Quick source of Medicare and other Payer data - Statista 2020

 https://www.statista.com/topics/1167/medicare/#:~:text=In%202019%2C%20over%2061%20million,beneficiaries%20due%20to%20various%20disabilities.

Palmetto DEX License Splash Screen, 12/2020

 https://app.dexzcodes.com/

License Splash Screen (12/2020)

Notice--DEX™ Diagnostics Exchange

General Terms: Palmetto GBA LLC and/or one of its subsidiaries (“Palmetto GBA”) is the owner/licensor of the DEX™ Diagnostics Exchange software product (“Software”) including its clinical content (“Clinical Content”, and together with the Software, the “Work”). The Work contains proprietary, confidential and trade secret information of Palmetto GBA and may only be used by licensees who have an existing license agreement in force only under the time-limited license as provided under that license agreement (“Licensee”). Palmetto GBA is also the owner of DEX Z-Codes and the catalog of Z-Codes. Licensee and any recipient thereunder shall use the Work and the Z-Codes in accordance with the terms and conditions of the license agreement. Any other use of the Work or the Z-Codes is unauthorized and prohibited by law. In the event of a conflict between these Terms and a written and signed agreement between Palmetto GBA and Licensee, such written and signed agreement shall control.

If You Have Been Provided Access for Evaluation Purposes: Palmetto GBA is the owner/licensor of the Work. Palmetto GBA has prepared this Work for use solely by its licensees. This Work contains proprietary, confidential and trade secret information of Palmetto GBA. If you have been provided access to the Work for evaluation purposes only, such access is provided to you only under a nontransferable, nonexclusive license whose term is limited to the time frame set forth in the e-mail notification sent to you containing your access password and any other terms or conditions of use provided by Palmetto GBA from time to time. You and any recipient hereunder shall use the Work in accordance with the terms and conditions of this license and the e-mail notification. You are granted this license solely for the purpose of your internal evaluation of the Work as part of your decision whether to license the Work, and for no other purpose. You expressly agree to keep the Work confidential and not to release or disclose the Work to any other third person without Palmetto GBA's express written permission. Publication of the Work or unauthorized reproduction of the Work, including but not limited to the printing or distribution of any portion of the Work or results obtained as part of the permitted evaluation, adaptation, incorporation into other media, and release of this Work by you, is strictly prohibited except upon prior written permission of Palmetto GBA. Any copies or reproductions of the Work, whether electronic or physical, made by you during the limited evaluation term shall be destroyed and shall not be used for any purpose upon the expiration of the term. The permissions granted herein are terminable at will by either party.

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The Clinical Content as provided reflects clinical interpretations and analyses and cannot alone either resolve medical ambiguities of particular situations or provide the sole basis for definitive decisions. The Clinical Content is intended solely for use as screening guidelines with respect to the medical appropriateness of healthcare services and not for final clinical or payment determinations concerning the type or level of medical care provided, or proposed to be provided, to a patient.

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CPT copyright 2019 American Medical Association. All rights reserved. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. CPT is a registered trademark of the American Medical Association.

Applicable FARS/DFARS Restrictions Apply to Government Use.

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This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable, which was developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60654. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable, for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (December 2007) and/or subject to the restricted rights provisions of FAR 52.227-14 (December 2007) and FAR 52.227-19 (December 2007), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.

HGNC: HUGO Gene Nomenclature Committee at the European Bioinformatics Institute http://www.genenames.org/

 

CMS Part B Drug Pricing Proposal Dynamites Existing Law; PhRMA Protests in Court; Hidden Backstory

 On November 20, 2020, CMS released a blockbuster proposal to national reprice Part B drugs according to international price metrics (aka Most Favored Nation Status, or MFN).   Response from the biopharma industry was swift and resulted in a major legal filing by December 4.   The Medicare policy facts are pretty bizarre and I'll both lay out the key facts and provide some fascinating backstory in this blog.

