Sam's Corner Collection

NEW Card-ENROLLED Specialty- SAM

Filters Filter Set
Carrier ID Not in 6680, 6683, 6697
Client Name Various
Specialty Indicator Specialty
Transaction Status Paid Paid
Date Filled QF
Label Name QF
Cardholder ID QF

All Clients Collection

All Clients - Exceeds Max Cost of $500
Filters Filter Set
Client Name Various
Plan Paid >= 500
Specialty Indicator Non-Specialty
Transaction Status Paid
Label Name QF
Date Filled QF
 CPC New Card-ENROLLED Specialty- SAM
Fields Filters Filter Set
Client Name Client Name CPC Logistics
Cardholder Id Specialty Indicator Specialty
Member Last Name Transaction Status Paid Paid
Member First Name Date Filled QF
DOB Label Name QF
Member Address 1 Cardholder ID QF
Member Address 2
Member City
Member State
Member Zip
Date Filled
Label Name
Generic Indicator
Avg Total Member Paid per Rx
Avg Plan Paid
Average Gross Cost per Rx
Days Supply
Metric Quantity
Most Common Indicator
GPI Name Level 1
Pharmacy Name
DataSource

0 All Clients - Specialty Rx Detail

Fields Filters Filter Set
Datasource Specialty Indicator Specialty
Date Filled Transaction Status Paid
Client Name Client Name QF
Label Name GPI Name QF
Average Total Member Paid Per Rx Label Name QF
Plan Paid
Average Gross Cost per Rx
Metric Quantity
Days Supply
Plan Paid per 30 day supply
Gross Cost per 30 day Supply
Cardholder ID
Member Last Name
Member First Name
DOB
Member Address 1
Member Address 2
Member City
Member State
Member Zip
Member Phone
GPI Name Level 1
Specialty Indicator 1
Transaction Status
-ENROLLED Specialty- SAM New Card-Net New Specialty- Sam
Fields Filters
Client Name Carrier ID
Cardholder Id Client Name
Member Last Name GPI Count
Member First Name Specialty Indicator
DOB Transaction Status Paid
Member Address 1 Date Filled
Member Address 2 Label Name
Member City Cardholder ID
Member State
Member Zip
Date Filled
Label Name
Generic Indicator
Avg Total Member Paid per Rx
Avg Plan Paid
Average Gross Cost per Rx
Days Supply
Metric Quantity
Most Common Indicator
GPI Name Level 1
Pharmacy Name

s - Specialty Rx Detail Enrolled All Clients - Specialty Rx Detail

Fields Filters
Datasource Specialty Copay Post-Imp
Date Filled Specialty Indicator
Client Name Transaction Status
Label Name Client Name
Average Total Member Paid Per Rx GPI Name
Plan Paid Label Name
Average Gross Cost per Rx
Days Supply
Metric Quantity
Cardholder ID
Member Last Name
Member First Name
DOB
Member Address 1
Member Address 2
Member City
Member State
Member Zip
Member Phone
GPI Name Level 1
Specialty Indicator 1
 New Card-Net New Specialty- Sam Enrolled High Coinsur Spec
Filter Set Fields Filters
Not in 6680, 6683, 6697 Client Name Carrier ID
Various Cardholder Id Client Name
<= 1 Member Last Name Specialty Indicator
Specialty Member First Name Transaction Status
Paid DOB Date Filled
QF Member Address 1 Cardholder ID
QF Member Address 2 Label Name
QF Member City GPI Name Level 1
Member State Pharmacist
Member Zip
Date Filled
Label Name
Generic Indicator
Avg Total Member Paid per Rx
Avg Plan Paid
Average Gross Cost per Rx
Days Supply
Metric Quantity
Most Common Indicator
GPI Name Level 1
Pharmacy Name

Enrolled All Clients - Specialty Rx Detail All clients - IMM Claims with Sav
Filter Set Fields Filters
Yes Datasource IMM Indicator Contains
Yes Date Filled Transaction Status
Paid Client Name Client Name
QF Label Name Date Filled
QF Average Total Member Paid Per Rx
QF Plan Paid
Average Gross Cost per Rx
Days Supply
Metric Quantity
Cardholder ID
Member Last Name
Member First Name
DOB
Member Address 1
Member Address 2
Member City
Member State
Member Zip
Member Phone
GPI Name Level 1
Specialty Indicator 1
 Enrolled High Coinsur Specialty - Sam Paid Excluded Specialty Drugs - S
Filter Set Fields Filters
Not in 6680, 6683, 6 Client Name Carrier ID
Various Cardholder Id Client Name
Specialty Member Last Name Specialty Indicator
Paid Member First Name Transaction Status
QF DOB Date Filled
QF Member Address 1 Cardholder ID
QF Member Address 2 Label Name
QF Member City GPI Name Level 1
QF Member State Pharmacist
Member Zip
Date Filled
Label Name
Generic Indicator
Avg Total Member Paid per Rx
Avg Plan Paid
Average Gross Cost per Rx
Days Supply
Metric Quantity
Pharmacy Name
Specialty Indicator
DataSource

