CapitalRx

What CapitalRx does

Capital Rx, operating as Judi Health since a September 2025 rebrand, is a US-based pharmacy benefit management (PBM) and health benefits technology company founded in 2017 and headquartered in New York. The company serves self-funded employers with 10,000+ members, labor unions, municipalities, commercial and Medicare/Medicaid health plans, TPAs, and benefits brokers/consultants. Its core differentiator is Judi, a cloud-native enterprise health platform built post-Medicare Part D that unifies pharmacy benefit workflows including claims adjudication, prior authorization, data integration, client reporting, invoicing, and reimbursement on a single instance capable of processing 180 million lives in real time, with 130+ open APIs supporting integration with more than 600 connected entities. In January 2025 Judi Health launched the first Unified Claims Processing platform spanning pharmacy, medical, vision, and dental benefits, and the June 2025 acquisition of Amino Health added AI-powered care navigation (branded Judi Care). The platform is protected by US Patent 11,983,192 covering the data tagging system and certified under SOC 1 Type 1, SOC 2 Type 2, URAC PBM (valid through 2027), HITRUST i1, NCQA Health Plan Accreditation, and Validation Institute.

The company's business model is a transparent, fee-based PBM administration model with 100% pass-through of pharmaceutical manufacturer rebates, no spread pricing, and no hidden fees. Revenue streams include recurring administrative fees on full-service PBM contracts, subscription fees for Judi SaaS and care navigation, transaction fees on the Capital Rx Advantage discount card ($0.99 per adjudicated claim), and white-label arrangements with organizations distributing the discount card to underinsured populations. Pricing is NADAC-based for the commercial retail network, providing drug price deflation rather than list-price inflation. Sales motion is enterprise field sales with 90-day commercial implementations and 9–12 month health plan implementations, supported by a broker and consultant channel. As of January 2026 the company surpassed 5 million contracted PBM lives and maintains a 99.5% client retention rate with a combined client and member Net Promoter Score of 96.

Capital Rx has raised approximately $450M+ across Series B (2020), Series C (2022), a $50M+ strategic round (2023), and a $400M round in September 2025 (including a $252M Series F led by Wellington Management and General Catalyst). Notable strategic relationships include a 2024 alliance with Prime Therapeutics (PBM owned by 18 Blue Cross and Blue Shield plans), a 2026 partnership with CLEAR for identity verification, and high-profile sports marketing partnerships with the Charlotte Hornets (NBA jersey patch) and NYC FC (MLS sleeve partner). The company is led by founder and CEO AJ Loiacono, with an executive team sourced from Medco, CVS/Caremark, OptumRx, Truveris, and other incumbents, lending institutional credibility to enterprise health plan buyers.

Name

CapitalRx

Legal name

Capital Rx, Inc.

Website

https://cap-rx.com

Company type

Private

Founded year

2017

Operating status

Operating

Short description

Capital Rx, operating as Judi Health, is a US pharmacy benefit manager and health benefits technology company serving self-funded employers, health plans, labor unions, and TPAs through its cloud-native Judi enterprise health platform, offering transparent pass-through pricing, unified pharmacy/medical/dental claims processing, and AI-powered care navigation across more than 5 million contracted lives.

Ownership category

akta.pro rank

Product category

Pharmacy Benefit Management

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)

SIC

Hospital & Medical Service Plans (6324)

akta.pro primary industry

Claims Processing, Adjudication & Payment Integrity (HLAEAKAC)

akta.pro secondary industries

Manufacturer Contracting, Rebates & Revenue Management (HLAEAKAD), PBM Technology Platforms (ePA/eRx/Real-Time Benefit Tools) (HLAEAKAL), Pharmacy Benefit Management (PBM) & Formulary Management IT (HLACAKAD), Formulary Management & Clinical Pharmacy Programs (HLAEAKAA)

Keywords

• Pharmacy benefit management
• Health benefits technology
• Enterprise health platform
• Unified claims processing
• Transparent PBM pricing

