Eligibility Verification (E1) Transaction

Pharmacies use this transaction to determine a client's program-specific eligibility, prescription benefits, and managed care enrollment status when applicable. The following payer sheets are available:

Refer to the Eligibility section for information about the Pharmacy Eligibility Verification Portal, an alternate method of verification.

* E1 transactions submitted to HHSC for clients enrolled in CHIP will return a response identifying the name of the client's MCO. Pharmacy providers should contact the client's specific MCO for details.