E-prescribing, pharmacy claims and medication data
We connect prescribers, pharmacies and digital health products to the US medication network: NCPDP SCRIPT e-prescribing over the Surescripts network, EPCS for controlled substances, formulary and real-time benefit checks, NCPDP Telecommunication pharmacy claims, and FHIR medication resources inside your product.
Eligibility, formulary and real-time benefit shown before the prescriber signs.
FHIR MedicationRequest in your product, NCPDP SCRIPT NewRx on the network.
Surescripts delivers to the pharmacy the patient chose, with EPCS where needed.
RxFill, RxRenewal, RxChange and CancelRx flow back to the original order.
The short answer
In the US, electronic prescriptions travel as NCPDP SCRIPT messages over the Surescripts network, pharmacy claims travel as NCPDP Telecommunication transactions to PBMs, and medication data inside EHRs and apps travels as FHIR. CMS has adopted NCPDP SCRIPT version 2023011 for Medicare Part D, and it becomes the only accepted version on 1 January 2028. We build the integrations that connect your product to all three worlds: e-prescribing through a certified eRx vendor or directly, EPCS with DEA-compliant identity proofing and two-factor signing, benefit checks before the prescriber signs, and a clean FHIR model inside your product.
Pharmacy standards
Each standard serves a different step. These are the versions and rules in force for US pharmacy workflows in September 2026.
| Standard | Version and date | What it carries | What we design for |
|---|---|---|---|
| NCPDP SCRIPT | 2023011 adopted by CMS for Part D in a final rule published 17 June 2024; required from 1 January 2028, when 2017071 retires | NewRx, RxRenewalRequest and Response, RxChangeRequest and Response, CancelRx, RxFill, RxHistory, ePA transactions | Structured sig, RxNorm and NDC coding, and upgrading from 2017071 before the cutoff |
| EPCS (DEA 21 CFR 1311) | In force; CMS EPCS program requires at least 70 percent of Part D Schedule II to V prescriptions to be electronic, after exceptions | Controlled substance prescriptions signed with two-factor authentication | Identity proofing, two-factor signing, logical access controls and the third-party audit or certification of the application |
| Real-Time Prescription Benefit | NCPDP RTPB version 13 required for Part D sponsors from 1 January 2028 | Patient-specific cost and covered alternatives at the point of prescribing | Showing price and alternatives before signing, without slowing the prescriber |
| Formulary and Benefit | NCPDP Formulary and Benefit standard, updated in the same 2024 CMS rule | Plan formulary status, coverage limits and alternatives | Pairing with an X12 270/271 pharmacy eligibility check to find the patient's PBM |
| NCPDP Telecommunication | D.0 today; F6 required from 14 April 2028, with a transition from 14 August 2027 | Pharmacy claims to PBMs: B1 billing, B2 reversal, B3 rebill, E1 eligibility | Planning the D.0 to F6 upgrade inside pharmacy and PBM software |
| HL7 FHIR R4 | US Core MedicationRequest; MedicationDispense and MedicationStatement | Orders, dispenses and reported use inside EHRs and apps | Keeping order, dispense and reported use distinct, coded to RxNorm |
Pharmacy identifiers run through every step: NCPDP Provider ID and NPI for the pharmacy, NPI and DEA number for the prescriber, NDC and RxNorm RxCUI for the drug.
What we build
Each workstream ships with a specification, tests and an owner.
NewRx, CancelRx and pharmacy responses through a certified eRx vendor API such as DoseSpot or DrFirst, or a direct Surescripts connection when your volume justifies certification.
NCPDP SCRIPT 2023011 · NewRx · CancelRx · Status · Error
Surescripts and NCPDP SCRIPT guide →RxRenewalRequest from the pharmacy routed to the right prescriber queue, RxChangeRequest for therapeutic or prior authorization changes, and RxFill notifications tied to the original order.
RxRenewalRequest · RxChangeRequest · RxFill · RxFillIndicatorChange
NCPDP SCRIPT and FHIR MedicationRequest →Identity proofing through a credential service provider, two-factor signing at the moment of prescribing, access controls set by two people, and the audit trail the DEA rule requires.
21 CFR 1311 · identity proofing · two-factor · audit logs
Telehealth software solutions →Pharmacy eligibility, formulary status and real-time prescription benefit shown in the prescribing screen, so cost and covered alternatives are visible before the prescription is sent.
