Pharmacy

A structured clinical or formulary evaluation associated with a National Drug Code, documenting the therapeutic review, safety profile, or coverage determination for a drug product. Used in pharmacy benefit management and formulary committee workflows to support drug tier placement and coverage policy decisions.

The remaining dollar amount outstanding on a pharmacy claim or account for a specific National Drug Code after payments, adjustments, and credits have been applied. Used in pharmacy billing and accounts receivable systems to track unresolved financial obligations at the drug transaction level.

The total dollar amount submitted by a pharmacy or drug supplier on a claim for a specific National Drug Code prior to adjudication and payer adjustments. Used in pharmacy claims processing to establish the initial charge basis for allowed amount calculations and member cost-sharing determinations.

The date on which a National Drug Code was first assigned or registered with the FDA, marking the initial entry of a drug product into the national drug registry. Used in drug reference databases and formulary management systems to track product age, regulatory history, and patent expiration timelines.

The arterial pressure value for a national drug code. 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 ndc management and reporting.

The date on which a National Drug Code was officially withdrawn, discontinued, or removed from active status in the FDA NDC Directory or payer formulary. Used in pharmacy benefit management systems to enforce dispensing restrictions and prevent claims submission for discontinued drug products.

Classifies a National Drug Code into a therapeutic or formulary grouping used in pharmacy claims processing and drug utilization review. Categories support formulary tier placement, prior authorization rules, and drug spend analytics across pharmacy benefit management systems.

The billed dollar amount associated with a specific National Drug Code on a pharmacy or medical claim. Represents the gross charge before payer adjudication, rebates, or patient cost-sharing are applied. Used in drug cost trend analysis and claims reconciliation workflows.

The primary clinical indication or presenting symptom documented in association with a dispensed National Drug Code. Links the prescribed drug to the patient condition driving treatment, supporting clinical appropriateness review and pharmacy utilization management programs.

Identifies a subordinate or package-level National Drug Code linked to a parent NDC in a hierarchical drug classification structure. Child NDCs typically represent specific package sizes or configurations under a broader labeler and product grouping used in formulary and drug master file management.

The city associated with the dispensing pharmacy or drug labeler linked to a National Drug Code record. Used in pharmacy network management, geographic drug utilization reporting, and compliance audits to identify dispensing locations at the municipal level.

The pharmacological or therapeutic classification assigned to a National Drug Code, such as drug schedule or formulary tier designation. Drives pharmacy benefit rules, controlled substance monitoring, clinical decision support alerts, and drug spend categorization in claims data systems.

The 11-digit National Drug Code stored in pharmacy claims, EHR medication records, and PBM adjudication systems to uniquely identify a drug product by labeler, product form, and package size. The ndc_cd field is the primary drug join key in NCPDP D.0 transactions, 837P claims, and drug reference crosswalk tables used for formulary management, rebate processing, and drug utilization review.

The portion of a drug claim cost shared by the patient as a percentage of the allowed amount for a specific National Drug Code after the deductible is met. Captured during pharmacy claims adjudication to calculate member out-of-pocket liability and reconcile plan versus member cost responsibility.

Free-text annotation associated with a National Drug Code record in pharmacy or claims data systems. Used to document clinical notes, formulary exceptions, dispensing instructions, or administrative flags that do not fit structured data fields during drug utilization or formulary management workflows.

The date on which processing or review of a National Drug Code transaction was finalized, such as prior authorization completion or formulary review. Used in pharmacy operations to track workflow cycle times and ensure timely adjudication of drug-related requests.

A flag indicating whether a National Drug Code record or associated prescription data is subject to enhanced privacy protections, such as those governing sensitive drug categories like HIV, mental health, or substance use disorder medications. Controls data access and disclosure in pharmacy and claims systems.

The fixed dollar amount owed by the patient at the point of dispensing for a drug identified by its National Drug Code. Determined by formulary tier placement and benefit design during pharmacy claims adjudication. Used in member cost-sharing analysis and pharmacy benefit reporting.

The actual acquisition or reimbursement cost associated with a drug identified by its National Drug Code, distinct from the billed charge. Used in pharmacy cost management, drug pricing benchmarks such as AWP or WAC comparisons, and net cost calculations after rebates and discounts.

The total number of occurrences or dispensing events associated with a specific National Drug Code within a defined reporting period. Used in pharmacy utilization analytics to measure drug volume, identify high-frequency prescribing patterns, and support formulary performance reporting.