Tip: PBM/Pharmacy Carrier Overlap





Number

0027

Submitting Entities

80799

Add Date

Jul 11, 2019

Update Date

 Aug 17, 2022

Update

 

Description

Pharmacy claims received from both the submitting entity and its PBM.  This gives the researcher the opportunity to examine the same prescription claims from both sources, providing some insight into the differences between the PBM and pharmacy information.  

Action / Resolution

These claim line pairs can be identified by joining pharmacy claims with submitting entity ID 99CAR1 and 80799 by claim number (PC004) and prescription fill date (PC032). 

Category 1

Merged SE & Overlap

Category 2

PBM

Tip / Issue

Tip