Draft_Data_Pkg_16_Historical_Federal_Ceiling_Price_(FCP)_Dispute_Volume_(May_22 _2013).xlsx

XLSX spreadsheet 12 KB Posted May 22, 2013

Attached to: TRICARE Pharmacy Program, Fourth Generation (TPharm4)
Solicitation number: HT9402-13-R-0001
Issued by: Defense Health Agency

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Draft Data Pkg 16_Historical Federal Ceiling Price (FCP) Dispute Volume (May 22 2013)

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Dispute Vol Manufacturer Disputes Submitted to Pharmacy Contractor

	CY 2010				CY 2011				CY 2012
	Q1	Q2	Q3	Q4	Q1	Q2	Q3	Q4	Q1	Q2	Q3
Utilization Disputes	27	29	38	99	142	119	125	145	224	130	104
OHI/COB Disputes	62	41	104	29	235	148	110	227	216	15	71

* Dispute Descriptions on the next tab.

Dispute Code Dispute Code Description

Dispute Code Descriptions

Utilization Disputes
L	Utilization/Quantity Inconsistent With Number Of Prescriptions
M	Utilization/Quantity Inconsistent With Historical Trends Or Current Program Information
N	Utilization/Quantity Inconsistent With Lowest Dispensable Package Size
O	Utilization/Quantity Exceeds Normal/Usual & Customary

OHI/COB Disputes
R	Duplicate Claim - Coordination of Benefit COB/OHI-Beneficiary Has Other Health Insurance (OHI)

File details come from the government source that posted it. Updated Oct 27, 2026.