Formulary Drug File Layout

This layout document describes the fields in the formulary drug search data file.

Field Name	Description	Length	Format	Note
Drug_Generic	Identifies the generic name of drug	35
Drug_HTW_code	Identifies whether the drug is active on Healthy Texas Women (HTW) Program formulary	3
Drug_limit_fp	Identifies whether the drug is a family planning drug	3
Drug_limit_ds	Identifies whether the drug is a diabetic supply drug	3
Drug_limit_ppg	Identifies whether the drug has premium preferred generic (PPG) pricing	3
Drug_limit_ppg	Identifies the refill utilization percentage	3		Refer to the Refill Utilization section of the pharmacy manual for more information
Drug_NDC	Identifies the 11-digit National Drug Code (NDC) number	11
Drug_Descr	Identifies the First Databank (FDB) label name of the drug	35
Drug_Pkg	Identifies the package size of the drug	12	ZZZZZZ.99999
Drug_Unit	Identifies the unit of measure of the drug	2		GM = Gram ML - Milliliter EA = Each
Drug_340B	Identifies the Texas reimbursement rate for 340B drugs	14	ZZZZZZ.99999
Drug_med_EffDate	Identifies the effective date of the drug on Medicaid formulary	10	MM/DD/CCYY
Drug_med_EndDate	Identifies the termination date of the drug on the Medicaid formulary	10	MM/DD/CCYY	A drug with a termination date will appear on the file for 90 days following the termination date
Drug_Med_Code	Identifies whether the drug is active on the Medicaid formulary	3
Drug_CMP_V	Identifies whether the drug is only available for multi-ingredient compound Medicaid claims	3
Drug_Med_Comment	Identifies any paper prior authorization form requirements for drugs on the Medicaid formulary	60
Drug_chip_EffDate	Identifies the effective date of the drug on CHIP formulary	10	MM/DD/CCYY
Drug_chip_EndDate	Identifies the termination date of the drug on the CHIP formulary	10	MM/DD/CCYY	A drug with a termination date will appear on the file for 90 days following the termination date
Drug_chip_code	Identifies whether the drug is active on the CHIP formulary	3
Drug_CMP_P	Identifies whether the drug is only available for multi-ingredient compound CHIP claims	3
Drug_cshcn_EffDate	Identifies the effective date of the drug on the CSHCN formulary	10	MM/DD/CCYY
Drug_cshcn_EndDate	Identifies the termination date of the drug on the CSHCN formulary	10	MM/DD/CCYY	A drug with a termination date will appear on the file for 90 days following the termination date
Drug_cshcn_code	Identifies whether the drug is active on the CSHCN formulary	3
Drug_CMP_C	Identifies whether the drug is only available for multi-ingredient compound CSHCN claims	3
Drug_cshcn_comment	Identifies any paper prior authorization form requirements for drugs on the CSHCN formulary	60
Drug_khc_EffDate	Identifies the effective date of the drug on the KHC formulary	10	MM/DD/CCYY
Drug_KHC_EndDate	Identifies the termination date of the drug on the KHC formulary	10	MM/DD/CCYY	A drug with a termination date will appear on the file for 90 days following the termination date
Drug_khc_code	Identifies whether the drug is active on the KHC formulary	3
Drug_CMP_K	Identifies whether the drug is only available for multi-ingredient compound KHC claims	3
Drug_htw_EffDate	Identifies the effective date of the drug on the HTW formulary	10	MM/DD/CCYY
Drug_htw_EndDate	Identifies the termination date of the drug on the HTW formulary	10	MM/DD/CCYY	A drug with a termination date will appear on the file for 90 days following the termination date
Drug_legend_status	Identifies whether the drug is legend or over-the-counter	21		Over the counter Prescription required
Drug_PDL_pa_required	Identifies whether the drug requires a Medicaid non-preferred (PDL) prior authorization	3
Drug_pdl_EffDate	Identifies the effective date of the Medicaid non-preferred (PDL) prior authorization	10	MM/DD/CCYY
Drug_MKID	Identifies the drug's PDL class code	4		Refer to the valid values for the PDL class description
Drug_Clinical_pa_required	Identifies whether the drug requires a Medicaid clinical prior authorization	3
Drug_Retail	Identifies the current acquisition cost for VDP-identified retail pharmacies	14	ZZZZZZ.99999
Drug_Retail_EffDate	Identifies the effective date of the current acquisition cost for VDP-identified retail pharmacies	10	MM/DD/CCYY
Drug_LTC	Identifies the current acquisition cost for VDP-identified long-term care pharmacies	14	ZZZZZZ.99999
Drug_LTC_EffDate	Identifies the effective date of the current acquisition cost for VDP-identified long-term care pharmacies	10	MM/DD/CCYY
Drug_SPC	Identifies the current acquisition cost for VDP-identified specialty pharmacies	14	ZZZZZZ.99999
Drug_SPC_EffDate	Identifies the effective date of the current acquisition cost for VDP-identified specialty  pharmacies	10	MM/DD/CCYY
Drug_VAC	Identifies the current VDP acquisition cost when the drug does not have retail, LTC, or specialty pricing	14	ZZZZZZ.99999
Drug_VAC_EffDate	Identifies the effective date of the current VDP acquisition cost	10	MM/DD/CCYY
Drug_MKID_Desc	Identifies the drug's PDL class description	50		Refer to the valid values for the PDL class description
ID	Identifies the 11-digit National Drug Code (NDC) number	11
Drug_med_EndReason	Identifies the reason for the drug's termination from the Medicaid formulary	50
Drug_chip_EndReason	Identifies the reason for the drug's termination from the CHIP formulary	50
Drug_cshcn_EndReason	Identifies the reason for the drug's termination from the CSHCN formulary	50
Drug_khc_EndReason	Identifies the reason for the drug's termination from the KHC formulary	50
Drug_limit_larc	Identifies whether the drug is a long-acting reversible contraception drug	3
Drug_limit_injection	Identifies whether the drug is long-acting injectable or Vivitrol	3
Drug_admin_fee	Identifies the administration cost value	14	ZZZZZZ.99999
Drug_manufacturer	Identifies the name of the drug manufacturer	15
Drug_HTWPLUS_code	Identifies whether the drug is active on HTW Plus Program formulary	3
Drug_htwplus_EffDate	Identifies the effective date of the drug on the HTW Plus formulary	10	MM/DD/CCYY
Drug_htwplus_EndDate	Identifies the termination date of the drug on the HTW Plus formulary	10	MM/DD/CCYY	A drug with a termination date will appear on the file for 90 days following the termination date
Drug_chip_comment	Identifies any paper prior authorization form requirements for drugs on the CHIP formulary	60
Drug_khc_comment	Identifies any paper prior authorization form requirements for drugs on the KHC formulary	60
Drug_medicare-B	Identifies an NDC considered a Medicare Part B covered benefit for dual eligible clients.	3
Drug_medicare-D	Identifies an NDC considered a wrap-around drug for Medicare Part D dual-eligible clients.	3
Drug_sdl_code	Identifies an NDC included on the Specialty Drug List.	3
Drug_sdl_EffDate	Identifies the effective date of an NDC included on the Specialty Drug List.	10	MM/DD/CCYY
Drug_sdl_EndDate	Identifies the termination date of an NDC included on the Specialty Drug List.	10	MM/DD/CCYY