basisOfCostDetermination"Code indicating the method by which Ingredient Cost Submitted was calculated." - NCPDP Telecommunication (Field 423-DN, Data Dictionary 201104). Possible values include: Default; AWP (Average Wholesale Price); Local Wholesaler; Direct; EAC (Estimated Acquisition Cost); Acquisition; MAC (Maximum Allowable Cost); Usual & Customary; 340B /Disproportionate Share Pricing/Public Health Service; ASP (Average Sales Price); AMP (Average Manufacturer Price); WAC (Wholesale Acquisition Cost); Special Patient Pricing; Other.
dispensingFee"Dispensing fee submitted by the pharmacy. This amount is included in the Gross Amount Due" - NCPDP Telecommunication (Field 412-DC, Data Dictionary 201104).
flatSalesTaxAmount"Flat sales tax submitted for prescription. This amount is included in the Gross Amount Due." - NCPDP Telecommunication (Field 481-HA, Data Dictionary 201104).
incentiveAmount"Amount represents a fee that is submitted by the pharmacy for contractually agreed upon services. This amount is included in the Gross Amount Due." - NCPDP Telecommunication (Field 438-E3, Data Dictionary 201104).
ingredientCost"Submitted product component cost of the dispensed prescription. This amount is included in the Gross Amount Due" - NCPDP Telecommunication (Field 409-D9, Data Dictionary 201104).
medicaidPaidAmount"Amount paid by the Medicaid Agency. Required if affects pricing in Medicaid Subrogation (contains the amount paid to the pharmacy). See Medicaid Subrogation Implementation Guide." - NCPDP Telecommunication (Field 113-N3, Data Dictionary 201104).
narrativeContains any comments to describe the billable event or to provide justification for payment.
otherAmountPointer to a set of additional costs incurred or claimed for a dispensed prescription or service. Examples of such costs include shipping, compound preparation, incentives, and taxes.
otherAmountSubmittedCount"Count of other amount claimed submitted occurrences." - NCPDP Telecommunication (Field 478-H7, Data Dictionary 201104). Note that this property could potentially be calculated based on the number of instances of the Other Amount class.
patientPaidAmount"Amount the pharmacy received from the patient for the prescription dispensed." - NCPDP Telecommunication (Field 433-DX, Data Dictionary 201104).
percentageSalesTaxAmount"Percentage sales tax submitted. This amount is included in the Gross Amount Due." - NCPDP Telecommunication (Field 482-GE, Data Dictionary 201104).
percentageSalesTaxBasis"Code indicating the basis for percentage sales tax." - NCPDP Telecommunication (Field 483-HE, Data Dictionary 201104). Possible values include: Ingredient Cost; Ingredient Cost plus Dispensing Fee; Not Specified.
percentageSalesTaxRate"Percentage sales tax rate used to calculate Percentage Sales Tax Amount Submitted" - NCPDP Telecommunication (Field 483-HE, Data Dictionary 201104).
professionalServiceFee"Amount submitted by the provider for professional services rendered." - NCPDP Telecommunication (Field 477-BE, Data Dictionary 201104).
usualAndCustomaryCharge"Amount charged cash customers for the prescription exclusive of sales tax or other amounts claimed." - NCPDP Telecommunication (Field 426-DQ, Data Dictionary 201104).