What CMS Did on November 20

CMS used its authority (from SSA 1115A, part of the Affordable Care Act) to create new demonstration products.  It's used this authority dozens or hundreds of times.  In this case, CMS asserts it can rapidly create a nationwide demonstration program that will last for years, and totally reconfigure drug pricing policy under Part B (e.g. intravenous drugs, chemotherapy, etc).   In fact, SSA 1115A does create the Center for Innovation (aka CMMI) and allows it waive any part of Medicare law for the purpose of demonstration projects.   The law is brief and doesn't state any limits on the duration of a demo (e.g. 6 months versus 999 years) or the scope (3 metropolitan areas versus all 50 states) or the project content (e.g. tweaking a small rule as a pilot versus raising the Medicare age to 75).  

• See the CMS fact sheet here.
• CMS calls this the PDPM, Prescription Drug Payment Model, which doesn't capture the fact it is Part B drugs only.
• However, the CMMI webpage it titled Most Favored Nation - here.
• See the CMS press release here.
• The proposal was released in tandem with an HHS report on drug price inflation here.
• See the November 27 Federal Register web page here.
• See the 80 page PDF here.  85 Fed Reg 76180-259, November 27, 2020.
• Yes, somebody was working the day after Thanksgiving.  
• My understanding the rule doesn't change what manufacturers charge, just what CMS pays in compensation to hospitals or doctors for those patients who are fee for service Medicare patients.
• It doesn't affect Medicare Advantage except in that overall per-patient capitation for MA will slip downward as FFS payments are reduced.  

What Happened Next?

A number of major stakeholders, including the Pharmaceutical Research and Manufacturers of America (PhRMA), the Association of Community Cancer Centers (ACCC), the Global Colon Cancer Association (GCCA) and National Infusion Center Association (NICA), filed a law suite against the CMS pilot on December 4.

The 65-page lawsuit argues first, that the pilot program is illegal.  That is, the pilot program is too big and exceeds the concept of a "demo" or "pilot" program under SSA 1115A.

In the alternative, if the project was legal under the text of SSA 1115A, it's not legal under the constitution, because it is too big a delegation of authority from Congress to the Agency.

• See ACCC press release here.
• See PhRMA here.
• You can download a legal one pager or the full case from the prior link.  
• Full complaint PDF here.
• There are collateral motions like injunctions and restraining orders.
• See trade press:
• PolicyMed here.
• National Law Review / K&L Gates - here.  And / Polsinelli, here.
• Healthcare Finance here.  "Would cut drug reimbursements to hospitals by an average of 65% when fully phased in, the AHA says."

What's All This About a Backstory?

There's a lot of fascinating backstory here.

Before 1115A, No Demo Projects without Specific Legislation

Before SSA 1115A in the ACA of 2010, CMS had no authority to do demonstration projects.  This allegedly impaired innovation in our health system.   From time to time, a little demo for this or that would squeak by Congress in a paragraph of law, and CMS would dutifully carry out the little demo, and issue a report on it, and close it down.

In fact, the SSA itself contains some line-item demo projects.  For example, ACA 3113 created a short demo project that provided an escape valve from the date of service rule, which bundled reference tests to being billed only by the hospital where the sample was obtained.  For example, if a patient in 2009 had a breast biopsy in Florida, and 7 days later had a genomic test report from the Genomic Health (Oncotype) lab in California, only the Florida hospital could bill for it.  But the Florida MAC might not know Genomic Health from a hole in the ground, and claims wouldn't get paid.   

Demo 3113, Complex Tests, Date of Service 

As of 12/2020, HHS still has a guidance webpage for Pilot 3113, one dated January 28, 2011, one dated March 10, 2011.  It refers to transmittal CR7278, Publication 100-19, Demonstrations, Transmittal 70.  Here.   CMS excluded tests that didn't have specific CPT codes, which left the advocates for this demo in the lurch, since proprietary codes (MAAA codes) or PLA codes...hadn't been invented yet.

See the CMS home page for Demo 3113 here.  See a Fact Sheet about the demo, July 2011, here. See a "request for G code" document here.   See the legislative language here.  See a Report to Congress, 2015, here, and a final report, 2016, here.   

1115A:  CMS Now Can Make Demo Projects On Its Own Volition

Section 1115A of the Social Security Act is brief and creates the Center for Innovation at CMS.  Read 1115A here.