Uses VPS All Claims Plus Rejects Dataset

All clients - IMM Claims with Savings Opportunity All clients - Rejected Rx Detai
Filter Set Fields Filters
Yes Datasource Transaction Status
Paid Date Filled
QF Client Name
QF Label Name
IMM Alternative Label Name
Cardholder ID
Member Last Name
Member First Name
DOB
Member Address 1
Member Address 2
Member City
Member State
Member Zip
Member Phone
Deductible Amount Applied
Plan Paid
Billed Copay
Gross Cost
IMM Alternative Cost
IMMSavings Per Fill
IMMPercent Savings
Days Supply
Metric Quantity
Transaction Status
 Uses VPS All Claims Plus Rejects Dataset
Paid Excluded Specialty Drugs - Sam Reject Exclud
Filter Set Fields Filters
Not in 6680, 6683, 6697 Datasource Carrier ID
Various Specialty Indicator Client Name
Specialty Client Name Specialty Indicator
Paid Cardholder ID Transaction Status
QF Member Last Name Date Filled
QF Member First Name Cardholder ID
QF DOB Label Name
QF Member Address 1 GPI Name Level 1
QF Member Address 2 Pharmacist
Member City
Member State
Member Zip
Date Filled
Label Name
GPI Name Level 1
Generic Indicator
Avg Total Member Paid per Rx
Avg Plan Paid
Average Gross Cost per Rx
Days Supply
Metric Quantity
Pharmacy Name

Claims Plus Rejects Dataset

All clients - Rejected Rx Detail Hig
Filter Set Fields Filters
Rejected Datasource Date Filled
Date Filled Days Supply
Client Name Generic Indicator
Cardholder ID Gross Cost
Member Last Name Transaction Status
Member First Name Label Name
DOB GPI Name Level 1
Member Address 1 Client Name
Member Address 2
Member City
Member State
Member Zip
Member Phone
Label Name
GPI Name Level 1
Specialty Indicator
Avg Gross Cost per Rx
Avg Plan Paid
Days Supply
Metric Quantity
jects Dataset
Reject Excluded Speialty Drugs - Sam
Filter Set Fields
Not in 6680, 6683, 6697 Datasource
Various Specialty Indicator
Specialty Client Name
Paid Cardholder ID
QF Member Last Name
QF Member First Name
QF DOB
QF Member Address 1
QF Member Address 2
Member City
Member State
Member Zip
Date Filled
Label Name
GPI Name Level 1
Generic Indicator
Avg Total Member Paid per Rx
Avg Plan Paid
Average Gross Cost per Rx
Days Supply
Metric Quantity
Pharmacy Name

High Cost Generic

Filter Set Fields
QF Datasource
<= 30 Date Filled
Generic Client Name
>= 500 Generic Indicator
Paid Label Name
QF NDC
QF Avg Total Member Paid Per Rx
QF Plan Paid
Average Gross Cost per Rx
Metric Quantity
Days Supply
Plan Paid per 30 day supply
Gross Cost per 30 day Supply
GPI Name Level 1
Cardholder ID
Member Last Name
Member First Name
DOB
Member Address 1
Member Address 2
Member City
Member State
Member Zip
Member Phone
GPI Name Level 1
Transaction Status
 Paid $1 Mandatory IMM - All Clients
Filters Filter Set
Client Name Various
Datasource Contains CVS, ESI
IMM Indicator Yes
NDC Does not contain 29033003106
Plan Paid >= 1
Transaction Status Paid
Date Filled QF