Headquarters

HQ city

New York

HQ country

United States

HQ region

North America

Offices3 records

Markets served

GTM type

B2B

Offering type

Software

Cost components

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

Revenue model

1. Pharmacy Benefit Management (PBM) Administrative Fees: Fee-based pricing model with clear, transparent administrative fees. No spread pricing, no hidden fees, 100% pass-through of pharmaceutical manufacturer revenue including rebates. Clients pay a flat administrative fee with full financial alignment.
2. Rebate Pass-Through: All pharmaceutical manufacturer rebates and revenue streams are fully passed through to plan sponsors. No rebate retention. Rebate definition includes all manufacturer revenue streams.
3. Capital Rx Advantage (Discount Card): $0.99 flat fee per adjudicated claim with no hidden costs. No clawbacks. Simple fee structure for prescription discount card program.
4. Enterprise Health Platform (Judi SaaS): Software-as-a-service arrangement delivering Judi platform to customers. Enterprise Solutions team accountable for delivery and service of Judi as a platform to customers leveraging SaaS arrangements. Modular services include data exchange, clinical services, and point solution integration.
5. Care Navigation (Judi Care): AI-powered care navigation solution acquired through Amino Health acquisition, now branded as Judi Care, helping members find care, book appointments, and understand benefits.

Pricing tiers

Go-to-market motion1 record

Distribution channels5 records

Marketing channels10 records

Core offering

Capital Rx delivers full-service and unbundled pharmacy benefit management (PBM) to self-funded employers, health plans, TPAs, labor unions, and Medicare/Medicaid sponsors, supported by Judi, its cloud-native enterprise health platform. The platform performs real-time claims adjudication, prior authorization, eligibility, invoicing, and rebate processing on a single instance, and now extends to unified pharmacy, medical, vision, and dental claims. Clients receive 100% manufacturer rebate pass-through, NADAC-based drug pricing, and no spread pricing.

Product overview

Capital Rx (rebranded as Judi Health in September 2025) operates as a health benefits technology company offering a platform-plus-modules architecture. The core is Judi, a cloud-native enterprise health platform that handles claims adjudication, prior authorization, and data management. This platform underpins all products including Full-Service PBM for employers and health plans, Never Move Again for unbundled pharmacy benefits, and the Judi Health unified claims processing platform combining pharmacy, medical, vision, and dental. Additional modules include Judi Care for AI-powered care navigation, Capital Rx Advantage for prescription discount cards, MPPP for Medicare compliance, and Capital Equilibrium for level-funded benefits.

Differentiator

Problem solved

Functional benefit

Brands

• Judi®: AI-powered enterprise health platform that unifies pharmacy benefit management operations
• Capital Rx Advantage
• Judi Care
• Never Move Again™
• Capital Equilibrium
• Single-Ledger Model™
• Judi Health™

Products and services

• Judi Enterprise Health Platform Cloud-native enterprise health platform that unifies all pharmacy benefit operations - including claims adjudication, prior authorization, eligibility, data integration, patient communication, client reporting, invoicing, and reimbursement - on a single scalable instance with real-time processing and 130+ open APIs. Sold to health plans and large self-funded employers as a SaaS platform.
• Full-Service Pharmacy Benefit Management (PBM) Turn-key pharmacy benefit solution for self-funded plan sponsors including claims processing, customer service, network management, clinical programs, and 100% manufacturer rebate pass-through with NADAC-based pricing and no spread pricing.
• Never Move Again (Unbundled Pharmacy Benefits) Modular, unbundled pharmacy benefit management solution for large self-funded employers with 10,000+ members. Provides transparent administrative fees, 100% rebate pass-through, NADAC-based pricing, and freedom to evaluate and select fulfillment and commodity services independently via the Judi platform.
• Judi Care (Care Navigation) AI-powered care navigation solution that helps plan members find care, book appointments, and understand their benefits by leveraging industry-leading data sources and the Judi enterprise health platform to reduce barriers to care.
• Capital Rx Advantage (Discount Card) Prescription discount card program offering savings on medications at 65,000+ retail pharmacies. Free for consumers to download with a $0.99 flat fee per adjudicated claim and no clawbacks. Available as a white-label program for organizations serving underinsured populations.
• Medicare Prescription Payment Plan (MPPP) Medicare Part D solution handling MPPP payments, collections, PDEs, CMS reporting, cost tracking, enrollment, and pharmacy notifications, with automatic updates to maximum monthly cap thresholds, delivered through the Judi platform.
• Capital Equilibrium (Level-Funded Pharmacy Benefits) Level-funded pharmacy benefit program providing predictable pricing and budget certainty for plan sponsors seeking transparent PBM economics with limited financial risk.
• Judi Health (Unified Claims Processing Platform) Healthcare's first Unified Claims Processing platform spanning pharmacy, medical, vision, and dental benefit programs, eliminating administrative waste and redundancies across benefit lines by combining claims adjudication on a single platform.

