How to Bill 340B Appropriately

December 2019

  • If you are billing the pharmacy benefit for a 340B claim, please follow the stated guidance to properly submit the claim
    • NCPDP Data ELEMENT 409-D9: Ingredient Cost Submitted = 340B Acquisition Cost
    • NCPDP Data Element 420-DK: Submission Clarification Code = 20
  • If you are billing the medical benefit for a 340B claim, please follow the stated guidance to properly submit the claim
    • Modifier: UD
    • Description: Medicaid level of care 13, as defined by each state