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N917 Remark Code: Alternative Refund, MFP Below 340B

N917 means the manufacturer calculated an alternative refund amount for this 340B-eligible claim because the maximum fair price (MFP) is lower than the 340B ceiling price. A refund is owed, but not the standard default amount. It is used only in the Medicare Drug Price Negotiation Program.

Quick facts

Code
N917 (RARC N917)
Status
Active In use since March 1, 2026.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): Where shown, the difference between the standard default refund and the alternative refund. It is not billable to the Medicare patient.
Official description
Alternative refund amount has been calculated because the maximum fair price is below the 340B ceiling price.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N917 means

When a drug in the Medicare Drug Price Negotiation Program is dispensed to a Part D patient under 340B, two discounts could apply: the 340B ceiling price and the maximum fair price. Manufacturers do not have to give both. The lower price wins.

N917 covers the case where the MFP is lower than the 340B ceiling price. The manufacturer must still make the MFP available, so it pays a refund. Because the unit was bought at a 340B price rather than list price, the refund is calculated differently from the standard WAC-minus-MFP formula.

Compare that with N907, which applies when the 340B price is already lower and no refund is due.

What to do

  1. Confirm the 340B status of the fill with your 340B records or third-party administrator.
  2. Check the refund math against your actual acquisition cost and the MFP.
  3. Post the refund and note it was calculated under the 340B alternative method.
  4. Dispute discrepancies with the manufacturer through the program’s process, with invoices.
  5. Coordinate with contract pharmacies so refunds and 340B replenishment are not double-counted.

Codes that may appear with N917

  • CO-307 (Medicare Maximum Fair Price Standard Default Refund Amount Adjustment.): The standard default refund adjustment, replaced here by an alternative amount.
  • N907 (No refund because this claim has been identified as 340B-eligible with a ceiling price lower than the maximum fair price.): The reverse situation: the 340B price is lower, so no MFP refund is owed.
  • N909 (Refund amount has been calculated using a methodology that differs from the Standard Default Refund Amount calculation ((Wholesale Acquisition Cost…): A non-standard refund calculation for reasons other than 340B.
  • N908 (No refund because this drug has been prospectively purchased at the maximum fair price.): No refund because the drug was bought at the MFP.

N917 FAQ

Why is the refund not the standard amount?

The standard formula assumes the pharmacy bought the drug at wholesale acquisition cost. A 340B-eligible unit was bought at or near the 340B price, so the manufacturer adjusts the refund to reflect that lower starting point.

Who sees N917?

Dispensing entities, such as 340B covered entity pharmacies and contract pharmacies, that dispense selected drugs to Medicare Part D patients.

How do I verify it?

Compare the refund with the difference between your actual acquisition cost for the units and the MFP, and ask the manufacturer for its calculation if the gap is unclear.