RxLogic

Name

RxLogic

Legal name

RxLogic

Website

https://rxlogic.com

Company type

Private

Founded year

2015

Operating status

Operating

Headcount range

11–50 employees

Ownership category

akta.pro rank

Product category

Pharmacy Benefit Management Technology

NAICS

Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (51821), Financial Transactions Processing, Reserve, and Clearinghouse Activities (522320)

SIC

Services-Prepackaged Software (7372)

akta.pro primary industry

PBM Technology Platforms (ePA/eRx/Real-Time Benefit Tools) (HLAEAKAL)

akta.pro secondary industry

Payer-Provider Data Exchange (X12, prior auth, claims/clinical attachment) (HLACABAK)

Keywords

• Pharmacy benefit management
• Claims adjudication software
• Rebate administration
• Payment reconciliation
• PBM technology platform

Headquarters

HQ city

Asheville

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Software

Cost components

Technology or R&D, Personnel, Marketing or Sales, Infrastructure, Operations

Revenue model

1. SaaS Platform Subscriptions: RxLogic operates as a SaaS technology provider offering its pharmacy benefit platform through subscription-based agreements. Organizations access the platform's claims adjudication, rebate administration, payment reconciliation, discount card technology, prior authorization, and other modules on a recurring subscription basis.

Pricing tiers

Go-to-market motion2 records

Distribution channels3 records

Marketing channels8 records

Core offering

RxLogic provides a cloud-native, SaaS-based pharmacy benefit management platform that delivers real-time claims adjudication, rebate administration, payment reconciliation, prior authorization, network services, and discount card technology to PBMs, TPAs, health plans, and self-insured employers. The modular API-first SMART platform processes 30M+ daily transactions with sub-2-second adjudication and NDC-11 level visibility, supporting both bundled and unbundled deployment models with full data ownership and no conflict-of-interest positioning.

Product overview

RxLogic offers a unified SMART adjudication platform architecture with cloud-native, modular SaaS solutions for pharmacy benefit management. The platform centers on a core Claims Adjudication engine complemented by discrete modules including Rebate Administration (NDC-11 level tagging and client-specific allocation), PayRec (payment reconciliation and Payables/Receivables), Prior Authorization, Network Services, Job Ticket Tracker, Discount Card Program, E-Prescribing, and 340B support. All solutions share API-first architecture, white-label capabilities, and built-in transparency with pricing logic, rebate governance, and financial workflows embedded directly within the claim lifecycle. The platform supports bundled, unbundled, or hybrid pharmacy benefit models.

Differentiator

Problem solved

Functional benefit

Brands

• SMART: RxLogic's SMART adjudication platform - cloud-native technology that brings impartiality to modern pharmacy benefits, providing transparency, control, and cost savings.
• SmartBytes
• SMART Adjudication Platform
• Formulary & Benefit Connect

Products and services

• Technology Enablement Platform

Quantifiable outcome

• 99.996% adjudication uptime and 99% of claims adjudicated in sub-2 seconds (100-250 transactions/sec per instance)
• +4 more outcomes

Named customers4 records

Segments12 records

Ideal customer profiles2 records

Technology focussed Yes

API detail

Has API

Yes

API docs

API detail

Core technology

AI maturity

App detail

Integration2 records

Feature10 records

Partnerships

Five partnerships are on record, tiered core and minor.

