United States Health Information Knowledgebase

 

Prescriber ID Qualifier

Name:Prescriber ID Qualifier
Field:466-EZ
Definition:Code qualifying the 'Prescriber ID' (411-DB).
Type:Data Element
$attribute_name$:$attribute_value$
Version:04-2014
Registration Authority:National Council for Prescription Drug Programs
Source:National Council for Prescription Drug Programs
Values for: Prescriber ID Qualifier
Standards Format: R
Value Value Meaning
A AMA or Medical Education (ME) number - A unique identification number assigned by the AMA to each physician or medical student when he or she is added to the AMA Physician Masterfile. The ME number is a record locator and is not related in any way to a medical license or other certification. (value for 'R')
B AOA Doctor of Osteopathy (DO) number - number assigned to each DO physician and is used in a variety of manners by the physician. (value for 'R')
C Contracting Organization PMO number - Alphanumeric code used to identify the PMO that sent a NCPDP manufacturer rebate flat file standard layout to a PICO. This code is an internal number assigned by the PMO.
D DEA number The identifier assigned by the DEA to all businesses that manufacturer or distribute controlled pharmaceuticals, all health professionals who are permitted to dispense, administer, or prescribe controlled pharmaceuticals and all pharmacies that fill prescriptions.
H HIBCC HIN - A 9 digit alphanumeric number used to identify health care entities such as veterinarians, animal clinics, and health care provider facilities. The number is assigned by HIBCC.
M Manufacturer (PICO) assigned number - A value assigned by a manufacturer and used internally to identify a given trading partner.
P National Provider ID - A HIPAA-mandated standard unique health identifier for health care providers
T Telephone number - Code indicating that the information to follow is a telephone number (for voice, data, fax, etc.).
Z Mutually agreed upon ID number - A value mutually agreed upon by trading partners. The value may be unique between the trading partners or from an existing industry standard.
 
Standards Format: J
Value Value Meaning
A AMA or Medical Education (ME) number - A unique identification number assigned by the AMA to each physician or medical student when he or she is added to the AMA Physician Masterfile. The ME number is a record locator and is not related in any way to a medical license or other certification. (value for 'R')
B AOA Doctor of Osteopathy (DO) number - number assigned to each DO physician and is used in a variety of manners by the physician. (value for 'R')
C Contracting Organization PMO number - Alphanumeric code used to identify the PMO that sent a NCPDP manufacturer rebate flat file standard layout to a PICO. This code is an internal number assigned by the PMO.
D DEA number The identifier assigned by the DEA to all businesses that manufacturer or distribute controlled pharmaceuticals, all health professionals who are permitted to dispense, administer, or prescribe controlled pharmaceuticals and all pharmacies that fill prescriptions.
H HIBCC HIN - A 9 digit alphanumeric number used to identify health care entities such as veterinarians, animal clinics, and health care provider facilities. The number is assigned by HIBCC.
M Manufacturer (PICO) assigned number - A value assigned by a manufacturer and used internally to identify a given trading partner.
P National Provider ID - A HIPAA-mandated standard unique health identifier for health care providers
T Telephone number - Code indicating that the information to follow is a telephone number (for voice, data, fax, etc.).
Z Mutually agreed upon ID number - A value mutually agreed upon by trading partners. The value may be unique between the trading partners or from an existing industry standard.
 
Standards Format: T
Value Value Meaning
01 National Provider Identifier (NPI) = a standard unique health identifier for health care providers. The NPI is a 10 position numeric identifier with a check digit in the 10th position and is assigned by the National Provider System (NPS).
02 Blue Cross = a number assigned by a Blue Cross health plan which is a nonprofit hospital expense prepayment plan primarily designed to provide benefits for hospitalization coverage, with certain restrictions on the accommodations to be used.
03 Blue Shield = a number assigned by a Blue Shield health plan which is a prepayment plan offered by voluntary nonprofit organizations that cover medical and surgical expenses.
04 Medicare = a number assigned by the carrier or intermediary which administers the Medicare health insurance program for people age 65 or older, some people with disabilities under age 65, and people with end-stage renal disease. Medicare has two parts, hospital insurance (Part A) and medical insurance (Part B).
