---
title: Provider Vendor Requirements
slug: electronic-prior-auth/guide/provider-vendor-requirements
docTags: 
createdAt: 2026-06-22T17:00:18.629Z
---

**PA.200:** The application shall make available for display the ResponseStatus and each occurrence of a PANote from all response transactions.

:::hint{type="info"}
**Note: **Multiple responses of the same type may be received.
:::

**PA.201:** When the PBM/payer provides a question set in the PAInitiationResponse, the application shall display:

- QuestionSetContactCommunicationNumber
- DeadlineForReply
- AttachmentNotes (when attachment required)

**PA.202: **The application shall require all specified questions to be answered (not blank) and an order, prior to sending the PARequest.

**PA.203:** In the event that a PA has been canceled by the initiator or closed by the PBM, and the prior authorization is still desired, a new PAInitiationRequest shall be sent.

**PA.204:** When the prescriber and main prior authorization contact vary, the application shall utilize the Provider composite to supply the prior authorization contact name and PrimaryTelephone.

**PA.205:** Provider vendors shall not send a PAAppealRequest if the value of the IsEAppealSupported field is "false" in the PAResponse.

**PA.206:** Prescribing vendors who are utilizing the Surescripts Eligibility 270/271 messages shall populate the first BenefitsCoordination element with the associated information returned in a Surescripts 271 message. If more than one active coverage is returned, only the single coverage information utilized to write the prescription is sent. The 271 message's ISA13 control number shall be populated in the BenefitsCoordination/InterchangeControlNumber field in all instances including scenarios where there is no active coverage.

**PA.207:** Either MedicationPrescribed/DaysSuppy or MedicationPrescribed/PADaysSupplyDosesPerDay shall be populated in the PAInitiationRequest when available.

**PA.208:** If the PAInitiationRequest includes a PAPriorityIndicator flag, the priority must be displayed to the end user. The value of "S" (Standard Priority) should be the default if the data element is sent in the transaction.

**PA.209:** The application shall make available for display the ExpirationDate to the prescriber for a Prior Authorization renewal request (unsolicited PAInitiationResponse).

**PA.210:** If a PBM/payer requires an attachment in an answered question, the application shall not allow a request to be sent without the attachment composite being populated.

**PA.211:** When both a brand and generic NDC exist for a medication, in the PAInitiationRequest provider vendors shall submit the drug description and NDC of the form of the medication they want to prescribe for the patient.

**PA.214:** The application shall support the ePA question set conditional logic as outlined in the NCPDP ePA standard.

**PA.219:** The drug name shall be an item that is currently available for dispensing. If there are active NDCs available, an inactive/obsolete NDC shall not be used. Customers are expected to work with their drug compendia vendor to satisfy this requirement.

**S.203:** Sender demographic information shall match what was registered by the customer in the Surescripts Directory. When a prescribing system utilizes the Surescripts Learning Directory service, this requirement is satisfied for learned locations.

**S.208:** Codified values within a message shall not conflict with the related textual concept.

**Example 1:**

| **Field Name**                                | **Proper Use**             | **Improper Use** |
| --------------------------------------------- | -------------------------- | ---------------- |
| DrugDescription                               | Primariea 10mg/10ml liquid |                  |
| DrugCoded/Strength/StrengthValue              | 10                         | \<empty>         |
| DrugCoded/Strength/StrengthUnitOfMeasure/Code | C42576 (mg/ml)             |                  |
| DrugCoded/Strength/StrengthForm/Code          | C42953                     |                  |

**Example 2:**

| **Field Name**                                | **Proper Use**                  | **Improper Use**    |
| --------------------------------------------- | ------------------------------- | ------------------- |
| DrugDescription                               | Amoxicillin 500 mg oral capsule |                     |
| DrugCoded/Strength/StrengthValue              | 500                             | 250                 |
| DrugCoded/Strength/StrengthUnitOfMeasure/Code | C28253 (Milligram)              | C28254 (Milliliter) |
| DrugCoded/Strength/StrengthForm/Code          | C25158 (Capsule)                | C42998 (Tablet)     |