Tip: EBD Pharmacy Claim Versioning Workaround

Number

0121

Submitting Entity (SE)

99EBD1

Add Date

Sep 12, 2022

Update Date

Oct 7, 2022

Update

 

Description

Older EBD pharmacy data is not currently versioned. This data tip provides the data user a methodology for identifying the best claim line record to use.

When PC001 = ‘99EBD1’ and PC706 is not null, group EBD PHM claims by:

  • PC058 – Script Number

  • PC020 – Pharmacy Number

  • PC032 – Fill Date

  • PC026 – Drug Code

Use the claim/claim lines with the highest value in PC004.

Active/Resolved

Active

Action / Resolution

 

Category 1

Versioning

Category 2

EBD

Tip / Issue

Tip