The information submitted for each prescription shall include the following items:

1. (1) Dispenser name and identification number;
2. (2) Date prescription filled;
3. (3) Prescription number;
4. (4) Prescription is new or is a refill;
5. (5) Identification code for drug dispensed;
6. (6) Quantity dispensed;
7. (7) Day's supply dispensed;
8. (8) Number of refills ordered;
9. (9) Patient name;
10. (10) Patient address;
11. (11) Patient date of birth;
12. (12) Patient gender;
13. (13) Prescriber identification number;
14. (14) Date prescription issued by the prescriber;
15. (15) Pharmacy phone number;
16. (16) Code identifying type of payment;
17. (17) Prescriber last name;
18. (18) Prescriber first name; and
19. (19) Prescriber phone number.

Source: 37 SDR 214, effective May 30, 2011; 45 SDR 86, effective December 24, 2018.

General Authority: SDCL 34-20E-20(2).

Law Implemented: SDCL 34-20E-2 , 34-20E-3 , 34-20E-20(2).

Prior versions effective: 2011-05-30.