MedicaidAdministrativeMedium impact
Changes to Pharmacy 835 PLB Segment
Illinois Medicaid - HFS·IL · Pharmacy·Provider Notice
Effective date
May 1, 2010
We identified it
Jun 21, 2026
Summary
Illinois Department of Healthcare and Family Services is changing the format of Electronic Remittance Advice (835) PLB segments for pharmacy claims to include Prescription Number and Date of Service instead of Adjustment Document Control Numbers. This change is designed to help pharmacies better match adjustments to original claims in their systems.
Action Required
Before May 1, 2010: Billing team must provide this notice to Information Systems department or software vendor immediately. Contact software vendor to ensure billing system can process the new PLB format that includes Prescription Number and Date of Service. For questions, contact Bureau of Pharmacy Services at 1-877-782-5565 Option 7.