DSP21 Electronic Prescription Order Number N Note: DSP20 and DSP21 should be reported as a pair to the prescription drug monitoring program, and each program decides which one, if not both, it decides to capture. PRE: Prescriber Information Required segment; used to identify the prescriber of the prescription. PRE01 National Provider Identifier (NPI) RR Identifier assigned to the prescriber by CMS. (if available) PRE02 DEA Number R Identifying number assigned to a prescriber or an institution by the Drug Enforcement Administration (DEA). PRE03 DEA Number Suffix RR Identifying number assigned to a prescriber by an institution (if available) when the institution’s number is used as the DEA number. PRE04 License Number N Identification assigned to the prescriber by the State Licensing Board. PRE05 Last Name RR Prescriber’s last name. PRE06 First Name RR Prescriber’s first name. PRE07 Middle Name N Prescriber’s middle name or initial. PRE08 Phone Number N CDI: Compound Drug Ingredient Detail Use of this segment is situational; required when medication dispensed is a compound and one of the ingredients is a PMP reporting drug. If more than one ingredient is for a prescription monitoring program reporting drug, then this would be incremented by one for each compound ingredient being reported. CDI01 Compound Drug Ingredient Sequence Number R First reportable ingredient is 1; each additional reportable ingredient is incremented by 1. CDI02 Product ID Qualifier R Code to identify the type of product ID contained in CDI03. 01 NDC 02 UPC 03 HRI 04 UPN 05 DIN 06 Compound (this code is not used in this segment) CDI03 Product ID R Full product identification as indicated in CDI02, including leading zeros without punctuation.
DSP21 Electronic Prescription Order Number Note: DSP20 and DSP21 should be reported as a pair to the prescription drug monitoring program, and each program decides which one, if not both, it decides to capture. N PRE: Prescriber Information Required segment; used to identify the prescriber of the prescription. PRE01 National Provider Identifier (NPI) Identifier assigned to the prescriber by CMS. RR (if available) PRE02 DEA Number Identifying number assigned to a prescriber or an institution by the Drug Enforcement Administration (DEA). R PRE03 DEA Number Suffix Identifying number assigned to a prescriber by an institution when the institution’s number is used as the DEA number. RR (if available) PRE04 License Number Identification assigned to the prescriber by the State Licensing Board. N PRE05 Last Name Prescriber’s last name. RR PRE06 First Name Prescriber’s first name. RR PRE07 Middle Name Prescriber’s middle name or initial. N PRE08 Phone Number N CDI: Compound Drug Ingredient Detail Use of this segment is situational; required when medication dispensed is a compound and one of the ingredients is a PMP reporting drug. If more than one ingredient is for a prescription monitoring program reporting drug, then this would be incremented by one for each compound ingredient being reported. CDI01 Compound Drug Ingredient Sequence Number First reportable ingredient is 1; each additional reportable ingredient is incremented by 1. R CDI02 Product ID Qualifier Code to identify the type of product ID contained in CDI03. 01 NDC 02 UPC 03 HRI 04 UPN 05 DIN 06 Compound (this code is not used in this segment) R CDI03 Product ID Full product identification as indicated in CDI02, including leading zeros without punctuation. R
PMP_DataSubmittersGuide_ASAP4.2.docx