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Blue Book OptimSync Pharmacy Portal — Full Feature Documentation

This document describes all modules, dashboards, metrics, and features visible in the OptimSync Pharmacy Portal UI. It is written as formal product documentation suitable for customers, auditors, onboarding guides, and internal teams.

House 1. Home Dashboard

The Home Dashboard provides a high‑level summary of pharmacy performance, financial status, and operational alerts. It is the primary landing page when a user logs in.

1.1 Dashboard Metrics

Total 340B Margin

  • Displays the total revenue margin generated from eligible 340B claims.
  • Helps pharmacies monitor profitability.
  • Shown as: $745.75 (example value from screenshot).

Qualified Claims

  • Indicates the total number of claims that passed 340B eligibility rules.
  • Shows compliance success rate.
  • Example: 440 qualified claims.

Replenished Packages

  • Shows how many NDC packages were successfully replenished under the 340B program.
  • Helps track purchasing activity.
  • Example: 15 packages.


1.2 Invoice Summary

The dashboard categorizes invoices for easy financial tracking.

Paid Invoices

  • Displays invoices that have been fully settled.
  • Example: "No paid invoices available" if list is empty.

Unpaid Invoices

  • Shows pending invoices awaiting payment.
  • Includes invoice ID, date, and amount.

Overdue Invoices

  • Lists invoices past the due date.
  • Important for financial compliance and reconciliation.
  • Example: "No overdue invoices available".

Pill 2. Eligible Claims Module

The Eligible Claims section provides a complete, searchable, and filterable list of all prescription claims that qualify under the 340B program. This tab is crucial for pharmacies to verify eligibility, track claim status, and export data for compliance or reimbursement.

2.1 Overview of the Manage Claims Screen

The screen displays a table of all eligible claims with detailed sortable columns. Users can search, filter, and export claims instantly.

2.2 Search Bar

  • Allows searching claims by RX number, NDC, drug name, or other identifiers.
  • Supports partial keywords (e.g., entering "LIN" shows Linzess claims).
  • Helps quickly locate specific prescriptions.

2.3 Filter Options

  • Clicking the Filter button opens advanced filters such as:
  • Date range (Fill Date)
  • Covered Entity
  • Drug name / NDC
  • Status (Approved, Rejected, Pending)
  • Quantity range
These filters help users narrow down claim lists for validation, export, or reporting.

2.4 Export CSV

  • Exports the currently displayed claim list into CSV format.
  • Used for reporting, audit evidence, and external data submissions.


2.5 Claim Table Columns (Explained)

Each row represents an individual eligible claim and includes the following fields:

Covered Entity

  • Name of the healthcare facility associated with the claim.
  • Example: Axis Medical Center.

NPI

  • National Provider Identifier of the prescribing provider.
  • Used to validate CE–provider relationships.

RX Number

  • Prescription number issued by the pharmacy system.

Fill Number (Refill Count)

  • Indicates whether this claim is an original fill (0) or a refill.
  • Helps in compliance reporting.

Quantity (Qty)

  • Number of units dispensed.
  • Example: 30, 18, 60, etc.

Fill Date

  • The date on which the prescription was dispensed.
  • Example: 11/17/2025.

NDC

  • National Drug Code identifying the specific drug.
  • Used for package replenishment and claim qualification.

Drug Name

  • The commercial name of the dispensed medication.
  • Examples:
  • Linzess CAP 290MCG
  • Ventolin HFA AER
  • Janumet TAB 50-1000

Status

  • Claim eligibility result:
  • Approved → qualifies for 340B
  • Rejected → fails eligibility rules
  • Pending → needs manual review


2.6 Sorting Capabilities

Users can click column headers to sort by:
  • Fill Date
  • NDC
  • RX Number
  • Quantity
  • Drug Name
  • NPI
Sorting helps pharmacies review trends or quickly find outliers.


2.7 Workflow Example

A typical workflow for a pharmacy user on this tab:
    Search for all claims for a specific drug.
    Filter claims by date range.
    Review eligibility status and confirm 340B qualification.
    Export results as CSV for accounting or CE reporting.
    Use Ask AI to summarize or explain anomalies.


Bookmark Tabs 3. Rx Details Module

The Rx Details tab provides a complete list of all prescriptions filled by the pharmacy, regardless of 340B eligibility. It is used for operational review, compliance checks, and identifying which prescriptions qualify or fail the 340B rules.

