Draft_MTF_to_TMOP_Implementation_Guide_(Feb _2013).pdf

Implementation Guide for Transferring Prescription Refills from the Military Treatment Facility (MTF) to the TRICARE Mail Order Pharmacy (TMOP)

Version 1.1 DRAFT

Prepared By:

TMA Pharmacy Operations Directorate February 2013

Table of Contents TRICARE Pharmacy Program i

1 Purpose

2 Scope

3 Pre-Implementation

3.1 Identifying TMOP Medications

3.2 Beneficiary Education

3.3 CHCS Pharmacy Set-up

3.3.1 Enabling the TMOP Transfer Process in CHCS

3.3.2 CHCS Drug File Changes to Add New Drug (ADN) option

4 Post-Implementation

4.1 Transferring Prescriptions/Refills

4.2 TMOP Warning/Notification Labels/Rejection Email/Activity Log Entries

4.3 Actions Against Transfers – TMOP

4.3.1 Via Pharmacy

4.3.2 Via CLN

4.4 Pharmacy TMOP Re-Submit Option

5 TMOP Reports

5.1 TMOP Mailable Drug Report

5.2 TMOP Transfer Report

6 Troubleshooting and Other Considerations

6.1 OHI – Other Health Insurance

6.2 NPI – National Provider Identification

6.3 Patient Address Missing

6.4 Drug File Access

6.5 Brand Name Medications

6.6 Split Fulfillment Patients

6.7 Days’ Supply Issues

6.8 Rejected Transfer Troubleshooting

7 Pre-Launch Considerations

8 Key Points of Contact

Appendix A – Drug Mapping Layout

Appendix B – Sample Flyer

Appendix C – Telephone Prescription Refill Request System Training Guide

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1 Purpose This document will provide information to Military Treatment Facility (MTF) pharmacy personnel on the capability of transferring prescription refills to the TRICARE Mail Order Pharmacy (TMOP). It will detail the pre-implementation efforts required, the TMOP points of contact once the capability has been enabled, and troubleshooting issues that may arise. It is strongly recommended that you read this entire document prior to approaching your local leadership regarding this program.

2 Scope The MTF to TMOP prescription refill transfer process is a new capability in the Composite Health Care System (CHCS). This new feature will allow a beneficiary to electronically transfer their eligible prescriptions to TMOP. There are two ways that a transfer can occur: 1) Beneficiary requests his/her medications be transferred via the Telephone Prescription Refill Request System. The system would prompt the beneficiary, if the medications have been flagged TMOP eligible, that his/her medications can be transferred. At that moment the beneficiary can elect to transfer the prescription or continue to have it filled locally. 2) Pharmacy initiates the transfer in CHCS at the beneficiary request.

Some key points with this new feature are:

a) The beneficiary must meet the eligibility criteria for TMOP. Specifically he/she cannot o be enrolled in US Family Health Plan (USFHP) o have Other Health Insurance (OHI) o fall into the DEERS Beneficiary Category of ‘Direct Care Only’ (DCO)

b) Certain medications are not eligible for the TMOP transfer. These medications are: controlled drugs, compound items, investigational drugs, over the counter (OTC) drugs (except for those included in the OTC Pilot Study), and blood products.

c) Once a prescription is transferred to TMOP it cannot be transferred back to the MTF.

d) All TMOP business rules apply to transferred prescriptions (i.e. co-pays).

e) If interested in activating this capability please coordinate with TRICARE Management

Activity, Pharmaceutical Operations Directorate (Points of Contact are identified in Section 8 of this document).

3 Pre-Implementation

3.1 Identifying TMOP Medications

The MTF pharmacy will need to determine medications that will be “flagged” as available for the TMOP transfer. Each site will need to generate a utilization report to identify those medications that would be the best candidates for this initiative. A top 500 utilization report (excluding OTCs and controlled medications) should identify the majority of the medications. After the report has been compiled it will need to be sent to the TRICARE pharmacy contractor for review.

Note: The report will need to be in a specific Excel ® format (see Appendix A). It is recommended that the pharmacy request the local software specialist to run an available CHCS utility routine (see below) that will generate a text-delimited output; this can then be imported into Excel ®.

