Your Submission Has Been Received.
What's next?
After submitting the form, look out for an email from your designated SmithRx contact. They'll help you gather the right documents to get the repricing analysis started.
Once you send your claims history to the designated SmithRx contact, expect the custom report in 5-10 business days.
Next Steps
We'll be in touch soon to request a claims history. Get started by preparing a set of claims that include the following fields or use our Excel Template linked below:
Once you submit a request, we'll be in touch soon.
For SmithRx performance
Fill Date
NPI/NABP (Pharmacy location)
NDC
Quantity
Days Supply
Retail / Mail Indicator
Brand / Generic Indicator
For Savings Comparison
Ingredient Cost
Dispensing Fee
Plan Cost
Member Cost
AWP
Admin Fee
Rebate Figures
Download the Excel Template below to organize your claim data. Don't have historical claims? No problem. We can get started with a Top Drug analysis.
