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Online .......�__ ._.....�....___..�_�_,.__..d�_..�. _.......... __ a_.._...� . ......._. .. ..ww _�.... _ <br />explanation of benefits Included <br />Online health improvement� � � � � tools and programs Included <br />Pharmacy look -up Included <br />Pharmacy resources — request a prior authorization, view drug interaction <br />data and access all forms Plans and benefits additional information — <br />Included <br />submitting new prescriptions, saving money with home delivery, educational <br />and pharmacy news <br />Plans and benefits additional information — submitting new prescriptions, <br />saving money with home delivery, educational and pharmacy news <br />Refill a prescription <br />Included <br />Savings center — compare costs to switch from retail to home delivery <br />Included <br />Search and price a medicine — search drugs by name, therapeutic class or <br />Included <br />subclass; compare costs and drug details, including price by pharmacy <br />Secure member message center <br />Included <br />Additional miscellaneous Internet services — view coverage and copayments, <br />Included <br />obtain an ID card, access drug and health guide <br />Administrative Prior Authorization program — non -clinical, losVstolen <br />Included <br />overrides, vacation supplies <br />Clinical Prior Authorization program <br />$55 per PA <br />This review focuses mainly on drugs that may have risk of serious side effects <br />or dangerous drug interactions, high potential for incorrect use or abuse, <br />better alternatives that may cost less, or restrictions for use with very specific <br />conditions. <br />_ <br />Clinical Pharmacy Review — physician review <br />Included ��...�m ... <br />Certain medications need a higher level of review than a Clinical Prior <br />Authorization and additional information from the prescriber. <br />Step Therapy � _._...._.�._.�._�_.�. _..__._...__...,.�a._. �.........�.__....__ _____�. <br />-$0.30 per script <br />Step therapy requires the member to use one medication before benefits for <br />the use of another medication can be authorized. Step therapy ensures <br />members have previously used first -line therapies or have risk factors making <br />the prescribed products inappropriate. <br />Quantity Limits and Dose Optimization <br />$0.55 per script <br />Quantity limits guard against high doses and excessive utilization based on <br />either doses exceeding the FDA or manufacturer recommended maximum <br />daily doses or limiting short-term medications to a certain number of fills over <br />a defined period of time. <br />Concurrent Drug Utilization Review programs � <br />p g <br />Included <br />� <br />This program includes real-time member health and safety protocols designed <br />to monitor and screen each claim against the member's integrated <br />