Tip: Shared Pharmacy Prescription Numbers

Number

0119

Submitting Entity (SE)

All

Add Date

Jul 29, 2022

Update Date

May 25, 2023 Apr 10, 2024

Update

Included in June 2023 data tip email. Reposted in April 2024 Data Tips Email

Description

Prescription numbers (PC058) are generated by the point of sale systems at the individual pharmacies.  Therefore, the same prescription number can be found on claims for different members (PC001+PC107) and pharmacies (PC020). 

To understand and track the progression of prescription fills across time, group the prescription number (PC058), pharmacy (PC020) and member (PC001+PC107) then sort by paid date (PC017) and/or fill date (PC032).  Unlike medical claims, the pharmacy claim number (PC004) and claim line (PC005) should be included with caution because prescription fills and refills are usually considered separate claims and have different claim numbers. 

See examples below.

Active/Resolved

Active

Action / Resolution

 

Category 1

Pharmacy

Category 2

Misc

Tip / Issue

Tip

Submitting Entity

Member ID

Claim Number

Gender

Year of Birth

Paid Date

Fill Date

Drug Name

Pharmacy Number

Script Number

73288

7171004171117

34z143454531

F

1945

8/3/2018

8/2/2018

HYDROCODONE/ACETAMINOPHEN

410263

306174

79413A

116174145414

113573z37733351111Q

M

1972

12/23/2019

12/23/2019

LISINOPRIL   TAB 5MG

418613

306174

79413A

784011857

1513z5313147307114Q

M

1936

5/16/2015

5/16/2015

HYDROCODONE-ACETAMINOPHEN

419766

306174

79413D

EA470177RCOX

1105443z4571013

F

1942

2/27/2019

2/27/2019

HYDROCODONE/ACETAMINOPHEN

419398

306174

95885

810004587177

35z434073171

M

1983

10/10/2015

10/9/2015

OXYCODONE/ACETAMINOPHEN

414780

306174

99EBD1

11001401

14300z540543015

F

1983

10/27/2014

10/27/2014

AMPHETAMINE-DEXTROAMPHETAMINE TAB 30 MG

NULL

306174

99EBD1

87707101

533z0174z4

M

1961

9/8/2016

9/8/2016

HYDROCODONE/ACETAMINOPHEN

NULL

306174

99MCD1

518567101

40143310011z3

F

1962

11/27/2014

11/17/2014

HYDROCODONE-ACETAMINOPHEN 5-32

140048407

306174

99MCD1

7174417701

40151z703zz43

M

2002

6/25/2015

6/16/2015

FOCALIN XR 20 MG CAPSULE

146315407

306174

99MCD1

7671700701

4013343037551

M

2002

12/19/2013

12/9/2013

FOCALIN XR 15 MG CAPSULE

140029407

306174

99MCD1

7711717701

4014047047034

M

2013

4/3/2014

3/28/2014

AMOX-CLAV 600-42.9 MG/5 ML SUS

137403407

306174