INFO

Used to sync prescription data in BestRx with a TPP’s external environment. BestRx sends data to TPP each time a prescription performs relevant workflow steps in the BestRx system.

Root Fields

Field Name	Type	Notes
APIKey	string	Optional field that can be used for authentication purposes. It’s up to the third party partner whether this field will be required or not.
PharmacyNumber	string	Number to help identify the pharmacy the data is coming from. By default BestRx will send the NPI number, but that can be changed if requested by the receiving partner.
PharmacyNumber_Alt	string	An alternate pharmacy identifier can be provided if needed. Most integrations will not need this value.
pharmacy_info	object	Information about the pharmacy. Please see the Pharmacy Info Fields section for more details
transaction_id	string	Unique identifier for the particular fill of the prescription. This value should be used when considering whether to add a new record or update an existing one.
transaction_date	string	Date transaction is sent in YYYY-MM-DD format. This value is sent as the UTC date.
transaction_time	string	Time transaction is sent in HH:MM:SS (24 hour) format. This value is sent as the UTC time.
transaction_time_fraction	string	Time fraction transaction is sent, with 7 decimal places
rx_number	string	Prescription number
patient_id	integer	Unique identifier of the patient in the BestRx system.
patient_last_name	string	Patient’s last name
patient_first_name	string	Patient’s first name
patient_middle_name	string	Patient’s middle name
patient_prefix	string	Prefix to patient’s name (i.e., Mr. Mrs., etc)
patient_suffix	string	Suffix to patient’s name (i.e., Jr, III, etc)
patient_address1	string	Patient street address line 1
patient_address2	string	Patient street address line 2 (i.e., Unit Number or other identifying info)
patient_city	string	Patient’s city portion of address
patient_state	string	Patient’s state portion of address
patient_zip	string	Patient’s zip code
patient_home_phone	string	Patient’s home phone number
patient_cell_phone	string	Patient’s cell phone number
patient_work_phone	string	Patient’s work phone number
patient_dob	string	Patient date of birth in YYYY-MM-DD format
patient_gender	string	Patient’s gender (M/F/N) **N=Non-Binary
patient_email	string	Patient’s email address
patient_group	array	Array of groups that the patient is linked to. This is a repeating field. Please refer to the Groups Fields section of this document for more info.
family_email	string	Family’s shared email address
patient_short_remark	string	Short remark relating to the patient
patient_remark	string	Long remark relating to the patient
family_remark	string	Shared remark relating to entire family
patient_shipto_organization	string	Ship To organization name
patient_shipto_last_name	string	Ship To last name
patient_shipto_first_name	string	Ship To first name
patient_shipto_careof	string	Ship To “care of” name
patient_shipto_address1	string	Ship To street address line 1
patient_shipto_address2	string	Ship To street address line 2
patient_shipto_city	string	Ship To City
patient_shipto_state	string	Ship To state
patient_shipto_zip	string	Ship To zip code
patient_shipto_phone	string	Phone number related to the Ship To Address
is_ltc_patient	boolean	Indicates whether the patient is linked to LTC Facility or not (true/false)
ltc_facility	object	Information about the LTC facility. Please refer to the LTC Facility Info Fields section of this document for more info.
is_deactivated	boolean	Indicated whether the prescription was deactivated by the pharmacy (true/false)
transferred_out	boolean	Indicates whether the prescription was transferred out to another pharmacy (true/false)
transferred_pharmacy	string	Name of the pharmacy the prescription was transferred to
transferred_pharmacy_address1	string	Address line 1 of the pharmacy the prescription was transferred to
transferred_pharmacy_address2	string	Address line 2 of the pharmacy the prescription was transferred to
transferred_pharmacy_city	string	City of the pharmacy the prescription was transferred to
transferred_pharmacy_state	string	State of the pharmacy the prescription was transferred to
transferred_pharmacy_zip	string	Zip code of the pharmacy the prescription was transferred to
transferred_pharmacy_phone	string	Phone number of the pharmacy the prescription was transferred to
transferred_pharmacy_fax	string	Fax number
transferred_pharmacy_ncpdp	string	NCPDP number of the pharmacy the prescription was transferred to
transferred_pharmacy_npi	string	NPI number of the pharmacy the prescription was transferred to
transferred_pharmacy_dea	string	DEA number of the pharmacy the prescription was transferred to
transfer_date	string	The date the prescription was transferred
transfer_contact_name	string	The contact name of the person at the pharmacy the prescription was transferred to
transfer_rph_initials	string	Initials of the pharmacist at your pharmacy that handled the transfer
transfer_rph_user_id	string	BestRx User ID of the pharmacist at your pharmacy that handled the transfer
transfer_rph_last_name	string	Last Name of the pharmacist at your pharmacy that handled the transfer
transfer_rph_first_name	string	First Name of the pharmacist at your pharmacy that handled the transfer
transferfrom_pharmacy	object	Information about the pharmacy that transferred the prescription to this pharmacy. Please see the Pharmacy Info Fields section for more details
bill_status	string	Coded value for the Billing Status of the prescription. Please refer to Appendix A for a list of bill status codes and their descriptions.
bill_status_text	string	Text Description for the billing status of this prescription.
workflow_status	string	Coded value for the Workflow Status of the prescription. Please refer to Appendix B for a list of workflow statuses and their descriptions.
workflow_status_text	string	Text Description for the workflow status of the prescription
workflow_queues	array	Array of workflow queues the prescription is in. This is a repeating field. Please refer to the Workflow Queues section of this document for more info.
workflow_step_performed_code	string	Coded value for the Workflow Step of the prescription. Please refer to Appendix D for a list of workflow steps and their descriptions.
workflow_step_performed_text	string	Text Description for the workflow step of the prescription
fill_number	string	Fill Number of the prescription (1 = original, 2 = first refill, 3 = second refill, etc).
fill_date	string	Date the prescription was filled. Also knows as Date of Service. Value will be in YYYY-MM-DD format.
fill_time	string	Time prescription was entered into the system. Value will be in HH:MM:SS (24 hour) format.
picked_up	string	Indicates if the prescription was picked up (true/false)
delivered	string	Indicates if the prescription was delivered (true/false)
qty_ordered	string	Quantity that the doctor prescribed for each fill
qty_filled	string	Quantity that was dispensed for this fill
days_supply	string	Days supply dispensed for this fill
refills_authorized	string	Number of refills authorized by the doctor
refills_remaining	string	Number of refills that are remaining for this prescription. This could be a decimal value if there were partial fills involved.
refill_number	string	Refill number of the prescription (0 = original, 1 = first refill, 2 = second refill, etc).
refill_exp_date	string	Latest date at which the prescription can still be refilled.
item_upc_code	string	For OTC items, the UPC code of the item
drug_ndc	string	The NDC of the dispensed drug.
drug_ndc_10digit	string	The NDC of the dispensed drug in 10-digit format without dashes.
drug_ndc_10digit_formatted	string	The NDC of the dispensed drug in 10-digit format with dashes.
drug_gpi	string	The GPI of the dispensed drug. The GPI allows you to check if drugs with different NDC’s are therapeutically equivalent or related. Please see Appendix C for more info about GPI values.
drug_name	string	The name of the dispensed drug
drug_strength	string	The strength of the drug (i.e., “20 MG”)
