Issue: Finding missing Pharmacy NPIs
- Kenley Money
Number | 0168 |
|---|---|
Submitting Entity (SE) | 99EBD1, 70998A, 95448A |
Add Date | Oct 22, 2024 |
Update Date |
|
Update |
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Description | These submitting entities do not collect the NPI for the servicing pharmacy (PC021) on the pharmacy claims records. The NPI can be pulled from the APCD provider file if required. If the data request includes the provider file, use the logic below. If the provider file is not part of the data request and this information is required for the project, work with the Arkansas APCD technical support team to generate a strip file to apply the information. This overlap will be applied to the entire APCD in a later build. NOTE, because of data quality differences between the claims and the provider data, not all NPIs can be appended this way. This approach has the highest match rate for Arkansas pharmacies. select a.PC001 as SE_ID,
a.PC004 as CLAIM_NBR,
a.PC005 as CLAIM_LINE,
a.PC020 as PHARMACY_NAME,
a.PC022 as PHARMACY_CITY,
a.PC023 as PHARMACY_STATE,
Substring(a.PC024,1,5) as PHARMACY_ZIP,
b.PV023 as PHARMACY_NPI
from [dbo].[Pharmacy] a
inner join .[dbo].[Provider] b on
a.PC020 = b.PV006
and
a.PC022 = b.PV010
and
a.PC023 = b.PV011
and
Substring(a.PC024,1,5) = b.PV012
where a.PC001 in ('99EBD1','70098A','95448A') |
Active/Resolved | Active |
Action / Resolution |
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Category 1 | Data Quality |
Category 2 | Pharmacy NPI |
Tip / Issue | Issue |