This transaction is used by the pharmacy to determine a person’s program-specific eligibility, prescription benefits, and managed care enrollment status when applicable.  Refer to the Eligibility chapter of this manual for information about the Pharmacy Eligibility Verification Portal, an alternate method of verification.

E1 transactions submitted to VDP for people enrolled in CHIP will reject with NCPDP code "AF" (“Patient Enrolled Under Managed Care") and identify the name of the MCO the person is enrolled with.  Refer to the Pharmacy MCO Assistance Chart on the VDP website "Downloads" page for the MCO-specific pharmacy claim billing values.