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Revised January, 2010 CONFIDENTIAL AND PROPRIETARY - page 24 / 31

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CONFIDENTIAL AND PROPRIETARY

1 = Substitution not allowed by prescriber 2 = Substitution allowed - patient requested product dispensed 3 = Substitution allowed - pharmacist selected product dispensed 4 = Substitution allowed - generic drug not in stock 5 = Substitution allowed - brand drug dispensed as a generic 6 = Override 7 = Substitution not allowed - brand drug mandated by law 8 = Substitution allowed - generic drug not available in marketplace 9 = Other

Submission of DAW 0 should be utilized when dispensing a prescribed generic drug. Additionally, single-source brands should be submitted with a DAW 0.

DAW 1 should be submitted when the prescriber has indicated only the brand-name drug may be dispensed, and is documented on the hard-copy prescription. For telephone orders, the DAW- brand only, no generic substitution per prescriber must be documented accordingly on the hard copy. Pharmacy software should never default to DAW 1.

DAW 2 should be submitted when the member requests the brand drug and the pharmacy should document the hard copy accordingly.

Incorrectly submitted prescription claims or claims lacking the proper DAW documentation may result in charge back. Failure to submit appropriate DAW-coded claims may result in the removal from the network, chargebacks and/or financial penalties.

Compounds

Compounds must be submitted in accordance with the requirements of the “Billing Compounds” section of this Pharmacy Manual. Audited prescription compound claims may require the pharmacy to complete a supplemental Compound Ingredient Worksheet to validate the claim submission. As determined by Walgreens Health Initiatives, unsatisfactory compound audit results may be determined to be cause for possible suspension of payment and removal from the network.

Reversals

Prescriptions not dispensed to the member, or the member’s authorized representative, within 10 calendar days must be reversed by the pharmacy at the point of sale. Failure to abide by this practice may result in chargebacks, additional financial penalties, and/or possible removal from the network.

Walgreens Health Initiatives – Pharmacy Manual

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