CHCS Utility Routine for mailable drug candidates

D EN^PSBTMDRG(PROD,MAILABLE)

If PROD is set to 1 Write to file TAB Separated Else write to screen carat separated If MAILABLE is set to 1 only select drugs mark mailable else select drugs with one NDC no schedule 1-5

Four ways To run drug list

1. Drugs marked mailable to screen D EN^PSBTMDRG(,1) see below

2. Drugs marked mailable to file tab separated D EN^PSBTMDRG(1,1) notice name of file has dmisid

***File TMOP_DRUG_CANDIDATES_FOR_HOST_HP0124.DAT created ***

*** 13 Drug candidates found ***

3. All CANDIATE Drugs to file tab separated D EN^PSBTMDRG(1)

4. all CANDIATE Drugs to screen D EN^PSBTMDRG()

Drug candidate list - Three ways to use program

1. D DT^DICRW D EN^PSBTMDRG()

To get an Interactive List (to the screen) of TMOP candidate Drugs. Each field is Carat Separated.

DRUG NAME^DRUG ROUTE^NDC^GCN SEQNO^CONTENT UNIT^DEFAULT

UNIT^PACKAGE SZ^DOSAGE STR^DOSAGE FORM^METRIC UNIT^TMOP UOM

Example::

HOSTHEADER^HP0124/7939/NEUTRAL NAME MTF2^148/0124/NMC PORTSMOUTH

1.

ACETAMINOPHEN--PO 325MG TAB(1)^PO

TAB^00440701010^004489^MG^^1^325^^Each^ 2.

ALBUTEROL--INH 90MCG AERP(10)^INH

AERP^00085113201^028090^MCG^^1^90^^GM^

3.

ALLOPURINOL--PO 100MG TAB(13)^PO TAB^65483099110^002535^MG^^1^100^^Each^ *** 454 Drug candidates found ***

2. D DT^DICRW D ^%ZIS U IO D EN^PSBTMDRG() D ^%ZIS

If a spooled report is preferred.

Example:

DEVICE: SPOOL VMS File Select SPOOL DOCUMENT NAME: TMOP CANDIATE DRUGS Are you adding 'TMOP CANDIATE DRUGS' as a new SPOOL DOCUMENT? Y (YES) EXPIRATION DATE: 18 Jun 2009// ***File TMOP_DRUG_CANDIDATES_FOR_HOST_HP0124.DAT created ***

3. D DT^DICRW D EN^PSBTMDRG(1)

With the parameter of 1, a file is written to the host directory to be delivered to TMOP A TAB character ASCII 9 is used instead of a carat The file name is WITH HP[DMIS] being the MTF CODE

Example:

***File TMOP_DRUG_CANDIDATES_FOR_HOST_HP0124.DAT created ***

3.2 Beneficiary Education

Prior to enabling this capability it is very important that sufficient beneficiary education has been performed. A few recommendations for educating beneficiaries are:

a) Flyers - used as “stuffers” in prescription refill bags and also placed in pharmacy waiting areas. A template has been created that can be used by MTFs (see Appendix B).

b) Telephone Prescription Refill Request System module- this feature can automate outbound messages to beneficiaries. A custom message can be created by each MTF to notify beneficiaries of this new capability. If there are any questions on how to setup this feature please review the training materials (see Appendix C).

c) Posting a message on the MTF website and/or the local post/base newspaper.

3.3 CHCS Pharmacy Set-up

3.3.1 Enabling the TMOP Transfer Process in CHCS

The enabling/un-enabling of the TMOP transfer is at the host Division level via a new Outpatient Maintenance Menu option. The MAIL Order Designation (MAI) option (see Screen 1) is effective for all Outpatient Pharmacy sites in that Division. This option is protected by a new Security Key

– PSO MAIL SUPERVISE MENU. The MAI default setting will be “NULL” and no transfers will occur until this setting is changed

PHARMACY MENU PATH: PHR->SFM->OMM->MAI

Figure 1 : MAI Menu Option [Screen 1]

Upon selecting “MAI” the user will enter the option (see Screen 2). Select the appropriate Division. Then at the “Designate/Modify Mail Order Vendor?” prompt type “Y”.

