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For an overview of NCPDP Standards, please see the Standards Matrix .
- Batch Transaction: allows a batch to contain claims from multiple pharmacies at a centralized site to multiple processors via a switch.
- Billing Unit: provides a consistent and well-defined billing unit for use in pharmacy transactions. This results in time savings and accuracy in billing and reimbursement.
- Data Dictionary: contains names and definitions and other information on all of the data elements used in all NCPDP Standards.
- External Code List: contains values and other information on all of the data elements used in all NCPDP Standards.
- Financial Information Reporting: provides a standardized format for the exchange of accumulated financial information between Medicare Part D plans.
- Formulary And Benefit: provides a standard means for pharmacy benefit payers (including health plans and Pharmacy Benefit Managers) to communicate formulary and benefit information to prescribers via technology vendor systems.
- Manufacturer Rebates: allows for integration of multiple file formats and provides a standard electronic format to adjudicate rebate claims.
- Medicaid Subrogation: provides guidelines for the process whereby a Medicaid agency can communicate to a processor for reimbursement.
- Medical Rebates Data Submission: provides a standardized format for health plans’ rebate submissions to multiple manufacturers throughout the industry.
- Pharmacy and/or Combination ID Card: provide guidelines for organizations or entities producing member identification (ID) cards for use in the pharmaceutical drug claim industry.
- Post Adjudication: supplies detailed drug or utilization claim information after the claim has been adjudicated.
- Prescription Transfer: to electronically transfer prescriptions between pharmacies
- Prior Authorization Transfer: transferring existing prior authorization data between payer/processors when transitioning clients, performing system database or platform changes.
- SCRIPT: developed for transmitting prescription information electronically between prescribers, providers, and other entities. The standard addresses the electronic transmission of new prescriptions, changes of prescriptions, prescription refill requests, prescription fill status notifications, cancellation notifications, relaying of medication history, and transactions for long-term care.
- Specialized: developed for transmitting information electronically between prescribers, providers, payers, pharmacies and other entities.
- Telecommunication: developed to provide a standard format for the electronic submission of third party drug claims and other transactions between pharmacy providers, insurance carriers, third-party administrators, and other responsible parties. The development of the standard was to accommodate the eligibility verification process at the point-of-sale and to provide a consistent format for electronic claims processing.
- Universal Claim Forms: For Telecommunication 5.1, D.0, and Workers’ Compensation/Property and Casualty manual claims processing.
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