Tip: Submitting Entity Merge - 60054A, 99CAR1 (PBM) RESOLVED
- Kenley Money
- Ashley Sigler
Number | 0066 |
|---|---|
Submitting Entity (SE) | 60054A, 99CAR1 |
Add Date | Feb 19, 2021 |
Update Date | May 17, 2022 |
Update | Included in May 2022 Data Tip email |
Description | Out of ~14k distinct member IDs in Aetna (60054A) orphaned pharmacy claims (have no corresponding member record), ~5k were found in Aetna’s PBM, Caremark (99CAR1). To join Aetna’s pharmacy data to Caremark members, use ME117 = PC108 and ME010 = PC009. |
Active/Resolved | Resolved |
Action / Resolution | Caremark resubmitted its data in 2024 with updated member IDs (ME107) and subscriber IDs (ME117) therefore this workaround no longer works. This issue is present in data prior to 2019. This workaround is still relevant for older data requests prior to 2024. Issue: Orphaned Pharmacy Claims - 60054A - Support: APCD Data Requests - ACHI Confluence |
Category 1 | Merged SE & Overlap |
Category 2 | PBM |
Tip / Issue | Tip |