Figure 2: MAI – Continue [Screen 2]

Note: If the user accepts the default “No” at the “Designate/Modify Mail Order Vendor?” prompt, the screen is exited with no information saved to the data base.

After “Y” is entered, the user is presented with the following designation prompt:

Mail Order Vendor: [TMOP/CMOP/”@” to Delete Current Selection /<RETURN>] to Accept Current Selection]

Select “TMOP” (which is equivalent to the MOP) at this prompt. If you need help type a “?” and the following screen will display:

/<RETURN>] to Accept Current Selection]?

Enter TMOP to designate it as Mail Order Vendor Enter CMOP to designate it as Mail Order Vendor Enter “@” to delete the current designated vendor Enter <Return> to accept the current designated Mail Order Vendor:

/<RETURN>] to Accept Current Selection]

After selecting “TMOP” the user will be presented with the following screen [Screen 3].

Figure 3: [Screen 3]

The following fields must be populated:

o Responsible Pharmacist - This will be the name of a pharmacist in-charge (i.e. Pharmacy

Chief/Head, Outpatient Supervisor, etc). Possible entries in this field are limited to CHCS users with a defined Provider Class of “PHARMACIST”, in the Provider File.

o Responsible Pharmacist Email Address - This email address will receive transfer rejection notifications. (This can also be a group email so that more than one person receives the rejection notifications.)

o Refill Outpatient Site Name - Select appropriate CHCS Outpatient Site. Recommend creating a new Outpatient Site for TMOP refills.

o Pharmacy Street Address 1 - Populate with appropriate pharmacy address.

o Pharmacy Street Address 2 - This is optional (i.e. Suite 206).

o Pharmacy City - Populate appropriately.

o Pharmacy Zip - Populate appropriately.

o Pharmacy Phone Number - Populate with a phone number that pharmacy contractor will use to contact MTF pharmacy, if there are any issues/questions. Do not populate with an 800 number.

o Test Mode - Leave blank.

o Pharmacy NPI - Auto populated.

After required fields are completed the TMOP vendor designation is complete [Screen 4].

Figure 4: Successful TMOP Designation Message [Screen 4]

3.3.2 CHCS Drug File Changes to Add New Drug (ADN) option

Drug file item mapping between the site and the TMOP vendor is a critical patient safety factor.

Close coordination between the MTF pharmacy department and the TMOP vendor implementation specialists is imperative to assure correct mapping.

In order for TMOP to accept and process prescription refill transfers, the CHCS Drug file must contain certain required data. Go to the ADN option in CHCS. The menu path is: Pharmacy Main Menu -> SFM -> FOM -> ADN.

The current Drug file fields must have entries as follows:

a. Full Drug Name (required)

b. Drug Route (may be null)

c. 11 Digit NDC (required)

d. Content Unit (may be null depending upon item)

e. Default Unit (may be null depending upon item)

f. Package Size (required).

g. Dosage Strength (required)

h. Dosage Form (required)

i. Metric Units (required – system generated)

j. GCN sequence # (required – system generated; not visible in ADN option)

Important Note: Any changes to the specified ADN fields above after the drug file has been provided to TMOP will result in prescription transfer rejections. While it is a site file/table responsibility to populate the Drug file fields, all changes should be coordinated with the pharmacy contractor. Recommend limiting user access to the ADN option.

Additionally, two new required fields are introduced; “TMOP Mailable:” and “TMOP Unit of Measure:” [Screen 5]

Figure 5: TMOP Add New Drug (ADN) Changes [Screen 5]

The three possible entries in the “TMOP Mailable:” fields are “YES”, “NO”, or NULL. [Screen 6] For prescription refills to be transferred to the TMOP, the “TMOP Mailable:” field must be set to “YES” for each Drug file item.

Figure 6: TMOP Mailable Flag [Screen 6]

The “TMOP Unit of Measure” field is the second new Drug file field. It must have a value for the TMOP to accept/process refill transfers. The possible values are displayed in Screens 7&8.

