Common use of Pharmacy Providers Clause in Contracts

Pharmacy Providers. As applicable, Providers who are pharmacy providers agree to comply with the following: i) 340B covered entities, and the entity’s 340B contract pharmacies, shall submit National Council for Prescription Drug Programs (NCPDP) code “08” in Basis of Cost Determination field 423-DN or in Compound Ingredient Basis of Cost Determination field 490-UE at the point of sale to identify claims submitted for drugs purchased through the 340B program; ii) 340B covered entities shall identify outpatient hospital and physician- administered drug claims submitted for drugs purchased through the 340B program using a UD modifier or other claim modifiers defined by the Department. 42 C.F.R. § 438.3(s)(3); iii) 340B covered entities’ written agreements with contracted pharmacies shall specify that contract pharmacies comply with the point of sale identification of drugs purchased through the 340B program. 42 C.F.R. § 438.3(s)(3); and iv) Pharmacy providers that retroactively identify 340B claims, shall resubmit the claims with the appropriate NCPDP 340B claims identification codes. 42 C.F.R. § 438.3(s)(3).

Pharmacy Providers. As applicable, Providers who are pharmacy providers agree to comply with the following: i) 340B covered entities, and the entity’s 340B contract pharmacies, shall submit National Council for Prescription Drug Programs (NCPDP) code “08” in Basis of Cost Determination field 423-DN or in Compound Ingredient Basis of Cost Determination field 490-UE at the point of sale to identify claims submitted for drugs purchased through the 340B program; ii) 340B covered entities shall identify outpatient hospital and physician- physician-administered drug claims submitted for drugs purchased through the 340B program using a UD modifier or other claim modifiers defined by the Department. 42 C.F.R. § 438.3(s)(3); iii) 340B covered entities’ written agreements with contracted pharmacies shall specify that contract pharmacies comply with the point of sale identification of drugs purchased through the 340B program. 42 C.F.R. § 438.3(s)(3); and iv) Pharmacy providers that retroactively identify 340B claims, shall resubmit the claims with the appropriate NCPDP 340B claims identification codes. 42 C.F.R. § 438.3(s)(3).