4729-37-04 Information required for submission.

 

 

 

4729-37-04                  Information required for submission.

 

 

 

(A)      Pharmacies pursuant to paragraphs (A) and (B) of rule 4729-37-03 of the Administrative Code that dispense drugs identified in rule 4729-37-02 of the Administrative Code to outpatients residing in this state must report the following dispensing information to the board of pharmacy:

 

(1)       Pharmacy   drug   enforcement   administration   registration   number.   If   not applicable, another mutually acceptable identifier;

 

(2)   Pharmacy name;

 

(3)   Pharmacy address;

 

(4)   Pharmacy telephone number;

 

(5)   Patient full name;

 

(6)   Patient residential address;

 

(7)   Patient telephone number;

 

(8)   Patient date of birth;

 

(9)   Patient gender;

 

(10)   Prescriber's full name (first name and last name)

 

(11)     Prescriber's  drug  enforcement  administration  registration  number.  If  not applicable, another mutually acceptable identifier;

 

(12)   Date prescription was issued by the prescriber;

 

(13)   Date the prescription was dispensed by the pharmacy;

 

(14)   Indication of whether the prescription dispensed is new or a refill;

 

(15)   Number of the refill being dispensed;

 

(16)   National drug code of the actual drug dispensed;

 

 

 

(17)   Quantity of drug dispensed;

(18)   Number of days' supply of drug dispensed;

(19)   Serial or prescription number assigned to the prescription order;

(20)    Source of payment for the prescription that indicates one of the following: private pay (cash), medicaid, medicare, commercial pharmacy benefit manager (PBM) insurance, major medical, or workers' compensation.

(B) Prescribers pursuant to paragraph (E) of rule 4729-37-03 of the Administrative Code that personally furnish drugs identified in rule 4729-37-02 of the Administrative Code to outpatients must report the following dispensing information to the board of pharmacy:

(1) Prescriber   drug   enforcement   administration   registration   number.   If   not applicable, another mutually acceptable identifier;

(2) Prescriber full name (first and last name);

(3) Prescriber address;

(4) Prescriber telephone number;

(5) Patient full name;

(6) Patient residential address;

(7) Patient telephone number;

(8) Patient date of birth;

(9) Patient gender;

(10) Date the drug was personally furnished by the prescriber;

(11) National drug code of the actual drug dispensed;

(12) Quantity of drug dispensed;

(13) Number of days' supply of drug dispensed; and

(14) Source of payment for the prescription that indicates one of the following: private pay (cash), medicaid, medicare, commercial insurance, or workers' compensation.

(B)(C) Wholesalers and pharmacies pursuant to paragraphs (C) and (D) of rule 4729-37-03 of the Administrative Code that sell drugs identified in rule 4729-37-02 of the Administrative Code at wholesale must at least report the following information to the board of pharmacy in the following sequenceformat described in rule 4729-37-06 of the Administrative Code:

(1)   Wholesaler or pharmacy drug enforcement administration registration number. If not applicable, then another mutually acceptable identifier;

(2)      Purchaser's  drug  enforcement  administration  registration  number.  If  not applicable, then another mutually acceptable identifier;

(3)   National drug code number of the actual drug sold;

(4)   Quantity of the drug sold;

(5)   Date of sale.; and

(6) Transaction identifier or invoice number.

Effective:                                                     10/27/2011

R.C. 119.032 review dates:                         12/01/2015

CERTIFIED ELECTRONICALLY

Certification

10/17/2011

Date

Promulgated Under:                           119.03

Statutory Authority:                           3719.28, 4729.26, 4729.83

Rule Amplifies:                                  4729.75, 4729.76, 4729.77, 4729.78, 4729.79,

4729.80, 4729.81, 4729.82, 4729.83, 4729.84

Prior Effective Dates:                         1/1/06, 4/27/07, 10/19/07, 1/1/11