✓ Tier 5 confirmed — specialty revenue of $42,172,793 through Apr 2026 exceeds the $34,233,123 threshold after just 6 months. Year-end true-up of $1,420,249 is locked.
Specialty Revenue YTD
$42.2M
6 months complete
Apr Specialty Revenue
$7.80M
COG 60.6% — on target
Apr 340B Utilization
80.6%
Watch — target is 85%
Gross Profit YTD
$14.82M
6 months complete
Net Profit YTD (adj)
$11.74M
After base fee + Tier 5 accrual
Avg Gross Margin
35.1%
vs 42% target (Feb drag)
Year-End True-Up Tracker — Tier 5 ($1,420,249 due Nov 2026)
$710,124
Accrued to date (6 months)
$710,125
Remaining to accrue (6 months)
$118,354
Monthly accrual rate
Specialty Revenue — Actual vs Budget ($M)
ActualBudget
Specialty COG % — Actual vs 58% Budget
Actual COG %Budget 58%
Specialty Gross Profit — Actual vs Budget ($M)
Actual GPBudget GP
Full Year Specialty Projection vs Budget ($M)
Projection excludes Feb outlier — uses avg of Nov, Dec, Jan, Mar for remaining months.
Retail Pharmacy
Retail Revenue YTD
$4.13M
6 months Nov 25 – Apr 26
Retail Gross Profit YTD
$1.38M
33.5% margin (incl. Mar credit)
Avg Retail GM% (ex-Mar)
19.1%
Mar excluded — inventory return
Apr Retail GM%
55.1%
$499,843 gross profit
Retail Gross Margin % — Monthly vs 22% Benchmark
Green ≥22% · Amber 15–21% · Red <15% · * March reflects inventory return credit
Industry benchmark 22%NCPA avg 19.7%
Retail Revenue — Monthly ($)
◆ This tab reflects Specialty Pharmacy performance only. Budget is $82M annual specialty revenue at 58% COG.
Budget: $82M specialty revenue · 58% COG target · Monthly = 1/12 annual · Variance = Actual − Budget (green = favorable for revenue/GP/net; red = over budget for COG)
Monthly Budget vs Actual — Specialty Segment
Line item
Budget/mo
Nov 25
Var
Dec 25
Var
Jan 26
Var
Feb 26
⚠ Var
Mar 26
Var
Apr 26
Var
⚠ Feb 2026 — WAC overpurchasing + $500K dead specialty inventory writedown. Operational correction implemented. Not indicative of ongoing performance.
YTD Cumulative Budget vs Actual (6 months)
Line item
YTD Budget
YTD Actual
Variance $
Variance %
Enter weekly 340B and WAC purchase totals. Scores against the 85/15 target and alerts immediately. Data saves in this browser — designate one person to enter data.
Add Weekly Purchase Data
Weekly History — WAC/340B Split
Week Ending340B SpendWAC Spend340B %Status
Weekly 340B % vs 85% / 80% Targets
340B %Target 85%Watch 80%
◆ This tab reflects Specialty Pharmacy performance only. Retail figures are tracked separately in the Retail P&L tab.
Fee structure: $394,513/month base + $118,354/month Tier 5 accrual = $512,867 effective monthly. Lump sum true-up of $1,420,249 due Nov 2026. Total Year 4 fee burden: $6,154,405.
Year 4 P&L — Specialty Segment (Accrual-Adjusted)
Line item
Nov 25
Dec 25
Jan 26
Feb 26
Mar 26
Apr 26
YTD
Revenue
Specialty revenue
$5,934,587
$7,676,005
$6,859,345
$6,539,742
$7,363,114
$7,800,000
$42,172,793
Retail revenue
$463,889
$561,057
$789,608
$746,819
$664,619
$906,917
$4,132,909
Total revenue
$6,398,476
$8,237,062
$7,648,953
$7,286,561
$8,027,733
$8,706,917
$46,305,702
Cost of Goods — Specialty
Drug spend (COG)
($4,075,726)
($4,789,899)
($4,749,331)
($5,355,580)
($3,658,467)
($4,728,577)
($27,357,580)
Specialty gross profit
$1,858,861
$2,886,106
$2,110,014
$1,184,162
$3,704,647
$3,071,423
$14,815,213
Gross margin %
31.3%
37.6%
30.8%
18.1%
50.3%
39.4%
35.1%
Partner Fees
Base fee ($394,513/mo)
($394,513)
($394,513)
($394,513)
($394,513)
($394,513)
($394,513)
($2,367,078)
Tier 5 accrual ($118,354/mo)
($118,354)
($118,354)
($118,354)
($118,354)
($118,354)
($118,354)
($710,124)
Specialty net profit
$1,345,994
$2,373,239
$1,597,147
$671,295
$3,191,780
$2,558,556
$11,738,011
Net margin % (adj)
22.7%
30.9%
23.3%
10.3%
43.3%
32.8%
27.8%
Year-End Settlement (Nov 2026)
Tier 5 true-up (lump sum)
Accrued monthly above — $1,420,249 lump sum due Nov 2026
($1,420,249)
⚠ Feb 2026 — WAC overpurchasing + $500K dead specialty inventory writedown. Operational correction implemented. Not indicative of ongoing performance.
Revenue vs COG vs Gross Profit ($M)
Specialty Net Profit — Monthly ($M)
◆ This tab reflects Specialty Pharmacy performance only. All metrics — 340B utilization, COG %, margins, and revenue — are specialty segment figures.
