Formulary Product File Layout
Last Updated
This layout document describes the fields in the formulary product search data file.
| Field Name | Description | Length | Format | Note |
|---|---|---|---|---|
| Product_Generic | Identifies the generic name of product | 35 | ||
| Product_limit_ds | Identifies whether the product is a diabetic supply | 3 | ||
| Product_limit_vm | Identifies whether the product is a vitamin or mineral | 3 | ||
| Product_NDC | Identifies the 11-digit National Drug Code (NDC) number | 11 | ||
| Product_Descr | Identifies the First Databank (FDB) label name of the product | 35 | ||
| Product_Pkg | Identifies the package size of the product | ZZZZZZ.99999 | ||
| Product_Unit | Identifies the unit of measure of the product | 2 |
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| Product_price | Identifies the current product price | 14 | ZZZZZZ.99999 | |
| Product_med_EffDate | Identifies the effective date of the product on the Medicaid formulary | 10 | MM/DD/CCYY | |
| Product_med_EndDate | Identifies the termination date of the product on the Medicaid formulary | 10 | MM/DD/CCYY | A product with a termination date will appear on the file for 90 days following the termination date |
| Product_Med_Code | Identifies whether the product is active on the Medicaid formulary | 3 | ||
| Product_chip_EffDate | Identifies the effective date of the product on the CHIP formulary | 10 | MM/DD/CCYY | |
| Product_chip_EndDate | Identifies the termination date of the product on the CHIP formulary | 10 | MM/DD/CCYY | A product with a termination date will appear on the file for 90 days following the termination date |
| Product_chip_code | Identifies whether the product is active on the CHIP formulary | 3 | ||
| Product_cshcn_EffDate | Identifies the effective date of the product on the CSHCN formulary | 10 | MM/DD/CCYY | |
| Product_cshcn_EndDate | Identifies the termination date of the product on the CSHCN formulary | 10 | MM/DD/CCYY | A product with a termination date will appear on the file for 90 days following the termination date |
| Product_cshcn_code | Identifies whether the product is active on the CSHCN formulary | 3 | ||
| Product_khc_EffDate | Identifies the effective date of the product on the KHC formulary | 10 | MM/DD/CCYY | |
| Product_khc_EndDate | Identifies the termination date of the product on the KHC formulary | 10 | MM/DD/CCYY | A product with a termination date will appear on the file for 90 days following the termination date |
| Product_khc_code | Identifies whether the product is active on the KHC formulary | 3 | ||
| Product_legend_status | Identifies whether the product is legend or over-the-counter | 21 |
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| Product_price_EffDate | Identifies the effective date of the current product price | 10 | MM/DD/CCYY | |
| Product_HCPCS | Identifies the Healthcare Common Procedure Coding System (HCPCS) code | 5 | Refer to the valid values for the HCPCS description | |
| Product_HCPCS_Desc | Identifies the Healthcare Common Procedure Coding System (HCPCS) description | 50 | Refer to the valid values for the HCPCS description | |
| ID | Identifies the 11-digit National Drug Code (NDC) number | 11 | ||
| Product_med_EndReason | Identifies the reason for the product's termination from the Medicaid formulary | 50 | ||
| Product_chip_EndReason | Identifies the reason for the product's termination from the CHIP formulary | 50 | ||
| Product_cshcn_EndReason | Identifies the reason for the product's termination from the CSHCN formulary | 50 | ||
| Product_khc_EndReason | Identifies the reason for the product's termination from the KHC formulary | 50 | ||
| Product_limit_hhs | Identifies whether the product is a home health supply | 3 | ||
| Product_limit_flu | Identifies whether the product is a influenza vaccine | 3 | ||
| Product_admin_fee | Identifies the administration cost value | 14 | ZZZZZZ.99999 | |
| Product_manufacturer | Identifies the name of the product manufacturer | 15 | ||
| Product_limit_zika | Identifies whether the product is a mosquito repellent | 3 | ||
| Product_limt_covid | Identifies whether the product is a COVID-19 vaccine | 3 | ||
| Product_med_Comment | Identifies any paper prior authorization form requirements for products on the Medicaid formulary | 60 | ||
| Product_cshcn_comment | Identifies any paper prior authorization form requirements for products on the CSHCN formulary | 60 | ||
| Product_khc_comment | Identifies any paper prior authorization form requirements for products on the KHC formulary | 60 | ||
| Product_chip_comment | Identifies any paper prior authorization form requirements for products on the CHIP formulary | 60 | ||
| Product_limit_ctk | Identifies whether the product is a COVID-19 test kit | 3 | ||
| Product_medicare-B | Identifies an NDC considered a Medicare Part B covered service for dual eligible clients. | 3 | ||
| Product_medicare-D | Identifies an NDC considered a wrap-around service for Medicare Part D dual-eligible clients. | 3 |