Pharmacy Qualification Analysis
simply complete the 2 minute questionnaire and Dr. Brandon Hendrickson (Pharm-D)
will reach out to you within 24 hours to discuss potential opportunities together.
List any Missing PBM Contracts:
What type of products are you currently processing: (Our focus is Topical Single NDC's)
Number of RX's currently being processed per month:
Potential Capacity of RX's per Month:
Patient Contact Policies: (Select the one that best describes your Pharmacy)
Absolutely must speak to every patient or we won’t ship their meds. No Exceptions.
We make every attempt to reach the patient but if we can’t reach the patient we will not let this be a barrier to the patient receiving their meds,
If we have everything we need to process a prescription then we mail the medication without contacting the patient.
Copay Policies: (Select all that best describes your Pharmacy)
We must collect every penny, of every copay, every month
We utilize a compliant manufacturers copay coupon to assist with patient responsibility
We work with the patient to determine what they can afford and in most cases will not allow their copay to prevent them from receiving their meds.
Our first priority is assuring the patients receive their medication.
Patients may sign a form to elect to be enrolled in auto-refill at the time of their physician visit. This form is submitted by the physician with the prescription.
The only way we accept auto-refill is by speaking with the patient on the phone.
Patients may not elect for auto-refill for their convenience.
Currently use manufacturer copay coupons:
Diclofenac 3% (100gm) CPU
Diclofenac 3% (100gm) UPM
Lidocaine 5% (35.44gm): CPU
Lidocaine 5% (35.44gm): UPM
Fluocinonide (120gm) CPU
Fluocinonide (120gm) UPM
Doxepin (45gm) CPU
Doxepin (45gm) UPM
Calcipotriene (120gm) CPU
Calcipotriene (120gm) UPM
Vanatol (1 Bottle) CPU
Vanatol (1 Bottle) UPM
Omeprazole (40mg) CPU
Omeprazole (40mg) UPM
List wholesalers you purchase from:
List any other Top Products utilized if different from above:
Conversion Rate (# of RX Adjudicated / # of RX Submitted:
Average Net per RX (Total Net Margin / Total # of RX’s Submitted):
Average Net per Patient (Total Net Margin / Total # of Patient’s Submitted):
Refill % (# of Adjudicated RX’s Previous Month / # of Adjudicated Refills Current Month):