>1.5k Non-Specialty All Clients - All Paid Claims

Filters Filter Set
Gross Cost >= 1,500
Specialty Indicator Non-Specialty
Transaction Status Paid
Label Name QF
GPI Level 1 QF
Client Name QF
Date Filled QF
DataSource QF
GPI QF
ients Voluntary IMM - All Clients
Fields Filters
Datasource Client Name
Date Filled IMM Indicator
Client Name Transaction Status
Label Name Date Filled
NDC
Cardholder ID
Plan Paid
Billed Copay
Gross Cost
Member Last Name
Member First Name
DOB
Member Address 1
Member Address 2
Member City
Member State
Member Zip
Member Phone
Deductible Amount Applied
IMM Alternate Cost
IMMSavings Per Fill
IMMPercent Savings
Days Supply
Metric Quantity
Transaction Status

aid Claims All Clients - All Paid Clients

Fields Filters
Datasource Transaction Status
Date Filled Label Name
Client Name GPI Name Level 1
Label Name Client Name
Most Common Indication Date Filled
Avg Total Member Paid Per Rx Datasource
Plan Paid GPI
Average Gross Cost per Rx Specialty Indicator
Product Name
Cardholder ID
Account ID
Account Name
Group ID
Group Name
Metric Quantity
Days Supply
Plan Paid per 30 day supply
Gross Cost per 30 day Supply
PBM Full AWP
NDC
GPI Name Level 1
Member Last Name
Member First Name
DOB
Member Address 1
Member Address 2
Member City
Pharmacy Name
Member State
Member Zip
Member Phone
GPI Name Level 1
GPI Name Level 2
GPI Name Level 3
GPI Name Level 4
GPI
DAW
Pharmacy Name
Medispan Generic Indicator
Transaction Status
Detailed Generic Indicator
Specialty Indicator
 Voluntary IMM - All Clients Mandatory IM
Filter Set Fields Filters
Various Datasource Client Name
Yes Date Filled DataSource
Paid Client Name IMM Indicator
QF Label Name Transaction Status
Cardholder ID Date Filled
Member Last Name
Member First Name
DOB
Member Address 1
Member Address 2
Member City
Member State
Member Zip
Member Phone
Deductible Amount Applied
Plan Paid
Billed Copay
Gross Cost
IMM Alternate Cost
IMMSavings Per Fill
IMMPercent Savings
Days Supply
Metric Quantity
Transaction Status

All Clients - All Paid Clients Search All Client

Filter Set Fields Filters
Paid Datasource Transaction Status
QF Date Filled Label Name
QF Client Name GPI Name Level 1
QF Label Name Client Name
QF Product Name Date Filled
QF Cardholder ID
QF Account ID
QF Account Name
Group ID
Group Name
GPI Count
Avg Total Member Paid Per Rx
Plan Paid
Average Gross Cost per Rx
Billed Ing Cost
Usual and Customary
Metric Quantity
Days Supply
Plan Paid per 30 day supply
Billed Fee
Deductible Amount Applied
OOP Amount Applied
Billed Tax
Gross Cost per 30 day supply
PBM Full AWP
Medispan Full AWP
Claim Count
NDC
Member Last Name
Member First Name
DOB
Member Address 1
Member Address 2
Member City
Member State
Member Zip
Member Phone
GPI
GPI Name Level 1
GPI Name Level 2
GPI Name Level 3
GPI Name Level 4
Most Common Indication
DAW
Pharmacy Name
Medispan Generic Indicator
Transaction Status
Mail Order Indicator
Detailed Generic Indicator
Specialty Indicator
Formulary Indicator
Compound Indicator
NDC
DAW
 Mandatory IMM - All Clients
Filter Set Fields
Various Datasource
CPC, CVS, ESI Date Filled
Yes Client Name
Paid Label Name
QF Cardholder ID
Member Last Name
Member First Name
DOB
Member Address 1
Member Address 2
Member City
Member State
Member Zip
Member Phone
Deductible Amount Applied
Plan Paid
Billed Copay
Gross Cost
IMM Alternate Cost
IMMSavings Per Fill
IMMPercent Savings
Days Supply
Metric Quantity
Transaction Status