drug_mfg	string	The manufacturer of the drug
drug_schedule	string	The DEA control schedule of the dispensed drug.
drug_is_generic	string	Indicates if the drug is generic (true/false)
drug_brand_name	string	For generic drugs, the brand drug name
drug_package_size	string	The package size of the drug when purchased from the drug wholesaler
drug_form	string	The form that the drug comes in. Ex: Tablet, Capsule, Gram, ML, etc.
drug_color	string	The color of the drug
drug_shape	string	The shape of the drug
drug_front_imprint	string	The imprint or markings on the front of the drug
drug_back_imprint	string	The imprint or markings on the back of the drug
drug_misc_info	string	Miscellaneous info that can help with identifying the drug
lot_number	string	Lot number of the dispensed drug
lot_exp_date	string	Lot expiration date of the dispensed drug (YYYY-MM-DD)
retail	string	The amount the pharmacy normally would charge for this prescription if the patient was to pay cash. Also knows as Usual & Customary Charges.
billed	string	Amount that was billed to the insurance.
payers	array	Array of insurance payers linked to this prescription. This is a repeating field. Please refer to the Payer Fields section of this document for more info.
cost	string	The acquisition cost of this drug for the quantity dispensed.
patient_amount_due	string	The total amount that the patient is responsible for this prescription. This includes all copays, deductibles, coinsurances, etc from all of the patient’s insurances that have been billed.
due_from_insurance	string	The total amount due from insurance from all of the patient’s insurances that have been billed.
total_paid	string	The total amount the pharmacy can expect to receive for the prescription. This includes anything the insurance will pay as well as anything the patient will pay.
margin	string	The profit margin made on this prescription. Essentially it will be the same as total_paid - cost.
margin_percent	string	Profit margin percentage (100 * ((total_paid - cost) / cost)
is340b	string	Indicates if it’s a 340B prescription (true/false)
dispense_as_written	string	“true” or “false” value indicating DAW
daw_code	string	DAW code of the prescription
date_rx_written	string	Date the doctor wrote the prescription
signature	string	The SIG directions of the prescription (i.e., TAKE 1 TABLET DAILY)
dosage_info	array	Array of dosage info linked to this prescription. This is a repeating field. Please refer to the Dosage Fields section of this document for more info.
rx_source	string	How the prescription reached the pharmacy 1 = Written 2 = Telephone 3 = Electronic 4 = Fax 5 = Generated by Pharmacy or Transferred to Pharmacy
rph_initials	string	Initials of the registered pharmacist that filled or verified the prescription
tech_initials	string	Initials of the technician that helped to fill the prescription
rx_serial_number	string	The serial number of the prescription from the doctor’s prescription pad
submission_clar_code	string	Submission Clarification Code used to override a reject during insurance billing
other_coverage_code	string	Other Coverage Code used to bill insurance to a secondary or tertiary payer
horizon_graveyard_code	string	Codified reason a prescription was not filled. Only used for pharmacies that report data to Horizon
diagnosis	array	Array of diagnosis code linked to this prescription. This is a repeating field. Please refer to the Diagnosis Fields section of this document for more info.
doctor_id	integer	Unique identifier of the prescriber in the BestRx system.
doctor_last_name	string	Prescriber’s last name
doctor_first_name	string	Prescriber’s first name
doctor_middle_name	string	Prescriber’s middle name
doctor_prefix	string	Prefix to prescriber’s name (i.e., Mr. Mrs., etc)
doctor_suffix	string	Suffix to prescriber’s name (i.e., MD, DO, etc)
doctor_npi	string	Prescriber’s NPI number
doctor_dea	string	Prescriber’s DEA number
doctor_state_licno	string	Prescriber's State License number
doctor_dps_no	string	Prescriber's DPS number
doctor_medicaid_no	string	Prescriber's Medicaid number
doctor_upin	string	Prescriber's UPIN number
doctor_address1	string	Prescriber’s street address line 1
doctor_address2	string	Prescriber’s street address line 1 (i.e., Suite Number or other identifying info)
doctor_city	string	Prescriber’s city portion of the address
doctor_state	string	Prescriber’s state portion of the address
doctor_zip	string	Prescriber’s zip code
doctor_phone	string	Prescriber’s office phone number
doctor_fax	string	Prescriber’s fax number
doctor_email	string	Prescriber’s email address
doctor_remark	string	Remarks associated with the prescribers
doctor_profession_code	string	Prescriber's Profession Code
doctor_profession_desc	string	Prescriber's Profession Code Description
doctor_ama_specialty_code	string	Prescriber's AMA Specialty Code
doctor_ama_grouping	string	Prescriber's AMA Grouping
doctor_ama_classification	string	Prescriber's AMA Classification
doctor_ama_specialization	string	Prescriber's AMA Specialization
doctor_surescripts_service_level	string	The service levels that this prescriber is enabled for with Surescripts. Possible values are New, Refill, Change, RxFill, Cancel, MedHistory, Eligibility, Resupply, Census, CCR, Controlled Substances, RxFill Indicator Change, Long Term Care, CI Message, CI Event, ePA, RLE, Medication Adherence, High Risk Medication, Missing Medication, PDC, MmpocMpiSearch, Disposition Request, Disposition Acknowledgement, Patient Med Benefit Check, and Specialty Patient Onboard
next_refill_date	string	Date that the next refill is due for the prescription
drug_therapeutic_class	string	Therapeutic class of the drug (at this time this field will not be populated)
prescribed_drug	string	Drug that was prescribed by the doctor
filled_by	string	The person at the pharmacy that “filled’ the prescription
erx_message_id	string	Message ID from the e-prescription message
erx_prescriber_order_no	string	Prescriber Order Number from the e-prescription message
erx_patient_medical_record_no	string	Patient Medical Record Number from the e-prescription message
erx_facility_code	string	LTC Facility Code from the e-prescription message
rx_remark	string	Remarks associated with the prescription
erx_pharmacy_remark	string	Pharmacy related remarks related to the e-prescription message for this prescription
erx_prescriber_remark	string	Prescriber related remarks related to the e-prescription message for this prescription
erx_drug_notes	string	The medication notes sent by the prescriber in the e-prescription message for this prescription
written_date_remark	string	Remarks related to the written date for this prescription (i.e., why was prescription filled after normal allowable time after written date)
inactivate_rx_remark	string	Remarks related to explaining why a prescription was deactivated
shipping_provider	string	Shipping provider used to ship prescription to patient. Current support values are “FedEx”, “UPS” and “USPS”.
shipping_tracking_number	string	Tracking number of shipment the prescription was a part of
dispense_using	string	Lets you know what type of packing the prescription will use (ie Safety Caps, Easy Caps, Bubble Packs, Pouch, etc)
is_medsync_shortfill	boolean	Indicates if this is a MedSync short fill
claim_reject_info	array	Array of reject codes and descriptions associated with the claim transmittal. This is a repeating field. Please refer to the Claim Reject Fields section of this document for more info.
pbm_message	string	Message sent from the PBM in the NCPDP field 504-F4
claim_additional_messages	array	Array of messages sent back in the NCPDP field 526-FQ. This is a repeating field. Please refer to the Claim Additional Messages Fields section of this document for more info.
document_count	integer	Count of the documents attached to the prescription
lot_serial_info	array	Array of Drug Lot info. Please refer to the Drug Lot Info Fields section of this document for more info.
ProgramInfo	object	Information about the BestRx source program that triggered the callback. Please refer to the Program Info Fields section of this document for more info.

