CapitalRx
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.
- Company typePrivate
- Founded2017
- HeadquartersNew York, United States
- Headcount—
- GTM typeB2B
- OfferingSoftware
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.
CapitalRx firmographics
Firmographics- 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
CapitalRx industry classification
Industry- 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
Where CapitalRx is headquartered
LocationHeadquarters
- HQ city
- New York
- HQ country
- United States
- HQ region
- North America
Offices3 records
Markets served
CapitalRx business model
Business model- GTM type
- B2B
- Offering type
- Software
- Cost components
- Technology or R&D, Personnel, Operations, Marketing or Sales, Infrastructure
Revenue model
- 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.
- 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.
- 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.
- 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.
- 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
| Model | Billing | Price |
|---|---|---|
| Transaction based/ take rate | Pay-as-you-go | Capital Rx Advantage (Consumer Discount Card) - $0.99 per claim |
| Subscription | Annual | Full-Service PBM - Custom fee-based pricing |
| Subscription | Annual | Never Move Again (Unbundled PBM) - For 10,000+ member groups |
| Subscription | Annual | Enterprise Health Platform (Judi SaaS) - Custom SaaS arrangements |
Go-to-market motion1 record
Distribution channels5 records
Marketing channels10 records
CapitalRx product offering
Product offeringCore 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
Companies that use CapitalRx
Customer profileNamed customers6 records
Segments7 records
Ideal customer profiles5 records
CapitalRx technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- Yes
- API docs
- API detail
Core technology
AI maturity
App detail
AI capability6 records
Feature10 records
CapitalRx partnerships and signals
Strategic signalPartnerships
Six partnerships are on record, tiered major, minor and core.
- CLEARmajorJudi 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 GroupminorIndustry 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 HornetsminorMulti-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)coreCapital 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 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 FCminorCapital 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
CapitalRx competitors and assessment
Company assessmentDirect 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
CapitalRx social profiles
Digital presenceCapitalRx compliance and trust
Trust signalCompliance5 records
CapitalRx financial estimates
Financial estimateRevenue estimate
Valuation estimate
CapitalRx leadership team
Management profileNumber of profiles
Profiles15 records
CapitalRx subsidiaries and ownership
Company hierarchySubsidiaries2 records
CapitalRx funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
CapitalRx M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about CapitalRx
What does CapitalRx do?
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.
Is CapitalRx a public or private company?
CapitalRx is a private company. It is classified as venture growth investor backed and is currently operating.
When was CapitalRx founded?
CapitalRx was founded in 2017.
Where is CapitalRx based?
CapitalRx is headquartered in New York, United States, in the North America region.
How does CapitalRx make money?
Five revenue lines are on record. Pharmacy Benefit Management (PBM) Administrative Fees are the primary driver. The others are rebate Pass-Through, capital Rx Advantage (Discount Card), enterprise Health Platform (Judi SaaS) and care Navigation (Judi Care).
Who are CapitalRx's main competitors?
Direct peers on record are Navitus Health Solutions, MedImpact Healthcare Systems, SmithRx, EmpiRx Health and RxBenefits. Broad incumbents are Humana Pharmacy Solutions, CVS Caremark, Express Scripts (Cigna) and OptumRx (UnitedHealth Group). Mark Cuban Cost Plus Drug Company is listed as an emerging player.
Does CapitalRx have an API?
Yes. Capital Rx offers an open API architecture with 130+ APIs available for adjudication, prior authorization (PA), identity and access management, and more. The platform enables any vendor leveraging API technology to connect to and share data or information with Capital Rx. The company can connect with over 600 unique entities.
What industry is CapitalRx in?
CapitalRx's product category is Pharmacy Benefit Management. Its primary akta.pro industry code is HLAEAKAC, Claims Processing, Adjudication & Payment Integrity, with a secondary code of HLAEAKAD, Manufacturer Contracting, Rebates & Revenue Management. Its NAICS code is 524292 and its SIC code is 6324.