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Appendix C <br />Rates, Claims & Payment Process for Direct Payment by Customer to Supplier <br />Rates <br />1. There will be no minimum order quantities for supplies. <br />2. K -Remedy on behalf of the Supplier will ship items to all diabetic members as <br />identified by Customer and who have registered on the Supplier's program. <br />3. Prices for supplies shipped are as follows: $58.00 per box of 50 strips and lancets. <br />All other supplies (including glucometer) and services are included (with the 3 - <br />year Purchase Agreement). It is noted that there will be no price escalations to <br />the quoted price until October 2018. Supplier shall notify Customer at least 120 - <br />days prior to any pricing changes. <br />4. In case of replacements occurring due to the covered member loosing a supply, <br />replacements will be charged at the following rates and includes shipping fee to <br />the members shipping address as follows: <br />a. Glucometer - $80.00/unit <br />b. Strips - $ 50.00 per box of 50 <br />c. Lancets - $ 8.00 per box of 50 <br />d. Lancing pen - $ 10 per pen <br />e. Control solution - $ 10 per bottle <br />5. Customer's explicit written authorization is required if lost replacement requests <br />exceed 10% of the regular shipments. <br />Monthly Invoice & Reimbursements <br />A. A monthly invoice will be raised for the preceding month that meet the following <br />requirements: <br />1. All shipments are associated with a valid prescription. Shipments will never <br />exceed what is allowed in the prescription except that strips and lancets will <br />be rounded off in increments of 50 (i.e. for example if a 90 -day prescription <br />warrants only 190 strips, the Customer will be charged for 4 boxes of strips). <br />2. The rates charged follow the rates agreed in this Purchase Agreement. <br />_ t� 151 <br />