Prescription Drug List definition

Prescription Drug List. Cigna Standard Prescription Drug List Specialty Pharmacy Management: • Clinical Programs o Prior authorization is not required on specialty medications but quantity limits may apply. o Theracare® Program • Medication Access Option o Retail and/or Home Delivery Additional Information Case Management Coordinated by Cigna HealthCare. This is a service designated to provide assistance to a patient who is at risk of developing medical complexities or for whom a health incident has precipitated a need for rehabilitation or additional health care support. The program strives to attain a balance between quality and cost effective care while maximizing the patient's quality of life. Comprehensive Oncology Program • Care Management outreach • Case Management Included Health Advisor - A Support for healthy and at-risk individuals to help them stay healthy • Health and Wellness Coaching • Gaps in Care coaching for select conditions • Preference Sensitive Care/Treatment Decision Support Coaching Included Healthy Pregnancies/Healthy Babies • Care Management outreach • Maternity Case Management • Neo-natal Case Management $400 (1st trimester) / $200 (2nd trimester) - Option 1 Multiple Surgical Reduction Multiple surgeries performed during one operating session result in payment reduction of 50% to the surgery of lesser charge. The most expensive procedure is paid as any other surgery. Pre-Certification - Continued Stay Review - PHS Inpatient - required for all inpatient admissions In Network: Coordinated by your physician Pre-Existing Condition Limitation (PCL) does not apply.
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Prescription Drug List. Cigna Standard Prescription Drug List Specialty Pharmacy Management: • Clinical Programs o Prior authorization is not required on specialty medications but quantity limits may apply. o Theracare® Program • Medication Access Option o Retail and/or Home Delivery Additional Information Case Management Coordinated by Cigna HealthCare. This is a service designated to provide assistance to a patient who is at risk of developing medical complexities or for whom a health incident has precipitated a need for rehabilitation or additional health care support. The program strives to attain a balance between quality and cost effective care while maximizing the patient's quality of life. Comprehensive Oncology Program • Care Management outreach • Case Management Included Additional Information Health Advisor - A Support for healthy and at-risk individuals to help them stay healthy • Health and Wellness Coaching • Gaps in Care coaching for select conditions • Preference Sensitive Care/Treatment Decision Support Coaching Included Healthy Pregnancies/Healthy Babies • Care Management outreach • Maternity Case Management • Neo-natal Case Management $400 (1st trimester) / $200 (2nd trimester) - Option 1 Maximum Reimbursable Charge Out-of-Network services are subject to a Contract Year deductible and maximum reimbursable charge limitations. Payments made to health care professionals not participating in Cigna's network are determined based on the lesser of: the health care professional's normal charge for a similar service or supply, or a percentage (300%) of a fee schedule developed by Cigna that is based on a methodology similar to one used by Medicare to determine the allowable fee for the same or similar service in a geographic area. In some cases, the Medicare based fee schedule is not used, and the maximum reimbursable charge for covered services is determined based on the lesser of: the health care professional's normal charge for a similar service or supply, or the amount charged for that service by 80% of the health care professionals in the geographic area where it is received. The health care professional may bill the customer the difference between the health care professional's normal charge and the Maximum Reimbursable Charge as determined by the benefit plan, in addition to applicable deductibles, co-payments and coinsurance. Multiple Surgical Reduction Multiple surgeries performed during one operating session result in payment reduction of 50% to the surgery of...
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Prescription Drug List means the list established by the Minister under section 29.1 of the Act; (Liste des drogues sur ordonnance)
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Examples of Prescription Drug List in a sentence

  • Benefits for Prescription Drug Products are subject to supply limits and Copayments and/or Coinsurance or other payments that vary depending on which of the tiers of the Prescription Drug List the Prescription Drug Product is placed.

  • Prescription Drug List means a list that categorizes into tiers medications, products or devices that have been approved by the U.S. Food and Drug Administration.

  • How to locate information and updates to the Colorado Prescription Drug List (PDL) program.

