Pharmacy providers must submit the following fields on single-ingredient claim transaction. Refer to the Claims Billing (B1) Transaction payer sheets for specific transaction, segment, and field requirements.
|Product/Service ID Qualifier
00 = Compound
03 = National Drug Code (NDC)
The Formulary Search (txvendordrug.com/formulary/formulary-search) provides program coverage, prior authorization requirements, and pricing information. There are three separate searches:
- Products ( including home health supplies and vitamins and minerals)
- Clinician-administered drugs
HHSC updates the search weekly, usually every Monday morning. Drugs and products removed from the formulary will show a termination date and remain viewable on the search for 90 days. The data used in the search is also available for download as a delimited text file. Refer to the VDP Website Handbook for search instructions and information about the data.