Report Form

Suspected Errors in the Return of Prescription Copies for Clarification: Report Form

Contact Name
Telephone Number
Contractor Code (F Code)
Email Address
Name of Pharmacy IT System

Prescription item exactly as written on the prescription (including dose and quantity)	Endorsement exactly as written on the prescription	NHSBSA PPD reason Code for Return*

*NHSBSA PPD reason codes

RB1: Order not listed in Part VIII of the Drug Tariff, endorsement information required
RB2: The order/endorsement is incomplete
RB3: Unable to determine exactly what was prescribed/supplied
DA1: Product in Part XVIIIA of the Drug Tariff
DA2: Non-listed Appliance or Chemical reagent
DA3: The Nurse Prescriber may not prescribe this item
DA4: The Dental Practitioner may not prescribe this item
DA6: Product can’t be prescribed on Form FP10MDA

Click here for a word version of the reporting form.