Pharmacy Info Fields

Field Name	Type	Notes
pharmacy_name	string	Name of the pharmacy
address	object	Contains address info of the pharmacy. Please see the Address Info Fields section for more info.
phone_number	string	Phone Number of the pharmacy
fax_number	string	Fax Number of the pharmacy
npi	string	NPI Number of the pharmacy
ncpdp	string	NCPDP Number of the pharmacy
dea	string	DEA Number of the pharmacy

LTC Facility Info Fields

Field Name	Type	Notes
ltc_facility_internal_id	integer	Unique ID assigned to LTC Facility
ltc_facility_name	string	Name of the LTC Facility
ltc_facility_code	string	Code of the LTC Facility
ltc_facility_payer_id	string	Payer ID of the LTC Facility
ltc_facility_contact_name	string	Contact Name for LTC Facility
ltc_facility_address	object	Contains address info of the LTC Facility. Please see the Address Info Fields section for more info.
ltc_facility_phone	string	Phone Number of the LTC Facility
ltc_facility_fax	string	Fax Number of the LTC Facility
ltc_facility_alt_phone1	string	Alternate Phone number of the LTC Facility
ltc_facility_alt_phone2	string	Alternate Phone number of the LTC Facility

Address Info Fields

Field Name	Type	Notes
address1	string	Street Address Line 1
address2	string	Street Address Line 2
city	string	City component of address
state	string	State component of address
zipcode	string	Zip Code component of address

Group Fields

Field Name	Type	Notes
group_code	string	Internal code of the group in the BestRx system.
group_name	string	Name of the group.