X12 270/271 · NCPDP F&B · NCPDP RTPB 13 · ePA
Prior authorization integration →MedicationRequest, MedicationDispense and MedicationStatement mapped to US Core, coded to RxNorm, and converted to NCPDP SCRIPT at the network edge, so your product works in FHIR.
FHIR R4 · US Core MedicationRequest · RxNorm · NDC
FHIR integration services →Interfaces between pharmacy management systems, PBMs, inventory and dispensing tools, NCPDP D.0 claims with a plan for F6, and HL7 RDE and RDS messages for hospital pharmacy.
NCPDP D.0 and F6 · HL7 RDE and RDS · inventory sync
Mirth Connect for NCPDP and pharmacy →Buyer decisions
How you reach pharmacies is the biggest decision in a prescribing product. We build on each path.
| Option | Best fit | What you get | What to plan for |
|---|---|---|---|
| Certified eRx vendor API (DoseSpot, DrFirst and similar) | Telehealth and digital health products that need to prescribe fast | Surescripts connectivity, EPCS and pharmacy directory through one API | Per-prescriber fees, the vendor's UI or API limits, and data you can export |
| Direct Surescripts certification | EHRs and high-volume prescribing platforms | Full control of the SCRIPT workflow and the prescriber experience | Surescripts certification testing, EPCS audit, and a longer runway |
| EHR-native prescribing | Products embedded in an EHR such as Epic or athenahealth | The EHR's existing eRx and EPCS | Launching into the EHR and reading orders back through FHIR |
| Pharmacy-side integration | Digital and specialty pharmacies receiving prescriptions | Inbound NewRx, RxRenewal and RxChange to your pharmacy system | Pharmacy certification with the network and inbound routing rules |
| FHIR only, inside your product | Medication lists, reconciliation and care coordination | MedicationRequest and MedicationStatement across apps and EHRs | FHIR does not send a prescription to a retail pharmacy on its own |
Most telehealth products start on an eRx vendor API and move to direct certification only when volume and product control justify it.
Integration boundaries
Prescribing crosses clinical, regulatory and network lines. We write ownership down before the build.
Clinical decisions, drug selection, substitutions and signing. The software supports them; it never decides for them.
Surescripts or your eRx vendor owns network participation, certification testing and pharmacy directory data.
EPCS requirements come from 21 CFR 1311 and state law, and the application's audit or certification is a gating step we plan for.
SCRIPT and FHIR mapping, routing, identity and signing workflows, correlation, retries and alerts. Defects here are ours to fix.
Prescription data is encrypted in transit and at rest, access is logged, and we sign a BAA and work inside our ISO 27001:2022 certified management system.
Deliverables
Everything below lands in your repository and your runbook.
SCRIPT transactions, FHIR resources, identifiers, routing rules and annotated sample messages.
eRx vendor or network connector, FHIR mapping and pharmacy interfaces in your repository.
Identity proofing flow, two-factor signing, access control records and audit logs ready for the third-party review.
NewRx, renewal, change, cancel and fill scenarios, including errors and pharmacy rejections.
RxNorm and NDC mapping with reviewer sign-off and a queue for unmapped drugs.
Alerts on failed or unacknowledged prescriptions, escalation contacts and support procedures.
Delivery phases
Prescribing through an eRx vendor API typically takes 6 to 10 weeks. Direct network certification and EPCS audit add time, set largely by the certifying bodies.
Weeks 1 to 2
eRx route chosen, vendor or network onboarding started, EPCS scope and state rules confirmed
Weeks 2 to 6
SCRIPT or vendor API integration, FHIR mapping, benefit checks and prescriber workflow built
Weeks 5 to 9
Vendor or network test scripts, EPCS identity and signing tested, pharmacy responses verified
Weeks 8 to 10
Production prescribers enabled, monitoring live, runbook handed over
Cost drivers
You get a fixed scope after one scoping call. These are the factors that move it.
An eRx vendor API is the fastest path; direct certification is a larger, longer workstream.
EPCS adds identity proofing, two-factor signing and an application audit or certification.
NewRx alone is the smallest unit; renewals, changes, fills and history each add workflows.
Formulary, RTPB and ePA checks add payer and PBM connectivity.
Mapping to US Core and reading or writing to an EHR adds its own testing.
