Optum Rx Genoa Pharmacy Workbench Pharmacy Care Services · Pilot Pharmacy
build 1790355941 sqlite · demo
JT

Prescription number

RX-100-F1

Benefit VerificationTier 3First fill · fill 1 of 2Source not linked
Open RxEntry
Workflow timelineCurrent: Benefit Verification · Total elapsed: 864h 49m · Revision 3

Immutable stage history

Prescription workflow timeline

3 stage records · provisional pharmacy SLA
StageStatusOwner / actorEnteredCompletedDuration / SLAOutcome
Intake / data entryRevision 1CompletedWorkbench2026-08-25 14:25 UTC2026-08-26 18:15 UTC27h 49mProvisional target 15m exceededfill overlay created
Clinical accuracy (DUR/PV1)Revision 2CompletedWorkbench2026-08-26 18:15 UTC2026-08-26 18:16 UTC45sProvisional target 30m on trackstage advanced
Benefit VerificationRevision 3CurrentWorkbench2026-08-26 18:16 UTCIn progress836h 59mProvisional target 20m exceededstage advanced
Evidence event detail 7 events
EventSourceActorDetailsRecorded at
workflow_case_createdRecorded workflow evidenceWorkbench{"rx_num":100,"refill_num":1}2026-08-25 14:25:58 +0000 UTC
stage_advancedRecorded workflow evidenceWorkbench{"from":"Intake / data entry","to":"Clinical accuracy (DUR/PV1)"}2026-08-26 18:15:36 +0000 UTC
pv1_evaluatedRecorded workflow evidenceWorkbench{"policy":"unknown legacy rules are TODO(SME)","result":"persisted"}2026-08-26 18:16:14 +0000 UTC
stage_advancedRecorded workflow evidenceWorkbench{"from":"Clinical accuracy (DUR/PV1)","to":"Benefit Verification"}2026-08-26 18:16:21 +0000 UTC
benefit_verification_recordedRecorded workflow evidenceWorkbench{"actor":"pharmacist-test-01","source":"local/test adapter","status":"APPROVED"}2026-08-27 00:44:57 +0000 UTC
benefit_verification_recordedRecorded workflow evidenceWorkbench{"actor":"pharmacist-test-01","source":"local/test adapter","status":"APPROVED"}2026-08-27 00:46:30 +0000 UTC
benefit_verification_recordedRecorded workflow evidenceWorkbench{"actor":"pharmacist-test-01","source":"local/test adapter","status":"APPROVED"}2026-08-27 00:48:16 +0000 UTC
Phase 4 validation: Benefits & ClaimDispensing remains gated until benefit evidence is resolved and every queued PSB claim has a successful adjudication.

Exception resolution

Evidence-linked resolution plan

These explanations are derived from persisted Workbench state. Only the linked authorized workflow controls can change a record.

2 open
!
Drug product

A verified matched record is required

INTAKE_DRUG_UNRESOLVED · DRUG · prescription-context:drug
ACTION_REQUIREDDrug
!
Order completeness

SIG, quantity, days supply, and fill authorization must be complete

INTAKE_ORDER_INCOMPLETE · ORDER · prescription:order
ACTION_REQUIREDPrescription
Phase 1 · Prescriber communication drafts 0 drafts · outbound disabled

Draft only

Prepare a prescriber communication

Drafts are immutable and require review by a different pharmacist. Approval does not transmit the message.

No communication drafts are recorded for this prescription.

Phase 3 · PV1 / DUR

Phase 3 · PV1 / DUR

Clinical accuracy evidence

Persisted checks and pharmacist resolution state for this fill.

MasterDURNot configured
ALLERGYProScript evidence unavailable
INFO · UNAVAILABLE

No authoritative legacy rule or source data is available; pharmacist review required.

DRUG_DISEASEProScript evidence unavailable
INFO · UNAVAILABLE

No authoritative legacy rule or source data is available; pharmacist review required.

DOSEProScript evidence unavailable
INFO · UNAVAILABLE

No authoritative legacy rule or source data is available; pharmacist review required.

DUPLICATE_THERAPYProScript evidence unavailable
INFO · UNAVAILABLE

No authoritative legacy rule or source data is available; pharmacist review required.

GPIProScript evidence unavailable
INFO · UNAVAILABLE

No authoritative legacy rule or source data is available; pharmacist review required.

PAYER_DURProScript evidence unavailable
INFO · UNAVAILABLE

No authoritative legacy rule or source data is available; pharmacist review required.

Licensed rules without authoritative results remain marked TODO(SME).
Phase 4 · Benefit review and claim adjudication

Phase 4 · Benefits & Claim

Coverage and benefit evidence

Local ProScript coverage checks are readiness evidence, not a real-time E1 eligibility response.

Status
APPROVED
Source
local/test adapter
Coverage reference
COV-SYNTHETIC-001
Eligibility
ELIGIBLE_LOCAL_TEST
Copay estimate
Not recorded
Copay result
Not available
Verifier
pharmacist-test-01
Blocking reason
Not available

Claim adjudication

Gateway
fake
Protocol
Not available
Outcome
No claim queued
Attempt
0
Response code
Not available
Message
Not available
Complete ProScript prescription record, fill history, and claim activity

ProScript prescription record

RX-100-F1

Fill 1 of 2Benefit Verificationreal SQLite fill
PatientPATIENT-BC75F18264VERIFIED
PrescriberPROVIDER-B4B58A9512VERIFIED
DrugCLOZAPINE 100MG TAB 100MGNDC 00172436060
FacilityBAHIA VISTAFACILITY-08C16F1CEE
Refills1 remainingFirst fill

Prescribed product

CLOZAPINE 100MG TAB 100MG

NDC 00172436060GPI-14 Not availableDEA N

Directions

Not supplied
Quantity
240
Days supply
28
Authorized
2 fill(s)
Origin Rx
RX-100

Clinical readiness

Allergy record
Not recorded
Diagnosis record
Not recorded
Inventory
Not available
Priority
Tier 3

Coverage routing

Payer
PRIVATE
Plan
Not available
Payer code
PR
BIN / PCN
98765400 / MEDD

Source and workflow

Source
Manual or unlinked
Workflow
case-rx-100-f1
Owner
Automation
Last updated
2006-12-22 00:00:00 +0000 UTC
Fill-scoped adjudicationOpen claim history or inspect the latest request and response.

Dispensing activity

Fill history

0 recorded

No prior fills are recorded.

Immutable evidence

Work ledger

1 records
Benefit verificationAPPROVEDlocal/test adapter

Keyboard help

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Focus the Current Work action
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Return to the prescription queue
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