External External Code Report the name of the drug that aligns to Code Name of the Drug Source 12 - the National Drug Code. Do not report PC 29 Source drug as All 95% B Name National Drug generic names with brand National Drug 12 - supplied Names Codes Text New Report the status of prescription by Prescription PC 30 6/24/10 Numeric ID char[2] numeric value. EXAMPLE: 00 = new All 99% A0 Status Indicator or Refill prescription; First Refill = 01, etc. Generic Lookup Report the value that defines the element. Generic Drug PC 31 Drug 11/8/12 Table - tlkpFlagIndicators int[1] EXAMPLE: 1 = Yes, the drug reported is All 100% A2 Indicator Indicator Integer a generic. Value Description 1 Yes 2 No 3 Unknown 4 5 Not Applicable Dispense Lookup Prescription Report the value that defines how the PC 32 as Written 6/24/10 Table - int[1] Dispensing drug was dispensed. EXAMPLE: 0 = All 98% C Code Integer Activity Code Not 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, brand drug 7 mandated by law Substitution allowed, generic drug not 8 available in marketplace 9 Other 0 Not dispensed as written Lookup Compound Report the value that defines the element. PC 33 Drug 11/8/12 Table - 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
PC 29 Drug Name External Code Source 12 - Text External Code Source 12 - National Drug Names Name of the drug as supplied Report the name of the drug that aligns to the National Drug Code. Do not report generic names with brand National Drug Codes All 95% B PC 30 New or Refill 6/24/10 Numeric ID char[2] Prescription Status Indicator Report the status of prescription by numeric value. EXAMPLE: 00 = new prescription; First Refill = 01, etc. All 99% A0 PC 31 Generic Drug Indicator 11/8/12 Lookup Table - Integer tlkpFlagIndicators int[1] Generic Drug Indicator Report the value that defines the element. EXAMPLE: 1 = Yes, the drug reported is a generic. All 100% A2 Value Description 1 Yes 2 No 3 Unknown 4 5 Not Applicable PC 32 Dispense as Written Code 6/24/10 Lookup Table - Integer int[1] Prescription Dispensing Activity Code Report the value 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, brand drug mandated by law 8 Substitution allowed, generic drug not available in marketplace 9 Other 0 Not dispensed as written PC 33 Drug Indicator 11/8/12 Lookup Table - 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
v5-apcd-pharmacy-claim-file-submission-guide-FINAL.docx