Exercise 3 – Build an NDC List

In order to construct new plan setups, you must go into the ‘Pre-Production’ environment and create the new or updated elements.

Step 1. From CCT600, type on the command line ‘CMX000’ and press Enter.

01/13/2009 Rel 6.0 Feb 2009 Release - DEV: VB-05142 Sys: RXCDEV
3:40:10 Z106027 RxCLAIM Plan Administrator Menu Menu: CCT600

1. Eligibility/Claim Transaction
2. Product
3. Manual Claim
4. Plan
5. Price
6. Drug Utilization Review (DUR)
7. Provider
8. Profile
9. Batch Process
10. Miscellaneous Tables
11. Call Queue Menu
12. Client Specific Menu
13. RxMAX System

90. Signoff

Selection or Command
===> CMX000
F1=Help F3=Exit F4=Prompt F6=Wrk Msg F9=Retrieve
F12=Return F14=WRKSBMJOB F18=WRKSPLF F22=Calculator F23=Calendar

Step 2. Type 1 and press Enter to access the Pre-Production environment with existing production eligibility.

01/13/2009 Rel 6.0 Feb 2009 Release - DEV: VB-05142 Sys: RXCDEV
3:41:04 Z106027 User Change Control Menu Menu: CMX000

1. Pre-Production Env w/prod elig

2. Pre-Prodctn Env w/pre-prod elg
3. Production Environment
4. Administrator
5. Prod Envrnmnt w/Pre Prod Elig
6. PDCC Control
7. Work With Error Codes
8. Work With User Elec Details
9. W/W Application Areas
10. W/W Glossary Entries
11. W/W Glossary to Appl Area Xref

90. Signoff

Selection or Command
===> 1
F1=Help F3=Exit F4=Prompt F6=Wrk Msg F9=Retrieve
F12=Return F14=WRKSBMJOB F18=WRKSPLF F22=Calculator F23=Calendar

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Step 3 – Type a 2 next to the BAR you created during Exercise 2 and press Enter to edit.

APBRU002 DISPLAY Caremark RxCLAIM - DEV. D02 (P-ELIG) 1/13/09

Z106027 Requested BARs 3:44:34

Type options, press Enter. 2=Edit 3=Close 4=Cancel 5=View BAR History
6=BAR Description 9=View Users B=Process Batch Claims E=Work With Errors
G=Bar Change Report P=Promote T=BAR Detail X=Unschedule

00000000 00 0:00:00

F3=Exit F6=Add BAR F8=ALL BARs F10=Report F12=Previous

F16=View Sched BARs
No data to display.

Step 4 – From CMX600, type 4 on the command line and press Enter.

01/13/2009 Rel 6.0 Feb 2009 Release - DEV: VB-05142 Sys: RXCDEV
3:45:50 Z106027 RxCLAIM Plan Administrator Menu Menu: CCT600

1. Eligibility/Claim Transaction
2. Product
3. Manual Claim
4. Plan
5. Price
6. Drug Utilization Review (DUR)
7. Provider
8. Profile
9. Batch Process
10. Miscellaneous Tables
11. Call Queue Menu
12. Client Specific Menu
13. RxMAX System

90. Signoff

Selection or Command
===> 4
F1=Help F3=Exit F4=Prompt F6=Wrk Msg F9=Retrieve
F12=Return F14=WRKSBMJOB F18=WRKSPLF F22=Calculator F23=Calendar

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Step 5 – Type 3 on the command line and press Enter.

01/13/2009 Rel 6.0 Feb 2009 Release - DEV: VB-05142 Sys: RXCDEV
3:47:24 Z106027 RxCLAIM Plan Maintenance Menu: CCT640

1. Plan 16. Reject Code Remap Table

2. Plan GPI List 17. Prior Authorization GPI List
3. Plan NDC List 18. Prior Authorization NDC List
4. Diagnosis Code 19. Plan Calendar
5. Diagnosis List 20. Plan Holiday Calendar
6. Message Code 21. Plan Authorization Agent Code
7. Call Type Code 22. PA Reason Code List
8. Prior Authorization Reason Cde 23. Carrier PA Drug Status Rstrctn
9. Dynamic Prior Authorization 24. Plan Withhold
10. Dynamic Prior Auth List 25. MChoice Plan Schedule
11. Preferred GPI List
12. Preferred NDC List
13. Prescriber DEA Validation List
14. Referral Status Code
15. Plan Qualifier

Selection or Command
===> 3
F1=Help F3=Exit F4=Prompt F6=Wrk Msg F9=Retrieve
F12=Return F14=WRKSBMJOB F18=WRKSPLF F22=Calculator F23=Calendar

Step 6 – The screen lists all NDC lists in alpha-numeric order.