The key issue with CMMI is what we introduced early in the blog:  it can create demo projects of variable length, geographic scope, and policy scope, but there is no remark anywhere in the law about how big or little, how long or short, how trivial or massive, the pilots can be.   So, hypothetically, you could waive Medicare law for a pilot project excluding women from Medicare enrollment for 100 years in all 50 states.   

Admittedly, the projects are supposed to be expected to not reduce health quality and not raise costs, which produces some scope limitations, but those are just guidelines for what the agency says it hopes to achieve in a demo.   

The law also lets CMS make permanent successful demos if they are shown (objectively, by actuarial review and endorsement) to maintain quality while not raising costs.  

However, there's a quirk in that the law says CMS may suspend or change (waive) any aspect of Medicare law "solely for purposes of carrying out this section with respect to testing models described in subsection (b)" where (b) refers to Pilots, not Extensions.  I've seen CMS argue, somewhere in the Federal Register, that the law giving ability to waive law for pilot projects (b) implies it can also waive law for resulting permanent programs.  However, as a non attorney, I find that reading hard to believe, see the law specifically says waivers can be SOLELY for the purpose of the section on pilot models "b."  Expansion of models is law section "c".  To me, a law that is "solely for [b] " is a law that does not include  the adjacent "c."   Of course, CMS could escape this problem by making the demo "b" phase 99 years long instead of a year or two, so the demo never faces finalization as expansion phase "c."

Obama Administration Proposed Part B Drug Pricing Demo!

The Obama administration proposed a less drastic Part B pricing model in 2016.  This was proposed on March 11, 2016, 81 Fed Reg 13229-13261, here.

Here's how the 2016 Obama administration described its fairly modest proposal:

This proposed rule discusses the implementation of a new Medicare payment model under section 1115A of the Social Security Act (the Act). We propose the Part B Drug Payment Model as a two-phase model that would test whether alternative drug payment designs will lead to a reduction in Medicare expenditures, while preserving or enhancing the quality of care provided to Medicare beneficiaries. The first phase would involve changing the 6 percent add-on to Average Sales Price (ASP) that we use to make drug payments under Part B to 2.5 percent plus a flat fee (in a budget neutral manner). The second phase would implement value-based purchasing tools similar to those employed by commercial health plans, pharmacy benefit managers, hospitals, and other entities that manage health benefits and drug utilization. We believe this model will further our goals of smarter, that is, more efficient spending on quality care for Medicare beneficiaries.

Republicans Hated CMMI and its Models and Trashed It

Republicans were quite hostile to CMMI, in 2016 and before, climaxing in 2016 after the drug model was proposed.    There were hearings on the Hill very toxic to the CMMI.  The group Citizens Against Government Waste wrote op eds against CMMI repeatedly (entry point here).  Some groups like AARP supported CMMI by writing letters to Tom Price, chair of the House budget committee (here).  

A House hearing lambasted the CMMI, see links at my blog of 9/24/2016, here.  Note that at that time, Republicans were basically taking positions against the constitutionality of CMMI that PhRMA is taking in 2020.

Moratorium on CMMI by New Trump Administration

I recall that Trump's first Secretary of Health, surgeon Tom Price, diss'ed the CMMI in his confirmation hearings. I believe in 2017 the Trump administration under Price went so far as to declare a CMMI moratorium.

However, by September of 2017, CMS was realizing that despite previous objections to the legality of CMMI, it could be a powerful tool for doing....well, for doing about anything.  Seema Verma had a Op Ed in WSJ on September 19, 2017, touting the possibility of a re-envisioned CMMI (here).  CMS held an open call for comments about how it could reboot and re-use CMMI.   Verma wrote, "This administration plans to lead the Innovation Center in a new direction. On Wednesday we are issuing a “request for information” to collect ideas on the path forward."  The 9/2017 RFI is still online here.

By 2020, the tenth anniversary of CMMI brought much praise via a symposium (see links here, anniversary video at YouTube here, and a subsequent 10/2020 article about "lies and revisionism" at CMMI, at MedCityNews, here.)  See a review article about the first decade of CMMI at Health Affairs here.

Trump Administration Touted International Pricing Model in 2018

Trump Administration touted the IPI, International Pricing Model in 2018, proposing it would launch in 2019 or 2020.  (The date in the brand new rulemaking is 1/1/2021).  See article at Modern Healthcare, 10/25/2018, here.   PhRMA did not like the IPI (e.g. here).