05 Medicaid = a number assigned to a provider by a state Medicaid agency. Each state has a unique identifier. Medicaid is a program established pursuant to Title XIX of the Social Security Act to provide medical benefits for certain categories of low-income individuals. The program provides benefits to indigent and disabled individuals and members of families receiving Aid to Families with Dependent Children. States have the option to provide benefits to a broader range of individuals. The program is a cooperative arrangement between the federal government and the states, under which both the federal government and a participating state contribute financial support. The state, however, retains a considerable amount of discretion over the operation and administration of the program, and has the right to determine the benefits to be provided, rules for eligibility, rates of payment for services and other matters, as long as broad regulatory guidelines established by the federal government are followed.
06 UPIN (Unique Physician/Practitioner Identification Number) = a number assigned to each Medicare physician/practitioner to identify the referring or ordering physician on Medicare claims. UPINs consist of an alpha character and five numerics and are assigned by CMS.
08 State License = the number assigned and required by a State Board or other State regulatory agency that uniquely identifies a pharmacy by category, as defined by each State or Territory or a prescriber by practice specialty for which they reside/practice.
09 TRICARE = a number that uniquely identifies a provider that participates in the TRICARE program which is a federal medical benefits program that helps pay for civilian medical care rendered to the spouses and children of active duty and retired personnel.
10 Health Industry Number (HIN) = a 9 digit alphanumeric number used to identify health care entities such as veterinarians, animal clinics, and health care provider facilities. The number is assigned by HIBCC.
11 Federal Tax ID = a 9-digit number assigned by the Internal Revenue Service to sole proprietors, corporations, partnerships, estates, trusts, and other entities for the purpose of tax filing and reporting.
12 Drug Enforcement Administration (DEA) Number = the number assigned by the DEA to all businesses that manufacture or distribute controlled pharmaceuticals, all health professionals who dispense, administer, or prescribe controlled pharmaceuticals and all pharmacies that fill prescriptions.
13 State Issued = a unique number issued by a state program or organization other than Medicaid, to a provider of service.
14 Plan Specific = a unique proprietary number assigned by a commercial health care plan to a provider of service.
15 HCID (HC IDea) = A 10-character, alphanumeric identifier assigned by NCPDP to identify authorized prescribers of drugs.
17 Foreign Prescriber Identifier = a value used to identify a prescriber who practices outside of the United States and does not have a prescriber identifier issued from within the United States.
99 Other = used to identify other health plans and enumerating organizations not listed above.
 
Standards Format: M
Value Value Meaning
01 National Provider Identifier (NPI) = a standard unique health identifier for health care providers. The NPI is a 10 position numeric identifier with a check digit in the 10th position and is assigned by the National Provider System (NPS).
02 Blue Cross = a number assigned by a Blue Cross health plan which is a nonprofit hospital expense prepayment plan primarily designed to provide benefits for hospitalization coverage, with certain restrictions on the accommodations to be used.
03 Blue Shield = a number assigned by a Blue Shield health plan which is a prepayment plan offered by voluntary nonprofit organizations that cover medical and surgical expenses.
04 Medicare = a number assigned by the carrier or intermediary which administers the Medicare health insurance program for people age 65 or older, some people with disabilities under age 65, and people with end-stage renal disease. Medicare has two parts, hospital insurance (Part A) and medical insurance (Part B).
05 Medicaid = a number assigned to a provider by a state Medicaid agency. Each state has a unique identifier. Medicaid is a program established pursuant to Title XIX of the Social Security Act to provide medical benefits for certain categories of low-income individuals. The program provides benefits to indigent and disabled individuals and members of families receiving Aid to Families with Dependent Children. States have the option to provide benefits to a broader range of individuals. The program is a cooperative arrangement between the federal government and the states, under which both the federal government and a participating state contribute financial support. The state, however, retains a considerable amount of discretion over the operation and administration of the program, and has the right to determine the benefits to be provided, rules for eligibility, rates of payment for services and other matters, as long as broad regulatory guidelines established by the federal government are followed.
06 UPIN (Unique Physician/Practitioner Identification Number) = a number assigned to each Medicare physician/practitioner to identify the referring or ordering physician on Medicare claims. UPINs consist of an alpha character and five numerics and are assigned by CMS.
