Updated research request forms and data security approval requirement effective 4/24/23
SAS Name
PRE_ICL_COSTSHARE_TYPE
Indicates the type of cost sharing that drugs on the tier are subject to in the during the pre-initial coverage limit (ICL) phase, which may include copayment, co-insurance, or the greater/lesser of the two.
| Code | Code value |
|---|---|
| 1 | Coinsurance |
| 2 | Copayment |
| 4 | Lesser of Coinsurance and Copayment |
The CCW constructs the Plan Characteristics File from information submitted by plan
sponsors to CMS’s Health Plan Management System (HPMS).
Source: CMS (HPMS Files)