How do 340B contract pharmacy duplicate-discount controls handle Medicaid carve-in and carve-out claims?

In 340B contract pharmacy arrangements, duplicate-discount control depends less on the carve-in or carve-out policy label and more on the claims records that identify, exclude, or accumulate Medicaid-related claims. A defensible setup must prove through split-billing, accumulator, and claims exclusion records that prohibited claims did not drive 340B replenishment.