Press F6 to add a new list.

RCPNL003 DISPLAY BAR 01241421-01 TEST DEV (P-ELIG) 1/13/09

Z106027 Plan NDC List by List ID 3:59:53

Type options, press Enter. 2=Edit 7=NDCs 8=Plans

3=Copy/Merge NDC Lists 13=Copy/Merge to Preferred NDC List 14=Add Maint List

? List Description
CLARR CLARITIN REJECT
**JCS **JORDAN'S TEST NDC
**KPTT **KP TEST NDC
**MJV *MJV NDC TEST PLAN
**RBCA *HN CA 648-650 REJ REBATE
**RBTZ *HN CA Z PLAN REJ REBATE
**REBT *HN REBATE NDC REJECTLIST
**RHN2 *HN CA PLAN REJ REBATE
**RMDC *HN MDC REBATE LIST
**RTAL *HNNE REBT REJLST ALLPLNS
**RTHN *HN CA&OR REJ REBATE LIST
**RTQ7 *HNNE REBT REJLST Q7 ONLY +

F3=Exit F6=Add F12=Previous F15=Search by List Description

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Step 7 – Type in any list name that includes your initials + ‘TEST’. Enter a description. Press Enter key and respond Y to confirm.

Add Plan NDC List

List CBTEST
Description MISC NDC FUNCTIONALITY

F3=Exit F12=Previous

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Step 8 – Type the name of your new list in the search line and press Enter. The list on screen should scroll to the new list. Type a 7 next to the new
NDC and press Enter.

RCPNL003 DISPLAY BAR 01241421-01 TEST DEV (P-ELIG) 1/13/09

Z106027 Plan NDC List by List ID 4:01:32

CLARR

Type options, press Enter. 2=Edit 7=NDCs 8=Plans

3=Copy/Merge NDC Lists 13=Copy/Merge to Preferred NDC List 14=Add Maint List

? List Description
7 CLARR CLARITIN REJECT
**JCS **JORDAN'S TEST NDC
**KPTT **KP TEST NDC
**MJV *MJV NDC TEST PLAN
**RBCA *HN CA 648-650 REJ REBATE
**RBTZ *HN CA Z PLAN REJ REBATE
**REBT *HN REBATE NDC REJECTLIST
**RHN2 *HN CA PLAN REJ REBATE
**RMDC *HN MDC REBATE LIST
**RTAL *HNNE REBT REJLST ALLPLNS
**RTHN *HN CA&OR REJ REBATE LIST
**RTQ7 *HNNE REBT REJLST Q7 ONLY +

F3=Exit F6=Add F12=Previous F15=Search by List Description

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Step 9- The listing shows all NDC’s associated with this list. As a message at the bottom of the screen notes, there is no data to display (because you
haven’t had a chance to add them yet).

Press F6 to add an NDC.

RCPNO001 DISPLAY BAR 01241421-01 TEST DEV (P-ELIG) 1/13/09

Z106027 Plan NDC List NDCs by Name 4:02:42
Current
Name
Plan NDC List CLARR CLARITIN REJECT

Type options, press Enter. 0=Note 2=Edit 5=Display

? NDC Name Manufacturer Sts

From Thru
00085 1217 02 A + D PERSON MIS CARE WIP S-P HEALTH R M P
10/05/08 12/31/39
55887 0188 09 MAXALT-MLT TAB 10MG DHS INC. W F
10/13/08
58016 0776 00 PRILOSEC CAP 10MG CR SOUTHWOOD F P
1/01/90 12/31/39
58016 0776 30 PRILOSEC CAP 10MG CR SOUTHWOOD F P
1/01/90 12/31/39
58016 0776 60 PRILOSEC CAP 10MG CR SOUTHWOOD F P
1/01/90 12/31/39 +

F3=Exit F6=Add F8=All F10=Add Default F12=Previous F15=Search by NDC

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Step 10 – The screen shows a listing of all NDC’s in alpha-numeric order by NDC name. Press F16 to search by NDC#.