Figure 7: TMOP Unit of Measure [Screen 7]

Figure 8: TMOP Unit of Measure [Screen 8]

If the TMOP Mailable field is set to “YES” and the “TMOP Unit of Measure:” is left blank, the user will not be able to File/Exit [Screen 9]

Figure 9: Incomplete F/T Warning [Screen 8]

4 Post-Implementation

4.1 Transferring Prescriptions/Refills

A refillable prescription may be transferred to the TMOP if:

• The designated Mail Order vendor is TMOP

• The patient is eligible

• The patient address is present in the CHCS Patient file

• The drug has been defined properly in the Drug file

• Mapping of the drug has been coordinated with the TMOP vendor

Transferring to TMOP

Menu Path: Pharmacy Main Menu -> OPM -> PM -> RAP

Transfer of prescriptions to the TMOP is accomplished via the Refill a Prescription (RAP) option or via the Telephone Refill Interface. The patient/user must confirm the accuracy of the patient’s address before a transfer can occur. Screen 14 shows the display presented to pharmacy personnel when transferring prescriptions via the RAP option. (For patients requesting transfers via the Telephone Prescription Refill Request System, the address is read to the patient on the phone and the patient is asked to confirm that the information is correct. If the patient indicates that the address information is not correct, the prescription will not be transferred to TMOP.)

Figure 10: TMOP RX Transfer [Screen 14]

If the answer to either of the questions is “No”, the prescription will not be transferred. Screen 15 shows the information displayed following this response. The prescription will then be put into suspense to be processed locally.

Figure 11: Address Not Correct [Screen 15]

If the answer to either of the questions is “Yes”, the prescription will be transferred. (Screen 16)

Figure 12: Address Correct [Screen 16]

The user may then use the TMOP Transfer Report to determine if the prescription was accepted or rejected. Note: For rejected prescriptions, the Responsible Pharmacist email account will receive notification of those prescriptions that were not accepted.

4.2 TMOP Warning/Notification Labels/Rejection Email/Activity Log Entries

Warning Label – If a prescription is transferred to TMOP, it undergoes local clinical screening before transmission of the request. If a positive screen is generated, its status is changed to WARNING and a clinical Screen label prints (Figure 13). The screen must be cleared before a transfer can occur.

* POSITIVE CLINICAL SCREEN*

* LAST,FIRST *

* RX# G643715 *

* MULTIVITAMIN,THER W/MIN *

* TMOP TRANSFER *

* 05 Jul 2009@1305 *

Figure 13: Positive Screening

Rejection Notifications – if a transfer request is successfully transmitted to the TMOP but the TMOP later rejects it due to clinical or administrative reasons, a notification label will print. These types of rejections will take an undetermined period of time. (Figure 14)

TMOP N O T I F I C A T I O N

RX REJECTED BY TMOP

REJECT REASON: 12: DRUG

INTERACTION DETECTED

RX NA854

LAST,FIRST 3165

TEL: 496-845-9832

RANITIDINE 150MG PO TAB

QTY: 60 11 Feb 09@0910

TMOP TEL: 111-222-2222

Figure 14: Notification Label

An email will be sent to the person (or group) defined as the “Responsible Pharmacist”. (Figure 15)

Subj: NOTIFY RX Wed, 11 Feb 2009 09:10:30 11 Lines From: POSTMASTER Patient : LAST,FIRST

FMP/SSN : 20/006-62-3165

Pharmacy: NI OP PHARMACY1 Comment : TEST

This refill transfer was rejected by the TMOP due to: <Reason Code and reject reason>

RX # : NA854 Fill # : 2

RANITIDINE—PO 150MG TAB ~T1 BID RF3 #60 DS30 on 11 Feb 2009@0910 Figure 15: Rejection Email

Activity Log Entries – the Activity Log will record the progression and outcome of TMOP Transfer requests.