08 State License = the number assigned and required by a State Board or other State regulatory agency that uniquely identifies a pharmacy by category, as defined by each State or Territory or a prescriber by practice specialty for which they reside/practice.
09 TRICARE = a number that uniquely identifies a provider that participates in the TRICARE program which is a federal medical benefits program that helps pay for civilian medical care rendered to the spouses and children of active duty and retired personnel.
10 Health Industry Number (HIN) = a 9 digit alphanumeric number used to identify health care entities such as veterinarians, animal clinics, and health care provider facilities. The number is assigned by HIBCC.
11 Federal Tax ID = a 9-digit number assigned by the Internal Revenue Service to sole proprietors, corporations, partnerships, estates, trusts, and other entities for the purpose of tax filing and reporting.
12 Drug Enforcement Administration (DEA) Number = the number assigned by the DEA to all businesses that manufacture or distribute controlled pharmaceuticals, all health professionals who dispense, administer, or prescribe controlled pharmaceuticals and all pharmacies that fill prescriptions.
13 State Issued = a unique number issued by a state program or organization other than Medicaid, to a provider of service.
14 Plan Specific = a unique proprietary number assigned by a commercial health care plan to a provider of service.
15 HCID (HC IDea) = A 10-character, alphanumeric identifier assigned by NCPDP to identify authorized prescribers of drugs.
17 Foreign Prescriber Identifier = a value used to identify a prescriber who practices outside of the United States and does not have a prescriber identifier issued from within the United States.
99 Other = used to identify other health plans and enumerating organizations not listed above.
 
Standards Format: A
Value Value Meaning
01 National Provider Identifier (NPI) = a standard unique health identifier for health care providers. The NPI is a 10 position numeric identifier with a check digit in the 10th position and is assigned by the National Provider System (NPS).
02 Blue Cross = a number assigned by a Blue Cross health plan which is a nonprofit hospital expense prepayment plan primarily designed to provide benefits for hospitalization coverage, with certain restrictions on the accommodations to be used.
03 Blue Shield = a number assigned by a Blue Shield health plan which is a prepayment plan offered by voluntary nonprofit organizations that cover medical and surgical expenses.
04 Medicare = a number assigned by the carrier or intermediary which administers the Medicare health insurance program for people age 65 or older, some people with disabilities under age 65, and people with end-stage renal disease. Medicare has two parts, hospital insurance (Part A) and medical insurance (Part B).
05 Medicaid = a number assigned to a provider by a state Medicaid agency. Each state has a unique identifier. Medicaid is a program established pursuant to Title XIX of the Social Security Act to provide medical benefits for certain categories of low-income individuals. The program provides benefits to indigent and disabled individuals and members of families receiving Aid to Families with Dependent Children. States have the option to provide benefits to a broader range of individuals. The program is a cooperative arrangement between the federal government and the states, under which both the federal government and a participating state contribute financial support. The state, however, retains a considerable amount of discretion over the operation and administration of the program, and has the right to determine the benefits to be provided, rules for eligibility, rates of payment for services and other matters, as long as broad regulatory guidelines established by the federal government are followed.
06 UPIN (Unique Physician/Practitioner Identification Number) = a number assigned to each Medicare physician/practitioner to identify the referring or ordering physician on Medicare claims. UPINs consist of an alpha character and five numerics and are assigned by CMS.
08 State License = the number assigned and required by a State Board or other State regulatory agency that uniquely identifies a pharmacy by category, as defined by each State or Territory or a prescriber by practice specialty for which they reside/practice.
09 TRICARE = a number that uniquely identifies a provider that participates in the TRICARE program which is a federal medical benefits program that helps pay for civilian medical care rendered to the spouses and children of active duty and retired personnel.
10 Health Industry Number (HIN) = a 9 digit alphanumeric number used to identify health care entities such as veterinarians, animal clinics, and health care provider facilities. The number is assigned by HIBCC.
11 Federal Tax ID = a 9-digit number assigned by the Internal Revenue Service to sole proprietors, corporations, partnerships, estates, trusts, and other entities for the purpose of tax filing and reporting.
