Dr. R. Whitfield

Internal MedicineRoanoke, VANPI 1487203955panel as of Sep 19

Slots this week

3of 4

1 already spent this week · 2 of the 12 rows below earn one

Your weekly cap4

Your measured saturation point is 4. Above 4 sends in a week your own open rate falls below half its 43.0% four-year average. Nobody typed that number — it is measured over 461 sends. Set the cap lower and the board re-ranks; the alerts that fall out do not get sent.

Open rate: 43.0%
Reply rate: 12.8%
Median latency: 60.5 min
Best hour: Tue 07:00
Cost of one uncorroborated send: none95% CI -2.0 to +3.5 pts, n=367

Sent · 4 of 12

2in-channelSTALE — a clinical window closes before the cash arrives. Re-issue, substitute or escalate: all three are prescriber acts.

2off-channelSTRUCTURAL — no date exists this plan year. A prescriber decision, taken in the assistance queue, spending no slot.

Not sent · 8 of 12

6suppressedTIMING — believed completely, and still not sent. The patient reaches the copay on their own money inside the clinical window, so there is no physician act. Our own attention engine, applied to our own best-scoring rows, refuses them.

2refusedOne source. Claims says the script was never picked up and the ledger produced no dated verdict, or the reverse. Not an affordability finding.

0heldCorroborated and actionable, outranked this week. It waits, it does not die.

Panel

2 sent2 off-channel6 suppressed0 held2 refused

State	Ref	Drug + copay	Index claims	Ledger bank	Ready	Why
Sent	P.S.rx-1043	Insulin glargine (Lantus)$145.00	no-fill	STALE	Oct 213d	Re-issue, substitute or escalate — the clinical window closes first.clinical window closes Sep 22 · bridge $145.00
Sent	D.A.rx-1052	Insulin glargine (Lantus)$118.00	no-fill	STALE	Sep 256d	Re-issue, substitute or escalate — the clinical window closes first.clinical window closes Sep 15 · bridge $118.00
Off-channel	M.D.rx-1049	Dulaglutide (Trulicity)$95.00	no-fill	STRUCTURAL	—	no date exists this plan year · routed to patient assistance off-channel · consumes no slot
Off-channel	C.L.rx-1044	Tirzepatide (Mounjaro)$1,240.00	no-fill	STRUCTURAL	—	no date exists this plan year · routed to patient assistance off-channel · consumes no slot
Suppressed	B.H.rx-1047	Levothyroxine 88mcg$40.00	no-fill	TIMING	Oct 415d	Nothing to do. The fill happens on payday either way.TIMING — the patient fills on payday either way, Oct 4 (15d). No physician action. Not sent, and it costs no slot.
Suppressed	H.K.rx-1051	Albuterol HFA (ProAir)$18.00	no-fill	TIMING	Sep 19today	Nothing to do. The fill happens on payday either way.TIMING — the patient fills on payday either way, Sep 19 (0d). No physician action. Not sent, and it costs no slot.
Suppressed	G.P.rx-1050	Escitalopram 10mg$210.00	no-fill	TIMING	Sep 256d	Nothing to do. The fill happens on payday either way.TIMING — the patient fills on payday either way, Sep 25 (6d). No physician action. Not sent, and it costs no slot.
Suppressed	D.W.rx-1042	Empagliflozin 10mg (Jardiance)$62.00	no-fill	TIMING	Sep 256d	Nothing to do. The fill happens on payday either way.TIMING — the patient fills on payday either way, Sep 25 (6d). No physician action. Not sent, and it costs no slot.
Suppressed	A.M.rx-1045	Sitagliptin 100mg (Januvia)$85.00	no-fill	TIMING	Sep 256d	Nothing to do. The fill happens on payday either way.TIMING — the patient fills on payday either way, Sep 25 (6d). No physician action. Not sent, and it costs no slot.
Suppressed	J.F.rx-1048	Metformin ER 1000mg$12.00	no-fill	TIMING	Sep 212d	Nothing to do. The fill happens on payday either way.TIMING — the patient fills on payday either way, Sep 21 (2d). No physician action. Not sent, and it costs no slot.
Refused	N.B.rx-1041	Atorvastatin 20mg$25.00	—	TIMING	Sep 19today	$1,098.42 free today — 43x this $25.00 copay. Not an affordability problem.Ledger side only — claims index event is nothing, not a no-fill. Single-source. Would cost 1 slot · channel cost none (95% CI -2.0 to +3.5 pts, n=367).
Refused	T.R.rx-1046	Semaglutide (Ozempic)$300.00	filled	TIMING	Sep 19today	$471.15 free today, clear of the $300.00 copay. Not an affordability problem.Ledger side only — claims index event is filled, not a no-fill. Single-source. Would cost 1 slot · channel cost none (95% CI -2.0 to +3.5 pts, n=367).

The 6 suppressed rows

These score highest on the board. A TIMING row is corroborated on both sides, the date is real, and the classifier is certain — and it is still not sent, because the patient fills on payday with or without you. There is no prescriber act, so there is no message. The strongest thing this product does is decline to interrupt you.

The 2 refused rows

These are the alerts that would have landed in your inbox today, unmetered, on one source. They are not affordability findings: the ledger says the money is there. Each would have cost a slot, and the channel cost of an uncorroborated send measures none (95% CI -2.0 to +3.5 pts, n=367) — reported as a band, because the interval is wider than the estimate.

What left the building

Sent on each of the 2 in-channel rows: one class and one date. Nothing at all on the 8 rows above.

Withheld: account balance, transaction history, income amount, employer, merchant names, account number.

Drawn at 100% bank linkage for legibility. Ready is a module for an entity that already holds the connection — a hub, a health system’s financial navigation team, a payer’s app. Penetration is their number, not a claim we make.