Prescription Drug Compensation definition

Prescription Drug Compensation means the reimbursement, remuneration, compensation, or other payment paid by United to Administrator for the provision of Covered Prescription Services to a Member.
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Prescription Drug Compensation means the actual amount which SOUTHERN SCRIPTS is contractually required to reimburse PHARMACY, on behalf of a Plan Sponsor, for the dispensing of a Covered Drug to a Member, which amount shall be determined in accordance with Exhibit A or Exhibit B. SOUTHERN SCRIPTS may from time to time amend the Prescription Drug Compensation which amendment shall become effective thirty (30) calendar days after such notice is received by PHARMACY unless, prior to such time, PHARMACY rejects the amendment in writing to SOUTHERN SCRIPTS.
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Prescription Drug Compensation shall equal the following (i) the lesser of (a) the Usual and Customary Charge or (b) the Prescription Drug Contracted Rate; minus (ii) any applicable Cost-Sharing Amount. The applicable Client shall pay Administrator the Prescription Drug Compensation for the provision of all Covered Prescription Services to Members by Administrator or facility locations. Administrator (and each facility location) shall accept the Prescription Drug Compensation plus any applicable Cost-Sharing Amount as payment in full for the provision of all Covered Prescription Services to Members. Administrator understands and agrees that the applicable Client is not responsible for the funding of Claims, is not a guarantor or insurer of the funding for Claims payment, and is not financially responsible or liable for the payment of Claims.
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Examples of Prescription Drug Compensation in a sentence

  • Medicaid claims (OptumRx BINs Only)Unless otherwise specified below, Prescription Drug Compensation for Compounded Drugs dispensed to Medicaid Members that are Medicaid Covered Prescription Services will be at the Network Pharmacy Provider’s agreed upon Prescription Drug Contracted Rate for each approved ingredient submitted for the applicable network associated with the Claim submission, plus a Compounded Drug dispensing fee.

  • Medicare Part D claims (OptumRx BINs Only)The Prescription Drug Compensation for Compounded Drugs dispensed to Medicare Part D Members that are Medicare Part D Covered Prescription Services will be at the Network Pharmacy Provider’s agreed upon Prescription Drug Contracted Rate for each approved ingredient submitted for the applicable network associated with the Claim submission, plus a Compounded Drug dispensing fee.

  • In the event that United contracts directly with a pharmacy, the Prescription Drug Compensation payable to such pharmacy shall be excluded from any calculation of the Guarantees, as defined in Exhibit C-1, et seq., as applicable.

  • Written notice by either party shall be sufficient to stop further performance of services by Party.

  • Administrator shall timely submit to United invoices, in reasonable detail, that accurately reflect the Services performed during the invoice period and include all Prescription Claims information, data and detail to support the Prescription Drug Compensation and any other charges appearing on such invoices which United is required to pay or reimburse Administrator.

  • United acknowledges that in the states where United maintains a traditional pricing structure with Administrator, the compensation Administrator pays Network Pharmacies pursuant to Network Pharmacy Agreements may not be the same amount of Prescription Drug Compensation paid to Administrator by Client.

  • Medicare Part D claims (OptumRx BINs Only)The Prescription Drug Compensation for Compounded Drugs dispensed to Medicare Part D Members that are Medicare Part D Covered Prescription Services will be at the Network Pharmacy Provider’s agreed upon Prescription Drug Contracted Rate for each approved ingredient submitted for the applicable network associated with the ClaimNextsubmission, plus a Compounded Drug dispensing fee not less than $19.72.

  • Administrator (and each facility location) shall accept the Prescription Drug Compensation plus any applicable Cost-Sharing Amount as payment in full for the provision of all Covered Prescription Services to Members.

  • Medicaid claims (OptumRx BINs Only)BackUnless otherwise specified below, Prescription Drug Compensation for Compounded Drugs dispensed to Medicaid Members that are Medicaid Covered Prescription Services will be at the Network Pharmacy Provider’s agreed upon Prescription Drug Contracted Rate for each approved ingredient submitted for the applicable network associated with the Claim submission, plus a Compounded Drug dispensing fee not less than $20.23.