12 Drug Enforcement Administration (DEA) Number = the number assigned by the DEA to all businesses that manufacture or distribute controlled pharmaceuticals, all health professionals who dispense, administer, or prescribe controlled pharmaceuticals and all pharmacies that fill prescriptions.
13 State Issued = a unique number issued by a state program or organization other than Medicaid, to a provider of service.
14 Plan Specific = a unique proprietary number assigned by a commercial health care plan to a provider of service.
15 HCID (HC IDea) = A 10-character, alphanumeric identifier assigned by NCPDP to identify authorized prescribers of drugs.
17 Foreign Prescriber Identifier = a value used to identify a prescriber who practices outside of the United States and does not have a prescriber identifier issued from within the United States.
99 Other = used to identify other health plans and enumerating organizations not listed above.
 
Standards Format: V
Value Value Meaning
01 National Provider Identifier (NPI) = a standard unique health identifier for health care providers. The NPI is a 10 position numeric identifier with a check digit in the 10th position and is assigned by the National Provider System (NPS).
02 Blue Cross = a number assigned by a Blue Cross health plan which is a nonprofit hospital expense prepayment plan primarily designed to provide benefits for hospitalization coverage, with certain restrictions on the accommodations to be used.
03 Blue Shield = a number assigned by a Blue Shield health plan which is a prepayment plan offered by voluntary nonprofit organizations that cover medical and surgical expenses.
04 Medicare = a number assigned by the carrier or intermediary which administers the Medicare health insurance program for people age 65 or older, some people with disabilities under age 65, and people with end-stage renal disease. Medicare has two parts, hospital insurance (Part A) and medical insurance (Part B).
05 Medicaid = a number assigned to a provider by a state Medicaid agency. Each state has a unique identifier. Medicaid is a program established pursuant to Title XIX of the Social Security Act to provide medical benefits for certain categories of low-income individuals. The program provides benefits to indigent and disabled individuals and members of families receiving Aid to Families with Dependent Children. States have the option to provide benefits to a broader range of individuals. The program is a cooperative arrangement between the federal government and the states, under which both the federal government and a participating state contribute financial support. The state, however, retains a considerable amount of discretion over the operation and administration of the program, and has the right to determine the benefits to be provided, rules for eligibility, rates of payment for services and other matters, as long as broad regulatory guidelines established by the federal government are followed.
06 UPIN (Unique Physician/Practitioner Identification Number) = a number assigned to each Medicare physician/practitioner to identify the referring or ordering physician on Medicare claims. UPINs consist of an alpha character and five numerics and are assigned by CMS.
08 State License = the number assigned and required by a State Board or other State regulatory agency that uniquely identifies a pharmacy by category, as defined by each State or Territory or a prescriber by practice specialty for which they reside/practice.
09 TRICARE = a number that uniquely identifies a provider that participates in the TRICARE program which is a federal medical benefits program that helps pay for civilian medical care rendered to the spouses and children of active duty and retired personnel.
10 Health Industry Number (HIN) = a 9 digit alphanumeric number used to identify health care entities such as veterinarians, animal clinics, and health care provider facilities. The number is assigned by HIBCC.
11 Federal Tax ID = a 9-digit number assigned by the Internal Revenue Service to sole proprietors, corporations, partnerships, estates, trusts, and other entities for the purpose of tax filing and reporting.
12 Drug Enforcement Administration (DEA) Number = the number assigned by the DEA to all businesses that manufacture or distribute controlled pharmaceuticals, all health professionals who dispense, administer, or prescribe controlled pharmaceuticals and all pharmacies that fill prescriptions.
13 State Issued = a unique number issued by a state program or organization other than Medicaid, to a provider of service.
14 Plan Specific = a unique proprietary number assigned by a commercial health care plan to a provider of service.
15 HCID (HC IDea) = A 10-character, alphanumeric identifier assigned by NCPDP to identify authorized prescribers of drugs.
17 Foreign Prescriber Identifier = a value used to identify a prescriber who practices outside of the United States and does not have a prescriber identifier issued from within the United States.
99 Other = used to identify other health plans and enumerating organizations not listed above.
 
Standards Format: Z
Value Value Meaning
01 National Provider Identifier (NPI) = a standard unique health identifier for health care providers. The NPI is a 10 position numeric identifier with a check digit in the 10th position and is assigned by the National Provider System (NPS).
