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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
Fields
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 />21530510000350 <br />Alunbrig TABS 90 MG <br />15.50% <br />21530510000365 <br />Alunbrig TABS 180 MG <br />15.80% <br />21530514000330 <br />Zykadia TABS 150 MG <br />15.50% <br />21530517000120 <br />Xalkori CAPS 200 MG <br />15.00% <br />21530517000125 <br />Xalkori CAPS 250 MG <br />15.00% <br />21530517006850 <br />Xalkori CPSP 150 MG <br />13.00% <br />21530556000320 <br />Lorbrena TABS 25 MG <br />15.00% <br />21530556000330 <br />Lorbrena TABS 100 MG <br />15.00% <br />21531060000120 <br />Ibrance CAPS 75 MG <br />18.35% <br />21531060000130 <br />Ibrance CAPS 100 MG <br />18.35% <br />21531060000140 <br />Ibrance CAPS 125 MG <br />18.35% <br />21531060000320 <br />Ibrance TABS 75 MG <br />18.35% <br />21531060000330 <br />Ibrance TABS 100 MG <br />18.35% <br />21531060000340 <br />Ibrance TABS 125 MG <br />18.35% <br />21531560002030 <br />romiDEPsin SOLN 27.5 MG/5.5ML <br />22.00% <br />21531575000120 <br />Zolinza CAPS 100 MG <br />16.00% <br />21531806100320 <br />Scemblix TABS 20 MG <br />15.75% <br />21531806100340 <br />Scemblix TABS 40 MG <br />15.75% <br />21531806100380 <br />Scemblix TABS 100 MG <br />13.00% <br />21531812000130 <br />Bosulif CAPS 100 MG <br />13.00% <br />21531812000320 <br />Bosulif TABS 100 MG <br />18.00% <br />21531812000327 <br />Bosulif TABS 400 MG <br />18.00% <br />21531812000340 <br />Bosulif TABS 500 MG <br />18.00% <br />21531875100315 <br />Iclusig TABS 10 MG <br />15.00% <br />21531875100320 <br />Iclusig TABS 15 MG <br />20.00% <br />21531875100330 <br />Iclusig TABS 30 MG <br />15.00% <br />21531875100340 <br />Iclusig TABS 45 MG <br />15.00% <br />21532025100120 <br />Tafinlar CAPS 50 MG <br />15.50% <br />21532025100130 <br />Tafinlar CAPS 75 MG <br />15.50% <br />21532040000130 <br />Braftovi CAPS 75 MG <br />15.50% <br />21532075000320 <br />Ojemda TABS 100 MG <br />13.00% <br />21532075001920 <br />Ojemda SUSR 25 MG/ML <br />13.00% <br />21532080000320 <br />Zelboraf TABS 240 MG <br />16.00% <br />21532103000120 <br />Calquence CAPS 100 MG <br />13.00% <br />21532103500320 <br />Calquence TABS 100 MG <br />15.75% <br />21532133000110 <br />Imbruvica CAPS 70 MG <br />15.80% <br />21532133000320 <br />Imbruvica TABS 140 MG <br />15.80% <br />54 <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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