  • Medicare Part D claims (OptumRx BINs Only)The Prescription Drug Compensation for Compounded Drugs dispensed to Medicare Part D Members that are Medicare Part D Covered Prescription Services will be at the Network Pharmacy Provider’s agreed upon Prescription Drug Contracted Rate for each approved ingredient submitted for the applicable network associated with the Claim submission, plus a Compounded Drug dispensing fee not less than $19.72.


More Definitions of Prescription Drug Compensation

Prescription Drug Compensation means the actual amount which MAKORX is contractually required to reimburse PHARMACY, on behalf of a Plan Sponsor, for the dispensing of a Covered Drug to a Member, which amount shall be determined in accordance with Exhibit A or Exhibit B, attached hereto. MAKORX may amend the Prescription Drug Compensation from time to time, which amendment shall become effective thirty (30) calendar days after such notice is received by PHARMACY unless, prior to such time, PHARMACY rejects the amendment in writing to MAKORX.
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Related to Prescription Drug Compensation

  • Prescription drugs means drugs, medicine and controlled substances which by law can only be prescribed for human use by persons authorized by law.

  • Prescription drug means any drug required by federal law or regulation to be dispensed only

  • Participating Prescription Drug Provider means an independent retail Pharmacy, chain of retail Pharmacies, mail-order Pharmacy or specialty drug Pharmacy which has entered into an agreement to provide pharmaceutical services to participants in the benefit program. A retail Participating Pharmacy may or may not be a select Participating Pharmacy as that term is used in the Vaccinations Obtained Through Participating Pharmacies section.

  • Prescription drug order means a lawful order of a practitioner for a drug or device for a specific patient that is communicated to a pharmacist.

  • Nonprescription drugs means nonnarcotic medicines or drugs which may be sold without a prescription and are prepackaged and labeled for use by the consumer in accordance with the requirements of the statutes and regulations of this state and the federal government;

  • Nonprescription drug or "over-the-counter drug" means any

  • Basic health plan model plan means a health plan as required in RCW 70.47.060(2)(e).

  • Basic health plan means the plan described under chapter

  • Participating Retail Health Clinic means a Retail Health Clinic which has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Medical Reimbursement Programs means a collective reference to the Medicare, Medicaid and TRICARE programs and any other health care program operated by or financed in whole or in part by any foreign or domestic federal, state or local government.

  • Basic health benefit plan means any plan offered to an individual, a small group,

  • Participating Clinical Laboratory means a Clinical Laboratory which has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Flexi Plan means any individual indemnity hospital insurance plan under the VHIS framework with enhancement(s) to any or all of the protections or terms and benefits that the Standard Plan provides to the Policy Holder and the Insured Person, subject to certification by the Government. Such plan shall not contain terms and benefits which are less favourable than those in the Standard Plan, save for the exception as may be approved by the Government from time to time.

  • Prescription monitoring program means the electronic system within the Department of Health Professions that monitors the dispensing of certain controlled substances.

  • Participating Clinical Social Worker means a Clinical Social Worker who has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Drug abuse means any pattern of pathological use of drugs that causes impairment in social or occupational functioning, or that produces physiological dependency evidenced by physical tolerance or by physical symptoms when it is withdrawn.

  • Non-Participating Clinical Laboratory means a Clinical Laboratory which does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan provide services to you at the time services are rendered.

  • Non-Participating Retail Health Clinic means a Retail Health Clinic which does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Biological safety cabinet means a containment unit suitable for the preparation of low to moderate risk agents where there is a need for protection of the product, personnel, and environment, according to National Sanitation Foundation (NSF) Standard 49.

  • Licensed clinical social worker means an individual who meets the licensed clinical social worker requirements established in KRS 335.100.

  • Health benefits plan means a benefits plan which pays or

  • Paycheck Protection Program means loan program created by Section 1102 of the CARES Act.

  • Basic health plan services means that schedule of covered

  • Clinical laboratory means a facility for the microbiological, serological, chemical, hematological, radiobioassay, cytological, immunohematological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of a disease or assessment of a medical condition.

  • Medical evaluation means the process of assessing an individual's health status that includes a medical history and a physical examination of an individual conducted by a licensed medical practitioner operating within the scope of his license.

  • Health and Welfare Benefits means any form of insurance or similar benefit programs, which may include but not be limited to, medical, hospitalization, surgical, prescription drug, dental, optical, psychiatric, life, or long-term disability.