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NADAC Reimbursement Quarterly Report
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REPORT QUARTER Quarter 4 October-December (Due January 31st)
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Date of Submission1/22/2026
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PBM Company NameTowers Administrators LLC
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PBM Doing Business As Name (DBA)RxSense Administrators
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Iowa TPA Registration #1002121966
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PBM National Producer Number (NPN)1904568
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PBM Company Address99 High Street, Floor 28, Boston, MA 02110
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PBM Contact NameAngela Plassmann
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PBM Contact E-mailaplassmann@rxsense.com
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Person Completing ReportAngela Plassmann
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Person Completing Report E-mailaplassmann@rxsense.com
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Person Completing Report Phone413-265-1260
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Link to PBM Website where this report will be keptN/A
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Instructions
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A pharmacy benefits manager must provide to the Iowa Insurance Division a quarterly report of all claims reimbursed at 10% below and 10% above the National Average Drug Acquisition Cost.
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A PBM must submit the data requested in each tab of this file to the Division.  Data fields left blank will result in an incomplete submission of this required report. 
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Filling in the tabs labeled as 'Iowa_Retail_Pharmacies' and 'All_Other_Pharmacies' will auto-populate the corresponding 'Web' versions of these tabs.
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PBMs are required to publish the 'Web' tabs, which are the last 2 tabs of this spreadsheet, on their website for 24 months after submitting the report to the Division.
Those tabs are labeled as 'Iowa Retail Pharmacies_Web' and 'All Other Pharmacies_Web.'
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A PBM may 'hide' the 'Contact Info and Instructions' tab and the non-Web tabs when publishing the 'Web' tabs on its website. To hide a tab, hover your mouse over each tab, right click, then select 'Hide.' To unhide, right click on any other tab, select 'Unhide,' hightlight the hidden tab, and click 'OK.'
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If additional rows are needed, please contact optinsmktg@naic.org for assistance.
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Definitions
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Product NDC #National Drug Code11-digit number assigned by FDA for each drug sold in the United States
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Product NameThe NDC descriptionThe complete name of the drug/medication associated with NDC#
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Prescription claim dateDate the prescription was filledMM-DD-YYYY
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Quantity of Drug DispensedQuantity in metric decimal units# of tablets/capsules, Grams, Mililiters, etc.
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Pharmacy nameIdentification of the unique pharmacy who filled prescriptionName may include store #
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Pharmacy NPI #National Provider Identifier assigned to pharmacy10-digit number issued to pharmacy by CMS
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Amount Pharmacy Was Reimburesed $The dollar amount per Unit, Not to include the member's cost share amountIn U.S Currency (ex: $1.00)
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Dispensing Fee Paid To Pharmacy $The dollar amount paid to pharmacy for dispensing fee onlyIn U.S Currency (ex: $1.00)
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Member Cost Share Amount $The dollar amount paid by member at the point of saleIn U.S Currency (ex: $1.00)
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NADAC Per Unit $The dollar amount per unit of the National Average Drug Acquisition CostIn U.S Currency (ex: $1.00)
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NADAC Report DateDate of CMS report used to determine NADAC rateMM-DD-YYYY
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Actual Percentage Reimbursement at 10% and BelowThe actual percentage amount calculated at 10% and below the NADACPercentage to two decimals (Ex:10.25%)
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Pharmacy ChainAn entity that has twenty (20) or more pharmacies under common ownershiop or control, located in at least twenty (20) or more states.
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Retail PharmacyA pharmacy that is not a pharmacy chain or a publicy traded entity, and that does not exclusively provide mail order dispensing of prescription drugs
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Affiliate PharmacyIndicate if the dispensing pharmacy is an affiliate of the PBM pursuant to §510b.1(16)Y=Yes, N=No
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Dispensed Pursuant to a Federal, State, Or Local Government Health PlanIndiciate of the payer is a Federal, State, or local government health planY=Yes, N=No
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IA 2025 PBM NADAC Quarterly Report V411/19/2025
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