Platform Data

Pharmacy Billing Research

Primary data from 50+ independent pharmacies on billing discrepancies, NDC swap patterns, PBM reimbursement trends, and revenue recovery benchmarks.

50+
Pharmacies Analyzed
Independent pharmacies nationwide
$2.4M+
Revenue Recovered
Identified and recovered for clients
98%+
Match Accuracy
NDC-level reconciliation precision
<3 min
Time to Report
From upload to full analysis

Industry Benchmarks

Key metrics from published pharmacy industry research and RxDelta platform analysis.

2-5%of prescription revenue lost to billing discrepancies at the average independent pharmacy
4-6 hrsspent on manual reconciliation per pharmacy per month using spreadsheets
8-15%error rate in manual spreadsheet-based reconciliation processes
$200K-$500Kaverage monthly prescription revenue for independent pharmacies

NDC Swap Insights

NDC swaps are the leading cause of phantom shortages in pharmacy reconciliation. Here is what our data shows.

5-15different NDC codes per therapeutic equivalent for generic medications
30-50%of total billing discrepancies caused by undetected NDC swaps
#1cause of phantom shortages in pharmacy reconciliation reports

PBM Reimbursement Trends

Pharmacy benefit manager reimbursement patterns observed across our pharmacy network.

2-4%average DIR fee as a percentage of gross reimbursement - and rising year over year
14-45 daysaverage days-to-pay range across PBMs, with significant variation by carrier
Significantreimbursement rate variation across PBMs for identical medications and NDCs

Methodology

RxDelta platform statistics are derived from anonymized, aggregated reconciliation data across 50+ independent pharmacies operating in the United States. All data is de-identified prior to analysis - no individual pharmacy, patient, or prescriber information is disclosed.

Industry benchmarks are sourced from a combination of RxDelta platform observations and published research from the National Community Pharmacists Association (NCPA), the National Association of Chain Drug Stores (NACDS), the Centers for Medicare & Medicaid Services (CMS), and peer-reviewed pharmacy economics literature.

Statistics are based on a rolling 12-month analysis window and are reviewed quarterly for accuracy. Platform-specific metrics (match accuracy, time to report, revenue recovered) reflect actual system performance measured across all active customer accounts.

Frequently Asked Questions

Where does RxDelta's research data come from?

Our data is aggregated from anonymized reconciliation reports across 50+ independent pharmacies nationwide. All data is de-identified and analyzed in aggregate - no individual pharmacy or patient data is ever disclosed. Statistics are based on a rolling 12-month analysis window.

How often is this data updated?

Platform statistics (pharmacies analyzed, revenue recovered, accuracy rates) are updated continuously as new reconciliation reports are processed. Industry benchmarks are reviewed quarterly against published research from NCPA, NACDS, and CMS data sources.

What is a pharmacy billing discrepancy?

A billing discrepancy occurs when there is a mismatch between what was dispensed and billed versus what was purchased. Common causes include NDC swaps (same drug billed under different codes), quantity mismatches, PBM underpayments, and claims processing errors. RxDelta detects these automatically.

How much revenue do pharmacies typically recover with RxDelta?

Based on our platform data, pharmacies using RxDelta identify an average of 2-5% of prescription revenue in billing discrepancies. For a pharmacy doing $300,000/month in Rx revenue, that translates to $6,000-$15,000/month in recoverable revenue. The exact amount depends on claim volume, payer mix, and current reconciliation practices.

Can I use this data in my own reports or presentations?

Yes. You are welcome to cite RxDelta research data with attribution (e.g., 'Source: RxDelta Platform Data, 2024-2026'). For custom data requests, media inquiries, or partnership opportunities, contact us at research@rx-delta.com.

See What Your Pharmacy Is Missing

Join 50+ pharmacies using RxDelta to identify billing discrepancies and recover lost revenue.