Type 00002-0604-40 on the search line and press Enter. The list should scroll to display this NDC.

Type an 1 next to the NDC# to select it for your NDC list.

RCPID034 DISPLAY BAR 01241421-01 TEST DEV (P-ELIG) 1/13/09

Z106027 Select/Add by Active Product IDs 4:06:03

Description
List Name CLARR CLARITIN REJECT

00002-0604-40

Type options, press Enter. 1=Select 5=Display

? Product ID Label Name GPI Mfg RPG

1 00002-0604-40 NDC SEROMYCIN CAP 250M 09000030000105 LILLY N
00002-0604-48 NDC PLACEBO TAB 00000000000300 LILLY
00002-0604-49 NDC TEST FOR MED D WINDOW LILLY
00002-0803-03 NDC DARVON CAP 65MG 65100085100110 AAIPHARMA N
00002-1407-01 NDC QUINIDINE GL INJ 80MG 35100030102005 LILLY N
00002-1485-01 NDC CAPASTAT SUL INJ 1GM 09000020102105 LILLY N
00002-2232-32 NDC SDSA
00002-2407-02 NDC GELATIN EMPT CAP SIZE 98700000000100 LILLY N
00002-2410-02 NDC GELATIN EMPT CAP SIZE 98700000000100 LILLY +

F3=Exit F8=All F12=Previous F15=Select by Label Name

F17=Select by GPI ID F18=Select by GPI Name
Step 11 – The detail entry is created with a default to Status=F and From date = today’s date.

Change the dates to match the illustration below. Change the drug status to R. Any claim submitted for this specific syringe will reject. This NDC
belongs to the wild-carded GPI that was set up as formulary on your GPI list, but the NDC listing is used to override the GPI. Press Enter to confirm.
Press F12 to return to previous screen.

RCPNO003 CHANGE BAR 10701250-01 RxClaim Tr QAT (PPELIG) 7/04/05

CBONNER Plan NDC Detail Page 1 of 3 13:26:48
Name
Plan NDC List CBTEST MISC NDC FUNCTIONALITY ------- Date -------
NDC 08290 3096 28 INSULIN SYRG MIS 1ML From Thru Sts
Reject 7/01/05 12/31/39 R
External

Minimum Maximum -------- Period to Date ---------

Quantity Type Days Maximum
Days Supply Quantity
Qty/DS Comparisons Days Supply
Patient Age Qty/DS Comp
Daily Dose Fills
Daily Dose Qual Amount Due
Acute Dosing Days Basis
Maint Dosing/Day PTD From
Pharmacy Network (I/E)
Mail Network ID
Added 7/04/05 Changed 7/04/05 User CBONNER
+
F3=Exit F10=Price F11=Delete F12=Previous F14=Note F15=Cont Therapy
F16=Bypas CT F17=PA Override F18=Refill F19=Refill/Fill Limit

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Step 12 – From the NDC selection list, select 00071023724. Change the From & Thru dates to match the illustration below. Change the Drug status
to R for Reject.

RCPNO003 CHANGE BAR 10701250-01 RxClaim Tr QAT (PPELIG) 7/04/05

CBONNER Plan NDC Detail Page 1 of 3 13:30:27
Name
Plan NDC List CBTEST MISC NDC FUNCTIONALITY ------- Date -------
NDC 00071 0237 24 ZARONTIN CAP 250M From Thru Sts
Reject 1/01/05 12/31/39 R
External

Minimum Maximum -------- Period to Date ---------

Quantity Type Days Maximum
Days Supply Quantity
Qty/DS Comparisons Days Supply
Patient Age Qty/DS Comp
Daily Dose Fills
Daily Dose Qual Amount Due
Acute Dosing Days Basis
Maint Dosing/Day PTD From
Pharmacy Network (I/E)
Mail Network ID
Added 7/04/05 Changed 7/04/05 User CBONNER
+
F3=Exit F10=Price F11=Delete F12=Previous F14=Note F15=Cont Therapy
F16=Bypas CT F17=PA Override F18=Refill F19=Refill/Fill Limit

Step 13 – From the NDC selection list, select 00071041724. Change the From & Thru dates to match the illustration below. Leave drug
status as F. Press Enter.

