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This variable is contained in the following files:
SAS Name
DRUG_UTLZTN_CD
A code indicating the conflict, intervention and outcome of a prescription presented for fulfillment.
Drug Utilization Code.txt3.96 KB
The T-MSIS Drug Utilization Code data element is composite field comprised of three distinct NCPDP data elements: "Reason for Service Code" (439-E4); "Professional Service Code" (440-E5); and "Result of Service Code" (441-E6). All 3 of these NCPDP fields are situationally required and independent of one another. Pharmacists may report none, one, two or all three. NCPDP situational rules call for one or more of these values in situations where the field(s) could result in different coverage, pricing, patient financial responsibility, drug utilization review outcome, or if the information affects payment for, or documentation of, professional pharmacy service.
1. The NCPDP "Reason of Service Code" (bytes 1 & 2 of this variable) explains whether the pharmacist filled the prescription, filled part of the prescription, etc. This variable is called RSN_SRVC_CD in the data file.
2. The NCPDP "Professional Service Code" (bytes 3 & 4 of this variable) describes what the pharmacist did for the patient. This variable is called PROF_SRVC_CD in the data file.
3. The NCPDP "Result of Service Code" (bytes 5 & 6 of this variable) describes the action the pharmacist took in response to a conflict or the result of a pharmacist’s professional service. This variable is called RSLT_SRVC_CD in the data file.
All six bytes should be populated if any of the three NCPDP fields has a value.
SOURCE: T-MSIS Analytic File (TAF) Claims