Pharmacy management, PBM claims and inventory interfaces are scoped per system.
Proof
Client names are withheld. The code linked here is public.
Built and run for a pharmacy group-purchasing organization serving independent pharmacies: one order desk kept in sync with inventory, CRM and member communications, so every order ships against real stock.
Our FHIR R4 EHR backend passed 47 of 47 ONC (g)(10) Inferno SMART App Launch STU2 standalone patient tests, the same foundation we use for MedicationRequest workflows.
View the repository on GitHub →Our CDS Hooks coverage requirements server returns coverage and documentation rules at order-sign, the same moment a prescriber needs benefit information.
View the CRD server on GitHub →Our platform runs X12, HL7 v2 and FHIR connectors behind one API, with per-partner configuration, replay and monitoring built in.
See Interoply →We are ISO 27001:2022 certified and sign Business Associate Agreements for work that touches patient data.
FAQ
Pharmacy integration services connect prescribers, pharmacies, PBMs and health products so medication data and prescriptions move electronically. The work covers NCPDP SCRIPT e-prescribing, EPCS for controlled substances, benefit and formulary checks, NCPDP Telecommunication pharmacy claims, pharmacy system interfaces and FHIR medication resources.
CMS adopted NCPDP SCRIPT version 2023011 for Medicare Part D e-prescribing in a final rule published 17 June 2024. Either 2017071 or 2023011 may be used during the transition, and from 1 January 2028 only 2023011 is accepted. Products still on 2017071 should plan the upgrade now.
Use FHIR inside your product and between apps and EHRs: MedicationRequest for the order, MedicationDispense and MedicationStatement for what happened next. To send a prescription to a US retail pharmacy, the network still expects NCPDP SCRIPT, so we convert FHIR to SCRIPT at the network edge.
Yes. A telehealth or digital health product can prescribe through a certified eRx vendor API, keep its own FHIR medication model and skip building an EHR. We connect the prescriber workflow, patient and pharmacy data and the vendor API, and store orders as FHIR MedicationRequest resources.
Almost every US retail pharmacy is reached through the Surescripts network. You can connect directly, which means Surescripts certification, or through a certified eRx vendor such as DoseSpot or DrFirst that already holds it. Most products start with a vendor and move direct when volume justifies it.
The pharmacy sends an RxRenewalRequest when refills run out. Your product routes it to the right prescriber, who approves, denies or modifies it, and an RxRenewalResponse goes back. RxChangeRequest handles substitutions and prior authorization changes, and RxFill tells you the prescription was dispensed.
Under DEA rule 21 CFR 1311, each prescriber's identity must be proofed by an approved credential service provider, every controlled substance prescription is signed with two-factor authentication, access controls are set by two people, and the application needs a third-party audit or certification. Many states also mandate EPCS.
The patient chooses a pharmacy, which we look up in the network's pharmacy directory by NCPDP Provider ID and NPI. The NewRx is addressed to that pharmacy, and Status, Error and RxFill responses come back tied to the original prescription, so failed routing shows up immediately.
The Telecommunication standard carries pharmacy claims from pharmacies to PBMs: B1 billing, B2 reversal, B3 rebill and E1 eligibility. D.0 is the current HIPAA version. HHS adopted F6 as its replacement, with a transition starting 14 August 2027 and compliance required from 14 April 2028.
Real-time prescription benefit shows the patient's actual cost and covered alternatives while the prescriber is choosing a drug. CMS requires Part D sponsors to support NCPDP RTPB version 13 from 1 January 2028. We add it to the prescribing screen alongside formulary and eligibility checks.
Prescribing through an eRx vendor API typically takes 6 to 10 weeks. Direct Surescripts certification and the EPCS audit add time, set largely by the certifying bodies. FHIR medication mapping inside your product runs in parallel with the network work.
Cost depends on the route to the network, whether you prescribe controlled substances, the SCRIPT transactions in scope, benefit and prior authorization checks, FHIR and EHR integration, and pharmacy-side systems. We give a fixed scope after one scoping call, before you commit.
Next step
Tell us your product, prescribers, pharmacy targets and whether you prescribe controlled substances. An integration engineer replies with the right route to the network and a fixed scope.
Send your details
Tell us about your product, the prescribers and pharmacies involved and the workflow you need. Please do not send patient data.