• Transmit 19 Jun 2009@1325 2 TMOP TRANSMIT NI OP PHARMACY1 smwsm Remarks: <Prescription transfer Request to TMOP> Comments: <LASTNAME,FIRSTNAME> Responsible Pharmacist

• Non-Clinical Rejection (Example of Immediate Rejection –refer to TMOP documentation for a complete list and descriptions)

18 Jun 2009@1550 2 TMOP REJECTED NI OP PHARMACY1 smwsm Remarks: <Prescription rejected/not processed by TMOP> Comments: <43/DRUG NOT LINKED TO TMOP DR Transfer rejected for invalid drug, not an authorized TMOP transfer drug>

• Re-Submit

22 Jun 2009@0534 2 TMOP RESUBMITED NI OP PHARMACY1 smwsm Remarks: <Prescription Re-Submitted to TMOP> Comments: <LASTNAME,FIRSTNAME>

• Successful Transfer (May take an undetermined period of time)

11 Feb 2009@1019 TMOP COMPLETED NI OP PHARMACY1 JMB Remarks: <Transferred to TMOP> Comments:<Receiving Pharmacist>

4.3 Actions Against Transfers – TMOP

4.3.1 Via Pharmacy

No action except Renew may be taken against a transferred prescription. Examples are Modify, Edit, Mark Noncompliant. The appropriate message will display.

Figure 16: Actions against transfers

4.3.2 Via CLN

Selecting via the Modify Action Item:

Figure 17: Selecting Modify

Transferred Prescriptions are not displayed on the candidate list:

Figure 18: Transferred prescriptions do not appear on the list

Via Browse Action Item, selecting a transferred prescription results in a warning message that an action cannot be taken against a transferred Prescription:

Figure 19: Warning Message

4.4 Pharmacy TMOP Re-Submit Option

Menu Path: Pharmacy Main Menu -> OPM -> PM -> SPM -> TMR

In the event that it is necessary (after making correction(s) to data, e.g. drug, patient, provider that caused a rejection) to re-submit a previously completed transfer, the pharmacy user may use a new option: TMR – Resubmit TMOP Transfer. The user is presented with a list, for the selected patient, of previously completed TMOP transfer attempts that resulted in a rejection. One or more of these rejections can be selected and re-submitted. The re-submission is documented in the prescription Activity Log.

It is important to remember that if you are correcting rejected prescriptions transfers, that you must use this TMR option to resubmit the prescription. You cannot “remove a refill” that was transferred and subsequently rejected using the “RRE” function.

Figure 20: Re-submission Candidates for patient LASTNAME,FIRST

Figure 21: Selected RX Display with Re-submit Prompt

Figure 22: Re-submit Confirmation

5 TMOP Reports

There are two new reports that pertain to TMOP – TMOP Mailable Drug (FLA) and TMOP Transfer Report (TMS). [Screen 10]

Menu Path: Pharmacy Main Menu -> PRM -> OPR -> TMO -> FLA Menu Path: Pharmacy Main Menu -> PRM -> OPR -> TMO -> TMS

Figure 23: TMOP Reports [Screen 10]

5.1 TMOP Mailable Drug Report

The TMOP Mailable Drug Report allows the site to easily determine which drugs have been flagged within the ADN function to transfer to the TMOP. This report provides the drug name and primary NDC number associated with every drug flagged for TMOP. The report sorts drugs by IEN. By capturing the report and dropping into Excel® you can sort it by drug name. Figure 24 below shows an example of this report.

Figure 24: TMOP Mailable Report [Screen 11]

5.2 TMOP Transfer Report

The TMOP Transfer Report allows you to monitor the status of refills (rejected, accepted, both) transferred to the TMOP. The user can sort by Status, choose a time period (a maximum of software Activation date or T-365), and sort by Patient, Date or Outpatient Site. [Screen 12]

Figure 25: TMOP Transfer Report Request [Screen 12]

Screen 13 shows how this report will display for the user. The report provides the prescription information as well as the reason any prescription transfers were rejected by TMOP. This will assist the site in troubleshooting rejected prescriptions. Once the corrections have been made, the prescription can be resubmitted for transfer to TMOP. This is done via the Pharmacy TMOP Re-Submit Option as explained in Section 4.4 of this document.

