ARSD 20:51:32:03. Data elements

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