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Docusign Envelope ID: 921 F7A24-D5CE-4BCC-9F3C-5E7844661266 <br />Optional <br />$3.00 per UCF processed <br />Manual pharmacy submitted Claims <br />processing (UCF) (Pharmacy submitted <br />Direct Reimbursement Claims) <br />Government Agency Claims processing <br />$3.00 per Claim <br />Standard eligibility management services <br />Included in Administrative Fee <br />Claim adjustments — Client requested or <br />$3.00 per adjustment <br />retrospective accumulator changes <br />Pharmacy network services <br />RIGHTWAY network management <br />Included in Administrative Fee <br />Pharmacy network credentialing & <br />Included in Administrative Fee <br />compliance <br />Mail service program management <br />Included in Administrative Fee <br />Specialty program (RIGHTWAY Specialty <br />Included in Administrative Fee <br />Drug) clinical management <br />Maximum allowable cost (MAC) program <br />Included in Administrative Fee <br />administration <br />Pharmacy reimbursement <br />Included in Administrative Fee <br />Pharmacy provider compliance audits: <br />Included in Administrative Fee if done at RIGHTWAY's <br />Routine compliance audits facilitated through <br />direction in our standard pharmacy audit program. <br />correspondence/telephonic interviews <br />Client requested pharmacy auditing services <br />For Client requested audits the following fees apply: <br />10% of recoveries <br />$750 per desk audit <br />$2,500 per on-site audit <br />E -prescribing <br />Included in Administrative Fee <br />Pharmacy provider communications — <br />Included in Administrative Fee <br />including quarterly newsletter, pharmacy <br />panel meetings, client implementation <br />communications <br />40 <br />This document is CONFIDENTIAL AND PROPRIETARY to RIGHTWAY Healthcare, Inc. and may not be reproduced, <br />transmitted, published, or disclosed to others without the prior written authorization of RIGHTWAY Healthcare, Inc. <br />