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DocuSign Envelope ID: 5B185859-5943-4C41-90BF-OCE5E90FDADD (0112021 Version) D. REBATES Rebate Amounts. Subject to: (i) the conditions set forth in Sections 2 through 4 below and elsewhere in this Agreement; and (ii) Client meeting the Plan Design conditions identified in the table below, the following guaranteed amounts will he payable to Client during the Term of this Agreement: REBATES NATIONAL PLUS NETWORK -NETWORK ParticipatingrSubmitted Vaccine Claims $470.00 per Brand claim Pharmacies/ESIVaccine Claims Submitted SPECIALTY PharmacyfESI Specialty (excluding'reign Pharmacy Electronically by Vaccine Pass -Through Lower of submitted Pass -Through Administration (capped at $15 for amount or pharmacy (capped at $15 for Fee influenza/$20 all other contracted rate (capped at influenza/ $20 all other vaccines per Vaccine $15 for 4nfluenzai$20 all vaccines per Vaccine Claim) other vaccines if Claim) administered at a -Participating Pharmacy) Ingredient Cost Pass -Through Lower of submitted Pass -Through amount or pharmacy contracted rate Dispensing Fee Pass -Through Lower of submitted Pass -Through amount or pharmacy contracted rate Vendor NIA N/A Pass through at ESI cost Transaction Fee for Vendor Transaction Fee (currently $3.75, subject to change) D. REBATES Rebate Amounts. Subject to: (i) the conditions set forth in Sections 2 through 4 below and elsewhere in this Agreement; and (ii) Client meeting the Plan Design conditions identified in the table below, the following guaranteed amounts will he payable to Client during the Term of this Agreement: REBATES NATIONAL PLUS NETWORK -NETWORK O•PREFERRED $203.00 per Brand claim RETAIL MAINTENANCE 84-90 DAYS' SUPPLI $470.00 per Brand claim HOME DELIVERY PRODUCTS $570.00 per Brand claim SPECIALTY $2,075.00 per Brand claim The Extended Days' Supply pricing set forth in this Agreement shall be subject to certain requirements, as follows. Extended Days' Supply shall mean; (1) for all lines of business other than Medicare or EGAT, any supply of a covered drug of 84 days or greater; and (2) for Medicare or EGN'VP, if applicable, any supply of a covered drug of 35 days or greater. Certain Participating Pharmacies have agreed to participate in the extended (84 - 90) day supply network ("Maintenance Network") for maintenance drugs. Rebate Amounts in the 84 - 90 Days' Supply column in the table set forth above are applicable only if Client implements a plan design that requires Members to fill such days' supply at a Maintenance Network Participating Pharmacy (i.e., Client must implement a plan design whereby Members who fill extended days' supply prescriptions at a Participating Pharmacy other than a Maintenance Network Participating Pharmacy do not receive benefit coverage under the Plan for such prescription). If no such plan design is implemented, Rebate Amounts for such days' supply will be the same as for Prescription Drug Claims for less than an 84 days' supply, and Rebate Amounts for an 84 - 90 days' supply in the table set forth above shall not apply, even da Maintenance Network Participating Pharmacy is used. Exclusions, Member Submitted Claims, Subrogation Claims, Coordination of Benefit Claims, Exclusive and Limited Distribution Products, biosimilar products, OTC products (except for insulin and diabetic strips and test strips), vaccines, claims older than 180 days, claims through Client -owned or 340b pharmacies. and claims pursuant to a 100% Member Copayment plan are not eligible for the guaranteed Rebate amounts set NOT FOR DISTRIBUTION. THE INFORMATION CONTAINED HEREIN IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF EXPRESS SCRIPTS AND RXBENEFITS 54