Search All Clients - All Paid Clients

Filter Set Fields
Paid Datasource
QF Date Filled
QF Client Name
QF Specialty Indicator
QF Label Name
Cardholder ID
GPI Count
Avg Total Member Paid Per Rx
Plan Paid
Average Gross Cost per Rx
Metric Quantity
Days Supply
Plan Paid per 30 day supply
Gross Cost
PBM Full AWP
NDC
GPI Name Level 1
Member Last Name
Member First Name
Date of Birth
Member Address 1
Member Address 2
Member City
Member State
Member Zip
Member Phone
GPI Name Level 1
GPI
DAW
Maintenance Drug Indicator
 Specialty
Filters Fields
Cardholder ID Average Gross Cost per Rx
Carrier ID Avg Plan Paid
Client Name Avg Total Member Paid per Rx
Date Filled Cardholder Id
GPI Count Client Name
GPI Name DataSource
GPI Name Level Date Filled
GPI Name Level 1 Days Supply
Label Name DOB
Pharmacist Generic Indicator
Specialty Copay Post-Imp GPI Name Level 1
Specialty Indicator Label Name
Transaction Status Member Address 1
Transaction Status Paid Member Address 2
Member City
Member First Name
Member Last Name
Member Phone
Member State
Member Zip
Metric Quantity
Most Common Indicator
Pharmacy Name
Plan Paid
Specialty Indicator
Specialty Indicator 1
 IMM
Filters Fields
Client Name Billed Copay
DataSource Cardholder ID
Date Filled Client Name
IMM Indicator Datasource
IMM Indicator Contains Date Filled
NDC Days Supply
Plain Paid Deductible Amount Applied
Transaction Status DOB
Gross Cost
IMM Alternative Cost
IMM Alternative Label Name
IMMPercent Savings
IMMSavings Per Fill
Label Name
Member Address 1
Member Address 2
Member City
Member First Name
Member Last Name
Member Phone
Member State
Member Zip
Metric Quantity
NDC
Plan Paid
Transaction Status
 Other
Filters Fields
Client Name Account ID GPI Name Level 3 Plan Paid
Plan Paid Account Name GPI Name Level 4 Plan Paid per 30 day supply
Specialty Indicator Average Gross Cost per Rx Gross Cost Product Name
Transaction Status Average Plan Paid Gross Cost per 30 day Suppl Specialty Indicator
Label Name Average Total Member Paid Per RGroup ID Specialty Indicator 1
Date Filled Billed Fee Group Name Transaction Status
Days Supply Billed Ing Cost Label Name Usual and Customary
Generic Indicator Billed Tax Mail Order Indicator
Gross Cost Cardholder ID Maintenance Drug Indicator
GPI Name Level 1 Claim Count Medispan Full AWP
DataSource Client Name Medispan Generic Indicator
GPI Compound Indicator Member Address 1
Datasource Member Address 2
Date Filled Member City
DAW Member First Name
Days Supply Member Last Name
Deductible Amount Applied Member Phone
Detailed Generic Indicator Member State
DOB Member Zip
Formulary Indicator Metric Quantity
Generic Indicator Most Common Indicator
GPI NDC
GPI Count OOP Amount Applied
GPI Name Level 1 PBM Full AWP
GPI Name Level 2 Pharmacy Name
0 day supply
 ALL - Filters
Filters Specialty IMM OTHER
Cardholder ID X
Carrier ID X
Client Name X X X
DataSource X X
Date Filled X X X
Days Supply X
Generic Indicator X
GPI X
GPI Count X
GPI Name X
GPI Name Level X
GPI Name Level 1 X X
Gross Cost X
IMM Indicator X
IMM Indicator Contains X
Label Name X X
NDC X
Pharmacist X
Plan Paid X
Specialty Copay Post-Imp X
Specialty Indicator X X
Transaction Status X X X
Transaction Status Paid X
 ALL - Fields
Fields Specialty IMM Other
Account ID X
Account Name X
Average Gross Cost per Rx X X
Average Plan Paid X X
Average Total Member Paid Per Rx X X
Billed Copay X
Billed Fee X
Billed Ing Cost X
Billed Tax X
Cardholder ID X X X
Claim Count X
Client Name X X X
Compound Indicator X
DataSource X X X
Date Filled X X
DAW X
Days Supply X X X
Deductible Amount Applied X X
Detailed Generic Indicator X
DOB X X X
Formulary Indicator X
Generic Indicator X X
GPI X
GPI Count X
GPI Name Level 1 X X
GPI Name Level 2 X
GPI Name Level 3 X
GPI Name Level 4 X
Gross Cost X X
Gross Cost per 30 day Supply X
Group ID X
Group Name X
IMM Alternative Cost X
IMM Alternative Label Name X
IMMPercent Savings X
IMMSavings Per Fill X
Label Name X X X
Mail Order Indicator X
Maintenance Drug Indicator X
Medispan Full AWP X
Medispan Generic Indicator X
Member Address 1 X X X
Member Address 2 X X X
Member City X X X
Member First Name X X X
Member Last Name X X X
Member Phone X X X
Member State X X X
Member Zip X X X
Metric Quantity X X X
Most Common Indicator X X
NDC X X
OOP Amount Applied X
PBM Full AWP X
Pharmacy Name X X
Plan Paid X X X
Plan Paid per 30 day supply X
Product Name X
Specialty Indicator X X
Specialty Indicator 1 X X
Transaction Status X X
Usual and Customary X