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adjudication system to either: dispense the Presenting Drug, convert from brand to generic, <br />attain approval to dispense,. <br />(h) "Generic Drug" shall mean a Covered Drug, whether identified by its chemical, <br />proprietary, or non-proprietary name, that (i) is accepted by the FDA as therapeutically <br />equivalent and interchangeable with drugs having an identical amount of the same active <br />ingredient; and (ii) defined as a generic drug in PBM proprietary Generic Code <br />Conversion ("GCC") logic. In the adjudication process, CorVel applies Customer's <br />negotiated Generic Drug discount rate to the AWP value of Covered Generic Drugs. <br />(i) "GCC" refers to PBM proprietary Generic Code Conversion logic. GCC logic converts <br />Medi-Span codes to the brand and generic codes used for claims adjudication. <br />(j) "Good Samaritan (Emergency) Fill" shall mean a limited supply of Covered Drugs that are <br />outside of the Formulary and typically dispensed outside of normal business hours <br />(overnight, weekends or holidays) by a Participating Pharmacy without Customer's or <br />CorVel's approval in order to meet, in the pharmacist's professional judgment, an <br />immediate or urgent need. Customer is responsible for payment of drug charges processed <br />through Good Samaritan Fills; CorVel assumes no liability. <br />(k) "Mail Order Program" or "Home Deliver Program" shall mean the managed program from <br />which Covered Drugs are dispensed and billed through CorVel's PBM. A pharmacy's <br />status as a mail order pharmacy does not indicate participation in the CorVel PBM Mail <br />Order Program. Mail Order participation is limited to designated pharmacies operating <br />within the strict parameters of CorVel's Mail Order Program. <br />(1) "Multi Source Brand" shall mean a Covered Drug specified as a brand name drug available <br />from more than one manufacturer as determined by CorVel primarily using a combination <br />of data fields provided to CorVel by Medi-Span (or another nationally available reporting <br />source that may be selected by CorVel). Multi Source Brand Drugs are eligible for <br />conversions to Generic Drugs at the Participating Pharmacy. <br />(m) "Multi Source Generic" shall mean a Covered Drug specified as a multi source generic <br />drug as determined by CorVel primarily using a combination of data fields provided to <br />CorVel by Medi-Span (or another nationally available reporting source that may by <br />selected by CorVel). Generic Drugs in their six month exclusivity period or limited supply <br />drugs may be excluded from Multi Source Generic Drugs. <br />(n) "PBM" shall mean Pharmacy Benefits Manager. CorVel performs as the PBM on behalf <br />of its Customers. <br />(o) "Presenting Drug" shall mean the drug ordered by the prescriber and presented on a signed <br />prescription to a Participating Pharmacy and processed through CorVel's PBM. <br />(p) "Rate application exceptions," per Billing and Payments of Pharmacy Program (below) <br />sections (d) and (e), apply when either State Fee Schedule AWP Values or Customer's <br />Negotiated PBM AWP Discount rates are lower than CorVel's Acquisition Price. CorVel's <br />Acquisition Price reflects CorVel's cost of the Covered Drug plus a processing and <br />management fee. <br />City of Everett, WA — CorVel EC Amendment 3 7-25-2022 <br />