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Historically, a pharmacy benefit manager (PBM) is a third-party administrator of prescription. drug programs. PBMs are primarily responsible for developing and maintaining the. formulary, contracting with pharmacies, negotiating discounts and rebates with drug. manufacturers, and processing and paying prescription drug claims.
The term means two things definition one is Medical Systems Development Group. But for this paper we will be using the second definition of Medicare Severity Diagnosis Related Group this acronym deals with Medicare Reimbursement.