Figure 26: TMOP Transfer Report [Screen 13]

6 Troubleshooting and Other Considerations

6.1 OHI – Other Health Insurance

The interface will screen out patients that are flagged as having other health insurance and not offer TMOP as an option. Sites are strongly encouraged to query patients at window for OHI prior to transferring prescriptions. If the prescription is transferred and it is later determined during adjudication that the patient does in fact have OHI, the prescription cannot be filled at TMOP. The pharmacy contractor will contact the MTF who will then need to “renew” the transferred prescription (no capability exists to transfer the record back through the interface). The site will then need to contact the patient and have them come in to pickup the refill. Downside is extra effort and delay in filling prescription. Upside is that patients that did not volunteer this OHI information up front can now be billed through the TPOCS program (even retroactively).

6.2 NPI – National Provider Identification

Providers that do not keep their personal information current with the national database will generate rejected transfers. This pertains to name changes only. Providers that marry or divorce not only need to update this information in DEERS, CCQAS, CHCS, etc., but also with NPI.

6.3 Patient Address Missing

If a patient does not have an address entered into CHCS, the system will not prompt them to transfer a flagged drug to TMOP.

6.4 Drug File Access

Sites with multiple staff members who have access to the drug file should establish business rules on how changes are handled within this file. Any changes to a TMOP flagged drug that are not coordinated with the pharmacy contractor will result in a rejected transfer of the prescription. Sites which share a CHCS host with other commands should coordinate these business rules as well since the ADN file under formulary management impacts all sites operating on that host.

6.5 Brand Name Medications

TMOP automatically substitutes generics for all prescriptions when available. Dispense As Written (DAW) orders will not carry over to TMOP. This is an important consideration for prescriptions for Synthroid, Coumadin, and other brand drugs that may have a narrow therapeutic window. Would recommend not adding these medications to your TMOP drug file without first getting concurrence from the Medical Staff.

6.6 Split Fulfillment Patients

Telephone Prescription Refill Request System will present an “opt out” at the end of the call for patients requesting multiple prescriptions. This is helpful when only some of the prescriptions are eligible for TMOP transfer and allows the beneficiary to cancel the transfer and pickup all prescriptions at the military site. When transferring prescriptions at the pharmacy window, staff members need to be aware of which drugs are available for transfer and should query the beneficiary up front about possible split fulfillment; i.e. if only some of the prescriptions can be transferred, is the beneficiary still interested in transferring those prescriptions.

6.7 Days’ Supply Issues

TMOP adheres to a maximum 90 day supply for all prescriptions. There is no filter in the transfer process to screen for BCPs that are written for 6 months’ supply. These prescriptions will get rejected from TMOP. Part of the education and preparation for implementing the TMOP transfer program should include changing business rules to a standardized 90 day supply for all medications, including BCPs. This will also apply to other medications that MTFs may dispense in quantities exceeding 90 days, i.e. Prenatal Vitamins. If you typically dispense a bottle of 100 tablets for PNVs, the days supply will calculate out as 100 days and subsequently be rejected by TMOP since this exceeds their business rules of providing a maximum of 90 days of medication.

6.8 Rejected Transfer Troubleshooting

• Drug File changes not coordinated with TMOP

• Patient has OHI*

• Provider NPI info not current

• Quantity in excess of 90 day supply

• Use the TMR prompt to resubmit these transactions after editing/correcting the prescription

• You cannot use the “RRE” prompt to remove rejected transfers

• Days’ supply exceeds 90 days (see Oral Contraceptive comments above in Section 6.7).

• System not prompting for Transfer

• No patient address on file

• Drug not flagged for TMOP

• Patient OHI flag on*

• Patient Direct Care Only*

• Telephone Prescription Refill Request System TMOP Function not turned on

7 Pre-Launch Considerations

• Use TMOP trifold to educate beneficiaries of “new feature”, i.e. bag stuffers

• You can enable the pharmacy window transfer capability prior to turning on the Telephone

Prescription Refill Request function as you ramp up the program

• Use Telephone Prescription Refill Request System Recall module to deliver outbound educational messages to beneficiaries

• Adjust drug file to support a maximum 90 days’ supply for medications flagged for TMOP

(see Oral Contraceptive comments above in Section 6.7).