02 Blue Cross = a number assigned by a Blue Cross health plan which is a nonprofit hospital expense prepayment plan primarily designed to provide benefits for hospitalization coverage, with certain restrictions on the accommodations to be used.
03 Blue Shield = a number assigned by a Blue Shield health plan which is a prepayment plan offered by voluntary nonprofit organizations that cover medical and surgical expenses.
04 Medicare = a number assigned by the carrier or intermediary which administers the Medicare health insurance program for people age 65 or older, some people with disabilities under age 65, and people with end-stage renal disease. Medicare has two parts, hospital insurance (Part A) and medical insurance (Part B).
05 Medicaid = a number assigned to a provider by a state Medicaid agency. Each state has a unique identifier. Medicaid is a program established pursuant to Title XIX of the Social Security Act to provide medical benefits for certain categories of low-income individuals. The program provides benefits to indigent and disabled individuals and members of families receiving Aid to Families with Dependent Children. States have the option to provide benefits to a broader range of individuals. The program is a cooperative arrangement between the federal government and the states, under which both the federal government and a participating state contribute financial support. The state, however, retains a considerable amount of discretion over the operation and administration of the program, and has the right to determine the benefits to be provided, rules for eligibility, rates of payment for services and other matters, as long as broad regulatory guidelines established by the federal government are followed.
06 UPIN (Unique Physician/Practitioner Identification Number) = a number assigned to each Medicare physician/practitioner to identify the referring or ordering physician on Medicare claims. UPINs consist of an alpha character and five numerics and are assigned by CMS.
08 State License = the number assigned and required by a State Board or other State regulatory agency that uniquely identifies a pharmacy by category, as defined by each State or Territory or a prescriber by practice specialty for which they reside/practice.
09 TRICARE = a number that uniquely identifies a provider that participates in the TRICARE program which is a federal medical benefits program that helps pay for civilian medical care rendered to the spouses and children of active duty and retired personnel.
10 Health Industry Number (HIN) = a 9 digit alphanumeric number used to identify health care entities such as veterinarians, animal clinics, and health care provider facilities. The number is assigned by HIBCC.
11 Federal Tax ID = a 9-digit number assigned by the Internal Revenue Service to sole proprietors, corporations, partnerships, estates, trusts, and other entities for the purpose of tax filing and reporting.
12 Drug Enforcement Administration (DEA) Number = the number assigned by the DEA to all businesses that manufacture or distribute controlled pharmaceuticals, all health professionals who dispense, administer, or prescribe controlled pharmaceuticals and all pharmacies that fill prescriptions.
13 State Issued = a unique number issued by a state program or organization other than Medicaid, to a provider of service.
14 Plan Specific = a unique proprietary number assigned by a commercial health care plan to a provider of service.
15 HCID (HC IDea) = A 10-character, alphanumeric identifier assigned by NCPDP to identify authorized prescribers of drugs.
17 Foreign Prescriber Identifier = a value used to identify a prescriber who practices outside of the United States and does not have a prescriber identifier issued from within the United States.
99 Other = used to identify other health plans and enumerating organizations not listed above.
 
Standards Format: W
Value Value Meaning
01 National Provider Identifier (NPI) = a standard unique health identifier for health care providers. The NPI is a 10 position numeric identifier with a check digit in the 10th position and is assigned by the National Provider System (NPS).
02 Blue Cross = a number assigned by a Blue Cross health plan which is a nonprofit hospital expense prepayment plan primarily designed to provide benefits for hospitalization coverage, with certain restrictions on the accommodations to be used.
03 Blue Shield = a number assigned by a Blue Shield health plan which is a prepayment plan offered by voluntary nonprofit organizations that cover medical and surgical expenses.
04 Medicare = a number assigned by the carrier or intermediary which administers the Medicare health insurance program for people age 65 or older, some people with disabilities under age 65, and people with end-stage renal disease. Medicare has two parts, hospital insurance (Part A) and medical insurance (Part B).
