Code 40 - Pharmacy not contracted with plan on DOS: Pharmacy not contracted with plan on date of service. The prescription must be filled at a contract pharmacy....
Code 76 - Plan Limitations Exceeded: The pharmacy is attempting to submit the claim as a refill and must be approved by the funding agency....
Code 19 - M/I Day Supply: The day supply requested exceeds the allowable day supply for this group and must be referred to the funding agency for approval....