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Revised January, 2010 CONFIDENTIAL AND PROPRIETARY - page 18 / 31

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18 / 31

CONFIDENTIAL AND PROPRIETARY

date will be the FIRST of the following month. If Walgreens Health Initiatives receives notification of a new service relationship starting between the 16th and the end of the month, the effective date will be the FIRST of the next month. For example – all notifications received between 08/01-08/15 will have an effective date of 09/01/2008. Notification received between 08/16-09/15 will have an effective date of 10/01/2008.

Terminations

If Walgreens Health Initiatives receives notification from a PSAO/TPA of a service relationship that is ending between the 1st of the month and the 15th, the termination or end date will be effective at the END of that month. If Walgreens Health Initiatives receives notification of a service relationship that is ending between the 16th and the end of the month, the termination date will be effective at the end of the following month.

For more information regarding this policy, please contact Provider Relations at Provider.Relations@walgreens.com.

Pricing

As referenced in the Pharmacy Network Agreement and Medicare Part D Prescription Drug Addendum, each submitted claim will be priced using the specific guidelines established by the plan sponsor using the average wholesale price (AWP) set forth in the POS System based on pricing files received by Walgreens Health Initiatives from First DataBank, as updated on January 1 and not less frequently than every seven days thereafter. If Walgreens Health Initiatives changes its price source from First DataBank to another nationally recognized price source, WHI will notify pharmacies of the identity of the new price source within 30 days prior to implementation of the new price source.

Medication Classification

Walgreens Health Initiatives reserves the right to classify medications as generics, provided the medications meet certain criteria.

Questions Regarding Claims Submission or Status

Any questions regarding claims status should be directed to our Customer Care Center available toll free at 800-207-2568. Please identify your pharmacy as a provider for Walgreens Health Initiatives and have your NCPDP number available, as well as any other relevant information. Please direct all other claim-related inquiries to:

Walgreens Health Initiatives Attn: Claims Department PO Box 545, Mail Stop 4355 Deerfield, IL 60015

Customer Care Center Phone: 800-207-2568

Walgreens Health Initiatives – Pharmacy Manual

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