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 insurance, 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.

(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 mustat least report the following information to the board of pharmacy in the format 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
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