RCPNO003 CHANGE BAR 10701250-01 RxClaim Tr QAT (PPELIG) 7/04/05

CBONNER Plan NDC Detail Page 1 of 3 13:32:26
Name
Plan NDC List CBTEST MISC NDC FUNCTIONALITY ------- Date -------
NDC 00071 0417 24 NITROSTAT SUB 0.3M From Thru Sts
Formulary 1/01/05 12/31/39 F
External

Minimum Maximum -------- Period to Date ---------

Quantity Type Days Maximum
Days Supply Quantity
Qty/DS Comparisons Days Supply
Patient Age Qty/DS Comp
Daily Dose Fills
Daily Dose Qual Amount Due
Acute Dosing Days Basis
Maint Dosing/Day PTD From
Pharmacy Network (I/E)
Mail Network ID
Added 7/04/05 Changed 7/04/05 User CBONNER
+
F3=Exit F10=Price F11=Delete F12=Previous F14=Note F15=Cont Therapy
F16=Bypas CT F17=PA Override F18=Refill F19=Refill/Fill Limit

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Step 14 –Press F18 to access Refill Limits.

RCPNO003 CHANGE BAR 10701250-01 RxClaim Tr QAT (PPELIG) 7/04/05

CBONNER Plan NDC Detail Page 1 of 3 13:32:26
Name
Plan NDC List CBTEST MISC NDC FUNCTIONALITY ------- Date -------
NDC 00071 0417 24 NITROSTAT SUB 0.3M From Thru Sts
Formulary 1/01/05 12/31/39 F
External

Minimum Maximum -------- Period to Date ---------

Quantity Type Days Maximum
Days Supply Quantity
Qty/DS Comparisons Days Supply
Patient Age Qty/DS Comp
Daily Dose Fills
Daily Dose Qual Amount Due
Acute Dosing Days Basis
Maint Dosing/Day PTD From
Pharmacy Network (I/E)
Mail Network ID
Added 7/04/05 Changed 7/04/05 User CBONNER
+
F3=Exit F10=Price F11=Delete F12=Previous F14=Note F15=Cont Therapy
F16=Bypas CT F17=PA Override F18=Refill F19=Refill/Fill Limit

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Step 15 – Set the refill limits to match the illustration below. These settings will allow the plan refill limits to be overridden for claims submitted for
this NDC only. Press Enter and Confirm with Y.

RCPNS001 CHANGE BAR 10701250-01 RxClaim Tr QAT (PPELIG) 7/04/05

CBONNER Plan NDC Refill Limits 13:36:14

NDC List CBTEST MISC NDC FUNCTIONALITY ------Date------

NDC 00071 0417 24 NITROSTAT SUB 0.3M From Thru Sts
Formulary 1/01/05 12/31/39 F

Please Enter Days Supply in Ascending Order

Days Supply % of Days Supply Used
Up To 999 75

Added 7/04/05 Changed 7/04/05 User CBONNER

F3=Exit F11=Delete F12=Previous

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Step 16 – Press F3 and view your NDC List entries.

RCPNO001 DISPLAY BAR 10701250-01 RxClaim Tr QAT (PPELIG) 7/04/05

CBONNER Plan NDC List NDCs by Name 13:39:53
Current
Name
Plan NDC List CBTEST MISC NDC FUNCTIONALITY

Type options, press Enter. 0=Note 2=Edit 5=Display

? NDC Name Manufacturer Sts

From Thru
08290 3096 28 INSULIN SYRG MIS 1ML B-D CONSUM R

7/01/05 12/31/39
00071 0417 24 NITROSTAT SUB 0.3M PFIZER US F
R
1/01/05 12/31/39
00071 0237 24 ZARONTIN CAP 250M PFIZER US R

1/01/05 12/31/39

F3=Exit F6=Add F8=All F10=Add Default F12=Previous F15=Search by NDC

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Step 167 – Press F3 4 times to return to th BAR selection screen. Your BAR should still display ACT status. F3 2 more times to exit Plan Database.
Always be sure to totally exit from Plan Database so that your changes are correctly stored for the BAR.

- End of Exercise 3 -

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