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Troubleshooter Guides

  • Code ET - Missing/Invalid Quantity Prescribed

    The quantity prescribed is either missing or invalid.  The pharmacy must submit the quantity prescribed and the quantity dispensed number of refills authorized should be 0.  PA approval from the fundi...

  • Prescription Benefits; Pharmacy; Drugs

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  • Medical Benefits; Doctors; Physicians; Hospitals

    Physician & Hospital Discounts Click here for benefits assessment. Going to the doctor doesn’t have to cost an arm and a leg. Save 10% to 40% at over 285,000 participating doctor offices and hospitals...

  • Dental Benefits; Dentist; Teeth

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  • Vision Benefits; Eyeglasses; Optical; Eye-care

    Coast To Coast Vision™ Click here for benefits assessment. Your eyes are the windows to your health. Now you and your family can see better savings at over 20,000 vision providers nationwide, includin...

  • Code 08 - M/I Person Code

    Code 08:  M/I Person Code - The person code should be two digits numeric form of 00.  Change the patient person code to 00, or refer the matter to your programmer....

  • Code 71 - Prescriber Not Covered

    Code 71:  Prescriber Not Covered - The prescriber ID (NPI/DEA) entered is not authorized or programmed for this group.  Contact the funding agency for authorization to accept prescriptions written by ...

  • Code 54-N/M Product

    Non-Matched Product/Service ID Number - the pharmacy is using a drug code that is not found or incorrect.  Please instruct the pharmacy to use a different NDC....

  • Code 70 - Product/Service Not Covered

    Code 70 - Product/Service Not Covered: The medication requested is not on the clinic formulary and must be approved by the funding agency....

  • Code 75 - Prior Authorization Required

    Code 75 - Prior Authorization Required:  The medication submitted is not on the group formulary and requires approval from the funding agency before issuing a prior authorization....