Lower of Pricing definition

Lower of Pricing means the lower of (1) 340B Acquisition Cost of the drug plus negotiated dispensing fee, or (2) the usual and customary pharmacy charge, or (3) MAC cost plus negotiated MAC dispensing fee, or
Sample 1Sample 2Sample 3
Lower of Pricing means the lower of (1) the negotiated AWP less “x”%, (2) usual and customary pharmacy charge, or (3) MAC Maximum Allowable Cost (MAC) not to exceed the California Medicaid MAC or Federal Upper Limit (FUL), whichever is the lowest on a per claim basis
Sample 1Sample 2
Lower of Pricing means the lower of (1) 340B drug acquisition cost plus negotiated dispensing fee, (2) usual and customary pharmacy charge, or (3) MAC cost plus negotiated MAC dispensing fee, or (4) non-340B replenished drug reimbursement as set forth by the County.
Sample 1Sample 2

Examples of Lower of Pricing in a sentence

  • The electronic claims adjudication process shall include a real time Lower of Pricing analysis to verify the lowest cost alternative for the specific claim, communicated back to the CPN at the time of claims adjudication.

  • Any payment to the 340B Contract Pharmacy shall be determined by Lower of Pricing and may include Maximum Allowable Cost (MAC) priced, and usual and customary-priced agents.

  • The payment to the 340B Contract Pharmacy shall be equal to Lower of Pricing.

  • Possess the ability to affect a Lower of Pricing reimbursement methodology on each claim at the time of submission, selecting the lowest reimbursement for each claim and providing immediate response to the pharmacy submitting the claim.

  • Lower of Pricing means the lower of (1) 340B Acquisition Cost of the drug plus negotiated dispensing fee, or (2) the usual and customary pharmacy charge, or (3) Maximum Allowable Cost (MAC) cost plus negotiated MAC dispensing fee, or (4) non-340B drug reimbursement as set forth by ICHD.

  • County shall receive and pay invoices as generated by the RAMSELL for payment of each Covered Entity’s 340B Covered Drug costs, MAC cost, or Usual & Customary Costs as calculated in the Lower of Pricing logic, and RAMSELL Administrative Fee.

  • This lowest price for 340B replenished drugs shall be equal to the Lower of Pricing.

  • The payment to the 340B Contract Pharmacy shall be equal to Lower of Pricing as specified in Attachment B to this Contract.

  • Contractor shall determine Lower of Pricing as the least of: • National Average Drug Acquisition Cost (NADAC) + Dispensing Fee (DF); or• Federal Upper Limit (FUL) + DF; or• Wholesaler acquisition cost (WAC) + DF (if no FUL or NADAC available or if WAC is lower than both); or• Usual and Customary (U&C); or• Any other proprietary pricing methodology that is less expensive than every option above.

  • Payment of the 340B Drug acquisition costs or MAC costs to each 340B Covered Entity, using Lower of Pricing logic for each submitted claim to obtain lowest reimbursement cost.


More Definitions of Lower of Pricing

Lower of Pricing means the lower of (1) 340B drug acquisition cost plus negotiated dispensing fee, (2) usual and customary pharmacy charge, or (3) MAC cost plus negotiated MAC dispensing fee, or or (4) negotiated reimbursement as set forth in the pharmacy provider Temporary Agreement.
Sample 1

Related to Lower of Pricing

  • Order of Priority means the order of priority of payments specified in paragraph 2.2 (Pre and Post Enforcement Waterfalls) of Annex 1.

  • Regular Allocation of Principal means, with respect to any Payment Date, an amount not less than zero equal to (1) the excess, if any, of (a) the Note Balance of the Notes as of such Payment Date (before giving effect to any principal payments made on the Notes on such Payment Date) over (b) (i) the Pool Balance as of the end of the related Collection Period less (ii) the Targeted Overcollateralization Amount minus (2) the sum of the First Allocation of Principal, the Second Allocation of Principal, the Third Allocation of Principal, the Fourth Allocation of Principal and the Fifth Allocation of Principal for such Payment Date.

  • Fourth Allocation of Principal means, with respect to any Payment Date, an amount equal to (1) the excess, if any, of (a) the sum of the Class A Note Balance, the Class B Note Balance, the Class C Note Balance and the Class D Note Balance as of such Payment Date (before giving effect to any principal payments made on the Notes on such Payment Date) over (b) the Pool Balance as of the end of the related Collection Period minus (2) the sum of the First Allocation of Principal, the Second Allocation of Principal and the Third Allocation of Principal for such Payment Date; provided, however, that the Fourth Allocation of Principal on and after the Final Scheduled Payment Date for the Class D Notes shall not be less than the amount that is necessary to reduce the outstanding principal amount of the Class D Notes to zero (after the application of the First Allocation of Principal, the Second Allocation of Principal and the Third Allocation of Principal).

