jagomart
digital resources
picture1_Excel Sheet Download 6313 | Pbmattachm Standardrptformats - Standar Format


 223x       Filetype XLS       File size 0.13 MB       Source: dbm.maryland.gov


File: Excel Sheet Download 6313 | Pbmattachm Standardrptformats - Standar Format
their proposal vendor name tier 1 tier 2 tier 3 retail scripts quarterly  ...

icon picture XLS Filetype Excel XLS | Posted on 22 Jun 2022 | 3 years ago

Related files



picture_Nutrition Facts Pdf 134954 | Directory Format Annuaire Format Eng
Nutrition Facts Pdf 134954 | Directory Format Annuaire...
picture_Excel Sheet Download 11496 | 2022 Application Form R2 1 | Sample Application
Excel Sheet Download 11496 | 2022 Application Form R2 1...
picture_Piano Pdf 91323 | Javamafegoxiloj
Piano Pdf 91323 | Javamafegoxiloj
picture_Nutrition Therapy Pdf 142274 | Compendium Of Label Styles
Nutrition Therapy Pdf 142274 | Compendium Of Label Styles
picture_02week Excel
02week Excel
picture_Microsoft Excel Tutorial Pdf 46356 | Sum Examples
Microsoft Excel Tutorial Pdf 46356 | Sum Examples
Partial file snippet. 
Sheet 1: M-1_Retail Util Schedule


	
	
	
	
	

		State of Maryland
		

		

		

		

		

		

		

	

	

		ATTACHMENT M-1: Utilization and Cost Schedule
		

		

		

		

		

		

		

	

	

		

		

		

		

		

		

		

		

	

	

		The purpose of Attachment M is to provide each Offeror with the templates which are to be used by the Contractor in providing the State with required reporting.  Please note that the Offeror is not required to populate and submit these reporting templates with their proposal.
		

		

		

	

	

		

		

		

		

		

		

		

		

	

	

		

		

		

		

		

		

		

		

	

	

		Vendor Name
		

		

		

		

		

		

		

	

	

		

		

		

		

		

		

		

		

	

	

		

		

		

		

		

		

		

		

	

	

		

		

		Tier 1
		Tier 2
		Tier 3
		

	

		

		Retail Scripts
		Quarterly Results
		Quarterly Results
		Quarterly Results
		

	

		

		Enter start date:
		

		

		

		

		

		

	

	

		

		Enter end date:
		

		

		

		

		

		

	

	

		

		Service
		

		

		

		

		

		

	

	

		Single Source
		

		Generic Tier 1
		Brand Tier 1
		Generic Tier 2
		Brand Tier 2
		Generic Tier 3
		Brand Tier 3
	

	

		a.
		Total AWP
		

		

		

		

		

		

	

	

		b.
		Total Discounted Ingredient Cost
		

		

		

		

		

		

	

	

		c.
		Total Dispensing Fees
		

		

		

		

		

		

	

	

		d.
		Total Administrative Fees
		

		

		

		

		

		

	

	

		e.
		Total Sales Tax
		

		

		

		

		

		

	

	

		f.
		Total Member Cost
		

		

		

		

		

		

	

	

		g.
		Total State Cost
		

		

		

		

		

		

	

	

		h.
		Total Number of Scripts
		

		

		

		

		

		

	

	

		I.
		Total Number of Scripts <46 day Supply
		

		

		

		

		

		

	

	

		j.
		Total Number of Scripts >45 day Supply
		

		

		

		

		

		

	

	

		k.
		Total Number of New Scripts
		

		

		

		

		

		

	

	

		l.
		Total Number of Refills
		

		

		

		

		

		

	

	

		m.
		Total Quantity Dispensed
		

		

		

		

		

		

	

	

		n.
		Total Days Supply
		

		

		

		

		

		

	

	

		o.
		Total Number of Unique Utilizers
		

		

		

		

		

		

	

	

		Multi-Source
		

		Generic Tier 1
		Brand Tier 1
		Generic Tier 2
		Brand Tier 2
		Generic Tier 3
		Brand Tier 3
	

	

		a.
		Total AWP
		

		

		

		

		

		

	

	

		b.
		Total Discounted Ingredient Cost
		

		

		

		

		

		

	

	

		c.
		Total Dispensing Fees
		

		

		

		

		

		

	

	

		d.
		Total Administrative Fees
		

		

		

		

		

		

	

	

		e.
		Total Sales Tax
		

		

		

		

		

		

	

	

		f.
		Total Member Cost
		

		

		

		

		

		

	

	

		g.
		Total State Cost
		

		

		

		

		

		

	

	

		h.
		Total Number of Scripts
		

		

		

		

		

		

	

	

		I.
		Total Number of Scripts <46 day Supply
		

		

		

		

		

		

	

	

		j.
		Total Number of Scripts >45 day Supply
		

		

		

		

		

		

	

	

		k.
		Total Number of New Scripts
		

		