Payer Fields

Field Name	Type	Notes
plan_seq_no	string	The sequence number of the plans associated with this prescription. This is the order in which the plans were billed for (1 = primary, 2 = secondary, etc).
plan_code	string	The code of the insurance plan. The code is assigned by the pharmacy and has no significance in terms of actual billing purposes.
plan_name	string	The name of the insurance plan
plan_bin	string	The BIN of the insurance plan
plan_pcn	string	The Processor Control Number of the insurance plan
card_id	string	The patient’s Cardholder ID for this plan
group	string	The patient’s Group Number for this plan
person_code	string	The patient’s Person Code for this plan
relation_code	string	The patient’s Relationship Code for this plan
plan_bill_status	string	Coded value for the Billing Status of this plan. Please refer to Appendix A for a list of bill status codes and their descriptions.
plan_bill_status_text	string	Text Description for the billing status of this plan.
cost_paid	string	Cost paid by insurance/payer
disp_fee_paid	string	Dispensing fee paid by insurance/payer
tax_paid	string	Tax paid by insurance/payer
discount	string	Discount applied to prescription
pat_pay_amount	string	Patient pay amount after billing to insurance/payer
due_from_payer	string	Total amount that will be paid by this insurance/payer
applied_to_deductible	string	The amount from this prescription that was applied to the patient’s deductible
accumulated_deductible	string	Amount met by the patient/family in a deductible plan
remaining_deductible	string	Amount not met by the patient/family in the deductible plan

Diagnosis Fields

Field Name	Type	Notes
qualifier	string	Qualifier indicating the type of diagnosis code 01 = ICD9 02 = ICD10
code	string	Diagnosis code
description	string	Diagnosis description for code

Dosage Fields

Field Name	Type	Notes
dose_slot	integer	Dosage slot (i.e., sequence of dose during the day). Currently BestRx supports up to 6 slots, so you can expect a value of 1-6 here.
dose_time	string	Dosage time. This can include specific times (i.e., 8:00 AM or 7:00 PM) or can contain keywords (i.e., (MORNING, LUNCH, DINNER, BEDTIME).
dose_qty	string	Quantity of the drug to take for this particular dose
dose_days	string	The days of the week that this dose should be administered “daily” = take every day “every_other_day” = take every other day “see_sig_instructions” = complicated instructions, so please look at signature field for more info “1” = Sunday “2” = Monday “3” = Tuesday “4” = Wednesday “5” = Thursday “6” = Friday “7” = Saturday Combination values also possible: “1;2;3” = Sunday, Monday, Tuesday “2;4;6” = Monday, Wednesday, Friday

Workflow Queues

Field Name	Type	Notes
queue_code	integer	Internal record number of the queue in the BestRx system.
queue_name	string	Name of the queue.

Claim Reject Fields

Field Name	Type	Notes
reject_code	string	Rejection code sent for the claim in the NCPDP field 511-FB
reject_description	string	The description associated with the Reject Code

Claim Additional Messages Fields

Field Name	Type	Notes
message	string	Message sent back in this iteration of the NCPDP field 526-FQ

Drug Lot Info Fields

Field Name	Type	Notes
drug_ndc	string	Drug NDC Number
qty	number	Drug Quantity
compound_seqno	integer	Sequence number of compound ingredient
lot_number	string	Drug lot number
lot_exp_date	string	Drug lot expiration date
serial_number	string	Drug lot serial number

Program Info Fields

Field Name	Type	Notes
ApplicationName	string	Name of the BestRx application
ApplicationVersion	string	Version of the BestRx application
ComputerName	string	Name of the Computer
ComputerUser	string	Username of the Computer

Appendix A - Billing Status Codes and Descriptions

Code	Description
0	Paid-Cash
1	Unbilled
2	Hold
3	Transmitted/Adjudicated
4	Paid by Ins (i.e., Reconciled)
5	Rejected
6	Transferred Out to Another Pharmacy (just this particular fill, not the entire prescription)

Appendix B - Workflow Status Codes and Descriptions

Code	Description
-1	Unspecified
0	Entered into System
1	Ready for Pickup
2	Ready for Delivery
3	Picked Up
4	Out for Delivery
5	Delivered
6	Unable to Deliver
7	Transferred Out to Another Pharmacy (just this particular fill, not the entire prescription)
8	Ready for Shipping
9	Shipped
10	Shipment Delivery Confirmed
11	Intake Complete
12	PA Request Pending
13	PA Request Sent
14	PA Request Received
15	Approved by Insurance
16	Rejected by Insurance
17	Label Printed
18	Verified before Fill
19	Filled
20	Verified before Dispense
21	Reversed from Insurance
22	Returned to Stock
23	Returned by Patient
24	On Hold
25	Delivery Cancelled
26	Shipment Order Created
27	Shipment Cancelled
28	Shipment in Transit
29	Shipment Delivered
30	Delivery Order Created
31	Shipment Exception
32	Returned by Shipment Provider
33	Queued
34	Verified Data Entry

