Use this article to understand the post-submission validations that may appear after submitting Pharmacy claims in 340B ESP and what they mean for your submission.
Post-submission validations may appear as either Issues or Warnings depending on the applicable manufacturer policy. The same validation may be treated as an Issue for one manufacturer, a Warning for another, or may not apply.
A single claim may also be associated with more than one Issue or Warning. As a result, validation counts may not add up to the total number of processed claims.
List of Pharmacy Submission Issues & Warnings
Validation | What it means |
Claim Expired | Date of dispense is outside Manufacturer's lookback period. |
Invalid Service Provider ID | Provider ID cannot be linked to an in-house pharmacy or contract pharmacy for the 340B ID. |
Duplicate | Identified as duplicative of a previously submitted claim. |
Duplicate - Submission Type | The claim was identified as a duplicate of a claim previously submitted under another submission type. |
Missing Service Provider ID Qualifier | No value was provided for this field in the submitted claim. |
Missing Prescriber ID Qualifier | No value was provided for this field in the submitted claim. |
Invalid Prescriber ID | The ID provided could not be verified as a valid prescriber in the registry. |
Missing Prescriber ID | No value was provided for this field in the submitted claim. |
Missing Payer BIN | No value was provided for this field in the submitted claim. |
Missing Payer PCN | No value was provided for this field in the submitted claim. |
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