Average Wholesale. Price (AWP) The current average wholesale price of a prescription drug listed in the Facts and Comparisons weekly price updates (or any other similar publication designated by Aetna) on the day that a pharmacy claim is submitted for adjudication. Ambulatory Surgical Center: A freestanding ambulatory surgical facility that: • Meets licensing standards. • Is set up, equipped and run to provide general surgery. • Makes charges. • Is directed by a staff of physicians. At least one of them must be on the premises when surgery is performed and during the recovery period. • Has at least one certified anesthesiologist at the site when surgery which requires general or spinal anesthesia is performed and during the recovery period. • Extends surgical staff privileges to: - physicians who practice surgery in an area hospital; and - dentists who perform oral surgery. • Has at least 2 operating rooms and one recovery room. • Provides, or arranges with a medical facility in the area for, diagnostic x-ray and lab services needed in connection with surgery. • Does not have a place for patients to stay overnight. • Provides, in the operating and recovery rooms, full-time skilled nursing services directed by a R.N. • Is equipped and has trained staff to handle medical emergencies. • It must have: a physician trained in cardiopulmonary resuscitation; and a defibrillator; and a tracheotomy set; and a blood volume expander. • Has a written agreement with a hospital in the area for immediate emergency transfer of patients. Written procedures for such a transfer must be displayed and the staff must be aware of them. • Provides an ongoing quality assurance program. The program must include reviews by physicians who do not own or direct the facility. • Keeps a medical record on each patient.
Average Wholesale. Price (AWP) AWP for a pharmaceutical as published by a third party source such as First DataBank or Medi-Span® Business Days Monday through Friday as defined in Section 6.5.5. excluding Thanksgiving, Christmas, and New Year’s Day. Calendar Quarter Period of three consecutive months; there are four quarters per calendar year. The quarters of the calendar year are January, February, March (quarter 1); April, May, June (quarter 2); July, August, September (quarter 3); and October, November, December (quarter 4.) CDPH/OA/ADAP Contract Manager The person designated by CDPH/OA/ADAP to manage this Agreement, as listed in Exhibit I, Contactor Information Form (CIF). Centers for Medicare and Medicaid Services (CMS) Centers for Medicare and Medicaid Services is the US federal agency which administers Medicare, Medicaid, and the State Children's Health Insurance Program. Client Individuals enrolled in ADAP. These individuals must be residents of California,18 years of age or older, living with HIV/AIDS, have a Modified Adjusted Gross Income up to 500% of federal poverty level based on family size and household income and are uninsured or underinsured. Contract Year Twelve month periods from the anniversary of the End Date. Contractor The company awarded the Agreement identified on the STD 213. Contractor’s Claims Adjudication System The system used by the Contractor to adjudicate claims for prescriptions dispensed to eligible Clients. Contractor’s Implementation Team Plans and executes the technical requirements of the Agreement by the go-live date. Contractor’s Contract Manager The primary Contractor contact person for CDPH/OA/ADAP; dedicated to overseeing and managing the Agreement. Contractor’s System The system and components owned, operated and/or controlled by the Contractor which includes the Contractor’s Claims Adjudication System. Customer Service Unit Contractor staff that assist Providers, Clients, CDPH/OA/ADAP, and other entities authorized by CDPH/OA/ADAP regarding services related to this Agreement. Deductible The amount a client owes for covered prescription services before their health insurance plan will pay. Department of General Services (DGS) The Department of General Services of the State of California. Dispense Fee The amount reimbursed to a pharmacy when filling a prescription to cover the charge for professional services and overhead costs. Drug Utilization Review (DUR) Monitoring of prescription drugs used by a patient to identify one or a co...
Average Wholesale. PRICE (AWP) means the wholesale price of a drug or supply at the time of purchase as defined by the latest edition of the drug file utilized by the Designated Administrator. The price shall be based on the National Drug Code (NDC) number of the container from which the drug or supply was dispensed.
Average Wholesale. Price or AWP means the average wholesale price of a prescription drug published and updated by Medi-Span, or another nationally-recognized reporting service purchased or licensed by Navitus. Brand Covered Product or Brand means a Covered Product where the Medi-Span Multi-Source Indicator for the Covered Product reported by Medi-Span contains an “M” (co-branded product), “O” (originator brand) or an “N” (single source brand) for the Covered Product on the date dispensed except where the claim is submitted with a DAW code of “3”, “5”, or “6”, in which case it shall be considered a Generic Drug.