Appendix C - GPI Information

GPI Structure The 14-character GPI consists of seven subsets, each providing increasingly more specific information about drug products. Asterisks included in the drug product name refer to the position of the product within Wolters Kluwer Clinical Drug Information’s TCS. The asterisk before the name indicates the location is within the first three Record Types; the asterisk(s) after the name indicates the level of specificity. Record Types 1 through 3 will always contain asterisks; Record Type 5 will only contain asterisks for partial GPIs. These subsets are structured and identified below:

Subset	Record Type	Number of Characters	Description	Example
12-xx-xx-xx-xx-xx-	1	2	Drug Group	ENDOCRINE AND METABOLIC AGENTS - MISC.*
12-34-xx-xx-xx-xx-	2	4	Drug Class	Posterior Pituitary Hormones**
12-34-56-xx-xx-xx-	3	6	Drug Subclass	Vasopressin**
12-34-56-78-xx-xx-	6	8	Drug Base Name	Desmopressin
12-34-56-78-90-xx-xx	4	10	Drug Name/Drug Name Extension	Desmopressin Acetate
12-34-56-78-90-12-xx	7	12	Drug Name and Dosage Form	Desmopressin Acetate Tablet
12-34-56-78-90-12-34	5	14	Full GPI with Drug Strength and Strength	Desmopressin Acetate Tablet 0.1 MG

Subsets Drug Group The two-character Drug Group (first subset) classifies general drug products. These 99 Drug Groups include the Drug Classes frequently used in general market research and third-party prescription processing.

Examples include:

01 PENICILLINS
25 CONTRACEPTIVES
27 ANTIDIABETICS
36 ANTIHYPERTENSIVES
86 OPHTHALMIC AGENTS

Drug Class The four-character Drug Class (first and second subset) identifies specific therapeutic drug classes designed to accommodate more detailed market research. The Drug Class also serves as the structural base for most therapeutic drug monitoring applications (such as dosage screening and disease contraindication monitoring). For example, Drug Group 37, DIURETICS, includes the following Drug Classes:

Note: “99” in the second or third subset is used to identify multiple ingredient (combination) drug products.

37 DIURETICS
37-10 Carbonic Anhydrase Inhibitors*
37-20 Loop Diuretics*
37-30 Mercurial Diuretics*
37-40 Osmotic Diuretics*
37-50 Potassium Sparing Diuretics*
37-60 Thiazides and Thiazide-Like Diuretics*
37-90 Diuretics-Miscellaneous*
37-99 Diuretic Combinations*

Drug Subclass The six-character Drug Subclass (first through third subset) is used if further distinction is needed within a Drug Class. For example, the Drug Class 21-40, Antineoplastic - Hormonal Agents, includes the following Drug Subclasses:

21 ANTINEOPLASTICS AND ADJUNCTIVE THERAPIES
21-40 Antineoplastic - Hormonal and Related Agents*
21-40-20 Androgens - Antineoplastic**
21-40-22 Antiadrenals**
21-40-24 Antiandrogens**
21-40-26 Antiestrogens**
21-40-28 Aromatase Inhibitors**
21-40-30 Estrogens - Antineoplastic**
21-40-35 Estrogen Receptor Antagonist**
21-40-40 Progestins - Antineoplastic**
21-40-50 LHRH Analogs**
21-40-55 Gonadotropin Releasing Hormone (GnRH) Antagonists**
21-40-60 Androgen Biosynthesis Inhibitors**

Drug Base Name The eight-character Drug Base Name (first through fourth subset) designates the basic drug moiety. The Drug Base Name may represent the therapeutic class and not a specific moiety. This often occurs with combination products. For example, the Drug Subclass 30-04-20, Bisphosphonates, includes the following Drug Base Names:

30-04-20 Bisphosphonates***
30-04-20-10 Alendronate
30-04-20-40 Etidronate
30-04-20-48 Ibandronate
30-04-20-60 Pamidronate
30-04-20-65 Risedronate
30-04-20-70 Tiludronate
30-04-20-90 Zoledronic Acid

Drug Name and Drug Name Extension The 10-character Drug Name and Drug Name Extension (first through fifth subset) designates the specific drug and salt, when applicable. When no salt is present, the Drug Name and Drug Name Extension will be the same as the Drug Base Name. For example, Drug Base Name 22-10-00-20, Dexamethasone, includes the following Drug Names and Drug Name Extensions:

22-10-00-20- Dexamethasone
22-10-00-20-10 Dexamethasone Acetate
22-10-00-20-20 Dexamethasone Sodium Phosphate

For combination drug products, the fourth subset generally specifies the number
of active ingredient(s) in a multiple ingredient (combination) product. The fifth
subset designates the specific combination of ingredients in the drug product.
For example, Drug Subclass 43-99-30, Decongestant & Antihistamines, includes,
but is not limited to, the following combination drug products:

43-99-30 Decongestant & Antihistamine**
43-99-30-02-03 Acrivastine & Pseudoephedrine
43-99-30-02-05 Astemizole & Pseudoephedrine
43-99-30-02-10 Azatadine & Pseudoephedrine
43-99-30-02-25 Carbinoxamine & Phenylephrine
43-99-30-02-30 Chlorpheniramine & Phenylephrine
43-99-30-02-59 Loratadine & Pseudoephedrine
43-99-30-02-70 Promethazine & Phenylephrine
43-99-30-02-72 Promethazine & Pseudoephedrine
43-99-30-02-80 Triprolidine & Pseudoephedrine
43-99-30-03-05 Brompheniramine-Diphenhydramine-Phenylephrine
43-99-30-03-24 Chlorpheniramine-Pyrilamine & Phenylephrine

