third-Party Signature Claim Log record: □ Prescription number (7 position numeric field — left justified with zeros) □ Date of service (date field — mm/dd/yyyy) □ Co-payment charged (9 position numeric field — two positions to the right of the decimal) □ Identification of the third-party program providing prescription coverage to this patient □ Patient’s first and last name (30 positions) □ Date and time the prescription was dispensed to the patient (date field mm/dd/yyyy — Time hh:mm — 24-hour time) □ The certification statement text in its entirety (text) □ Dispensing Pharmacy’s NCPDP number (7 position numeric field) □ The unique signature of the Eligible Person or authorized agent captured at the time of dispensing that particular prescription (image format — .bmp, .gif, .tif, .jpg) □ Counseling (1 position “R” — Refused, “A” – Accepted)

Minimum Data Elements. Company acknowledges that the following minimum data elements should be included in all files transmitted or otherwise provided to Proactive in order to satisfy the successful and timely transfer of data requirements of Section 3.4. Items in bold text are required for analysis.

Minimum Data Elements. A certification of origin that is the basis for a claim for preferential tariff treatment under this Agreement shall include the following elements: