Prescription Drug Allowed Benefit definition

Prescription Drug Allowed Benefit means the lesser of:
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Prescription Drug Allowed Benefit means the lesser of: The Pharmacy's actual charge; or
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Examples of Prescription Drug Allowed Benefit in a sentence

  • Except in cases of Emergency Services or Urgent Care received outside of the Service Area, the difference between the non-Contracting Pharmacy’s actual charge and the Prescription Drug Allowed Benefit is a non-covered service.

  • In all other cases, Members will be entitled to reimbursement from CareFirst or its designee for the amount up to the Prescription Drug Allowed Benefit, minus any applicable Deductible, or Copayment or Coinsurance.

  • In all other cases, Members will be entitled to reimbursement from CareFirst BlueChoice or its designee for the amount up to the Prescription Drug Allowed Benefit, minus any applicable Deductible, or Copayment or Coinsurance.

  • Members will be entitled to reimbursement up to the Prescription Drug Allowed Benefit from CareFirst or its designee, minus any applicable Deductible, Copayment or Coinsurance.

  • The Member is responsible for any balances above the Prescription Drug Allowed Benefit.

  • Members will be entitled to reimbursement from CareFirst BlueChoice or its designee up to the amount of the Prescription Drug Allowed Benefit, minus any applicable Deductible, Copayment, or Coinsurance.

  • Le Roy Hall Award for Teaching Excellence, Weinberg College of Arts and Sciences, 2010-11.- Harold and Virginia Anderson Outstanding Teaching Professor, Northwestern University, 1999-2003.- Excellence in Teaching Award, Interfraterity Council/Panhellenic Association, Northwestern, 1997.- Hewlett Grant: “Technology: History, Society, and Economy.” Co-winner with Joel Mokyr, 1993-94.

Related to Prescription Drug Allowed Benefit

  • MEDICAL PRESCRIPTION DRUGS are prescription drugs that require administration (or the FDA approved recommendation is for administration) by a licensed healthcare provider (other than a pharmacist). These medical prescription drugs include, but are not limited to, medications administered by infusion, injection, or inhalation, as well as nasal, topical or transdermal administered medications. Medical prescription drugs are covered as a medical benefit. MEDICALLY NECESSARY (MEDICAL NECESSITY) means that the healthcare services provided to treat your illness or injury, upon review by BCBSRI are: • appropriate and effective for the diagnosis, treatment, or care of the condition, disease, ailment or injury for which it is prescribed or performed; • appropriate with regard to generally accepted standards of medical practice within the medical community or scientific evidence; • not primarily for the convenience of the member, the member’s family or provider of such member; and • the most appropriate in terms of type, amount, frequency, setting, duration, supplies or level of service, which can safely be provided to the member (i.e. no less expensive professionally acceptable alternative, is available). We will make a determination whether a healthcare service is medically necessary. You have the right to appeal our determination or to take legal action as described in Section

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