• Waltz Health (an EVERSANA company)coreTechnology or Integration · 14 January 2026RxLogic provides its payment and reconciliation technology to power Waltz Health's prescription care platform. Waltz Health selected RxLogic for its modern cloud-based architecture, modular design, and API capabilities that support complex financial workflows for multi-constituent healthcare programs. The partnership aims to strengthen Waltz Health's operational capabilities while exploring additional collaboration areas including discount program technology integration, network expansion, and programs aimed at reducing drug costs and improving affordability for members.
• SurescriptscoreTechnology or Integration · 10 December 2025RxLogic integrated Surescripts certified eligibility and formulary solutions into its claims processing system through the RxLogic Formulary & Benefit (F&B) Connect capability. This integration provides real-time, patient-specific coverage and medication data to prescribers, payers, and PBMs, improving prescription decisions and reducing delays. Surescripts is the nation's leading health information network enabling secure, real-time access to prescription benefit and medication data.
• NCPDP (National Council for Prescription Drug Programs)coreStrategic or Co-development PartnerRxLogic is an active participant in NCPDP standards work groups and attended the 2026 NCPDP Annual Technology & Business Conference as a Gold Sponsor. The company engages in standards development discussions that shape pharmacy data exchange and prescription processing standards.
• The Granite ListminorGTM or Marketing PartnerRxLogic co-hosted a webinar titled 'Unbundled, Unbiased, Unlocked: Taking Back Control of Pharmacy Benefits' with The Granite List, a community for pharmacy benefit stakeholders. The partnership involves joint content creation and audience engagement through webinars.
• Leavitt Partners (an HMA Company)minorStrategic or Co-development PartnerRxLogic participated in a two-day NDC Implementation Workshop hosted by Leavitt Partners in Washington, D.C., bringing together over sixty industry professionals to develop a coordinated cross-sector roadmap for the FDA's 12-digit NDC format transition.

Scale indicators9 records

Recent moves6 records

Expansion highlights7 records

Emerging players

• Rx Savings Solutions: Pharmacy transparency and member engagement software that surfaces lowest-net-cost options and rebates to plan sponsors and members. Overlaps with RxLogic's discount card, rebate administration, and member-portal modules in addressing drug-cost transparency for self-funded plans.
• DrFirst: An ePrescribing, clinical decision support, and medication history vendor integrating into prescriber EHR workflows. Adjacent to RxLogic's E-Prescribing module and prior authorization integrations, particularly through smart-Script-style real-time benefit intelligence.
• Truveta: A pharmacy benefit analytics and consulting platform offering claims auditing, contract optimization, and rebate-validation tools to payers, PBMs, and employers. Comparable to RxLogic's rebate administration and PayRec modules, particularly where clients seek independent oversight of pharmacy spend.

Direct peers

• RxBenefits: A pharmacy benefit consulting and administration platform serving benefit brokers and self-funded employers. Competes with RxLogic's TPA and self-insured employer modules by combining PBM procurement, claims adjudication oversight, and rebate transparency.
• CoverMyMeds: A McKesson subsidiary providing electronic prior authorization, Real-Time Prescription Benefit, and benefit verification tools integrated into pharmacy and prescriber workflows. Competes directly with RxLogic's Formulary & Benefit Connect, prior authorization, and ePrescribing modules.
• SmithRx: A technology-first PBM purpose-built for self-funded employers, offering transparent pricing and pass-through rebates. Targets the same self-insured employer buyer that RxLogic serves through its claims adjudication and rebate administration modules.
• Capital Rx: Capital Rx operates JUDICA, a cloud-native PBM technology platform competing on price transparency, real-time adjudication, and modular architecture. Like RxLogic, it serves self-funded employers, TPAs, and unions seeking to replace Big-3 PBM infrastructure with independent software.
• MedImpact Healthcare Systems: An independent, technology-driven PBM operating its own adjudication platform serving health plans, employers, and government programs. Comparable to RxLogic as another non-Big-3 PBM emphasizing transparency, flexible plan design, and audit-ready claim-level rebate visibility.

Broad incumbents

• Surescripts: The nation's largest health information network for electronic prescribing, eligibility, and formulary data, operated as a strategic partner to RxLogic's Formulary & Benefit Connect. Functions as a peer infrastructure layer whose coverage and certification depth shape RxLogic's PBM-side data integrations.
• OptumRx: The largest US PBM and a division of UnitedHealth Group, operating a fully proprietary adjudication, rebate, and clinical management stack at massive scale. Represents both the dominant incumbent RxLogic seeks to displace and a benchmark for what enterprise buyers expect from a PBM technology platform.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks6 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/rxlogic

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles7 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about RxLogic