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Billing L&I for Pharmacy Services

For pharmacy providers who bill L&I directly

Point-of-sale system (POS) for reimbursement

Use the NCPDP Payer sheet ver. 5.1 (142 KB PDF) for billing format. Effective 01/01/2012 use the NCPDP Payer Sheet ver. D.0 for billing format.

POS hours:

  • 6 a.m. to midnight Monday through Saturday.
  • 6 a.m. to 10 p.m. on Sunday.

To receive remittance advice in the HIPAA compliant EDI 835 transaction, see
HIPAA 5010 Companion Guide (1.83 MB PDF / 5 min).

Paper forms for reimbursement

For State Fund claims

For Crime Victim claims

Helpful billing information

To prevent a rejection to your prescription (71 - Prescriber not covered) use the prescriber's:

* L&I provider numbers for large groups, clinics or hospitals are no longer accepted for prescription billing.

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