  • Fixed Interest Rate means the annual interest rate of five and forty hundredths percent (5.40%).

  • Original Accrual Rate With respect to each Payment Date and any Reference Obligation, the lesser of (i) the related Accounting Net Yield as of the Cut-off Date; and (ii) the related mortgage rate as of the Cut-off Date minus 0.35%.

  • Default Interest Rate is two percent above the base lending rate of Barclays Bank PLC, as varied from time to time;

  • Third Allocation of Principal means, with respect to any Payment Date, an amount equal to (1) the excess, if any, of (a) the sum of the Class A Note Balance, the Class B Note Balance and the Class C Note Balance as of such Payment Date (before giving effect to any principal payments made on the Class A Notes, the Class B Notes and the Class C Notes on such Payment Date) over (b) the Pool Balance as of the end of the related Collection Period minus (2) the sum of the First Allocation of Principal and the Second Allocation of Principal for such Payment Date; provided, however, that the Third Allocation of Principal on and after the Final Scheduled Payment Date for the Class C Notes shall not be less than the amount that is necessary to reduce the outstanding principal amount of the Class C Notes to zero (after the application of the First Allocation of Principal and the Second Allocation of Principal).

  • Interest Rate shall have the meaning assigned to such term or analogous term in the Mortgage Loan Agreement.

  • Overdue Interest Rate means, with respect to any Class, the Interest Rate applicable to such Class.

  • Rate means the Adjusted LIBO Rate and the Alternate Base Rate.

  • Capped Interest Rate is defined in the Note, if applicable.

  • Interest Rate Contracts means all interest rate swap agreements, interest rate cap agreements, interest rate collar agreements and interest rate insurance.

  • Point of Privilege means a matter that a member considers to question their integrity and/or the integrity of the Council.

  • Interest Rate Protection Obligations means the obligations of any Person pursuant to any Interest Rate Protection Agreements.

  • Nonpayment of premium means the failure or inability of the named insured to discharge any obligation in connection with the payment of premiums on a policy of insurance subject to this section, whether such payments are payable directly to the insurer or its agent or indirectly payable under a premium finance plan or extension of credit;

  • Applicable Federal Rate means the "applicable federal rate" as defined in Section 1274(d) of the Code.

  • Second Allocation of Principal means, with respect to any Payment Date, an amount equal to (1) the excess, if any, of (a) the sum of the Class A Note Balance and the Class B Note Balance as of such Payment Date (before giving effect to any principal payments made on the Class A Notes and the Class B Notes on such Payment Date) over (b) the Pool Balance as of the end of the related Collection Period minus (2) the First Allocation of Principal for such Payment Date; provided, however, that the Second Allocation of Principal on and after the Final Scheduled Payment Date for the Class B Notes shall not be less than the amount that is necessary to reduce the outstanding principal amount of the Class B Notes to zero (after the application of the First Allocation of Principal).

  • Penalty Rate means the Stated Rate plus two percent (2.00%) per annum of the Liquidation Price of each share of Series A Preferred Stock.

  • additional rate means the additional rate levied by the City of Cape Town on rateable properties within the designated boundaries of the Special Rating Area for purposes of raising funds for improving and upgrading that area, subject to any exemptions or permissible differentiation between categories of property, as contemplated in section 22(1) of the Rates Act, read with sections 8(1) and 12(2) of the By-Law;

  • Loan Terms means and refers collectively to (a) all the terms and conditions set out in the Application Form, (b) these General Terms and Conditions, and (d) all terms and conditions specified in the other Loan Documents.

  • Interest Rate Protection Agreements means any interest rate swap agreement, interest rate cap agreement, synthetic cap, collar or floor or other financial agreement or arrangement designed to protect Guarantor or any Consolidated Subsidiary against fluctuations in interest rates or to reduce the effect of any such fluctuations.

  • Stripped Interest Rate For each Mortgage Loan, the excess, if any, of the Net Mortgage Rate for such Mortgage Loan over the Remittance Rate.

  • First Allocation of Principal means, with respect to any Payment Date, an amount equal to the excess, if any, of (a) the Class A Note Balance as of such Payment Date (before giving effect to any principal payments made on the Class A Notes on such Payment Date) over (b) the Pool Balance as of the end of the related Collection Period; provided, however, that the First Allocation of Principal for any Payment Date on and after the Final Scheduled Payment Date for any Class of Class A Notes shall not be less than the amount that is necessary to reduce the Note Balance of that Class of Class A Notes to zero.