Point-of-Sale Processing for Ohio Medicaid Pharmacy Claims
The pharmacy NPI is required on all point-of-sale and paper claims submissions beginning May 23, 2007. Please see the updated payer sheet below. The pharmacy's NPI should be submitted in NCPDP version 5.1 field #201-B1 (service provider ID), with field #202-B2 (service provider ID qualifier) submitted as 01 (NPI). Claims submitted with a service provider ID other than NPI may be rejected beginning May 23, 2007.
The prescriber ID in fields #411-DB (prescriber ID) and #466-EZ (prescriber ID qualifier) may be submitted as either NPI (qualifier 01) or Medicaid ID (qualifier 05) until further notice. ODJFS asks that pharmacies collect and use prescriber NPIs when they are available, but will not deny claims using a prescriber's Medicaid ID until it is apparent that pharmacies have adequate access to prescriber NPIs.
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