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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 />21532133000330 <br />Imbruvica TABS 280 MG <br />15.80% <br />21532133000340 <br />Imbruvica TABS 420 MG <br />15.80% <br />21532133000350 <br />Imbruvica TABS 560 MG <br />15.80% <br />21532133001820 <br />Imbruvica SUSP 70 MG/ML <br />15.80% <br />21532165000330 <br />Jaypirca TABS 100 MG <br />15.25% <br />21532195000120 <br />Brukinsa CAPS 80 MG <br />16.44% <br />21532225000320 <br />Balversa TABS 3 MG <br />13.00% <br />21532225000325 <br />Balversa TABS 4 MG <br />13.00% <br />21532225000330 <br />Balversa TABS 5 MG <br />13.00% <br />21532260000320 <br />Pemazyre TABS 4.5 MG <br />14.00% <br />21532260000330 <br />Pemazyre TABS 9 MG <br />14.00% <br />21532260000340 <br />Pemazyre TABS 13.5 MG <br />14.00% <br />21532350200320 <br />Ogsiveo TABS 50 MG <br />15.50% <br />21532410000320 <br />Krazati TABS 200 MG <br />19.30% <br />21532480000320 <br />Lumakras TABS 120 MG <br />17.00% <br />21532480000340 <br />Lumakras TABS 320 MG <br />16.75% <br />21532530000310 <br />Afinitor TABS 2.5 MG <br />16.00% <br />84.00% <br />21532530007310 <br />Afinitor Disperz TBSO 2 MG <br />16.00% <br />45.00% <br />21532530007320 <br />Afinitor Disperz TBSO 3 MG <br />16.00% <br />45.00% <br />21532530007340 <br />Afinitor Disperz TBSO 5 MG <br />16.00% <br />45.00% <br />21533010100320 <br />Cabometyx TABS 20 MG <br />18.00% <br />21533010100330 <br />Cabometyx TABS 40 MG <br />18.00% <br />21533010100340 <br />Cabometyx TABS 60 MG <br />18.00% <br />21533010106460 <br />Cometriq (60 MG Daily Dose) KIT 20 <br />MG <br />16.00% <br />21533010106470 <br />Cometriq (100 MG Daily Dose) KIT 80 <br />&20 MG <br />16.00% <br />21533010106480 <br />Cometriq (140 MG Daily Dose) KIT 3 x <br />20 MG&80 MG <br />16.00% <br />21533020200320 <br />Xospata TABS 40 MG <br />16.00% <br />21533030000130 <br />Rydapt CAPS 25 MG <br />18.00% <br />21533042100320 <br />Votrient TABS 200 MG <br />16.50% <br />35.00% <br />21533045010110 <br />Turalio CAPS 125 MG <br />15.82% <br />21533045010120 <br />Turalio CAPS 200 MG <br />13.00% <br />21533047100320 <br />Vanflyta TABS 17.7 MG <br />13.00% <br />21533047100325 <br />Vanflyta TABS 26.5 MG <br />13.00% <br />21533050000320 <br />Stivarga TABS 40 MG <br />17.00% <br />21533053000320 <br />Qinlock TABS 50 MG <br />13.00% <br />21533060400320 <br />NexAVAR TABS 200 MG <br />17.50% <br />17.50% <br />6M <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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