Submission clarification code

SAS Name
SUBMSN_CLR_CD

For beneficiaries living in long-term care (LTC) facilities, this variable indicates how many days’ supply of the medication was dispensed by the long-term care pharmacy and provides some details about the dispensing event.

This variable is only populated when beneficiary lives in an LTC facility (i.e., when the PTNT_RSDNC_CD variable equals 03).

Comments

CMS requires Part D plans to have drug utilization management programs to encourage compliance with the formulary; this variable is designed to make it easier to monitor how well LTC pharmacies comply with formularies by making it easier to aggregate LTC prescriptions into 31-day equivalent prescriptions and thus compare pricing.

Note that this variable is different than the days supply of the medication on the PDE (the DAYS_SUPLY_NUM variable).

This variable was new in 2013 and required for all PDEs beginning on February 28, 2013.

Source: PDE