First MCO PBM

We Do More so That You Don’t Pay More Our overall approach to pharmacy management eliminates costs from unnecessary medications. This ensures that you pay for what your patients need, but only for what they need.

Clinical Oversight Prescriptions are reviewed to ensure they are medically necessary, appropriate for the injury claimed and at a suitable dosage. We also monitor for: ◊ High-risk physicians/patients ◊ Early or frequent renewals ◊ Medication not prescribed by approved provider Point of Service Cost Controls ◊ Generic medication is dispensed unless Brand is required by physician ◊ All high-cost prescriptions require Case Manager approval ◊ Medication outside of the formulary is automatically rejected Network Benefits ◊ A list of network pharmacies is issued during 1st Report ◊ Realtime adjudication before drug is dispensed ◊ Mail order delivery available in most cases

We have over 45,000 pharmacies in our network nationwide We have nurses available 24/7 to: • Respond to patient questions or concerns • Authorize medication off hours • Contact physicians who prescribe brand medications when a generic is available

*Catching that “1st Fill” • Pharmacy card is emailed or texted to the patient before the intake call is complete.

• Pharmacy cards can be fully branded or co-branded

*In 50% of Workers’ Compensation claims, the 1st prescription filled is the only one.