Last Updated

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 current 340B price of the drug 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 preferred prior authorization therapeutic class code 4   Refer to the valid values for the PDL therapeutic 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 preferred prior authorization therapeutic class description 50   Refer to the valid values for the PDL therapeutic 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