Manual claims will not be accepted. Claims must be submitted online and include the following information:
| Field | Information Required |
| Carrier ID | NB |
| Group Number or Code | J (Note: this also applies to New Brunswick Drug Plans beneficiaries.) |
| Client ID | Patient’s NB Medicare number. (Note: this also applies to New Brunswick Drug Plans beneficiaries.) |
| Patient Code |
Leave blank |
| Patient Name |
Patient's first and last name |
| Patient DOB |
Patient's date of birth |
| Prescriber ID | Prescriber’s license or registration number (see below) |
| Prescriber ID Reference Code | Code identifying a prescriber’s licensing body (see below) |
| DIN / PIN | Drug Identification Number / Product Identification Number. See eligible benefits below. |
| Drug Cost / Product Value | Please refer to Dispensing Fees and Drug Cost Reimbursement |
| Cost Upcharge | Please refer to Dispensing Fees and Drug Cost Reimbursement |
| Professional Fee | Please refer to Dispensing Fees and Drug Cost Reimbursement |