Drug Name and Dosage Form The 12-character Drug Name and Dosage Form (first through sixth subsets) designates the specific drug and its dosage form. For example, Drug Name and Drug Name Extension 67-40-60-70-10, Sumatriptan Succinate, includes the following Drug Name and Dosage Forms:

67-40-60-70-10 Sumatriptan Succinate
67-40-60-70-10-03 Sumatriptan Succinate Tablet
67-40-60-70-10-20 Sumatriptan Succinate Solution
67-40-60-70-10-62 Sumatriptan Succinate Device
67-40-60-70-10-64 Sumatriptan Succinate Kit

Full GPI with Drug Strength and Strength UOM The 13th and 14th characters (seventh subset) identify various strengths. For example, Drug Name and Dosage Form 37-20-00-30-00, Furosemide, includes the following:

37-20-00-30-00-03 Furosemide Tablet
37-20-00-30-00-03-05 Furosemide Tab 20 MG
37-20-00-30-00-03-10 Furosemide Tab 40 MG
37-20-00-30-00-03-15 Furosemide Tab 80 MG
37-20-00-30-00-20-05 Furosemide Inj 10 MG/ML
37-20-00-30-00-20-50 Furosemide Oral Soln 10 MG/ML

Note The seventh subset can also imply a route when the first twelve characters
of the GPI cannot define the route difference, as illustrated by the last two
rows in the table above. When strengths are not specified, the seventh subset may be “00”. For example, Drug Name 90-55-00-75, Hydrocortisone, includes the following
dosage forms without strengths:

90-55-00-75-00-29-00 Hydrocortisone Powder
90-55-00-75-10-29-00 Hydrocortisone Acetate Powder**

The 12-character Drug Name and Dosage Form (first through sixth subsets) designates the specific drug and its dosage form. For example, Drug Name and Drug Name Extension 67-40-60-70-10, Sumatriptan Succinate, includes the following Drug Name and Dosage Forms:

Appendix D - Workflow Step Codes and Descriptions

Code	Description
-1	Unspecified
0	Intake
1	Entered into System
2	Fill Prescription
3	Dispensed
4	Edit Prescription
5	Patient Counselled
6	Verify before Fill
7	Verify before Dispense
8	Label Printed
9	PA Request Sent
10	PA Response Received
11	Approved by Insurance
12	Out for Delivery
13	Unable to Deliver
14	Shipment Delivery Confirmed
15	Reversed from Insurance
16	Returned to Stock
17	Transferred
18	Reconciled
19	Returned by Patient
20	Signature Deleted by Pharmacy User
21	Picked Up
22	Delivered
23	Shipped
24	Refill Request Sent
25	Refill Request Failed to Send
26	PA Request Failed to Send
27	Placed on Hold
28	Taken off Hold
29	Un-Transferred
30	Patient Declined Counseling
31	Delivery Cancelled
32	Shipment Order Created
33	Shipment Cancelled
34	Shipment in Transit
35	Shipment Delivered
36	Paper Claim Printed
37	PDMP Verified
38	Added To Delivery Queue
39	Rx Inactivated
40	Rx Re-Activated
41	Added to Will Call
42	Rejected by Insurance
43	Delivery Order Created
44	Shipment Exception
45	Returned By Shipment Provider
46	Review Patient Allergies
47	Review Drug Interactions
48	Refill Request Approved
49	Refill Request Denied
50	Sent to [Drug Robot Name]
51	Cancel to [Drug Robot Name]
52	Patient Requested Refill
53	Auto Refill Consent Captured
54	Verify Data Entry (PV1)
55	Waiting For Refill Response
56	Add to Custom Queue
57	Remove from Custom Queue
58	Auto Refill Consent Captured
59	Return to Stock Label Printed
999	Prescription Deleted

