Payer Specification Sheet
is valid and prescribing requirements have been validated. 43-Prescriber's DEA is active with DEA Authorized Prescriptive Right 45-Prescriber’s DEA is a valid Hospital DEA with Suffix and has prescriptive authority for this drug DEA Schedule. 46-Prescriber's DEA has prescriptive authority for this drug DEA Schedule 49-Prescriber does not
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Pharmacy Provider Manual - Home | …
www.primetherapeutics.comPrescription Drug Services for its clients through Prime’s ... order to illegally receive a drug benefit; ... Pharmacy Provider Manual ...
Prime Therapeutics Provider Manual
www.primetherapeutics.comProvider Manual 3 Table of Contents ... Prescription Drug Services for our Benefit Sponsors through our online claims processing system. This system
Payer Specification Sheet
www.primetherapeutics.com455-EM PRESCRIPTION/SERVICE REFERENCE NUMBER QUALIFIER 1-Rx Billing M 4Ø2-D2 PRESCRIPTION/SERVICE REFERENCE NUMBER M 436-E1 PRODUCT/SERVICE ID QUALIFIER Ø3-National Drug Code (NDC) M If billing for a Multi-Ingredient Compound, value is “ØØ”-Not Specified 407-D7 PRODUCT/SERVICE ID M NDC Number If billing for a
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Payer Specification Sheet
www.primetherapeutics.comis valid and prescribing requirements have been validated. 43-Prescriber's DEA is active with DEA Authorized Prescriptive Right 45-Prescriber’s DEA is a valid Hospital DEA with Suffix and has prescriptive authority for this drug DEA Schedule. 46-Prescriber's DEA has prescriptive authority for this drug DEA Schedule 49-Prescriber does not RW Payer