  • Benefits for Prescription Drug Products are subject to supply limits and Copayments and/or Coinsurance or other payments that vary depending on which of the tiers of the Prescription Drug List the Prescription Drug Product is listed.

  • Refer to the Prescription Drug List for alisting of Specialty Pharmaceuticals and specialty pharmacies.

  • Please refer to the Prescription Drug List for a listing of drugs that do not apply toward the Calendar Year Maximum.

  • Call customer service for a copy of the Prescription Drug List or visit Our website at www.bluekc.com for the most current information.

  • Refer to the Prescription Drug List for a listing of Specialty Pharmaceuticals and specialty pharmacies.

  • Our Prescription Drug List (PDL) Management Committee makes tier placement changes on our behalf.

  • Call customer service for a copy of the Prescription Drug List or visit our website at www.bluekc.com for the most current information.


More Definitions of Prescription Drug List

Prescription Drug List means a list that categorizes into tiers medications, products or devices that have been approved by the U.S. Food and Drug Administration. This list is subject to the Company’s periodic review and modification (generally quarterly, but no more than six times per calendar year).
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Prescription Drug List means the list established under section 29.1 of the Food and Drugs Act
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Prescription Drug List means a list that categorizes Prescription Drug Products covered under the Healthplan’s Prescription Drug Benefits into coverage tiers. This list is developed by Cigna based on clinical factors communicated by the P&T Committee, and adopted by the Group as part of the Healthplan. The list is subject to periodic review and change, and is subject to the limitations and exclusions of the Healthplan. You may determine to which tier a particular Prescription Drug Product has been assigned through the Internet at xxx.xxxxxxx.xxx or by calling customer service at the telephone number on your ID card. Prescription Drug Product means a drug, Biologic (including a Biosimilar), or other product that has been approved by the U.S. Food and Drug Administration (FDA), certain products approved under the Drug Efficacy Study Implementation review, or products marketed prior to 1938 and not subject to review and that can, under federal or state law, be dispensed only pursuant to a Prescription Order or Refill. A Prescription Drug Product includes a drug, Biologic or product that, due to its characteristics, is approved by the FDA for self- SAMPLE DOCUMENT administration or administration by a non-skilled caregiver. For the purpose of benefits under the Plan, this definition also includes: . The following diabetic supplies: alcohol pads, swabs, wipes, Glucagon/Glucagen, injection aids, insulin pump accessories (but excluding insulin pumps), needles including pen needles, syringes, test strips, lancets, urine glucose and ketone strips; . Needles and syringes for self-administered medications or Biologics covered under the Plan’s Pharmacy Benefit; and Inhaler assistance devices and accessories, peak flow meters. This definition does not include any charges for mobile, web-based or other electronic applications or software, even if approved for marketing as a prescription product by the FDA. Prescription Order or Refill means the lawful directive to dispense a Prescription Drug Product issued by a Physician whose scope of practice permits issuing such a directive.
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Related to Prescription Drug List

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

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

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

  • 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.

  • Drug addiction means a disease characterized by a

  • Drug means (i) articles or substances recognized in the official United States Pharmacopoeia

  • 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.

  • Drug Master File or “DMF” is described in 21 C.F.R. Part 314.420. A DMF is a submission to the FDA that may be used to provide confidential detailed information about facilities, processes, or articles used in the manufacturing, processing, packaging, and storing of one or more human drugs.

  • FDA means the United States Food and Drug Administration or any successor agency thereto.

  • 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.

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

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

  • 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.

  • MHLW means the Japanese Ministry of Health, Labour and Welfare, and any successor agency thereto.

  • Department sample means liquor that is placed in the possession of the

  • PDMA means the Prescription Drug Marketing Act of 1987, as amended from time to time, together with any rules or regulations promulgated thereunder.

  • Prescription means an order for drugs or medical supplies, written or signed or transmitted by word

  • Brand Name Drug means a Prescription Drug that has been given a name by a manufacturer or distributor to distinguish it as produced or sold by a specific manufacturer or distributor and may be used and protected by a trademark.