Cvs Caremark Pricing Information
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Health Plan Sponsor
Health Action Council of Northeast Ohio
Employers Health Purchasing KS State Corporation of Employees Health Ohio Care Commission
Montgomery County Public Schools
Houston Independent School District
Philadelphia, PA
City of Austin, TX
Onondaga County, NY
Phoenix, AZ
Albany County, NY
Genesee County, Genesee County, Genesee County, MI ABS/ Caremark MI AEPC/ MI VPS/ Caremark Bid Caremark Bid Bid
1,500,000
500,000
87,670
40,000
29,000
28,117
17,431
15,991
14,149
6,964
4,149
4,149
4,149
26.5% $1.50
16% $1.65
22.5% $1.50
16% $1.65
20.7% $1.75
16.5% $1.50
20.20% $1.50
15.7% $1.85
16.0% $1.80
14% $1.95
16.0% $1.60
17.5% $1.40
17.0% $1.50
Ingredient Cost (AWP Discount) Dispensing Fee
57.5% $1.50
MAC $1.85
62% $1.50
52% $1.65
50% $1.75
MAC $1.50
MAC $1.75
15.7% or MAC $1.95
MAC $1.80
RIGHTMAC $1.95
16% or MAC $1.60
64% Effective Rate Guarantee $1.40
61% Effecitve Rate Guarantee $1.50
Ingredient Cost (AWP Discount) Dispensing Fee Generic -
34.4% $0.00
24% $0.00
32.6% $0.00
24% $0.00
27.5% $0.00
24% $0.00
26.80% $0.00
23% $0.00
23% $0.00
20% $0.00
24% $0.00
25.9% $0.00
24% $0.00
Ingredient Cost (AWP Discount) Dispensing Fee
59.5% $0.00
60% $0.00
63% $0.00
58% $0.00
55% $0.00
57% $0.00
MAC $0.00
55% $0.00
55% $0.00
RIGHTMAC $0.00
NOT PROVIDED $0.00
64.5% Effective Rate Guarantee $0.00
63% $0.00
16% $0.00
17% $0.00
16% $1.65
15.25% $1.75
N/A N/A
15% $1.50
15.7% $1.85
16.0% $1.80
15% $2.50
16.0% $0.00
17.0% $0.00
17.0% $0.00
Retail
N/A
$3.92
N/A
$2.85
N/A
$3.67
N/A
$2.64
$4.30
$3.00
$2.87
$4.12
$4.12
Mail Reinvestment / Pass Thru Into Pricing Administrative Fees: Participating Pharmacy Claim Mail Service Claim Specialty Claim Paper Claim Prior Authorization
N/A Y
$12.19
N/A Y
$10.00
N/A Y
$14.19
N/A Y
$7.91
$11.45
$7.60
$11.85
$12.01
$12.01
$0.00 $0.00 $0.00 $0.00 $35.00
$0.95 $0.95
$0.00 $0.00 $0.00 $1.25 $40.00
$0.00 $0.00
$0.00 $0.00 $0.00 $1.50 $40.00
Covered Lives Retail Rx: Brand Ingredient Cost (AWP Discount) Dispensing Fee Generic -
Mail Rx: Brand -
Specialty Rx: Ingredient Cost (AWP Discount) Dispensing Fee Rebates: Per Script -
$20.00
$2.00
$0.15 $0.00 $0.00 $0.00
$1.50
$1.50 $0.00
$30.00
$40.00
Each column represents a contract between Caremark and the health plan sponsor, except, as noted, for the three Genessee County entries, which represent bids from Caremark and three separate partner entities, and the entry for the San Antonio Water System, which represents a bid from Caremark. Note: Contract terms cited in this table are representative of the respective contracts; some contracts include alternatives and/or exceptions to certain terms.
