Data Template: Pharmacy Claims Data

Field

Data Type

Description

340B ID*

Alpha/Numeric

The unique identification number provided by HRSA to the 340B covered entity.

Date Prescribed*

Standard date formats

Date the prescriber wrote the prescription.

Date of Service*

Standard date formats

Date on which the pharmacy filled the prescription.

Rx Number*

Numeric

The native (unmodified) prescription number for the prescription as generated by the pharmacy.

Fill Number*

Numeric - 0-99

Indicates the number of times a prescription has been filled.

NDC-11*

Numeric - 11 digits

The 11-digit National Drug Code which indicates the manufacturer, product, and the commercial package size.

Quantity Dispensed*

Numeric

The number of units dispensed to the patient.

Prescriber ID*

Numeric - 10 digits

National provider identifier (NPI) of the physician that wrote the prescription. 

Service Provider ID*

Numeric - 10 digits

NPI of the pharmacy that filled the prescription.

Rx Bin*

Numeric - 6 digits

Prescription Drug Bank Identification Number. Enables pharmacies to electronically transmit data to the appropriate PBM for processing and reimbursement. Include BIN for the primary payer on the claim. If patient is uninsured or a cash payer, mark “999999” in this field.

Rx PCN*

Alpha/Numeric

Processor Control Number. Identifier used to determine which processor will handle a prescription drug claim. Include PCN for the primary payer on the claim. If patient is uninsured or a cash payer, mark “CASH” in this field. If there is no PCN, mark “NONE” in this field.