Quantifiable outcome

• 10-30% reduction in PMPM costs in first full year
• +7 more outcomes

Named customers6 records

Segments7 records

Ideal customer profiles5 records

Technology focussed Yes

API detail

Has API

Yes

API docs

API detail

Core technology

AI maturity

App detail

AI capability6 records

Feature10 records

Partnerships

Six partnerships are on record, tiered major, minor and core.

• CLEARmajorTechnology or Integration · 1 May 2026Judi Health partnered with CLEAR as a Preferred Identity Verification Partner. CLEAR provides secure, biometric identity verification technology that Judi Health integrates to power secure and interoperable health benefits access for members.
• The Judi GroupminorChannel Partner/ Reseller/ Distributor · 1 January 2026Industry veterans launched The Judi Group in January 2026 as the first health benefits advisory firm focused on fiduciary compliance, cost control, and plan oversight for employers. Operating independently from Judi Health.
• Charlotte HornetsminorGTM or Marketing Partner · 1 September 2025Multi-year jersey patch partnership with the Charlotte Hornets NBA team. Judi Health's branding appears on the right front jersey patch of Charlotte Hornets players, providing significant sports marketing visibility.
• Amino Health (Acquired, now Judi Care)coreStrategic or Co-development Partner · 1 June 2025Capital Rx acquired Amino Health in June 2025, rebranding it as Judi Care. Amino Health is an AI-powered care navigation company that helps plan members find care, book appointments, and understand their benefits. This acquisition enabled the launch of Judi Health's unified claims processing platform.
• Prime TherapeuticsmajorStrategic or Co-development Partner · 1 January 2024Strategic alliance with Prime Therapeutics announced in 2024. Prime Therapeutics is a pharmacy benefit management company owned by 18 Blue Cross and Blue Shield plans, serving as a significant strategic relationship in the PBM ecosystem.
• NYC FCminorGTM or Marketing Partner · 1 January 2024Capital Rx became New York City FC's official sleeve partner in 2024, providing brand visibility through Major League Soccer.

Scale indicators16 records

Recent moves12 records

Expansion highlights8 records

Direct peers

• Navitus Health Solutions: Independent, transparent PBM owned by SSM Health and Costco, serving health plans, employers, and government programs. Closely comparable to Capital Rx on pass-through model and health plan segment focus.
• MedImpact Healthcare Systems: Independent, PBM-only (no retail pharmacy) competitor serving health plans, employers, and government programs with a transparent, client-aligned model. Comparable business model and customer set to Capital Rx.
• SmithRx: Transparent, pass-through PBM purpose-built for self-funded employers. Competes head-to-head with Capital Rx/Judi Health in the same RFP-based enterprise channel, with similar fee-based economics and a focus on mid-market and large employers.
• EmpiRx Health: Pass-through PBM emphasizing clinical pharmacy and member outcomes for self-funded employers and labor unions. Directly comparable to Capital Rx on transparent pricing and employer-centric GTM.
• RxBenefits: PBM aggregator focused on mid-market employers via the broker channel. Comparable GTM motion and employer-segment focus, although with a traditional (rather than pass-through) economic model.

Broad incumbents

• Humana Pharmacy Solutions: PBM inside Humana, with strong Medicare Part D franchise. Relevant incumbent especially in the Medicare Part D sponsor segment where Capital Rx's MPPP product competes.
• CVS Caremark: PBM arm of CVS Health with vertically integrated specialty pharmacy, retail, and (via Aetna) insurance. The benchmark incumbent whose rebate-retention economics Capital Rx explicitly attacks.
• Express Scripts (Cigna): Largest standalone PBM in the US (vertically integrated with Evernorth/Cigna). Sets the dominant industry economics Capital Rx is disrupting; key competitive incumbent in any large employer or health plan RFP.
• OptumRx (UnitedHealth Group): PBM of UnitedHealth Group, the largest US health insurer by membership. Most consequential incumbent: vertical integration with UnitedHealthcare insurance, Optum Health providers, and specialty pharmacy creates structural lock-in that Capital Rx must overcome in RFPs.

Emerging players

• Mark Cuban Cost Plus Drug Company: Transparent, low-cost pharmacy operating with a cost-plus pricing model rather than a traditional PBM structure. Tangentially comparable on the transparency narrative but not a direct PBM competitor; an adjacent disruptor that affects employer and consumer expectations.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xtwitter.com/capitalrx
• YouTubeyoutube.com/channel/UC27mtrNZoyFnf6BQNZsHYhZ
• Facebookfacebook.com/CapitalRx
• LinkedInlinkedin.com/company/capital-rx
• Instagraminstagram.com/capitalrx

Compliance5 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles15 records

Subsidiaries2 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 CapitalRx