Columbia, MO
Boone County, MO
Chenango County, NY
2,200
2,148
1,575
1,242
666
600
17.0% $1.50
16.5% $1.70
15.5% $1.70
15.5% $1.95
14% $2.20
14.0% $2.25
17% or MAC $1.50
16.5% or MAC $1.70
15.5% or MAC $1.70
52% or MAC $1.95
14% or MAC $2.20
14% or MAC $2.25
25.25% $0.00
24% $0.00
22% $0.00
22% $0.00
19% $0.00
19% $0.00
64% $0.00
57% $0.00
22% or MAC $0.00
55% $0.00
45% $0.00
50% $0.00
17.0% $0.00
16.5% $0.00
15.5% $1.70
15.5% $1.95
15% $0.00
14.0% $2.25
Kent County, MI
$3.92 $17.73
Bethlehem Area San Antonio Water School District, PA System
$7.25 (brand only) $17.00 (brand only)
$8.00 (brand only) $22.98 (brand only)
$3.95 (brand only) $11.30 (brand only)
$0.00 $0.00 $0.00 $1.50 $30.00
$0.00 $0.00
$30.00
$9.78
$3.00 (brand only) $7.15 (brand only)
$0.45 $0.00
$0.49 $0.00
$3.34
$1.50 $30.00
Health Action Council of Northeast Ohio
Employers Health Purchasing KS State Corporation of Employees Health Ohio Care Commission
Montgomery County Public Schools
Houston Independent School District
Philadelphia, PA
City of Austin, TX
Onondaga County, NY
Phoenix, AZ
Albany County, NY
Genesee County, Genesee County, Genesee County, MI ABS/ Caremark MI AEPC/ MI VPS/ Caremark Bid Caremark Bid Bid
1,500,000
500,000
87,670
40,000
29,000
28,117
17,431
15,991
14,149
6,964
4,149
4,149
4,149
26.5% $1.50
16% $1.65
22.5% $1.50
16% $1.65
20.7% $1.75
16.5% $1.50
20.20% $1.50
15.7% $1.85
16.0% $1.80
14% $1.95
16.0% $1.60
17.5% $1.40
17.0% $1.50
Ingredient Cost (AWP Discount) Dispensing Fee
57.5% $1.50
MAC $1.85
62% $1.50
52% $1.65
50% $1.75
MAC $1.50
MAC $1.75
15.7% or MAC $1.95
MAC $1.80
RIGHTMAC $1.95
16% or MAC $1.60
64% Effective Rate Guarantee $1.40
61% Effecitve Rate Guarantee $1.50
Ingredient Cost (AWP Discount) Dispensing Fee Generic -
34.4% $0.00
24% $0.00
32.6% $0.00
24% $0.00
27.5% $0.00
24% $0.00
26.80% $0.00
23% $0.00
23% $0.00
20% $0.00
24% $0.00
25.9% $0.00
24% $0.00
Ingredient Cost (AWP Discount) Dispensing Fee
59.5% $0.00
60% $0.00
63% $0.00
58% $0.00
55% $0.00
57% $0.00
MAC $0.00
55% $0.00
55% $0.00
RIGHTMAC $0.00
NOT PROVIDED $0.00
64.5% Effective Rate Guarantee $0.00
63% $0.00
16% $0.00
17% $0.00
16% $1.65
15.25% $1.75
N/A N/A
15% $1.50
15.7% $1.85
16.0% $1.80
15% $2.50
16.0% $0.00
17.0% $0.00
17.0% $0.00
Retail
N/A
$3.92
N/A
$2.85
N/A
$3.67
N/A
$2.64
$4.30
$3.00
$2.87
$4.12
$4.12
Mail Reinvestment / Pass Thru Into Pricing Administrative Fees: Participating Pharmacy Claim Mail Service Claim Specialty Claim Paper Claim Prior Authorization
N/A Y
$12.19
N/A Y
$10.00
N/A Y
$14.19
N/A Y
$7.91
$11.45
$7.60
$11.85
$12.01
$12.01
$0.00 $0.00 $0.00 $0.00 $35.00
$0.95 $0.95
$0.00 $0.00 $0.00 $1.25 $40.00
$0.00 $0.00
$0.00 $0.00 $0.00 $1.50 $40.00
Covered Lives Retail Rx: Brand Ingredient Cost (AWP Discount) Dispensing Fee Generic -
Mail Rx: Brand -
Specialty Rx: Ingredient Cost (AWP Discount) Dispensing Fee Rebates: Per Script -
$20.00
$2.00
$0.15 $0.00 $0.00 $0.00
$1.50
$1.50 $0.00
$30.00
$40.00
Each column represents a contract between Caremark and the health plan sponsor, except, as noted, for the three Genessee County entries, which represent bids from Caremark and three separate partner entities, and the entry for the San Antonio Water System, which represents a bid from Caremark. Note: Contract terms cited in this table are representative of the respective contracts; some contracts include alternatives and/or exceptions to certain terms.
Columbia, MO
Boone County, MO
Chenango County, NY
2,200
2,148
1,575
1,242
666
600
17.0% $1.50
16.5% $1.70
15.5% $1.70
15.5% $1.95
14% $2.20
14.0% $2.25
17% or MAC $1.50
16.5% or MAC $1.70
15.5% or MAC $1.70
52% or MAC $1.95
14% or MAC $2.20
14% or MAC $2.25
25.25% $0.00
24% $0.00
22% $0.00
22% $0.00
19% $0.00
19% $0.00
64% $0.00
57% $0.00
22% or MAC $0.00
55% $0.00
45% $0.00
50% $0.00
17.0% $0.00
16.5% $0.00
15.5% $1.70
15.5% $1.95
15% $0.00
14.0% $2.25
Kent County, MI
$3.92 $17.73
Bethlehem Area San Antonio Water School District, PA System
$7.25 (brand only) $17.00 (brand only)
$8.00 (brand only) $22.98 (brand only)
$3.95 (brand only) $11.30 (brand only)
$0.00 $0.00 $0.00 $1.50 $30.00
$0.00 $0.00
$30.00
$9.78
$3.00 (brand only) $7.15 (brand only)
$0.45 $0.00
$0.49 $0.00
$3.34
$1.50 $30.00
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