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DocuSign Envelope ID: 5B185859-5943-4C41-90BF-OCE5E90FDADD <br />(01/2021 Version) <br />Term (as described in Article VI(A) of the Agreement) that begins on or after the Addendum <br />Effective Date. <br />[1 -(total discounted AWP ingredient cost (including any retrospective pharmacy <br />payments) but excluding dispensing fees and ancillary charges, and prior to application <br />of Copayments) of applicable Prescription Drug Claims for the annual period divided <br />by total undiscounted AWP ingredient cost (both amounts will be calculated as of the <br />date of adjudication) for the annual period)]. Discounted ingredient cost will be the <br />lesser of MAC (as applicable), U&C or AWP discount. <br />Notwithstanding anything herein to the contrary: (i) a Prescription Drug Claim that <br />processes at the Brand rates (Participating Pharmacy Reimbursement Rates) and (Mail <br />Pharmacy Reimbursement Rates), as indicated on the ingredient cost field of the <br />Prescription Drug Claim's data record, shall be reconciled as part of the Brand <br />guarantee below; and (ii) a Prescription Drug Claim that processes at the Generic Drug <br />rates (Participating Pharmacy Reimbursement Rates) and (Mail Pharmacy <br />Reimbursement Rates) above, as indicated on the ingredient cost field of the <br />Prescription Drug Claim's data record, shall be reconciled as part of the Generic Drug <br />guarantee below. The only Prescription Drug Claims that may be excluded from the <br />reconciliation of the pricing guarantees are as identified in the "Claims Excluded" <br />paragraph below in addition to claims dispensed in Puerto Rico, Guam, Northern <br />Mariana Islands, Virgin Islands, Hawaii, Massachusetts, and Alaska,. All other <br />Prescription Drug Claims may be included in the reconciliation of the guarantees. <br />PARTICIPATING PHARMACY <br />BRAND <br />AWP —19.50% <br />GENERIC <br />MAINTENANCE <br />I AWP — <br />NETWORKRETAIL (84-90 1 <br />84.50% <br />BRAND <br />AWP — <br />22.00% <br />GENERIC <br />MAIL SERVICE PHARMACY <br />AWP — <br />84.50% <br />BRAND <br />AWP — <br />25.00% <br />GENERIC <br />AWP — <br />87.00% <br />Claims Excluded: OTC products (excluding insulin, diabetic strips, and test strips), compounds, U&C claims, <br />Member Submitted Claims, Subrogation Claims, Coordination of Benefit Claims, Exclusive and Limited <br />Distribution Products/Claims, vaccines, Specialty Products (other than specialty guarantee) biosimilar <br />products (other than Specialty Product guarantee, if applicable), long term care pharmacy claims and/or <br />claims with ancillary charges and products filled through in-house or 340b pharmacies (if applicable). <br />(b) Dispensing Fee. ESI will guarantee an average aggregate annual per Prescription Drug Claim <br />dispensing fee on Client utilization to be calculated as follows: <br />[total dispensing fee of applicable Prescription Drug Claims for the annual period <br />divided by total of applicable Prescription Drug Claims for the annual period <br />which will represent the same underlying claims dataset used to calculate the <br />"Ingredient Cost Guarantee" of this Exhibit A]. Dispensing fees will be calculated <br />using the lesser of MAC (as applicable), U&C or AWP discount adjudication <br />methodology. <br />NOT FOR DISTRIBUTION. THE INFORMATION CONTAINED HEREIN IS CONFIDENTIAL, PROPRIETARY <br />AND CONSTITUTES TRADE SECRETS OF EXPRESS SCRIPTS AND RXBENEFITS <br />