Pharmacy

A standardized code identifying the type, method, or outcome of a pharmacy dispense event, such as new fill, refill, partial fill, or mail order. Used in pharmacy claims adjudication and PBM systems to categorize dispense transactions and apply appropriate benefit rules.

The dollar amount owed by the member as a percentage-based cost-share for a dispensed medication after the deductible is met. Captured in pharmacy claims transactions to calculate member out-of-pocket liability and reconcile plan versus member payment responsibility.

Free-text notation entered by a pharmacist or pharmacy technician at the time of dispense, capturing clinical instructions, patient counseling notes, dispense exceptions, or workflow annotations not captured in structured data fields within the pharmacy management system.

The calendar date on which a pharmacy dispense event was fully processed and the medication was made available to the patient. Used in pharmacy operations and claims adjudication to measure fill cycle times, track dispensing turnaround, and establish the service completion timeline.

A flag indicating that a dispensed medication is associated with a sensitive health condition, such as mental health, substance use, or reproductive care. Restricts visibility of the dispense record in shared systems to protect patient privacy per federal and state confidentiality regulations.

The fixed dollar amount collected from the member at the point of dispensing as their required cost-share for the medication. Recorded in pharmacy claims to document member out-of-pocket payments, reconcile pharmacy remittance, and calculate annual out-of-pocket accumulator totals.

The total ingredient cost of a dispensed medication as calculated by the pharmacy at the point of sale, typically based on AWP, WAC, or negotiated contract pricing. Used in pharmacy claims adjudication to establish the basis for plan payment, member cost-share, and drug spend reporting.

The total number of dispense events associated with a prescription, patient, drug, or time period within a pharmacy or PBM system. Used in medication adherence analysis, refill pattern monitoring, utilization management, and pharmacy operations reporting to measure dispensing volume.

The country where the dispensing pharmacy is located, used to identify international or cross-border prescription fills. Critical for pharmacy benefit management systems tracking mail-order or specialty pharmacy dispenses and applying appropriate benefit coverage and regulatory rules.

The system username or staff identifier of the individual who initiated the dispense record in the pharmacy management system. Used for audit trail purposes, workflow accountability, and identifying which pharmacist or technician entered or processed the original dispense transaction.

The calendar date on which the dispense record was first entered into the pharmacy or PBM system, which may differ from the actual dispense date. Used for audit trail documentation, data lineage tracking, and identifying workflow processing timelines within pharmacy operations.

The timestamp recording when the dispense record was first created in the pharmacy management or PBM system. Combined with the created date to provide precise audit trail documentation, support workflow analysis, and identify processing sequence in high-volume pharmacy dispensing environments.

The kidney function marker for a medication distribution. Used in healthcare data management and clinical workflows. This field is commonly used in electronic health records (EHR), healthcare information systems (HIS), and clinical data warehouses for dispense management and reporting.

The calendar date on which a medication was dispensed to the patient at the pharmacy. Serves as the primary date field in pharmacy claims adjudication, used to determine benefit eligibility, apply plan year accumulators, measure days supply coverage, and analyze medication adherence.

The combined date and time at which a medication dispense event occurred in the pharmacy system. Provides precise sequencing of dispense transactions, supports 24-hour pharmacy operations reporting, and enables accurate chronological ordering of clinical and claims events in integrated health data systems.

The Drug Enforcement Administration registration number of the prescribing clinician or dispensing pharmacy associated with a controlled substance dispense. Required by federal law for Schedule II-V medications and used in pharmacy claims to validate prescriber authorization and support controlled substance compliance monitoring.

The date of death for a medication distribution. Used to track temporal information related to dispense death date. This field is commonly used in electronic health records (EHR), healthcare information systems (HIS), and clinical data warehouses for dispense management and reporting.

The dollar amount applied to a member's pharmacy deductible for a specific dispense event before plan benefits begin paying. Captured in pharmacy claims adjudication to track accumulation toward the annual deductible threshold and calculate remaining member cost-sharing obligations under the pharmacy benefit plan.

The date on which a dispense record was logically removed or voided within the pharmacy or PBM system, typically due to a reversal, data correction, or duplicate claim. Used in audit trail tracking and data quality processes to maintain an accurate historical record of dispensing activity changes.

Flags whether a pharmacy dispense record has been voided or removed from the active dispense history. Used in pharmacy claims and medication management systems to identify cancelled or erroneous dispense transactions that should be excluded from utilization reporting and patient medication histories.