PharmacyRebate Auditor
Keystone Rx Solutions paid $18,090.00 against $21,200.00 of guaranteed rebates on 22 eligible brand claims: a $3,260.00 shortfall across 3 quarter-channel cells.
Guaranteed for 2026 Q1 Retail: 3 x $210.00 (Retail, 1-83 days) + 1 x $640.00 (Retail, 84+ days) = $1,270.00 on 4 brand claims. RX26021810 is left out: NDC '0003-894-21' is not a valid 11-digit NDC ($210.00 of guarantee at risk). The PBM paid $1,050.00 (KRX-26Q1-R), so $1,270.00 - $1,050.00 = $220.00 is short.
Method1Eligible: brand claims (B, or Medi-Span M, N, O) with ingredient cost above zero and a valid NDC; generics (G or Y) and zero-cost claims are excluded.
2NDC: 11 digits in 5-4-2 form. Hyphenated 10-digit forms (4-4-2, 5-3-2, 5-4-1) are padded to 11 and counted; anything else is invalid and excluded, with the guarantee shown as at risk.
| Quarter | Channel | Brand claims |
|---|---|---|
| 2026 Q1 | Retail | 4 |
| 2026 Q1 | Specialty | 3 |
| 2026 Q2 | 3 |
PBM claims file, plus the contract rebate guarantee table
Rebate shortfall by drug and a PBM audit demand (PBM audit demand letter, Shortfall by quarter and channel (CSV), Claim exceptions (CSV))
$3,000 / month, 30% to the referring partner
Read in memory for the session, never stored, never used to train a model.
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