05 Medicaid = a number assigned to a provider by a state Medicaid agency. Each state has a unique identifier. Medicaid is a program established pursuant to Title XIX of the Social Security Act to provide medical benefits for certain categories of low-income individuals. The program provides benefits to indigent and disabled individuals and members of families receiving Aid to Families with Dependent Children. States have the option to provide benefits to a broader range of individuals. The program is a cooperative arrangement between the federal government and the states, under which both the federal government and a participating state contribute financial support. The state, however, retains a considerable amount of discretion over the operation and administration of the program, and has the right to determine the benefits to be provided, rules for eligibility, rates of payment for services and other matters, as long as broad regulatory guidelines established by the federal government are followed.
06 UPIN (Unique Physician/Practitioner Identification Number) = a number assigned to each Medicare physician/practitioner to identify the referring or ordering physician on Medicare claims. UPINs consist of an alpha character and five numerics and are assigned by CMS.
08 State License = the number assigned and required by a State Board or other State regulatory agency that uniquely identifies a pharmacy by category, as defined by each State or Territory or a prescriber by practice specialty for which they reside/practice.
09 TRICARE = a number that uniquely identifies a provider that participates in the TRICARE program which is a federal medical benefits program that helps pay for civilian medical care rendered to the spouses and children of active duty and retired personnel.
10 Health Industry Number (HIN) = a 9 digit alphanumeric number used to identify health care entities such as veterinarians, animal clinics, and health care provider facilities. The number is assigned by HIBCC.
11 Federal Tax ID = a 9-digit number assigned by the Internal Revenue Service to sole proprietors, corporations, partnerships, estates, trusts, and other entities for the purpose of tax filing and reporting.
12 Drug Enforcement Administration (DEA) Number = the number assigned by the DEA to all businesses that manufacture or distribute controlled pharmaceuticals, all health professionals who dispense, administer, or prescribe controlled pharmaceuticals and all pharmacies that fill prescriptions.
13 State Issued = a unique number issued by a state program or organization other than Medicaid, to a provider of service.
14 Plan Specific = a unique proprietary number assigned by a commercial health care plan to a provider of service.
15 HCID (HC IDea) = A 10-character, alphanumeric identifier assigned by NCPDP to identify authorized prescribers of drugs.
17 Foreign Prescriber Identifier = a value used to identify a prescriber who practices outside of the United States and does not have a prescriber identifier issued from within the United States.
99 Other = used to identify other health plans and enumerating organizations not listed above.
 
Standards Format: X
Value Value Meaning
01 National Provider Identifier (NPI) = a standard unique health identifier for health care providers. The NPI is a 10 position numeric identifier with a check digit in the 10th position and is assigned by the National Provider System (NPS).
02 Blue Cross = a number assigned by a Blue Cross health plan which is a nonprofit hospital expense prepayment plan primarily designed to provide benefits for hospitalization coverage, with certain restrictions on the accommodations to be used.
03 Blue Shield = a number assigned by a Blue Shield health plan which is a prepayment plan offered by voluntary nonprofit organizations that cover medical and surgical expenses.
04 Medicare = a number assigned by the carrier or intermediary which administers the Medicare health insurance program for people age 65 or older, some people with disabilities under age 65, and people with end-stage renal disease. Medicare has two parts, hospital insurance (Part A) and medical insurance (Part B).
05 Medicaid = a number assigned to a provider by a state Medicaid agency. Each state has a unique identifier. Medicaid is a program established pursuant to Title XIX of the Social Security Act to provide medical benefits for certain categories of low-income individuals. The program provides benefits to indigent and disabled individuals and members of families receiving Aid to Families with Dependent Children. States have the option to provide benefits to a broader range of individuals. The program is a cooperative arrangement between the federal government and the states, under which both the federal government and a participating state contribute financial support. The state, however, retains a considerable amount of discretion over the operation and administration of the program, and has the right to determine the benefits to be provided, rules for eligibility, rates of payment for services and other matters, as long as broad regulatory guidelines established by the federal government are followed.
06 UPIN (Unique Physician/Practitioner Identification Number) = a number assigned to each Medicare physician/practitioner to identify the referring or ordering physician on Medicare claims. UPINs consist of an alpha character and five numerics and are assigned by CMS.
