Attachment 15 - Reversal Payment Reconciliation.xlsx

XLSX spreadsheet 10 KB Posted

Attached to
R408--FY24 IVC PHARMACY BENEFIT MANAGER
Solicitation number
36C79123R0007
Issued by

About this file

This spreadsheet attachment outlines reversal payments for a pharmacy benefit manager solicitation. The spreadsheet will track reversal files submitted through Pay.gov with names, amounts returned, and a total. It currently lists three past determinations with a total return of $65,710.42. The related solicitation is from the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 19. Solicitation number 36C79123R0007 seeks a pharmacy benefit manager for its FY24 Integrated Veterans Community Pharmacy program.

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Other files

File Type Posted
36C79123R0007 0003 9-25-23.docx DOCX document
36C79123R0007 0003.docx DOCX document
Attachment 12 - Pricing Worksheet revised 9-25-23.xlsx XLSX spreadsheet
Attachment 16 - NASP Definitions of Specialty Pharmacy and Specialty Medications.pdf PDF
36C79123R0007 0002 9-25-23.docx DOCX document
36C79123R0007 0001 9-11-2023.docx DOCX document
36C79123R0007 0001_1.docx DOCX document
Attachment 1 - Eligibility Primary Status Secondary Response Reversal and Reversal Response Formats updated 6-8-23.pdf PDF
Attachment 9 - Quality Assurance Surveillance Plan 7-20-2023.pdf PDF
Attachment 13- Labor Wage Determination 2015-5419 7-25-2023.pdf PDF
Attachment 2 - Override Procedures updated 6-21-2023.pdf PDF
Attachment 6 - FY22 NDC Listing.xlsx XLSX spreadsheet
Attachment 3 - Excluded Items.pdf PDF
Attachment 8- Small Business Subcontracting Plan.docx DOCX document
Attachment 4 - FY22 Zip Codes.xlsx XLSX spreadsheet
Attachment 14 - Authority to Operate.docx DOCX document
Attachment 12 - Pricing Worksheet final 8-9-23.xlsx XLSX spreadsheet
36C79123R0007 9-05-23 final.docx DOCX document
Attachment 5 - Adjudication and Recoupment Process Maps updated 6-8-2023.pdf PDF
Attachment 7 - Business Associate Agreement updated 6-8-2023.pdf PDF
Attachment 10 - Past Performance References.docx DOCX document
Attachment 11 - Past Performance Questionnaire.docx DOCX document
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Text version

Sheet1

When a reversal check is submitted to pay.gov, this spreadsheet will be filled out with the reversal file name and the amount returned with a total returned at the end.
REVERSAL FILE NAMEAMOUNT RETURNED
Determined at Contract Award17289.42
Determined at Contract Award32785.48
Determined at Contract Award15635.52
Total Returned65710.42

File details come from the government source that posted it. Updated .