3.1 Features

  • Search prescriptions by RX number, NDC, or drug name.
  • Export complete RX lists as CSV for audit or internal review.
  • Filter by fill dates, drug, provider, or status.

3.2 Table Columns Explained

Rx Number

Unique identifier of the prescription.

Fill Date

The date the prescription was dispensed.

Fill Number

Indicates if the claim is an original (0) or refill.

340B Status

Shows whether the RX qualifies for 340B:
  • Qualified → meets compliance rules
  • Not Qualified → fails matching or eligibility requirements
This helps users see which prescriptions may later appear in the Eligible Claims section.


Package 4. Inventory Module

The Inventory tab tracks drug stock levels, replenishment activity, and 340B qualification volumes.

4.1 Search & Filters

  • Search by NDC or drug name.
  • Filter by store, covered entity, or unit type.

4.2 Inventory Table Columns

Pharmacy

Name of the pharmacy tied to the drug.

Covered Entity

The CE associated with the drug and its qualified claims.

Drug NDC

Unique 11-digit code identifying the medication.

Drug Name

Product name used in dispensing.

Qualified Units

Number of dispensed units that qualify for 340B.

Replenished Units

Units already replenished by wholesalers.

Variance Units

Difference between qualified and replenished units:
Positive variance means replenishment is pending.

Shopping Cart 5. Orders Module

The Orders tab allows pharmacies to manage 340B replenishment orders.

5.1 Actions Available

Place New Order

Create a replenishment purchase order tied to qualified claim volumes.

Export CSV

Export all order data for financial or CE reporting.

5.2 Order Table Columns

Order Number

Unique identifying code for each replenishment order.

# of Items

Number of NDCs included in the order.

Order Date

When the order was placed.

Store Name

Pharmacy placing the order.

Status

Tracking status of each order:
  • Preparing
  • Submitted
  • Pending Approval
  • Delivered

Due From Pharmacy

Dollar amount the pharmacy owes for the replenishment.

Details

Opens a detailed view of ordered NDCs, quantities, and invoice details.


Dollar Banknote 6. Financials Module

The Financials section provides an overview of invoices and payment responsibilities.

6.1 Search

Search invoices by invoice number.

6.2 Table Columns

Pharmacy

The pharmacy tied to the invoice.

Invoice Number

Clickable ID linking to full invoice details.

Invoice Total

Amount billed.

Invoice Date

Date invoice was issued.

Invoice Due Date

Deadline for payment.

Status

Indicates payment condition:
  • Paid
  • Unpaid
  • Overdue


Hospital 7. Covered Entity Information

Displays all Covered Entities connected with the pharmacy.

7.1 Features

  • Search by CE name.
  • View CE-related configuration.

7.2 Table Columns

Covered Entity

CE name.

Unique URL

Custom CE portal link.

340B ID

Federal 340B entity identifier.

Status

Indicates whether the CE relationship is Active or Inactive.

Created On

Date the CE profile was added.


Gear 8. Settings

The Settings tab contains all profile and staff management tools.

8.1 General Profile

Fields include:

  • Profile Picture
  • First Name
  • Last Name
  • Phone Number
  • Email
  • Address
  • Change Password option

8.2 Staff Management

  • Add or manage pharmacy staff.
  • Assign user roles.
  • Enable or disable account access.


Robot 9. Ask AI (OptimSync AI Assistant)

The Ask AI feature provides real-time AI-powered assistance.

Capabilities

  • Answer pharmacy workflow questions.
  • Summaries of claims or invoices.
  • Eligibility explanations.
  • Quick action suggestions (e.g., "show all unpaid invoices").
  • Analyze claim failure reasons.

Ask AI — Example Use Cases

  • "Show my last 10 qualified claims."
  • "Why did claim #123 fail qualification?"
  • "Summarize overdue invoices."
  • "Explain how 340B margin is calculated."

Ask AI History Records

  • Every AI interaction is stored.
  • Users can review earlier AI suggestions.
  • Great for audit tracking and internal training.


BooksClaims List on Dashboard

The dashboard also shows a quick-view list of claims.

Displayed Items

  • Claim date
  • Drug name
  • Status
  • Claim value
  • Navigation to full claim details


Pushpin Summary

This portal provides:
  • Full financial transparency
  • 340B program compliance
  • Inventory & order automation
  • Real-time analytics
  • Integrated AI support
It is designed to simplify pharmacy operations while ensuring regulatory compliance.