Days Supply
Pharmacy claims are submitted with the number of consecutive days covered by the prescription in the "Days Supply" field (405-D5). Incorrect reporting in this field may impact early refill edits or inaccurate drug use review warnings. Pharmacy providers should divide the quantity by total dosage units per day to identify the correct day supply.
| Program | Maximum Day Supply |
|---|---|
| Medicaid | 185 |
| CHIP | Up to 90 |
| CSHCN | 185 |
| KHC | 34 unless Medicare is the primary payer; KHC will pay for a 90-day supply if Medicare allows a 90-day supply |