Common use of Covered Products Clause in Contracts

Covered Products. The products to which the Supplemental Rebate Agreement shall apply are the following: Manufacturer NDC Product Description Formula ATTACHMENT B Rebate Formula Manufacturer NDC (11 digits required) Product Description WAC National Rebate Tier1 Formula2 Contracted GNP Comments 1 Tiers (Preferred Brand Levels) Preferred Brand Levels, referred to as Tiers in the offer entry system, represent how the Member States will use an offer in a given tier. Manufacturers may submit an offer in any combination of or all of the eight possible tiers. An offer must be made for all state grouping categories in any selected tier. Levels 1-3 • Step-care will not be used to influence the preferred prescribing choices of physicians in these levels • The preferred brand level or tier number represents the number of preferred drugs in that PDL category Level 4 • Step-care will not be used to influence the preferred prescribing choices of physicians in this level • Your drug will be one of four or more drugs in that PDL category Levels 5-7: This offer assumes that every drug within this range is subject to Prior Authorization (PA) and that your drug would be designated as the first, second, or third choice after a PA is received. Step care will be used to influence the prescribing choices of physicians. Level 8: This offer assumes that the Manufacturer’s drug would be designated as one of the agents subject to Prior Authorization (PA). Step care will not be used to influence the prescribing choices of physicians, unless there are other products listed in Level 1, 2, and 3 on the Preferred Drug List (PDL). Although the prescriber must go through the PA process to determine if a medicine can be utilized, there is no interference with product selection.

Covered Products. The products to which the Supplemental Rebate Agreement shall apply are the following: Manufacturer NDC Product Description Formula ATTACHMENT B Rebate Formula Manufacturer NDC (11 digits required) Product Description WAC National Rebate Tier1 Formula2 Contracted GNP Comments 1 Tiers (Preferred Brand Levels) Preferred Brand Levels, referred to as Tiers in the offer entry system, represent how the Member States will use an offer in a given tier. Manufacturers may submit an offer in any combination of or all of the eight possible tiers. An offer must be made for all state grouping categories in any selected tier. Levels 1-3 • Step-care will not be used to influence the preferred prescribing choices of physicians in these levels • The preferred brand level or tier number represents the number of preferred drugs in that PDL category Level 4 • Step-care will not be used to influence the preferred prescribing choices of physicians in this level • Your drug will be one of four or more drugs in that PDL category Levels 5-7: This offer assumes that every drug within this range is subject to Prior Authorization (PA) and that your drug would be designated as the first, second, or third choice after a PA is received. Step care will be used to influence the prescribing choices of physicians. Level 8: This offer assumes that the Manufacturer’s drug would be designated as one of the agents subject to Prior Authorization (PA). Step care will not be used to influence the prescribing choices of physicians, unless there are other products listed in Level 1, 2, and 3 on the Preferred Drug List (PDL). Although the prescriber must go through the PA process to determine if a medicine can be utilized, there is no interference with product selection.

Covered Products. The products to which the Supplemental Rebate Agreement shall apply are the following: Manufacturer NDC Product Description Formula ATTACHMENT B Rebate Formula Manufacturer NDC (11 digits required) Product Description WAC National Rebate Tier1 Formula2 Contracted GNP Comments 1 Tiers (Preferred Brand Levels) Preferred Brand Levels, referred to as Tiers in the offer entry system, represent how the Member States will use an offer in a given tier. Manufacturers may submit an offer in any combination of or all of the eight possible tiers. An offer must be made for all state grouping categories in any selected tier. Levels 1Xxxxxx 0-3 • 0  Step-care will not be used to influence the preferred prescribing choices of physicians in these levels •  The preferred brand level or tier number represents the number of preferred drugs in that PDL category Level 4 • Xxxxx 0  Step-care will not be used to influence the preferred prescribing choices of physicians in this level •  Your drug will be one of four or more drugs in that PDL category Levels 5-7: This offer assumes that every drug within this range is subject to Prior Authorization (PA) and that your drug would be designated as the first, second, or third choice after a PA is received. Step care will be used to influence the prescribing choices of physicians. Level 8: This offer assumes that the Manufacturer’s drug would be designated as one of the agents subject to Prior Authorization (PA). Step care will not be used to influence the prescribing choices of physicians, unless there are other products listed in Level 1, 2, and 3 on the Preferred Drug List (PDL). Although the prescriber must go through the PA process to determine if a medicine can be utilized, there is no interference with product selection.