Data Pkg 14 Retail Claims with COB.xlsx

XLSX spreadsheet 14 KB Posted

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DRAFT RFP TRICARE Pharmacy Services, 5th Generation (TPharm5)
Solicitation number
HT940220R0002
Issued by

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This document contains a draft request for proposals for the TRICARE Pharmacy Services, 5th Generation contract. The Defense Health Agency is seeking pharmacy services including retail, mail order, and specialty pharmacy for TRICARE beneficiaries. The anticipated contract would have an 18-month transition period and seven 1-year option periods, for a total potential performance period of 9 years. The draft RFP includes sections on contract line item structure, retail network access, compounded medications, care coordination, patient safety notifications, and quality control. Interested vendors are invited to provide feedback on the draft RFP by January 17th, 2020. The Defense Health Agency intends to issue a formal solicitation in mid-2020 and host an information session on the draft RFP on December 11th, 2019.

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2017 Data

FOR OFFICIAL USE ONLY
Title: Retail COB Claim Volume by Other Coverage Code
Date Range: 1/1/2017 - 12/31/2017
Retail COB Volume by OCC Code
Jan-17Feb-17Mar-17Apr-17May-17Jun-17Jul-17Aug-17Sep-17Oct-17Nov-17Dec-17Grand Total
Service Category (Claim)CobindicatorOther Coverage Code# RX# RX# RX# RX# RX# RX# RX# RX# RX# RX# RX# RX# RX
RetailYes02381,961369,314414,251384,033411,566396,116383,605395,577360,769380,522356,438353,1094,587,261
RetailYes0350,57945,25350,26345,68349,52746,70044,94348,77247,38450,45847,76347,746575,071
RetailYes04221,581202,884221,278199,303207,190192,993184,083189,801179,768181,899173,971178,4922,333,243
Grand Total654,121617,451685,792629,019668,283635,809612,631634,150587,921612,879578,172579,3477,495,575
Retail RX Volume
Jan-17Feb-17Mar-17Apr-17May-17Jun-17Jul-17Aug-17Sep-17Oct-17Nov-17Dec-17Grand Total
# RX# RX# RX# RX# RX# RX# RX# RX# RX# RX# RX# RX# RX
3,853,6013,598,8353,939,3293,524,1413,748,5363,560,4273,380,6613,638,4123,566,9113,855,4343,656,2423,682,92044,005,449
Retail COB Ratio to Total Retail Volume
Jan-17Feb-17Mar-17Apr-17May-17Jun-17Jul-17Aug-17Sep-17Oct-17Nov-17Dec-17Grand Total
16.97%17.16%17.41%17.85%17.83%17.86%18.12%17.43%16.48%15.90%15.81%15.73%17.03%

2018 Data

FOR OFFICIAL USE ONLY
Title: Retail COB Claim Volume by Other Coverage Code
Date Range: 1/1/2018 - 12/31/2018
Retail COB Volume by OCC Code
Jan-18Feb-18Mar-18Apr-18May-18Jun-18Jul-18Aug-18Sep-18Oct-18Nov-18Dec-18Grand Total
Service Category (Claim)CobindicatorOther Coverage Code# RX# RX# RX# RX# RX# RX# RX# RX# RX# RX# RX# RX# RX
RetailYes02392,441353,154382,398373,051380,267347,218364,275364,614328,890362,316337,181335,6164,321,421
RetailYes0354,17945,34446,70244,53746,04243,22944,42746,83544,65351,75747,53045,818561,053
RetailYes04229,355200,525212,276197,681197,768180,588178,745181,026161,811168,190156,422153,7262,218,113
Grand Total675,975599,023641,376615,269624,077571,035587,447592,475535,354582,263541,133535,1607,100,587
Retail RX Volume
Jan-18Feb-18Mar-18Apr-18May-18Jun-18Jul-18Aug-18Sep-18Oct-18Nov-18Dec-18Grand Total
# RX# RX# RX# RX# RX# RX# RX# RX# RX# RX# RX# RX# RX
4,073,8903,546,2373,707,5323,534,6123,644,0473,361,7063,435,8953,626,4823,496,5624,082,4383,700,5543,608,14843,818,103
Retail COB Ratio to Total Retail Volume
Jan-18Feb-18Mar-18Apr-18May-18Jun-18Jul-18Aug-18Sep-18Oct-18Nov-18Dec-18Grand Total
16.59%16.89%17.30%17.41%17.13%16.99%17.10%16.34%15.31%14.26%14.62%14.83%16.20%

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