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Pharmacy Solutions <br />Description <br />Pricing <br />Retail Pharmacies <br />Brand <br />Generic <br />Mail Order <br />Brand <br />Generic <br />AWP -11% + $4.25 dispensing fee <br />AWP -50% + $4.25 dispensing fee <br />AWP -12% + $3.50 dispensing fee <br />AWP -50% + $3.50 dispensing fee <br />Clinical Modeling <br />Integration of Pharmacy Data <br />Dynamic Calculation/Display in Care' <br />Included <br />Included <br />Pharmacy Interventions <br />Certified Pharmacy Technician <br />Rx Nurse <br />Nurse Management <br />Pharmacy Review - Per Review <br />Cognitive Behavioral Therapy - Per Hour <br />Medication Review - Per Hour <br />Included <br />Included <br />Case Management hourly rate <br />$375.00 <br />$250.00 <br />$250.00 <br />Ancillary Benefit Management Services <br />Description <br />Pricin <br />Medical Imaging Services <br />Varies by State and Diagnostic <br />Independent Medical Exam <br />See 2022 IME/Peer Fee Schedule <br />Physical and Occupational Therapy <br />Varies by State <br />Durable Medical Equipment <br />Varies by State and Equipment <br />IME Peer Review - Per Hour <br />See 2022 IME/Peer Fee Schedule <br />Transportation <br />Varies by State and Service <br />Translation <br />Varies by State and Service Level <br />Medicare Agent Re u ortin <br />Description <br />Set up and Engagement <br />Pricing <br />Included <br />Monthly Maintenance <br />Included <br />Quarterly Reporting <br />Included <br />The above pricing per claim is based on handling of all claims that occur and are reported during the agreement <br />period. If life of contract pricing is selected, claims will be handled until closed or until the end of the agreement <br />period, whichever comes first. If life of claim pricing is selected, claims will be handled until closed.. <br />Any service not identified in this proposal will be provided at a later time. <br />City of Everett, WA — CorVel EC Amendment 3 7-25-2022 <br />