		

		

		

		

	

	

		l.
		Total Number of Refills
		

		

		

		

		

		

	

	

		m.
		Total Quantity Dispensed
		

		

		

		

		

		

	

	

		n.
		Total Days Supply
		

		

		

		

		

		

	

	

		o.
		Total Number of Unique Utilizers
		

		

		

		

		

		

	






Sheet 2: M-2_Mail Util Schedule


	
	
	
	
	
	

		State of Maryland
		

		

		

		

		

		

		

		

		

		

	

	

		ATTACHMENT M-2: Utilization and Cost Schedule
		

		

		

		

		

		

		

		

		

		

	

	

		

		

		

		

		

		

		

		

		

		

		

	

	

		The purpose of Attachment M is to provide each Offeror with the templates which are to be used by the Contractor in providing the State with required reporting.  Please note that the Offeror is not required to populate and submit these reporting templates with their proposal.
		

		

		

		

		

		

	

	

		

		

		

		

		

		

		

		

		

		

		

	

	

		

		

		

		

		

		

		

		

		

		

		

	

	

		Vendor Name
		

		

		

		

		

		

		

		

		

		

	

	

		

		

		

		

		

		

		

		

		

		

		

	

	

		

		

		

		

		

		

		

		

		

		

		

	

	

		

		

		Tier 1
		Tier 2
		Tier 3
		

		

		

	

	

		

		Mail Order Scripts
		Quarterly Results
		Quarterly Results
		Quarterly Results
		

		

		

	

	

		

		Enter start date:
		

		

		

		

		

		

		

		

		

	

	

		

		Enter end date:
		

		

		

		

		

		

		

		

		

	

	

		

		Service
		

		

		

		

		

		

		

		

		

	

	

		Single Source
		

		Generic Tier 1
		Brand Tier 1
		Generic Tier 2
		Brand Tier 2
		Generic Tier 3
		Brand Tier 3
		

		

		

	

	

		a.
		Total AWP
		

		

		

		

		

		

		

		

		

	

	

		b.
		Total Discounted Ingredient Cost
		

		

		

		

		

		

		

		

		

	

	

		c.
		Total Dispensing Fees
		

		

		

		

		

		

		

		

		

	

	

		d.
		Total Administrative Fees
		

		

		

		

		

		

		

		

		

	

	

		e.
		Total Sales Tax
		

		

		

		

		

		

		

		

		

	

	

		f.
		Total Member Cost
		

		

		

		

		

		

		

		

		

	

	

		g.
		Total State Cost
		

		

		

		

		

		

		

		

		

	

	

		h.
		Total Number of Scripts
		

		

		

		

		

		

		

		

		

	

	

		I.
		Total Number of Scripts <46 day Supply
		

		

		

		

		

		

		

		

		

	

	

		j.
		Total Number of Scripts >45 day Supply
		

		

		

		

		

		

		

		

		

	

	

		k.
		Total Number of New Scripts
		

		

		

		

		

		

		

		

		

	

	

		l.
		Total Number of Refills
		

		

		

		

		

		

		

		

		

	

	

		m.
		Total Quantity Dispensed
		

		

		

		

		

		

		

		

		

	

	

		n.
		Total Days Supply
		

		

		

		

		

		

		

		

		

	

	

		o.
		Total Number of Unique Utilizers
		

		

		

		

		

		

		

		

		

	

	

		Multi-Source
		

		Generic Tier 1
		Brand Tier 1
		Generic Tier 2
		Brand Tier 2
		Generic Tier 3
		Brand Tier 3
		

		

		

	

	

		a.
		Total AWP
		

		

		

		

		

		

		

		

		

	

	

		b.
		Total Discounted Ingredient Cost
		

		

		

		

		

		

		

		

		

	

	

		c.
		Total Dispensing Fees
		

		

		

		

		

		

		

		

		

	

	

		d.
		Total Administrative Fees
		

		

		

		

		

		

		

		

		

	

	

		e.
		Total Sales Tax
		

		

		

		

		

		

		

		

		

	

	

		f.
		Total Member Cost
		

		

		

		

		

		

		

		

		

	

	

		g.
		Total State Cost
		

		

		

		

		

		

		

		

		

	

	

		h.
		Total Number of Scripts
		

		

		

		

		

		

		

		

		

	

	

		I.
		Total Number of Scripts <46 day Supply
		

		

		

		

		

		

		

		

		

	

	

		j.
		Total Number of Scripts >45 day Supply
		

		

		

		

		

		

		

		

		

	

	

		k.
		Total Number of New Scripts
		

		

		

		

		

		

		

		

		

	

	

		l.
		Total Number of Refills
		

		

		

		

		

		

		

		

		

	

	

		m.
		Total Quantity Dispensed
		

		

		

		

		

		

		

		

		

	

	

		n.
		Total Days Supply
		

		

		

		

		

		

		

		

		

	

	

		o.
		Total Number of Unique Utilizers
		

		

		

		

		

		

		

		

		

	






Sheet 3: M-3_Specialty Util Schedule


	
	
	
	
	

		State of Maryland
		

		

		

		

		

		

		

	

	

		ATTACHMENT M-3: Utilization and Cost Schedule
		

		

		

		

		

		

		

	

	

		

		

		

		

		

		

		

		

	

	

		The purpose of Attachment M is to provide each Offeror with the templates which are to be used by the Contractor in providing the State with required reporting.  Please note that the Offeror is not required to populate and submit these reporting templates with their proposal.
		