08 State License = the number assigned and required by a State Board or other State regulatory agency that uniquely identifies a pharmacy by category, as defined by each State or Territory or a prescriber by practice specialty for which they reside/practice.
09 TRICARE = a number that uniquely identifies a provider that participates in the TRICARE program which is a federal medical benefits program that helps pay for civilian medical care rendered to the spouses and children of active duty and retired personnel.
10 Health Industry Number (HIN) = a 9 digit alphanumeric number used to identify health care entities such as veterinarians, animal clinics, and health care provider facilities. The number is assigned by HIBCC.
11 Federal Tax ID = a 9-digit number assigned by the Internal Revenue Service to sole proprietors, corporations, partnerships, estates, trusts, and other entities for the purpose of tax filing and reporting.
12 Drug Enforcement Administration (DEA) Number = the number assigned by the DEA to all businesses that manufacture or distribute controlled pharmaceuticals, all health professionals who dispense, administer, or prescribe controlled pharmaceuticals and all pharmacies that fill prescriptions.
13 State Issued = a unique number issued by a state program or organization other than Medicaid, to a provider of service.
14 Plan Specific = a unique proprietary number assigned by a commercial health care plan to a provider of service.
15 HCID (HC IDea) = A 10-character, alphanumeric identifier assigned by NCPDP to identify authorized prescribers of drugs.
17 Foreign Prescriber Identifier = a value used to identify a prescriber who practices outside of the United States and does not have a prescriber identifier issued from within the United States.
99 Other = used to identify other health plans and enumerating organizations not listed above.
 
Standards Format: Y
Value Value Meaning
01 National Provider Identifier (NPI) = a standard unique health identifier for health care providers. The NPI is a 10 position numeric identifier with a check digit in the 10th position and is assigned by the National Provider System (NPS).
02 Blue Cross = a number assigned by a Blue Cross health plan which is a nonprofit hospital expense prepayment plan primarily designed to provide benefits for hospitalization coverage, with certain restrictions on the accommodations to be used.
03 Blue Shield = a number assigned by a Blue Shield health plan which is a prepayment plan offered by voluntary nonprofit organizations that cover medical and surgical expenses.
04 Medicare = a number assigned by the carrier or intermediary which administers the Medicare health insurance program for people age 65 or older, some people with disabilities under age 65, and people with end-stage renal disease. Medicare has two parts, hospital insurance (Part A) and medical insurance (Part B).
05 Medicaid = a number assigned to a provider by a state Medicaid agency. Each state has a unique identifier. Medicaid is a program established pursuant to Title XIX of the Social Security Act to provide medical benefits for certain categories of low-income individuals. The program provides benefits to indigent and disabled individuals and members of families receiving Aid to Families with Dependent Children. States have the option to provide benefits to a broader range of individuals. The program is a cooperative arrangement between the federal government and the states, under which both the federal government and a participating state contribute financial support. The state, however, retains a considerable amount of discretion over the operation and administration of the program, and has the right to determine the benefits to be provided, rules for eligibility, rates of payment for services and other matters, as long as broad regulatory guidelines established by the federal government are followed.
06 UPIN (Unique Physician/Practitioner Identification Number) = a number assigned to each Medicare physician/practitioner to identify the referring or ordering physician on Medicare claims. UPINs consist of an alpha character and five numerics and are assigned by CMS.
08 State License = the number assigned and required by a State Board or other State regulatory agency that uniquely identifies a pharmacy by category, as defined by each State or Territory or a prescriber by practice specialty for which they reside/practice.
09 TRICARE = a number that uniquely identifies a provider that participates in the TRICARE program which is a federal medical benefits program that helps pay for civilian medical care rendered to the spouses and children of active duty and retired personnel.
10 Health Industry Number (HIN) = a 9 digit alphanumeric number used to identify health care entities such as veterinarians, animal clinics, and health care provider facilities. The number is assigned by HIBCC.
11 Federal Tax ID = a 9-digit number assigned by the Internal Revenue Service to sole proprietors, corporations, partnerships, estates, trusts, and other entities for the purpose of tax filing and reporting.
12 Drug Enforcement Administration (DEA) Number = the number assigned by the DEA to all businesses that manufacture or distribute controlled pharmaceuticals, all health professionals who dispense, administer, or prescribe controlled pharmaceuticals and all pharmacies that fill prescriptions.
