Rejections 1
Rejections 2
Rejections 3
Rejections 4
Rejections 5
100

65

Patient is not covered

100

79

Refill Too Soon

100

70

Product/Service Not Covered

100

76 

Plan Limitations Exceeded

100

01

M/I BIN Number

200

69

filled After Coverage Termination

200

67

Filled Before Coverage Effective

200

68

Filled after coverage expired

200

83

Duplicate Paid/Captured Claim

200

40

Pharmacy not contracted with plan

300

NSS

Medilodge

300

88

DUR Reject Error

300

51

Non-matched Group ID

300

19/219

M/I Days Supply

300

70

Product/ Service Not covered

400

08

M/I Person Code

400

A6

This product may be covered under Medicare Part B

400

M1

Patient not covered in this Aid Category

400

A5

Not covered under Part D Law

400

75 

Prior Authorization is Required

500

G6

Pharmacy not contracted in Specialty Network

500

MR

Product Not on Formulary

500

41

Submit bill to Other Processor Primary Payer

500

7x

Days Supply Exceeds Plan Limitations

500

A3 

May be covered under hospice benefit

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