		

		

	

	

		

		

		

		

		

		

		

		

	

	

		

		

		

		

		

		

		

		

	

	

		Vendor Name
		

		

		

		

		

		

		

	

	

		

		

		

		

		

		

		

		

	

	

		

		

		Tier 1
		Tier 2
		Tier 3
		

	

		

		Specialty Scripts
		Quarterly Results
		Quarterly Results
		Quarterly Results
		

	

		

		Enter start date:
		

		

		

		

		

		

	

	

		

		Enter end date:
		

		

		

		

		

		

	

	

		

		Service
		

		

		

		

		

		

	

	

		Single Source
		

		Generic Tier 1
		Brand Tier 1
		Generic Tier 2
		Brand Tier 2
		Generic Tier 3
		Brand Tier 3
	

	

		a.
		Total AWP
		

		

		

		

		

		

	

	

		b.
		Total Discounted Ingredient Cost
		

		

		

		

		

		

	

	

		c.
		Total Dispensing Fees
		

		

		

		

		

		

	

	

		d.
		Total Administrative Fees
		

		

		

		

		

		

	

	

		e.
		Total Sales Tax
		

		

		

		

		

		

	

	

		f.
		Total Member Cost
		

		

		

		

		

		

	

	

		g.
		Total State Cost
		

		

		

		

		

		

	

	

		h.
		Total Number of Scripts
		

		

		

		

		

		

	

	

		I.
		Total Number of Scripts <46 day Supply
		

		

		

		

		

		

	

	

		j.
		Total Number of Scripts >45 day Supply
		

		

		

		

		

		

	

	

		k.
		Total Number of New Scripts
		

		

		

		

		

		

	

	

		l.
		Total Number of Refills
		

		

		

		

		

		

	

	

		m.
		Total Quantity Dispensed
		

		

		

		

		

		

	

	

		n.
		Total Days Supply
		

		

		

		

		

		

	

	

		o.
		Total Number of Unique Utilizers
		

		

		

		

		

		

	

	

		Multi-Source
		

		Generic Tier 1
		Brand Tier 1
		Generic Tier 2
		Brand Tier 2
		Generic Tier 3
		Brand Tier 3
	

	

		a.
		Total AWP
		

		

		

		

		

		

	

	

		b.
		Total Discounted Ingredient Cost
		

		

		

		

		

		

	

	

		c.
		Total Dispensing Fees
		

		

		

		

		

		

	

	

		d.
		Total Administrative Fees
		

		

		

		

		

		

	

	

		e.
		Total Sales Tax
		

		

		

		

		

		

	

	

		f.
		Total Member Cost
		

		

		

		

		

		

	

	

		g.
		Total State Cost
		

		

		

		

		

		

	

	

		h.
		Total Number of Scripts
		

		

		

		

		

		

	

	

		I.
		Total Number of Scripts <46 day Supply
		

		

		

		

		

		

	

	

		j.
		Total Number of Scripts >45 day Supply
		

		

		

		

		

		

	

	

		k.
		Total Number of New Scripts
		

		

		

		

		

		

	

	

		l.
		Total Number of Refills
		

		

		

		

		

		

	

	

		m.
		Total Quantity Dispensed
		

		

		

		

		

		

	

	

		n.
		Total Days Supply
		

		

		

		

		

		

	

	

		o.
		Total Number of Unique Utilizers
The words contained in this file might help you see if this file matches what you are looking for:

...Sheet m retail util schedule state of maryland attachment utilization and cost the purpose is to provide each offeror with templates which are be used by contractor in providing required reporting please note that not populate submit these their proposal vendor name tier scripts quarterly results enter start date end service single source generic brand a total awp b discounted ingredient c dispensing fees d administrative e sales tax f member g h number i lt day supply j gt k new l refills quantity dispensed n days o unique utilizers multisource mail order specialty...

Share

https://contohsurat.jagomart.net/item/7637/standar-format-pbmattachm-standardrptformats-standar-format

no reviews yet
Please Login to review.

Category: Standard Format / Excel Format
Posted on: 22 Jun 2022 | 3 years ago
Tag: download xls, download file Excel Format, Standar Format, 1655940601, pbmattachm, standardrptformats, standar, format,
Filetype: XLS
File size: 0.13 MB
Views: 223x
Link recommended: filekonstruksi.com