Example

{
  "APIKey": "",
  "PharmacyNumber": "1234567890",
  "PharmacyNumber_Alt": "9876543210",
  "pharmacy_info": {
    "pharmacy_name": "BestRx Pharmacy",
    "address": {
      "address1": "2625 Butterfield Road",
      "address2": "Suite 200S",
      "city": "Oak Brook",
      "state": "IL",
      "zipcode": "60523"
    },
    "phone_number": "6308939210",
    "fax_number": "6303393171",
    "npi": "9876543210",
    "ncpdp": "1234567",
    "dea": "AB1234567"
  },
  "transaction_id": "888057520190315",
  "transaction_date": "2019-03-15",
  "transaction_time": "22:56:21",
  "transaction_time_fraction": "0054182",
  "rx_number": "8880575",
  "patient_id": 25731,
  "patient_last_name": "DOE",
  "patient_first_name": "JOHN",
  "patient_middle_name": "WAYNE",
  "patient_prefix": "",
  "patient_suffix": "",
  "patient_address1": "167 W GRAND AVE",
  "patient_address2": "UNIT 1408",
  "patient_city": "CHICAGO",
  "patient_state": "IL",
  "patient_zip": "60654",
  "patient_home_phone": "3129555555",
  "patient_cell_phone": "6304005555",
  "patient_work_phone": "6308935555",
  "patient_dob": "1980-04-23",
  "patient_gender": "M",
  "patient_email": "johndoe@email.com",
  "patient_group": [
      {
          "group_code": "1",
          "group_name": "Group Name One"
      },
      {
          "group_code": "3",
          "group_name": "Group Name Three"
      }
    ],
  "family_email": "",
  "patient_short_remark": "Test short remark",
  "patient_remark": "",
  "family_remark": "",
  "patient_shipto_organization": "",
  "patient_shipto_last_name": "",
  "patient_shipto_first_name": "",
  "patient_shipto_careof": "",
  "patient_shipto_address1": "",
  "patient_shipto_address2": "",
  "patient_shipto_city": "",
  "patient_shipto_state": "",
  "patient_shipto_zip": "",
  "patient_shipto_phone": "",
  "is_ltc_patient": true,
  "ltc_facility": {
    "ltc_facility_internal_id": "123",
    "ltc_facility_name": "JOSEPH REHABILITATION CENTER",
    "ltc_facility_code": "JRC",
    "ltc_facility_payer_id": "12345",
    "ltc_facility_contact_name": "Jos",
    "ltc_facility_address": {
      "address1": "1234 Newport Dr",
      "address2": "",
      "city": "Wheaton",
      "state": "IL",
      "zipcode": "60187"
    },
    "ltc_facility_phone": "6301234567",
    "ltc_facility_fax": "6307654321",
    "ltc_facility_alt_phone1": "9876543210",
    "ltc_facility_alt_phone2": "1234567890"
  },
  "is_deactivated": false,
  "transferred_out": false,
  "transferred_pharmacy": "",
  "transferred_pharmacy_address1": "",
  "transferred_pharmacy_address2": "",
  "transferred_pharmacy_city": "",
  "transferred_pharmacy_state": "",
  "transferred_pharmacy_zip": "",
  "transferred_pharmacy_phone": "",
  "transferred_pharmacy_fax": "",
  "transferred_pharmacy_ncpdp": "",
  "transferred_pharmacy_npi": "",
  "transferred_pharmacy_dea": "",
  "transfer_date": "",
  "transfer_contact_name": "",
  "transfer_rph_initials": "",
  "transfer_rph_user_id": "",
  "transfer_rph_last_name": "",
  "transfer_rph_first_name": "",
  "bill_status": "3",
  "bill_status_text": "Transmitted",
  "workflow_status": "15",
  "workflow_status_text": "Approved by Insurance",
  "workflow_step_performed_code": "11",
  "workflow_step_performed_text": "Approved by Insurance",
  "workflow_queues": [],
  "fill_number": "2",
  "fill_date": "2019-03-15",
  "fill_time": "22:50:46",
  "picked_up": "false",
  "delivered": "false",
  "qty_ordered": "30",
  "qty_filled": "30",
  "days_supply": "30",
  "refills_authorized": "5",
  "refills_remaining": "4",
  "refill_number": "1",
  "refill_exp_date": "2019-12-03",
  "item_upc_code": "",
  "drug_ndc": "43547036109",
  "drug_ndc_10digit": "4354736109",
  "drug_ndc_10digit_formatted": "43547-361-09",
  "drug_gpi": "36150040200330",
  "drug_name": "LOSARTAN 50MG TAB SOL",
  "drug_strength": "50 MG",
  "drug_mfg": "SUN PHARMACEUTICALS",
  "drug_schedule": "0",
  "drug_is_generic": "true",
  "drug_brand_name": "COZAAR 50 MG TABLET",
  "drug_package_size": "90",
  "drug_form": "EACH",
  "drug_color": "WHITE TO OFF WHITE",
  "drug_shape": "ROUND,CONVEX,BEVELED EDGE",
  "drug_front_imprint": "S",
  "drug_back_imprint": "11  2",
  "drug_misc_info": "Convex,White to off-white,Beveled edge",
  "lot_number": "",
  "lot_exp_date": "",
  "retail": "80.00",
  "billed": "75.38",
  "payers": [
    {
      "plan_seq_no": "1",
      "plan_code": "TESTREJ70",
      "plan_name": "TEST REJECTION CODE 70",
      "plan_bin": "330033",
      "plan_pcn": "REJ70",
      "card_id": "44444444",
      "group": "",
      "person_code": "",
      "relation_code": "",
      "plan_bill_status": "5",
      "plan_bill_status_text": "Rejected",
      "cost_paid": "0.00",
      "disp_fee_paid": "0.00",
      "tax_paid": "0.00",
      "discount": "0.00",
      "pat_pay_amount": "0.00",
      "due_from_payer": "0.00"
    },
    {