Early 2020 Legislation Would Have Reigned In the Scope of CMMI

See coverage in February 2020 at Healthcare Dive here.  Legislators (both "D" and "R") introduced HR 5741 to rein and CMMI and introduce more accountability to it.   See press here.   See House legislative text here.

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CMS's COVID Test Table Pertains to Physician Ordering PHE Rules, Not To Coverage

 UPDATE.

A colleague pointed out that CMS says its ;lengthy table of COVID-containing tests is a comprehensive listing of all tests that contain COVID, and any of them may qualify for special emergency rules regarding a physician's order.   However, CMS adds the table ONLY concerns tests that fall under its physician-order-policy, and this is not a table regarding COVERAGE.    For example, a 22-pathogen test containing COVID would fall under the special ordering rules, BUT it is not necessarily covered by various MACs.  Check with the MAC.

See the CMS clarification at its (currently 165 page) guidance of COVID special rules, here:

 https://www.cms.gov/files/document/03092020-covid-19-faqs-508.pdf

I'm quoted from the 12/8 update, but the particular question in the FAQ is dated back to 6/19.

11. Question: Does the CMS table “COVID-19, Influenza, and RSV Clinical Diagnostic Laboratory

Tests for which Medicare Does Not Require a Practitioner Order during the PHE” list Clinical Diagnostic Laboratory Test codes that Medicare will cover during the PHE? Answer: This table lists codes that, if otherwise covered by Medicare, do not require a treating practitioner’s order as a condition of Medicare payment. The table should not be interpreted as a statement of coverage for the listed codes. There may be some codes for which there are local coverage determinations that non-cover or limit coverage of certain tests. Practitioners and laboratories should check with their local Medicare Administrative Contractor regarding specific questions of coverage. New 6/19/20

A Third Party Description of the MOLDX System

 

• I can't vouch if I think every word of this is correct, but it's a pretty good review of the MOLDX system written by a third party in 2017, looking at the JJ transition in 2018.

  
  

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  http://mmplusinc.com/news-articles/item/the-molecular-diagnostic-services-moldx-program
  

  
  

  
  

  The Molecular Diagnostic Services (MolDX) Program

  on Tuesday, 07 November 2017. All News Items | Outpatient Services | Medicare Coverage

  ATTENTION JURISDICTION J PROVIDERS – ACTION NEEDED

  Over the past several weeks, our newsletter has focused attention on the transition of the Jurisdiction J (Alabama, Georgia, and Tennessee) Medicare Administrative Contractor (MAC) from Cahaba to Palmetto GBA.  For those providers affected by this transition, please pay special attention to this article as you will be required to participate in this program under the Palmetto contract.  Special information affecting Jurisdiction J is included at the end of this article.

  If you are a regular reader of our Wednesday@One newsletter, you may already know that my original role in healthcare was as a clinical laboratory scientist (CLS) or Medical Technologist (MT). I loved working in the clinical laboratory, but my detail oriented brain also loves my current work with Medicare regulations. In the realm of healthcare compliance, I keep up with the rapid and never-ending changes of Medicare healthcare regulations.  Unfortunately, since Compliance is now my focus, I no longer keep up with the also rapid and never-ending changes to laboratory medicine. 

  Molecular diagnostic testing (MDT) is one area of laboratory advancements that is having a tremendous impact on the practice of medicine overall.  Human genomics is reshaping the medical approach to therapy and diagnosis in areas such as inherited genetic diseases, infectious disease, oncology, human leucocyte antigen typing to predict immune function, coagulation, and pharmacogenomics—the genetic prediction of which drugs will work best.  As this testing has become more common, healthcare payers have struggled with determining the appropriate coverage and payment for these tests.

  Some of the challenges for Medicare related to molecular diagnostic testing were:

  • HCPCS and CPT descriptions for these codes describe the pathology and laboratory categories but do not identify a specific test.
  • The Clinical Laboratory Fee Schedule pricing methodology does not account for the unique characteristics of these tests.
  • Who determines if the tests fall within a Medicare benefit category?
  • Some tests have not been assessed for clinical and analytical validity and clinical utility.

