Authorization Number : 50750281
Agency Series No. : 2020-00-04
Status : Active
Agency Web Link :
Agency : ODM
Confidential Description : Protected Health Information (PHI) as defined by HIPAA.
Division : ODMHINQ
Vital Description : Pharmacy claims and prior authorization historical data required to process future pharmacy claims.
Section : ODMHINQ
Record Title : SPBM Pharmacy Program Data
Revision : 0
Record Description : All electronic and paper records associated with Single Pharmacy Benefit Manager (SPBM) Contractor administration of pharmacy benefits, including claims, prior authorizations, eligibility, customer service records, clinical data and data received from managed care organizations