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2025-126D
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2025-126D
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Last modified
9/18/2025 10:43:54 AM
Creation date
9/8/2025 1:42:16 PM
Metadata
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Template:
Official Documents
Official Document Type
Agreement
Approved Date
06/03/2025
Control Number
2025-126D
Agenda Item Number
13.D.1.
Entity Name
Rightway Healthcare, Inc.
Subject
Pharmacy Benefit Management Services Agreement
Document Relationships
2025-126
(Cover Page)
Path:
\Official Documents\2020's\2025
2025-126A
(Cover Page)
Path:
\Official Documents\2020's\2025
2025-126B
(Cover Page)
Path:
\Official Documents\2020's\2025
2025-126C
(Cover Page)
Path:
\Official Documents\2020's\2025
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Docusign Envelope ID: 921 F7A24-D5CE-4BCC-9F3C-5E7844661266 <br />21358035406420 <br />Zevalin Y-90 KIT 3.2 MG/2ML <br />13.00% <br />21358215002020 <br />Tecentriq SOLN 1200 MG/20ML <br />14.50% <br />21360006100320 <br />Gilotrif TABS 20 MG <br />15.00% <br />21360006100340 <br />Gilotrif TABS 40 MG <br />15.00% <br />21360019000320 <br />Vizimpro TABS 15 MG <br />16.00% <br />21360019000330 <br />Vizimpro TABS 30 MG <br />16.00% <br />21360019000340 <br />Vizimpro TABS 45 MG <br />16.00% <br />21360025100360 <br />Tarceva TABS 150 MG <br />18.50% <br />40.00% <br />21360048300320 <br />Lazcluze TABS 80 MG <br />13.00% <br />21360048300340 <br />Lazcluze TABS 240 MG <br />13.00% <br />21360050600120 <br />Exkivity CAPS 40 MG <br />16.00% <br />21370030300320 <br />Daurismo TABS 25 MG <br />16.00% <br />21370030300335 <br />Daurismo TABS 100 MG <br />16.00% <br />21370060200120 <br />Odomzo CAPS 200 MG <br />15.50% <br />21370070000120 <br />Erivedge CAPS 150 MG <br />15.50% <br />21402410000320 <br />Erleada TABS 60 MG <br />16.00% <br />21402410000360 <br />Erleada TABS 240 MG <br />16.00% <br />21403720100340 <br />Orserdu TABS 345 MG <br />15.50% <br />21405010256450 <br />Lupron Depot (6 -Month) KIT 45 MG <br />19.00% <br />21406010250310 <br />Yonsa TABS 125 MG <br />15.00% <br />21409902120320 <br />Akeega TABS 50-500 MG <br />14.00% <br />21409902120330 <br />Akeega TABS 100-500 MG <br />14.00% <br />21421020000320 <br />Welireg TABS 40 MG <br />13.00% <br />21450080000110 <br />Pomalyst CAPS 1 MG <br />17.90% <br />21450080000115 <br />Pomalyst CAPS 2 MG <br />17.90% <br />21450080000120 <br />Pomalyst CAPS 3 MG <br />17.90% <br />21450080000125 <br />Pomalyst CAPS 4 MG <br />17.90% <br />21470080000360 <br />Venclexta TABS 100 MG <br />15.85% <br />21490009000310 <br />Ayvakit TABS 25 MG <br />15.25% <br />21490009000315 <br />Ayvakit TABS 50 MG <br />15.25% <br />21490009000320 <br />Ayvakit TABS 100 MG <br />15.25% <br />21490009000330 <br />Ayvakit TABS 200 MG <br />15.25% <br />21490009000340 <br />Ayvakit TABS 300 MG <br />15.25% <br />21500003002020 <br />Jevtana SOLN 60 MG/1.5ML <br />13.50% <br />21530320000320 <br />Truqap TABS 160 MG <br />13.00% <br />21530320000325 <br />Trugap TABS 200 MG <br />15.50% <br />21530507100120 <br />Alecensa CAPS 150 MG <br />15.50% <br />53 <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 />
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