Question

When a brand name or high cost medication is not covered by the PBM formulary the insurance rejection a technician would see is ______.

a. out of network prescriber
b. NDC not covered
c. refills too soon
d. incorrect days supply

Answer 1

When a brand name or high-cost medication is not covered by the PBM formulary, the insurance rejection a technician would see is NDC not covered.

Step-by-step explanation:

When a brand name or high-cost medication is not covered by the PBM formulary, the insurance rejection a technician would see is NDC not covered. NDC stands for National Drug Code, which is a unique identifier for each prescription drug. If a medication is not covered by the formulary, it means it is not on the list of approved drugs for that specific insurance plan.