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).
|00||(Unknown value – rarely populated)|
|05||Therapy change. Physician determined that a change in therapy was required – either the medication was used faster than expected, or a different dosage form is needed.|
|07||Emergency supply of non-formulary drugs (or formulary drugs which typically require step therapy or prior authorization). Medication has been determined by the physician to be medically necessary.|
|08||Process compound for approved ingredients|
|14||LTC leave of absence – short fill required for take-home use|
|16||LTC emergency box (e box) /automated dispensing machine|
|17||LTC emergency supply remainder (remainder of drug from the emergency supply)|
|18||LTC patient admit/readmission indicator. This status required new dispensing of medication.|
|19||Split billing. The quantity dispensed is the remainder billed to a subsequent payer after Medicare Part A benefits expired (partial payment under Part A).|
|21||LTC dispensing rule for <=14 day supply is not applicable due to CMS exclusion or the fact that the manufacturer’s packaging does not allow for special dispensing|
|22||LTC dispensing, 7-day supply|