OAR 410-121-0220: Instructions for Completion of the Prescription Drug Invoice

Edition: Current OARD snapshotEffective: 2018-03-02Last verified: 2026-09-07

(1) The 1.2 Universal Claim Form is the required billing form for pharmacies billing on a paper claim. Use the standard instructions for completion of the 1.2 Universal Claim Form. (2) Enter all applicable information for billing of prescription drug claims for clients on the Oregon Health Plan.

Official history and status

Statutory/Other Authority: ORS 413.042, 414.034 & 414.065

Statutes/Other Implemented: ORS 414.065

History: DMAP 11-2018, amend filed 03/02/2018, effective 03/02/2018 OMAP 40-2003, f. 5-27-03, cert. ef. 6-1-03 OMAP 1-1999, f. & cert. ef. 2-1-99 HR 23-1995, f. 12-29-95, cert. ef. 1-1-96 HR 2-1995, f. & cert. ef. 2-1-95 HR 20-1994, f. 4-29-94, cert. ef. 5-1-94 HR 14-1993, f. & cert. ef. 7-2-93 HR 29-1990, f. 8-31-90, cert. ef. 9-1-90, Renumbered from 461-016-0280 AFS 56-1989, f. 9-28-89, cert. ef. 10-1-89

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Official source: https://secure.sos.state.or.us/oard/