Scored against accrual-adjusted net margin — most conservative and accurate view. Select a month to view its live scorecard.
All Months vs Benchmarks
Metric
Target
YTD
Nov 25
Dec 25
Jan 26
Feb 26
Mar 26
Apr 26
⚠ Feb 2026 — WAC overpurchasing + $500K dead specialty inventory writedown. Not indicative of ongoing performance.
Benchmark Reference — Year 4 Targets
Metric
Target (green)
Watch (amber)
Act (red)
340B utilization
≥ 85%
80–84%
< 80%
ⓘ Theoretical 340B ceiling is 86.1% due to $550K/mo structural Medicaid WAC floor (13.9% of COG). Target 85% / Watch 80–84%.
WAC utilization
≤ 15%
16–20%
> 20%
Specialty gross margin
≥ 40–42%
35–39%
< 35%
Specialty net margin (adj)
≥ 30–32%
25–29%
< 25%
COG as % of specialty revenue
≤ 60%
61–65%
> 65%
Partner fee as % of gross profit
≤ 15%
16–25%
> 25%
Monthly specialty revenue
≥ $7.0M
$6.83M–$6.99M
< $6.83M
Monthly GP floor
≥ $2.6M
$1.8M–$2.59M
< $1.8M
◆ This tab reflects Specialty Pharmacy performance only. Charts show specialty COG split (340B vs WAC), specialty margins, and specialty fee burden.
340B % of COG — Monthly vs Targets (85% / 80% / 75%)
340B %Target 85%Watch 80%
Gross Margin vs Net Margin (adj) vs Targets (%)
Gross marginNet margin (adj)
Partner Fee as % of Gross Profit — incl. accrual
Green ≤15% · Amber 16–25% · Red >25%
Partner Fee as % of Specialty Revenue — vs 18% Contract Baseline
18% = vendor's contracted rate at projected revenue of $26.3M · MVHS actual reflects 3.2x over-projection
Actual fee %Contract baseline 18%Internal target 15%
340B vs WAC Drug Spend — Monthly ($M)
340BWAC
Retail P&L tracks the non-specialty pharmacy book. Revenue = Total Sales minus Specialty. No WAC/340B split tracked on retail side.
⚠ March retail COG reflects a large inventory return credit — gross margin of 87.6% is not representative of run rate. Excluding March, avg retail gross margin is 19.1%.
Retail Revenue YTD
$4.13M
6 months Nov 25 – Apr 26
Retail COG YTD
$2.75M
incl. Mar inventory return credit
Retail Gross Profit YTD
$1.38M
33.5% margin
Avg Retail GM% (ex-Mar)
19.1%
Mar excluded — inventory return
Retail P&L — Monthly (Nov 2025 – Apr 2026)
Line item
Nov 25
Dec 25
Jan 26
Feb 26
Mar 26
Apr 26
YTD
Revenue
Total pharmacy sales
$6,398,476
$8,237,062
$7,648,953
$7,286,561
$8,027,733
$8,706,917
$46,305,702
Less: Specialty revenue
($5,934,587)
($7,676,005)
($6,859,345)
($6,539,742)
($7,363,114)
($7,800,000)
($42,172,793)
Retail revenue
$463,889
$561,057
$789,608
$746,819
$664,619
$906,917
$4,132,909
Cost of Goods — Retail
Retail drug COG
($376,398)
($694,605)
($504,475)
($684,639)
($82,132)*
($407,074)
($2,749,323)
Retail COG %
81.1%
neg
63.9%
91.7%
12.4%*
44.9%
66.5%
Retail gross profit
$87,491
($133,548)
$285,133
$62,180
$582,487*
$499,843
$1,383,586
Retail gross margin %
18.9%
(23.8%)
36.1%
8.3%
87.6%*
55.1%
33.5%
Notes
* March COG reflects large inventory return credit — not representative of run rate. Dec and Feb source data under review.
ⓘ Retail revenue = Total pharmacy sales minus specialty segment. Apr retail of $906,917 reflects the delta between $8,706,917 total sales and $7,800,000 specialty. No 340B/WAC tracking on retail side.
* March retail COG of $82,132 reflects a large inventory return credit and is not representative of run rate. Excluding March, average retail gross margin is 19.1%.
Retail Pharmacy — Industry Benchmarks
ⓘ Source: 2024 NCPA Digest & HHS supply chain margins report. Benchmarks reflect community/retail pharmacy gross margin industry averages. Hospital-affiliated retail may differ based on payer mix.
Green Threshold
≥ 22%
At or above industry avg
Amber Threshold
15–21%
Below industry avg (NCPA 19.7%)
Red Threshold
< 15%
Significantly below benchmark
MVHS Avg (ex-Mar)
19.1%
Amber — just below 2024 NCPA avg
Metric
Industry Benchmark
MVHS YTD
MVHS ex-Mar
Status
Retail gross margin %
19.7% (NCPA 2024)
33.5%
19.1%
Amber (ex-Mar)
Retail COG %
~78–80%
66.5%
~80.9%
Amber (ex-Mar)
Retail as % of total pharmacy rev
N/A — program specific
8.9%
—
Tracking
ⓘ Dec and Feb below red threshold — source data under review. Mar excluded (inventory return credit). YTD margin skewed by Mar anomaly.