PayerIQ
Production
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Tier 3MDPBM

Capital Rx

Monitor & nurture — quarterly touchpoints + data sharing

Composite
52.5
Rank
#195
Members
21.0M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
71
+17.8
Lives
20%
46
+9.2
Geography
20%
52
+10.4
Restrictions
15%
10
+1.5
Relationship
10%
82
+8.2
Financials
10%
55
+5.5
Composite Score52.5
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 17.8 + 9.2 + 10.4 + 1.5 + 8.2 + 5.5 = 52.5
Intelligence

Qualitative intelligence

Members
21.0M
Drug spend
$7.6B
Formulary
2-tier
PA / RA level
None
Biosimilar policy
Preferred substitution
Avg reimbursement
27 days
Strategic notes

Recent merger with regional system creates expanded formulary committee access

Peer set

Closest peers in PBM

Elixir Industries
OR · Tier 3
56.1
+3.6
AllianceRx Walgreens Prime Health Plan
HI · Tier 3
56.2
+3.7
Zinc Health Services HMO
WA · Tier 3
56.9
+4.3
OptumRx MCO
MD · Tier 3
56.9
+4.4
OptumRx
CT · Tier 2
58.3
+5.7
Playbook · Tier 3

Engagement timeline

Week 2
Account manager check-in
Bi-annually
Formulary monitoring report