A free-form description to clarify the related data elements and their content

DRA01 is the drug name. Position of data in the repeating data element conveys no significance.

Code indicating the type of certification

DRA02 is the drug therapy type.

DRA03 Position of data in the repeating data element conveys no significance.

Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken

Numeric value of quantity

DRA05 is the quantity being requested.

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DRA06 is the Sig (The Sig is a Latin term used in the pharmacy industry that represents the instructions/directions that are printed on the drug label.)

Code indicating a Yes or No condition or response

DRA07 is the self administer indicator. A "Y" value indicates that the drug can be administered by the patient. An "N" value indicates that the drug can not be administered by the patient.

Code indicating a Yes or No condition or response

DRA08 is the end stage renal disease (ESRD) indicator. A "Y" value indicates that the patient has ESRD. An "N" value indicates that the patient does not have ESRD.

Code specifying type of date or time, or both date and time

Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year

DRA10 is the ESRD certification date.

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DRA11 is for questions that are related to the authorization of the drug. Position of data in the repeating data element conveys no significance.

Numeric value of quantity

DRA12 is the number of refills requested.

DRA13 Position of data in the repeating data element conveys no significance.

Code indicating the form in which the drug is dispensed

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DRA15 is for comments and/or instructions regarding the authorization. Position of data in the repeating data element conveys no significance.