13 State Issued = a unique number issued by a state program or organization other than Medicaid, to a provider of service.
14 Plan Specific = a unique proprietary number assigned by a commercial health care plan to a provider of service.
15 HCID (HC IDea) = A 10-character, alphanumeric identifier assigned by NCPDP to identify authorized prescribers of drugs.
17 Foreign Prescriber Identifier = a value used to identify a prescriber who practices outside of the United States and does not have a prescriber identifier issued from within the United States.
99 Other = used to identify other health plans and enumerating organizations not listed above.
 
Standards Format: E
Value Value Meaning
01 National Provider Identifier (NPI) = a standard unique health identifier for health care providers. The NPI is a 10 position numeric identifier with a check digit in the 10th position and is assigned by the National Provider System (NPS).
02 Blue Cross = a number assigned by a Blue Cross health plan which is a nonprofit hospital expense prepayment plan primarily designed to provide benefits for hospitalization coverage, with certain restrictions on the accommodations to be used.
03 Blue Shield = a number assigned by a Blue Shield health plan which is a prepayment plan offered by voluntary nonprofit organizations that cover medical and surgical expenses.
04 Medicare = a number assigned by the carrier or intermediary which administers the Medicare health insurance program for people age 65 or older, some people with disabilities under age 65, and people with end-stage renal disease. Medicare has two parts, hospital insurance (Part A) and medical insurance (Part B).
05 Medicaid = a number assigned to a provider by a state Medicaid agency. Each state has a unique identifier. Medicaid is a program established pursuant to Title XIX of the Social Security Act to provide medical benefits for certain categories of low-income individuals. The program provides benefits to indigent and disabled individuals and members of families receiving Aid to Families with Dependent Children. States have the option to provide benefits to a broader range of individuals. The program is a cooperative arrangement between the federal government and the states, under which both the federal government and a participating state contribute financial support. The state, however, retains a considerable amount of discretion over the operation and administration of the program, and has the right to determine the benefits to be provided, rules for eligibility, rates of payment for services and other matters, as long as broad regulatory guidelines established by the federal government are followed.
06 UPIN (Unique Physician/Practitioner Identification Number) = a number assigned to each Medicare physician/practitioner to identify the referring or ordering physician on Medicare claims. UPINs consist of an alpha character and five numerics and are assigned by CMS.
08 State License = the number assigned and required by a State Board or other State regulatory agency that uniquely identifies a pharmacy by category, as defined by each State or Territory or a prescriber by practice specialty for which they reside/practice.
09 TRICARE = a number that uniquely identifies a provider that participates in the TRICARE program which is a federal medical benefits program that helps pay for civilian medical care rendered to the spouses and children of active duty and retired personnel.
10 Health Industry Number (HIN) = a 9 digit alphanumeric number used to identify health care entities such as veterinarians, animal clinics, and health care provider facilities. The number is assigned by HIBCC.
11 Federal Tax ID = a 9-digit number assigned by the Internal Revenue Service to sole proprietors, corporations, partnerships, estates, trusts, and other entities for the purpose of tax filing and reporting.
12 Drug Enforcement Administration (DEA) Number = the number assigned by the DEA to all businesses that manufacture or distribute controlled pharmaceuticals, all health professionals who dispense, administer, or prescribe controlled pharmaceuticals and all pharmacies that fill prescriptions.
13 State Issued = a unique number issued by a state program or organization other than Medicaid, to a provider of service.
14 Plan Specific = a unique proprietary number assigned by a commercial health care plan to a provider of service.
15 HCID (HC IDea) = A 10-character, alphanumeric identifier assigned by NCPDP to identify authorized prescribers of drugs.
17 Foreign Prescriber Identifier = a value used to identify a prescriber who practices outside of the United States and does not have a prescriber identifier issued from within the United States.
99 Other = used to identify other health plans and enumerating organizations not listed above.
 
Downloads
PDF
Download as a PDF file.
[Download PDF Reader Exit Disclaimer]
Download as an MS Excel™ spreadsheet.
[Download Excel Reader Exit Disclaimer]
Scroll To Top