  Medicare’s solution was the Molecular Diagnostic Services (MolDX) Program, which was developed by Palmetto GBA in 2011 to identify and establish coverage and reimbursement for molecular diagnostic tests. Palmetto GBA currently administers the MolDX Program and all its information. 

  The program applies to all private, reference, and hospital laboratories that perform molecular diagnostic testing and submit claims to Medicare Part A or Part B.  The following molecular diagnostic assays/tests are included in MolDX.

  Code Category/Description	2017 MolDX CPT Code Range
  Tier 1	81161-81383
  Tier 2	81400-81408
  Genomic Sequencing and other MAA	81410-81471
  Molecular Multianalyte Assays (MAA)	81490-81595
  MAA Proprietary Codes	0001M-0009M
  Immunology	86152-86153
  Microbiology	87149, 87150, 87505-87507
  PLA	*All Codes
  NOC	81479, 81599, 84999, 85999, 86849, 87999, 88199, 88299, 88399, 89398

  How does the MolDX Program address the above challenges?

  The MolDX program performs the following functions, which solve the challenges noted above concerning molecular diagnostic tests:

  • Facilitates detailed and unique identification through registration of molecular diagnostics tests to facilitate claims processing and to track utilization.
  • Establishes clinical utility expectations
  • Completes technical assessments of published test data to determine clinical utility and coverage
  • Establishes reimbursement

  How does the MolDX Program work?

  Obtain a DEX Z-Code

  Laboratories must apply for and obtain a unique test identifier for each MDT or LDT (lab developed test) they perform.

  Attention Hospitals - You are NOT expected to submit tests to obtain Z-Codes for tests sent to another laboratory to perform.  You submit tests to obtain a Z-code only for those tests you perform in-house.  However, the MolDX FAQs state it is the responsibility of the billing provider to obtain a DEX Z-Code™ identifier, such as in cases where the performing lab is not in a jurisdiction under the MolDX program. Since reference labs performing genetic testing generally offer services across the nation, most will have already obtained the necessary Z-codes.

  These are the steps required for participation in the MolDX program:

  • You are required to register your organization in the DEX Diagnostics Exchange if you plan to submit claims for the MolDX codes to MACs participating in the MolDX program (see list of Participating MACs below). 
  • Providers billing Part A for molecular tests performed by a proprietary or reference laboratory will “Request Sharing” in DEX, from your reference lab, to get access to the Z-Code for billing purposes. You must obtain the DEX Z-CodeTM for the molecular test(s) from the performing laboratory, either directly or through the DEX system. 
  • Hospital providers billing for molecular services performed by their hospital-based laboratory must register and obtain a unique DEX Z-CodeTM for each molecular test in the MolDX code ranges designated above. 

  Obtain a Technical Assessment Approval (Coverage Determination)

  Once a Z-code is assigned, coverage is determined through a technical assessment (TA). Established FDA-approved tests with proven utility that are performed within labeling indications may not require a technical assessment. A TA is required for molecular assays that are laboratory developed tests (LDT), employ new or novel technology, or have undefined or unproven clinical utility. For these tests, labs/developers must submit a detailed dossier of clinical data to substantiate the test meets Medicare’s requirements for coverage. The Technical Assessment Submission Instructions (M00115) provides the steps to submit a dossier.

  All new test services will be denied as noncovered until the test completes the TA process and reasonable and necessary criteria is established. Claims submission for tests in the TA process should be suspended until a final coverage determination is made. Labs should not provide lab tests pending a TA approval until coverage is approved and appropriate billing and coding guidelines are published.

  Once a coverage determination has been established, the results will be published to the provider community. A Local Coverage Determination (LCD) or Coverage Article may be developed if the test requires administration of reasonable and necessary limitations.

  Report Z-Code on Claim

  When the unique test identifier (DEX Z-Code™) is reported in conjunction with the appropriate CPT/HCPCS code on the claim, it allows Medicare to determine the exact test that has been performed, facilitating the process of making pricing and/or coverage determinations. The MolDX Manual provides instructions on the claim line detail fields for reporting the Z-codes.

