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1/13/2009 11:20:46 PM
  MEDICAID EXCLUSION FILES

The Office of Pharmacy Affairs has replaced the former Medicaid Exclusion Files (both the DBF and Excel files) with a new online report found at http://opanet.hrsa.gov/opa/CE/CEMedicaidExtract.aspx. This report allows States to download only those records that are relevant for that State.  In addition, this new report has real-time information on each covered entity (such as address and contact information) and allows covered entities to list more than one Medicaid Provider Number, if appropriate.

Instructions for accessing this report may be found on page 7 of the User Manual (found at http://opanet.hrsa.gov/opa/Manuals/Public_User_Instruction_Manual.pdf) or you may call the Pharmacy Services Support Center at 1-800-628-6297 for live help.


Medicaid exclusion files help States and manufacturers avoid the application of the 340B discount and the Medicaid rebate to the same drug purchases (a duplicate discount).

Covered entities that bill Medicaid for drugs purchased at 340B prices must provide the Office of Pharmacy Affairs (OPA) with their pharmacy Medicaid provider number, which is placed in an “exclusion” file. OPA makes this exclusion file available to the state Medicaid agencies so that the state does not request a Medicaid rebate from a manufacturer for the already discounted 340B drugs. Federal Register Notice establishing the mechanism, May 7, 1993.

Format for text file

Record Layout
Field Size Position Remarks
Ent_Name 40 1 thru 40 Character
Addrhdr 40 41 thru 80 Character
Addr 30 81 thru 110 Character
Addr2 20 111 thru 130 Character
City 23 131 thru 153 Character
State 2 154 thru 155 Character
Zip 5 156 thru 160 Character
Dp_No 20 161 thru 180 Character
Tele 15 181 thru 195 Character
Fax 10 196 thru 205 Character
Contact 20 206 thru 225 Character
Title 25 226 thru 250 Character
Particip 1 251 thru 251 Character
Certified 1 252 thru 252 Character
Add_Date 8 253 thru 260 Date
Ent_Type 9 261 thru 269 Character
Med_No 15 270 thru 284 Character
Term_Date 8 285 thru 292 Date
_Dbaselock 8 293 thru 300 Character

Exclusion files from previous quarters