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"ESI Specialty Pharmacy' means CuraScript, Inc., Accredo Health Group, Inc., Express Scripts Specialty
<br />Distribution Services, Inc., or another pharmacy or home health agency wholly-owned or operated by ESI or
<br />one or more of its affiliates that primarily dispenses Specialty Products or provides services related thereto;
<br />provided, however, that when the Mail Service Pharmacy dispenses a Specialty Product, it shall be considered
<br />an ESI Specialty Pharmacy hereunder.
<br />"Fees" means, with respect to Client, all the fees specified on the applicable Exhibits attached hereto and all
<br />other amounts due by Client hereunder, which Client (or, if applicable, any Member) is required to pay
<br />pursuant to the terms and conditions of this Agreement. In the event ESI, Administrator and Client agree
<br />upon a modification of the Fees from time to time, Client shall be responsible for timely communicating such
<br />changes to Members and for obtaining the necessary consents, if any, required from Client and/or Members
<br />in order to implement the new pricing.
<br />"Formulary" means the list of FDA -approved prescription drugs and supplies developed by ESI's Pharmacy
<br />and Therapeutics Committee and/or customized by Client, and which is selected and/or adopted by Client.
<br />The drugs and supplies included on the Formulary will be modified by ESI from time to time as a result of
<br />factors, including, but not limited to, medical appropriateness, manufacturer Rebate arrangements, and patent
<br />expirations. Additions and/or deletions to the Formulary are hereby adopted by Client, subject to Client's
<br />discretion to elect not to implement any such addition or deletion through the Set -Up Form process, which
<br />such election shall be considered a Client change to the Formulary.
<br />"GenericDrun'means a prescription drug, whether identified by its chemical, proprietary, or non-proprietary
<br />name, that is therapeutically equivalent and interchangeable with drugs having an identical amount of the
<br />same active ingredient(s) and approved by the FDA and which is identified as such in ESI's master drug file
<br />using indicators from Medispan on their provided (M,N,O,Y) codes. The multisource code field in Medi -
<br />Span contains an "M" (co -branded product), "O" (originator brand), or an "N" (single source brand); on the
<br />basis of a standard Brand/Generic AIgorithm utilized by ESI for all of its clients, a copy of which may be
<br />made available for review by Client upon request.
<br />"HIPAA" means the Health Insurance Portability and Accountability Act of 1996, as amended, and the
<br />regulations promulgated thereunder.
<br />"Losses" means any and all liabilities, damages, claims, causes of action, judgments, demands, penalties,
<br />fines, assessments, costs, expenses, fees (including without limitation attorneys' fees and other professional
<br />fees) and other losses of any kind or nature whatsoever.
<br />"MAC" or "Maximum Allowable Cost' consists of a list of ofd patent drugs subject to maximum allowable
<br />cost payment schedules developed or selected by ESI. The payment schedules specify the maximum unit
<br />ingredient cost payable by or on behalf of Client and its Members for drugs on the MAC List. The MAC
<br />List and payment schedules are frequently updated.
<br />"MAC List" means a list of off -patent prescription drugs or supplies subject to maximum reimbursement
<br />payment schedules. developed or selected by ESI.
<br />"Mail Service Pharmacy' means a pharmacy wholly-owned or operated by ESI or one or more of its affiliates,
<br />other than an ESI Specialty Pharmacy, where prescriptions are filled and delivered to Members via mail
<br />delivery service.
<br />"Manufacturer Administrative Fees" means those administrative fees paid by manufacturers to, ESI pursuant
<br />to a contract between ESI and the manufacturer in connection with ESI's administering, invoicing, allocating
<br />and collecting the Rebates under the Rebate program.
<br />"Member" means each person who is eligible to receive prescription drug benefits as indicated by or on
<br />behalf of Client in the Eligibility Files.
<br />NOT FOR DISTRIBUTION. THE INFORMATION CONTAINED HEREIN IS CONFIDENTIAL, PROPRIETARY
<br />AND CONSTITUTES TRADE SECRETS OF ESI AND RXBENEFITS
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