Product/Service ID

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.

Field Number Field Name Values Usage
Product/Service ID Qualifier 436-E1

00 = Compound

03 = National Drug Code (NDC)

Product/Service ID 407-D7 11-digit NDC M

The Formulary Search ( provides program coverage, prior authorization requirements, and pricing information. There are three separate searches:

  • Drugs
  • 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.