Data Pkg 14 Retail Claims with COB.xlsx

XLSX spreadsheet 14 KB Posted

Attached to
DRAFT RFP TRICARE Pharmacy Services, 5th Generation (TPharm5) Federal contract opportunity
Solicitation number
HT940220R0002
Issued by
Defense Health Agency

About this file

Written by GovTribe AI ·

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.

View the file

Other files for this federal contract opportunity

Other files attached to DRAFT RFP TRICARE Pharmacy Services, 5th Generation (TPharm5), newest first.
File Type Posted
QA CAS Applicability Specific Clauses (May 15 2020).pdf PDF
Responses to Industry on Revised Draft Section C 20200504.pdf PDF
TPharm5 - Overview of Changes to Draft Section C.DOCX DOCX document
DHA Responses to Industry on Draft RFP 20200318.pdf PDF
Data Pkg 7 Specialty Drug Utilization, Retail and Mail.xlsx XLSX spreadsheet
Attachment J-5 TPharm5 Award Fee Plan 20191122.docx DOCX document
Data Pkg 5 MOP Utilization by Drug.xlsx XLSX spreadsheet
Data Pkg 23 - Paid Claims and Rejects - MHS GENESIS.xlsx XLSX spreadsheet
Data Pkg 22 - Paid Claims and Rejects - Retail.xlsx XLSX spreadsheet
Data Pkg 24 - CHCBP Volume.xlsx XLSX spreadsheet
Attachment L-9.6 Self-Admin Injectables List.xlsx XLSX spreadsheet
Attachment L-9.7 Expanded Use of MTF and TMOP List.xlsx XLSX spreadsheet
Attachment L-18 CDRL Supplemental Bid Schedule.xlsx XLSX spreadsheet
Attachment L-1 Ordering Instructions for Data Files not on SAM.gov.docx DOCX document
TPharm5 Draft Section L 20191202.docx DOCX document
Data Pkg 25 - OHI Development.xlsx XLSX spreadsheet
Attachment L-9.5 Non-Formulary List.xlsx XLSX spreadsheet
Data Pkg 9 Customer_Service_Volume.xlsx XLSX spreadsheet
Data Pkg 16 VA_VA CHDR Volume.xlsx XLSX spreadsheet
Data Pkg 13 - MTF Claims Volumes by Site.xlsx XLSX spreadsheet
Attachment L-3 Specialty Reimbursement for Use in Determining Incentiv....docx DOCX document
Attachment L-9 Benefit Design Document_TPharm5.xlsx XLSX spreadsheet
Attachment L-2 Retail Network Reimbursement Table.docx DOCX document
TPharm5 Draft RFP READ FIRST 20191202.docx DOCX document
Tpharm5 Draft Section G 20191202.docx DOCX document
Attachment L-8 MMC Sample File.xlsx XLSX spreadsheet
Attachment L-9.8 PA_ST_QL List.XLSX XLSX spreadsheet
Attachment L-4 Negotiated Specialty Retail Replenished Dispensing Fees.docx DOCX document
Attachment L-9.9 Fluoride Products List.xlsx XLSX spreadsheet
Attachment L-12 IHS_Pharmacy_Listing_2019.xlsx XLSX spreadsheet
Data Pkg 15 IHS_Pharmacy_Claims_Volume_2017_&_2018.xlsx XLSX spreadsheet
TPharm5 Draft Section E 20191120.docx DOCX document
TPharm5 Draft Section D 20191120.docx DOCX document
Attachment L-1.1 List of Data Packages.docx DOCX document
Attachment L-19 Past Performance Questionnaire Template Tab F 20191120.docx DOCX document
Attachment J-2 Acronym List.docx DOCX document
Attachment J-3 Website Links.docx DOCX document
Attachment L-5 Guaranty_Agreement.pdf PDF
Attachment L-7 Teaming Subcontractor Consent Ltr.docx DOCX document
Attachment L-9.3 Covered OTCs - Purchased Care.xlsx XLSX spreadsheet
Attachment L-19.1 PPI Tool Instructions.docx DOCX document
Data Pkg 3 TRICARE Retail Pharmacy Claim Volume.xlsx XLSX spreadsheet
TPharm5 Draft Section C 20191202.docx DOCX document
Data Pkg 6 - MOP Utilization.xlsx XLSX spreadsheet
Attachment L-13 VA_Pharmacy_Listing_2019.xlsx XLSX spreadsheet
Attachment L-1.2 Non-Disclosure Agreement.docx DOCX document
Data Pkg 21 Enrolled Beneficiary Population.xlsx XLSX spreadsheet
TPharm5 Draft Section H 20191121.docx DOCX document
Data Pkg 10 - Compound Utilizers.xlsx XLSX spreadsheet
TPharm5 Draft Section I 20191120.docx DOCX document
Show all 50

DRAFT RFP TRICARE Pharmacy Services, 5th Generation (TPharm5) has more files on GovTribe.

On GovTribe

Work with this file on GovTribe

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file
Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

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%

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