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Elizabeth M. Whitehorn, Director

Provider Notice issued 07/21/08

Prescriber ID For Over-the-Counter (OTC) Plan B

To:​

Participating Pharmacies​

​Date: ​July 21, 2008
​Re: Prescriber ID For Over-the-Counter (OTC) Plan B​

The Department of Healthcare and Family Services (HFS) continues to prepare for the implementation of the National Provider Identifier (NPI) requirements. Effective August 4, 2008, pharmacies must submit claims using the prescriber’s NPI in the Prescriber ID field (411-DB).

The prescriber NPI requirement will impact the way that pharmacies bill for over-the-counter (OTC) Plan B. The Department covers OTC Plan B for women 18 years of age and older without requiring a prescription or physician’s order. The Department announced this policy in a November 6, 2006 provider notice.

Prescriber Name and Prescriber ID are required fields. In the November 6, 2006 notice, the Department provided data elements to pharmacies to populate these fields for claims for OTC Plan B. Effective August 4, 2008, when the Department requires NPI in the Prescriber ID field, pharmacies need to use a different data element in the Prescriber ID field.

NCPDP 5.1 Claim Segment field and valid value:

Prescriber ID Qualifier (466-EZ)

Value = 01

Prescriber ID (411-DB)

Value = 2223334444

Prescriber Last Name (427-DR)

Value = PLANB

If you have any questions regarding this notice, please contact the Bureau of Pharmacy Services toll-free at 1-877-782-5565, Option 7.

Theresa A. Eagleson, Administrator

Division of Medical Programs