Tip: Using CareMark data

Number

0146

Submitting Entity (SE)

99CAR1

Add Date

Jan 17, 2024

Update Date

 

Update

Included in January 2024 data tips email

Description

Though Caremark is considered a pharmacy benefits manager, it is possible that in some instances it can participate like a fully insured plan not as a PBM. At this time, there is no indicator in the claims or member data to make this distinction.

 

Redefined field - ME001_CAT (PAYER_TYPE)

Active/Resolved

Active

Action / Resolution

 

Category 1

PBM

Category 2

Pharmacy

Tip / Issue

Tip