Billing for 340B drugs in NCTracks for the Outpatient (Retail) Pharmacy Program

When a 340B drug is dispensed, the pharmacy provider will enter a value of "08� in the Basis of Cost Determination field (423-DN) to identify the 340B claim and a value of "20" in the Submission Clarification Code field (420-DK) to denote the 340B provider. For 340B drugs, pharmacy providers are required to submit their acquisition cost in the Usual and Customary charge field (426-DQ) without the dispensing fee. NCTracks will apply the appropriate dispensing fee when determining the reimbursement amount for the claim. Providers can reference the NCPDP D.0 Companion Guide below for more information.