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(q) <br />"Single Source Brand" shall mean a Covered Drug specified as a brand name drug <br />available from only one manufacturer as determined by CorVel primarily using a <br />combination of data fields provided to CorVel by Medi-Span (or another nationally <br />available reporting source that may by selected by CorVel). Single Source Brand Drugs <br />are not eligible for conversions to Generic Drugs. <br />(r) "Single Source Generic" shall mean a Covered Drug as determined by CorVel that may <br />not have been purchased by pharmacies at standard Multi Source Generic Drug rates <br />because of limited manufacturers, limited supply or exclusivity rights. In the adjudication <br />process, Customer's Brand Drug AWP Discount value may be applied to Single Source <br />Generic Drugs. <br />(s) "Specialty Medications" shall mean certain pharmaceuticals, biotech or biological drugs, <br />that are Covered Drugs used in the management of chronic or genetic disease, including <br />but not limited to, injectable, infused, or oral medications, or products that otherwise <br />require special handling. In the adjudication process, Customer's Claims Professional's <br />approval is required, and Customer's Brand Drug AWP Discount value and dispensing fee <br />may be applied irrespective of the Presenting Drug's GCC (Generic Code Conversion) <br />status. <br />III. DELIVERY OF SERVICES. <br />(a) CorVel shall provide its Pharmacy Program's PBM and Network for the benefit of <br />Customer. <br />(b) Eligibility, First Fill, Pharmacy Identification (ID) Cards, and Mail Order/Home Delivery. <br />Pharmacy ID cards contain the necessary data elements to enable a Participating Pharmacy <br />provider to electronically process through and transmit claim data to CorVel's PBM. The <br />electronic transmission that occurs at the point of sale is required for application of <br />Formulary, Concurrent Drug Utilization Review and contractual pricing. <br />i. Customer agrees to promptly provide CorVel all information needed to produce <br />and distribute Pharmacy ID cards to Eligible Claimants. Subject to applicable law, <br />Customer will instruct Eligible Claimants to use the Pharmacy ID cards at <br />participating network providers in order to facilitate the Pharmacy Program. <br />ii. Distribution of Pharmacy ID cards does not guarantee that Pharmacy ID cards will <br />be appropriately utilized by Eligible Claimants or Participating Pharmacies; <br />therefore, Customer understands that claims assigned by Pharmacies to third party <br />billers or paper bills submitted by the Pharmacies are not adjudicated through the <br />prospective PBM. <br />iii. CorVel, agrees to produce and distribute Pharmacy ID cards to Eligible Claimants <br />upon receipt of all necessary Eligible Claimant information from Customer. <br />CorVel will also send an introduction letter to the Eligible Claimant along with the <br />Pharmacy ID card. <br />iv. CorVel will provide access for Eligible Claimants to the PBM Mail Order <br />Program. CorVel will work with Customer to establish the parameters of the Mail <br />Order Program and the process which will be utilized to encourage Eligible <br />Claimant use of the Mail Order Program. <br />City of Everett, WA — CorVel EC Amendment 3 7-25-2022 <br />