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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.
- 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.
- 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.
- Telecommunication: addresses the data format and content, the transmission protocol, and other appropriate telecommunication requirements.
- SCRIPT: allows for quick and accurate communication between the physician and pharmacist allowing for heightened security and tracking capability while reducing the potential for medical errors.
- Universal Claim Forms: For Telecommunication 5.1, D.0, and Workers’ Compensation/Property and Casualty manual claims processing.
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