Data Pkg 6 - MOP Utilization.xlsx

XLSX spreadsheet 12 KB Posted

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

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This draft request for proposal from the Defense Health Agency concerns pharmacy services for the fifth generation of TRICARE, known as TPharm5. The agency anticipates an 18-month transition period followed by seven 1-year option periods for health care delivery and a potential 6-month extension. The RFP seeks a contractor to provide fixed unit price pharmacy services to TRICARE beneficiaries, including specialty pharmacy, retail network access, care coordination, patient safety notifications, and quality control. The agency encourages interested vendors to review and provide feedback on key sections of the draft RFP by January 17, 2020. A formal solicitation may be issued in mid-2020, with any updates posted to Beta.SAM.gov. An information session on the draft RFP was held on December 11, 2019.

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TPharm5 Draft RFP Info Session 20191211.pdf PDF
Data Pkg 2 - Retail Utilization by Drug.xlsx XLSX spreadsheet
Attachment L-9.8 PA_ST_QL List.XLSX XLSX spreadsheet
Data Pkg 15 IHS_Pharmacy_Claims_Volume_2017_&_2018.xlsx XLSX spreadsheet
Data Pkg 3 TRICARE Retail Pharmacy Claim Volume.xlsx XLSX spreadsheet
Attachment L-9.4 Covered OTC List - MHS GENESIS.xlsx XLSX spreadsheet
Attachment L-10 Small Business Participation Plan.docx DOCX document
TPharm5 Draft Section J 20191127.docx DOCX document
Data Pkg 8 Mail and Retail Monthly Utilizers.xlsx XLSX spreadsheet
Attachment J-1 Definitions.DOCX DOCX document
TPharm5 Draft Section M 20191202.docx DOCX document
Attachment L-9.6 Self-Admin Injectables List.xlsx XLSX spreadsheet
Attachment L-19 Past Performance Questionnaire Template Tab F 20191120.docx DOCX document
Attachment L-3 Specialty Reimbursement for Use in Determining Incentiv....docx DOCX document
Attachment L-9 Benefit Design Document_TPharm5.xlsx XLSX spreadsheet
Data Pkg 14 Retail Claims with COB.xlsx XLSX spreadsheet
Attachment L-9.5 Non-Formulary List.xlsx XLSX spreadsheet
Data Pkg 5 MOP Utilization by Drug.xlsx XLSX spreadsheet
Data Pkg 25 - OHI Development.xlsx XLSX spreadsheet
Data Pkg 22 - Paid Claims and Rejects - Retail.xlsx XLSX spreadsheet
TPharm5 Draft Section C 20191202.docx DOCX document
Attachment L-5 Guaranty_Agreement.pdf PDF
Attachment L-13 VA_Pharmacy_Listing_2019.xlsx XLSX spreadsheet
Data Pkg 19 Historical_TMDS_Volume_2017-2018.xlsx XLSX spreadsheet
Attachment L-1.1 List of Data Packages.docx DOCX document
Data Pkg 13 - MTF Claims Volumes by Site.xlsx XLSX spreadsheet
TPharm5 Draft Section I 20191120.docx DOCX document
Attachment L-19.1 PPI Tool Instructions.docx DOCX document
Attachment L-9.3 Covered OTCs - Purchased Care.xlsx XLSX spreadsheet
Attachment J-5 TPharm5 Award Fee Plan 20191122.docx DOCX document
TPharm5 Draft Section D 20191120.docx DOCX document
Attachment L-12 IHS_Pharmacy_Listing_2019.xlsx XLSX spreadsheet
TPharm5 Draft Section E 20191120.docx DOCX document
Attachment L-18 CDRL Supplemental Bid Schedule.xlsx XLSX spreadsheet
Data Pkg 7 Specialty Drug Utilization, Retail and Mail.xlsx XLSX spreadsheet
Data Pkg 16 VA_VA CHDR Volume.xlsx XLSX spreadsheet
TPharm5 Draft Section H 20191121.docx DOCX document
Attachment L-7 Teaming Subcontractor Consent Ltr.docx DOCX document
Attachment L-2 Retail Network Reimbursement Table.docx DOCX document
Attachment L-4 Negotiated Specialty Retail Replenished Dispensing Fees.docx DOCX document
Tpharm5 Draft Section G 20191202.docx DOCX document
Data Pkg 10 - Compound Utilizers.xlsx XLSX spreadsheet
TPharm5 Draft Section F 20191202.docx DOCX document
Data Pkg 21 Enrolled Beneficiary Population.xlsx XLSX spreadsheet
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CY 2017 - 2018

FOR OFFICIAL USE ONLY
Title: Mail Order Workoad by NCPDP/NPI #2
Date Range: 1/1/2017 - 12/31/2018
Month Date1/31/172/28/173/31/174/30/175/31/176/30/177/31/178/31/179/30/1710/31/1711/30/1712/31/171/31/182/28/183/31/184/30/185/31/186/30/187/31/188/31/189/30/1810/31/1811/30/1812/31/18
Pharmacy NameNCPDP #NPI #2# Rx# Rx# Rx# Rx# Rx# Rx# Rx# Rx# Rx# Rx# Rx# Rx# Rx# Rx# Rx# Rx# Rx# Rx# Rx# Rx# Rx# Rx# Rx# Rx
EXPRESS SCRIPTS03273171649352006935,690853,796937,210665,045857,679870,000779,208620,862578,310579,723566,049541,700585,014513,572500,034505,556480,486426,543461,562452,345401,746450,744433,785413,725
EXPRESS SCRIPTS15627601063645026321221158162561486
EXPRESS SCRIPTS262373515584439111,637,7821,499,7581,739,4601,748,0711,806,8951,698,7171,716,4752,043,6321,912,5901,997,7781,964,2691,874,1772,009,2951,801,1901,712,9161,773,2941,884,1441,687,1711,818,2961,837,8531,620,9971,829,1921,712,9311,650,534
EXPRESS SCRIPTS314842314173767651336151151
EXPRESS SCRIPTS3650442124525121421151
EXPRESS SCRIPTS Total2,573,4722,353,5542,676,6702,413,1162,664,5742,568,7172,495,6832,664,4942,490,9002,577,5042,530,3222,415,8782,594,3102,314,7652,212,9562,278,8612,364,6382,113,7282,279,8752,290,2282,022,7502,279,9562,146,7302,064,266

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