5 Not Applicable Dispense Lookup Prescription Report the that defines how the drug PC 32 as Written 6/24/10 - int[1] Dispensing was dispensed. EXAMPLE: 0 = Not All 98% C Code Integer Activity Code dispensed as written Value Description 1 Physician dispense as written 2 Member dispense as written 3 Pharmacy dispense as written 4 No generic available 5 Brand dispensed as generic 6 Override Substitution not allowed, drug 7 mandated by law Substitution allowed, generic drug not 8 available in marketplace 9 0 Not dispensed as written Lookup Compound Report the value that defines the element. PC 33 Drug 11/8/12 - tlkpFlagIndicators int[1] All 98% A2 Drug Indicator EXAMPLE: 1 = Yes, drug is a compound. Indicator Integer Value Description 1 Yes 2 No 3 Unknown 4 Other 5 Not Applicable Date Full Report the date the pharmacy filled AND Century Year Prescription PC 34 6/24/10 Date - int[8] dispensed prescription to the patient in All 99% A0 Day - CCYYMMDD filled date Filled Integer CCYYMMDD Format. Quantity Quantity Claim line units Report the number of metric units of PC 35 11/8/12 Counter All 99% A1 Dispensed - Integer dispensed medication dispensed Day’s Quantity Prescription Report the number of days the PC 36 11/8/12 Days Prescription All 99% A2 Supply - Integer Supply Days prescription will last if taken as prescribed
5 Not Applicable PC 32 Dispense as Written Code 6/24/10 Lookup - Integer int[1] Prescription Dispensing Activity Code Report the that defines how the drug was dispensed. EXAMPLE: 0 = Not dispensed as written All 98% C Value Description 1 Physician dispense as written 2 Member dispense as written 3 Pharmacy dispense as written 4 No generic available 5 Brand dispensed as generic 6 Override 7 Substitution not allowed, drug mandated by law 8 Substitution allowed, generic drug not available in marketplace 9 0 Not dispensed as written PC 33 Drug Indicator 11/8/12 Lookup - Integer tlkpFlagIndicators int[1] Compound Drug Indicator Report the value that defines the element. EXAMPLE: 1 = Yes, drug is a compound. All 98% A2 Value Description 1 Yes 2 No 3 Unknown 4 Other 5 Not Applicable PC 34 Date Filled 6/24/10 Full Date - Integer Century Year Day - CCYYMMDD int[8] Prescription filled date Report the date the pharmacy filled AND dispensed prescription to the patient in CCYYMMDD Format. All 99% A0 PC 35 Quantity Dispensed 11/8/12 Quantity - Integer Counter Claim line units dispensed Report the number of metric units of medication dispensed All 99% A1 PC 36 Day’s Supply 11/8/12 Quantity - Integer Days Prescription Prescription Supply Days Report the number of days the prescription will last if taken as prescribed All 99% A2