Pharmacy Claims Clause Samples

Pharmacy Claims. Reporting Entities shall report all paid pharmacy claims for prescriptions dispensed to Members.
Pharmacy Claims. INTERMEDIARY shall, with available Outpatient Funding, 7 reimburse those outpatient pharmaceutical costs typically not claimed through the COUNTY’s 8 Pharmacy Benefits Manager for the MSI Program, including, but not limited to, chemotherapy and other 9 injectable drugs provided in Physician offices.
Pharmacy Claims. CONTRACTOR shall reimburse those outpatient 32 pharmaceutical costs typically not claimed through the COUNTY’s Pharmacy Benefits Manager for the 33 MSN Program, including, but not limited to, chemotherapy and other injectable drugs provided in 34 Physician offices. Upon written authorization from ADMINISTRATOR, other pharmaceutical costs or 35 costs from other non-hospital outpatient Providers may be paid by CONTRACTOR.
Pharmacy Claims. INTERMEDIARY shall, with available Outpatient Funding, 20 reimburse those outpatient pharmaceutical costs typically not claimed through the COUNTY’s 21 Pharmacy Benefits Manager for the MSI Program, including, but not limited to, chemotherapy and other 22 injectable drugs provided in Physician offices. 23 1) Except as otherwise specified, in writing, by ADMINISTRATOR, reimbursement 24 of pharmaceutical costs by INTERMEDIARY shall not exceed that which would otherwise be paid by 25 COUNTY’s Pharmacy Benefits Manager. ADMINISTRATOR shall provide INTERMEDIARY the 26 reimbursement rates in effect with COUNTY’s Pharmacy Benefits Manager and any exceptions. 27 2) Upon written authorization from ADMINISTRATOR, other pharmaceutical costs 28 or costs from other non-hospital outpatient Providers may be paid by INTERMEDIARY.
Pharmacy Claims. INTERMEDIARY shall, with funds from the “Outpatient Trust Fund 32 Account,” reimburse those outpatient pharmaceutical costs typically not claimed through the 33 COUNTY’S Pharmacy Benefits Manager for the MSI Program, including, but not limited to, 34 chemotherapy and other injectable drugs provided in Physician offices. 35 1) Except as otherwise authorized, in writing, by ADMINISTRATOR, reimbursement 36 of pharmaceutical costs by INTERMEDIARY shall not exceed that which would otherwise be paid by 37 // 1 COUNTY’S Pharmacy Benefits Manager. ADMINISTRATOR shall provide INTERMEDIARY the 2 reimbursement rates in effect with COUNTY’S Pharmacy Benefits Manager and any exceptions. 3 2) Upon written authorization from ADMINISTRATOR, other pharmaceutical costs 4 or costs from other non-hospital outpatient provider may be paid by INTERMEDIARY.

Related to Pharmacy Claims

  • Tax Claims Notwithstanding any other provision of this Agreement, the control of any claim, assertion, event or proceeding in respect of Taxes of the Company (including, but not limited to, any such claim in respect of a breach of the representations and warranties in Section 3.22 hereof or any breach or violation of or failure to fully perform any covenant, agreement, undertaking or obligation in Article VI) shall be governed exclusively by Article VI hereof.

  • Product Claims The parties acknowledge that NCR Voyix, not Apple, is responsible for addressing any claims you or any third party relating to the Software or your possession and/or use of the Software, including, but not limited to: (a) product liability claims; (b) any claim that the Software fails to conform to any applicable legal or regulatory requirement; and (c) claims arising under consumer protection or similar legislation.

  • Covered Claims Claim" means any claim, dispute or controversy between you and us that in any way arises from or relates to this Agreement, the Account, the issuance of any Card, any rewards program, any prior agreement or account. "Claim" includes disputes arising from actions or omissions prior to the date any Card was issued to you, including the advertising related to, application for or approval of the Account. "Claim" has the broadest possible meaning, and includes initial claims, counterclaims, cross-claims and third-party claims. It includes disputes based upon contract, tort, consumer rights, fraud and other intentional torts, constitution, statute, regulation, ordinance, common law and equity (including any claim for injunctive or declaratory relief). "Claim" does not include disputes about the validity, enforceability, coverage or scope of this Arbitration Provision or any part thereof (including, without limitation, the prohibition against class proceedings, private attorney general proceedings and/or multiple party proceedings described in Paragraph C.7 (the "Class Action Waiver"), the last sentence of Paragraph

  • Infringement Claims You may submit an infringement claim notice to us at our Contact Formavailable here if you have a good faith belief that Your Content has been copied and made accessible through the Services (including as a part of the Service Content or Third Party Content) in violation of your Inte lectual Property Rights. A copyright infringement claims notice must include at (i) the identification of such a legedly infringing materials, including information su ficient for us to locate it within our Services, ( i) a demand that such a legedly infringing materials be removed or access disabled, ( i) a statement that you have a good faith belief that use of the material in the manner complained of is not authorized by the copyright owner, its agent, or the law; (iv) a statement that the information in the notification is accurate, and under penalty of perjury, that you are authorized to act on behalf of the owner of an exclusive right that is a legedly infringed; (v) contact information for you, such as address, phone number, and, if available, an email address; and (vi) must be signed by you or the person authorized to act on behalf of the owner of the a legedly infringed work (the “Notice Requirements”). Pursuant to 17 U.S.C. 512(c)(3), if the above Notice Requirements are not met, we may disregard the notice. Pursuant 17 U.S.C. 512(f), be advised that knowingly making a material misrepresentation that online material or activity is infringing or that material or activity was removed or disabled by mistake or misidentification, may subject you to heavy civil penalties. These penalties include monetary damages, including costs and attorneys' fees, incurred by the a leged infringer, by any copyright owner or copyright owner's authorized licensee, or by a service provider who is injured by your misrepresentation. If we make a decision to remove Your Content in response to a complaint, we may notify you and provide you with contact information for the complaining party. You may also object to such determination by writing to our designated agent, which must contain the fo lowing information pursuant to 17 U.S.C. 512(g)(3), (i) your physical or electronic signature; ( i) identification of the material that has been removed or to which access has been disabled and the location at which the material appeared before it was removed or access to it was disabled; ( i) a statement under penalty of perjury that the you have a good faith belief that the material was removed or disabled as a result of mistake or misidentification of the material to be removed or disabled; and (iv) your name, address, phone number, and a statement that you consent to the jurisdiction of Federal District Court for the judicial district in which the address is located, or if you are located outside of the United States, for any judicial district in which the service provider may be found, and that you wil accept service of process from the person who provided notification under subsection 17 U.S.C. 512(c)(1)(C) or an agent of such person.

  • Product Liability Claims Notwithstanding the provisions of Section 9.2, any Losses arising out of any Third Party claim, suit, action, proceeding, liability or obligation involving any actual or alleged death or bodily injury arising out of or resulting from the development, manufacture or Commercialization of any Fibrocell Products or Improved Products for use or sale in the Field, to the extent that such Losses exceed the amount (if any) covered by the applicable Party’s product liability insurance (“Excess Product Liability Costs”), shall be paid by [*****], except to the extent such Losses arise out of any Third-Party Claim based on the gross negligence or willful misconduct of a Party, its Affiliates, or its Affiliates’ sublicensees, or any of the respective officers, directors, employees and agents of each of the foregoing entities, in the performance of obligations or exercise of rights under this Agreement.