Pharmacy claims are submitted with the amount dispensed by the pharmacy at point-of-sale in the "Quantity Dispensed" field (442-E7). Pharmacy staff must dispense the quantity prescribed or ordered by the prescribing provider except as limited by the policies and procedures described in this manual. When the actual quantity dispensed deviates from the prescribed quantity, pharmacy staff must submit for the amount dispensed. Incorrect reporting in this field may prompt drug companies to dispute the claim and cause rebate auditors to review the claim level data.
Drugs such as ear drops, eye drops or ointments, inhalers, and injectable products are packaged in sizes without a whole number. When submitting a claim for a drug packaged in a metric decimal-sized package (e.g. 10.2; 2.5; etc.), pharmacy staff should include the decimals on the claim and not round up.
Contact your software vendor for assistance with issues resolving whole number units on the package size and submitting decimal units.