      "plan_seq_no": "2",
      "plan_code": "TESTCPAY50",
      "plan_name": "TEST COPAY 50",
      "plan_bin": "330033",
      "plan_pcn": "COPAY50",
      "card_id": "44444444",
      "group": "",
      "person_code": "",
      "relation_code": "",
      "plan_bill_status": "3",
      "plan_bill_status_text": "Transmitted",
      "cost_paid": "218.20",
      "disp_fee_paid": "0.00",
      "tax_paid": "0.00",
      "discount": "0.00",
      "pat_pay_amount": "50.00",
      "due_from_payer": "168.20",
      "applied_to_deductible": "50.00",
      "accumulated_deductible": "150.00",
      "remaining_deductible": "350.00"
    }
  ],
  "cost": "0.89",
  "patient_amount_due": "50.00",
  "due_from_insurance": "168.20",
  "total_paid": "218.20",
  "margin": "217.31",
  "margin_percent": "24416.85",
  "is340b": "true",
  "dispense_as_written": "false",
  "daw_code": "0",
  "date_rx_written": "2018-12-04",
  "signature": "TAKE 1 TABLET DAILY|TOME 1 TABLETA AL DIA",
  "dosage_info": [
    {
      "dose_slot": 1,
      "dose_time": "MORNING",
      "dose_qty": "1",
      "dose_days": "daily"
    }
  ],
  "rx_source": "1 - Written",
  "rph_initials": "HD",
  "tech_initials": "",
  "rx_serial_number": "",
  "submission_clar_code": "20",
  "other_coverage_code": "03",
  "horizon_graveyard_code": "",
  "diagnosis": [
    {
      "qualifier": "02",
      "code": "I10",
      "description": "Essential (primary) hypertension"
    },
    {
      "qualifier": "02",
      "code": "I27.0",
      "description": "Primary pulmonary hypertension"
    }
  ],
  "doctor_id": 4696,
  "doctor_last_name": "SMITH",
  "doctor_first_name": "MICHELLE",
  "doctor_middle_name": "",
  "doctor_prefix": "",
  "doctor_suffix": "",
  "doctor_npi": "1679856987",
  "doctor_dea": "MR2314019",
  "doctor_state_licno": "IL01637",
  "doctor_dps_no": "",
  "doctor_medicaid_no": "",
  "doctor_upin": "",
  "doctor_address1": "WEST CITY MEDICAL CENTER",
  "doctor_address2": "SECOND FLOOR",
  "doctor_city": "CHICAGO",
  "doctor_state": "IL",
  "doctor_zip": "60612",
  "doctor_phone": "7732229987",
  "doctor_fax": "7732229999",
  "doctor_email": "michellesmith@email.com",
  "doctor_remark": "",
  "doctor_profession_code": "",
  "doctor_profession_desc": "",
  "doctor_ama_specialty_code": "",
  "doctor_ama_grouping": "",
  "doctor_ama_classification": "",
  "doctor_ama_specialization": "",
  "doctor_surescripts_service_level": "New, Refill, Change, RxFill, Cancel, ePA",
  "next_refill_date": "2019-04-14",
  "drug_therapeutic_class": "",
  "prescribed_drug": "LOSARTAN 50MG TAB SOL",
  "filled_by": "",
  "erx_message_id": "",
  "erx_prescriber_order_no": "",
  "erx_patient_medical_record_no": "",
  "erx_facility_code": "",
  "rx_remark": "",
  "erx_pharmacy_remark": "",
  "erx_prescriber_remark": "",
  "erx_drug_notes": "",
  "written_date_remark": "",
  "inactive_rx_remark": "",
  "shipping_provider": "",
  "shipping_tracking_number": "",
  "dispense_using": "Safety Caps",
  "is_medsync_shortfill": false,
  "claim_reject_info": [
    {
      "reject_code": "05",
      "reject_description": "M/I Service Provider Number"
    }
  ],
  "pbm_message": "",
  "claim_additional_messages": [
    {
      "message": "sample message text"
    },
    {
      "message": "more sample message text"
    }
  ],
  "document_count": 0,
  "lot_serial_info": [
    {
      "drug_ndc": "43547036109",
      "qty": 10.0,
      "compound_seqno": 0,
      "lot_number": "12345",
      "lot_exp_date": "2025-12-31",
      "serial_number": "1234567890"
    },
    {
      "drug_ndc": "43547036109",
      "qty": 20.0,
      "compound_seqno": 0,
      "lot_number": "67890",
      "lot_exp_date": "2026-12-31",
      "serial_number": "0987654321"
    }
  ],
  "ProgramInfo": {
      "ApplicationName": "BestRxWin",
      "ApplicationVersion": "6.5.828.0",
      "ComputerName": "BESTRX_SERVER",
      "ComputerUser": "BESTRX_SERVER\\bestrx.qa"
  }
}

Prescription Update Callback

Root Fields#

Pharmacy Info Fields#

LTC Facility Info Fields#

Address Info Fields#

Group Fields#

Payer Fields#

Diagnosis Fields#

Dosage Fields#

Workflow Queues#

Claim Reject Fields#

Claim Additional Messages Fields#

Drug Lot Info Fields#

Program Info Fields#

Appendix A - Billing Status Codes and Descriptions#

Appendix B - Workflow Status Codes and Descriptions#

Appendix C - GPI Information#

Appendix D - Workflow Step Codes and Descriptions#

Example#

Root Fields

Pharmacy Info Fields

LTC Facility Info Fields

Address Info Fields

Group Fields

Payer Fields

Diagnosis Fields

Dosage Fields

Workflow Queues

Claim Reject Fields

Claim Additional Messages Fields

Drug Lot Info Fields

Program Info Fields

Appendix A - Billing Status Codes and Descriptions

Appendix B - Workflow Status Codes and Descriptions

Appendix C - GPI Information

Appendix D - Workflow Step Codes and Descriptions

Example