CLM-2024-89234

Under Review High Risk

Volume Rebate Claim - Johnson & Johnson

Gross Sales

$1,495,620.00

Eligible Sales

$1,342,450.00

Rebate Rate

3.9% (Tier 3)

Net Claim Amount

$52,340.00

Claim Details

Contract
CTR-2024-0089
Contract Type
Volume Rebate
Vendor
Johnson & Johnson
Claim Period
November 1-30, 2024
Transactions
1,247 line items
Created
Nov 25, 2024 09:00 AM
Assigned To
Sarah Johnson

Tier Achievement

Current Tier Tier 3 (3.9%)
Tier 1 Tier 2 Tier 3 Tier 4

2.5%

$0-500K

3.0%

$500K-1M

3.9%

$1M-2M

4.5%

$2M+

$657,550 more in eligible sales needed to reach Tier 4 (4.5%)

Calculation Breakdown

Gross Sales $1,495,620.00
Less: Non-eligible Items -$98,450.00
Less: Returns -$54,720.00
Eligible Sales $1,342,450.00
Rebate Rate (Tier 3) x 3.9%
Net Claim Amount $52,340.00
Invoice Date Customer Item Qty Unit Cost Ext. Cost Rebate Status
INV-2024-12345 11/15/2024 ABC Hospital SKU-JNJ-001 100 $12.50 $1,250.00 $48.75 Included
INV-2024-12346 11/15/2024 XYZ Medical Center SKU-JNJ-002 50 $25.00 $1,250.00 $48.75 Included
INV-2024-12347 11/16/2024 Regional Clinic SKU-JNJ-099 25 $45.00 $1,125.00 - Excluded
INV-2024-12348 11/16/2024 City Hospital SKU-JNJ-003 200 $8.75 $1,750.00 $68.25 Included
INV-2024-12349 11/17/2024 Metro Health SKU-JNJ-004 75 $32.00 $2,400.00 $93.60 Flagged

Showing 1-5 of 1,247 line items

...

Cost Validation Results

Contract Cost Match

All items match contract cost master

Pass

Lowest Eligible Cost

LEC applied: 23 items adjusted to lower contract cost

Pass

Customer Eligibility

All customers are on contract

Pass

Item Eligibility

3 items not on contract (excluded from claim)

Warning

Period Validation

All transactions within claim period

Pass

Suppression Analysis

The following rebates were suppressed based on business rules:

Suppression Type Transactions Value Suppressed Reason
ASV Suppression 45 $2,340.00 Average Selling Variance exceeded 15% threshold
Duplicate Claim 12 $890.00 Already claimed in previous period
Minimum Threshold 8 $120.00 Below minimum claim amount ($10.00)
Manual Exclusion 3 $450.00 Excluded by analyst during review
Total Suppressed 68 $3,800.00

Audit Trail

Claim Created

Nov 25, 2024 09:00 AM

Generated from batch RUN-2024-1125-001

System

Flagged for Review

Nov 25, 2024 09:15 AM

High value claim above $50,000 threshold

System

Assigned to Reviewer

Nov 25, 2024 09:30 AM

Assigned to Sarah Johnson for review

System

Review Started

Nov 25, 2024 10:30 AM

Claim opened for review

Sarah Johnson

Items Excluded

Nov 25, 2024 10:45 AM

3 line items excluded: SKU-JNJ-099 (not on contract)

Sarah Johnson

Approve Claim

Claim ID CLM-2024-89234
Amount $52,340.00

Reject Claim