• Get “buy-in” from MTF providers prior to flagging brand name medications (e.g. Coumadin, Synthroid). These medications will automatically be converted to generic equivalents when transferred to TMOP.

• Be realistic in your timeline. Educating beneficiaries is critical to program success. Mapping drugs requires coordination with the Pharmaceutical Operations Directorate and TMOP.

Contact with these offices should be established prior to establishing a “go live” date with your command.

8 Key Points of Contact

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Appendix A – Drug Mapping Layout

Layout for Drug Mapping file for new MTF site Delimiter between fields: “|” SAIC has created a report that the sites will get with the “mail order package”. That is the preferred report format. If this report is unavailable, then the format below should be used. Fields should be in the order shown.

Field Comments

HOST Header - this information will be used for all drugs in this file WHERE MTF = Military Transfer Facility

MTFODE 4-6 char code associated with the MTF record. The 1st two chars are the host platform name - must be "HP". For example: HP0091

MTFIEN The internal entry number for the MTF

MTFNAM The site defined Host Platform Name

DMISIEN The internal entry number of the DMIS ID CODES file

DMISID This field is the Defense Medical Information System Identification Number.

DMISNAM This field identifies the formal name of the medical entry associated with a

DMISID

Full Drug Name (required) – 40 Char Alpha Num

Example: ALLOPURINOL--PO 100MG TAB Drug Route (not required - may be null) Alpha Num – 10 Char

Example: PO

11 Digit NDC (required) 11 digits, right justified with leading 0’s. No dashes.

Example: 00054474131 TMOP uses the 5-4-2 NDC format 99999 – manufacturer identifier 9999 – product identifier (strength/size/formulary) 99 – package size or type

GCN SEQ # (required) 6 digits , right justified. Add leading 0’s. No dashes.

Example:081828

Generic Code Number Sequence Number – Separates all medical supplies that share the same GCN

Content Unit MAX 12 - characters. This field defines the common unit of measure for all the components in the drug. The content field of each component is a numeric, whose unit of measure is defined in this field. Some examples: MG, GM, MEQ, ML, UNITS, MG/ML, MG/5ML, GM/TBSP, MEQ/L, OZ, % etc.

(not required - may be null or blank)

Default Unit (not required - may be null) Alpha Num – 12 Char populated for multiple use items such as vials, bottles, or tubes.

If the medication is a multiple use item and is always dispensed in a specific size or complete unit such a 30GM tube, the size of the item should be entered in this field. For example, a 30GM tube of Hydrocortisone Cream 1% should have a default unit of 30GM or 30GM/TUBE. The default unit for a 15ML bottle of eye drops should be 15ML or 15ML/BTL. If the medication is dispensed in individual units such as TAB, TBSL, CAP or ML it is recommended that the default unit be populated with that unit of measure.

Package Size (required) numeric . If Null, assume it is 1, but do not populate with a 1. Num w/ three decimal points – NUM 9 (7).9(3)

Example: 473.000

Dosage Strength (required) Num – 12 w/ two decimals (10.2) For example: 100mg would be 100.00

Dosage Form (required) 10 CHAR (from FDB) Examples: TAB, CAP, SOL, CRE, AER

Metric Units (required) 10 Char Example: Each, ML, GM

Unit of Measure TMOP unit of Measure (uom) 01 – Tablets or Capsules

02 – ML

03 – GRAMS

04 – Ounces 05 – Pounds 06 – package (eg, inhalers or blister packs)

Examples of unit pack drugs are tablets or capsules dispensed together on a blister pack, a box of syringes, a tube of cream or ointment, or a vial of liquid.

Appendix B – Sample Flyer

Appendix C – Telephone Prescription Refill Request System Training Guide

3.3.2 CHCS Drug File Changes to Add New Drug (ADN) option

4.4 Pharmacy TMOP Re-Submit Option