  • Part B providers – Paper claim - Block 19 of the CMS 1500 claim form; electronic claims (837P) - SV101-7 field adjacent to the applicable CPT code.
  • Part A providers – Paper claim - block 80 of the UB04 claim form; electronic claims (837I) - line SV202-7.
  • Part A providers will need to specify which lines are billed for MolDX and the appropriate DEX Z-Code per line within the remarks section of the claim.

  Adjudication

  The molecular test is adjudicated in accordance with the MAC’s LCDs and coverage articles.

  Palmetto GBA’s “Molecular Diagnostic Tests (MDT)” LCD provides coverage for MDTs and LDTs that are identified as covered in the LCD. Palmetto has also developed and published specific LCDs, and/or coverage articles for some MolDX tests. MDTs and LDTs not identified as covered in an NCD, LCD, or coverage article are not covered.  Palmetto GBA will continue to accept and consider requests on excluded genetic tests.  You can find a link to Palmetto’s LCDs, as well as list of covered and excluded tests, on Palmetto’s MolDX website.

  Participating MACs

  Although Palmetto “owns” the MolDX program, several other MACs also participate in the program.  These include Noridian JE and JF, CGS J15, and WPS J5 and J8.  Each of these MACs have coverage policies and websites dedicated to the MolDX program.  If you are a provider in one of these jurisdictions, please check you MACs website for more information.  At this time CMS has not determined how MolDX will be expanded.

  Jurisdiction J Transition

  Medicare Part A and Part B providers in the Palmetto GBA Jurisdiction J will be required to register all molecular tests with the Diagnostics ExchangeTM (DEX), an online test registry.  There will be a phase in for Jurisdiction J to allow time for test providers to obtain their Z-codes. We strongly suggest labs and other test providers begin the process now to avoid any claim processing delays once the Z-code is required on the claim, which is currently projected to be no later than claims submitted on or after June 1, 2018 (note this is not Date of Service driven). 

  Refer to the Steps for Participating in the MolDX Program listed above to determine exactly what actions are needed for JJ providers billing for molecular diagnostic testing.  JJ providers should carefully study all the information on the MolDX website and become familiar with Palmetto’s MolDX LCDs.  This is a necessary piece of the JJ transition.

  
  

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Jan 2020: FDA Draft Clinical Effectiveness Rules (for Drugs)

 https://www.fda.gov/regulatory-information/search-fda-guidance-documents/demonstrating-substantial-evidence-effectiveness-human-drug-and-biological-products

Quinn file as:

2019 FDA 1201 Clin Effectiveness of Drugs (Draft) 21pp.pdf

Excel Match, VLookup, Index Functions

See an earlier column in 7/2020 here.

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Let's say I've got two different Excel tables.  One gives NPI numbers in Column A, and Test Names in Column B, and Test Prices in Column C.   

The other gives NPI numbers in Column A and Lab Name in Column B.

Easy to see where this is going.  I want ONE table that gives:

• NPI Number, and Lab Name, and Test Name, and Test Price, in four columns on one page.

Basically, you start with the longer table - let's say its NPI + Name + Price.   You insert a new column between NPI and Name.   Now, on a separate sheet, you place the two columns of NPI and Lab Name.  

You go down the empty column, and take the NPI number at its left, and look through the other table from top to bottom until you find a matching NPI.  Then, you insert the Lab Name next to that NPI (in the second table) into the empty column in the first table.

Here are some instructions.

How to use INDEX and MATCH

https://exceljet.net/index-and-match

VIDEO: How to use INDEX and MATCH

https://www.youtube.com/watch?v=yH_ArqoB0no

How to use INDEX and MATCH

https://www.excel-easy.com/examples/index-match.html

How to use VLOOKUP

https://exceljet.net/excel-functions/excel-vlookup-function#:~:text=VLOOKUP%20is%20an%20Excel%20function,the%20table%20passed%20into%20VLOOKUP.

VIDO: How to use VLOOKUP

https://support.microsoft.com/en-us/office/video-vlookup-when-and-how-to-use-it-9a86157a-5542-4148-a536-724823014785

How to use VLOOKUP

https://www.excel-easy.com/examples/vlookup.html

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zexcel