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Tip - Using CareMark data

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Number

0146

Submitting Entity (SE)

99CAR1

Add Date

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

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