Ingredient cost definition

Ingredient cost means the actual amount paid to a pharmacy provider by a carrier or the carrier’s pharmacy benefits manager for a prescription drug, not including the dispensing fee or cost-sharing amount.
Ingredient cost means the portion of a prescription's cost attributable to the drug ingredients, chemical components, and/or substances.
Ingredient cost means the portion of the total medicaid payment amount attributable to the cost of the drug product, or in the case of a compound drug, the sum of the cost of the ingredients that are covered in accordance with rule 5160-9-03 of the Administrative Code.

Examples of Ingredient cost in a sentence

Ingredient cost is based on Medispan’s Average Wholesale Prices (AWPs) as reflected in the Online System at the time the prescription was filled less a discount as specified in the Participating Pharmacy Agreement.

We do not release the four subcomponents of drug cost: Ingredient cost, dispensing fee, vaccine administration fee, and total amount attributable to sales tax.Comment: One commenter stated that the rule does not address how states that have all payer claims databases (APCDs) can access Medicare data.Response: We do not believe that state APCDs are prohibited from becoming qualified entities.

This code is represented in this document to offset the Claim audit adjustments in conjunction with CARC code.216 - Based on the findings of a review organization90 = Ingredient cost adjustmentLQ01 – Code List Qualifier Code4HE = Claim payment remark code (411 Code Source)LQ02 – Remark CodeN199 = Additional payment/adjustment approved based on payer-initiated review/auditPLB03-1CS – AdjustmentFB – Forwarding balance 1 Accredited Standards Committee X12, Insurance Subcommittee, X12N.

Drugs acquired at Nominal Price (outside of 340B or FSS) – Ingredient cost based on AAC plus a professional dispensing fee of $11.29.

Drugs acquired via the Federal Supply Schedule (FSS) – Ingredient cost based on AAC plus a professional dispensing fee of $11.29.


More Definitions of Ingredient cost

Ingredient cost means)) - The portion of a prescrip- tion's cost attributable to the covered drug ingredients or chemical components.
Ingredient cost means, for each ingredient in a Product, the cost of that ingredient. The cost shall be
Ingredient cost means the agreed upon pass-through rate, inclusive of any agreed upon payment logic applied, paid to the pharmacy for the drug dispensed based on the type of medication provided (as outlined in the cost proposal) and does not include the Dispensing Fee, Copayments, Coinsurance, Deductibles or sales tax, if any.
Ingredient cost means the amount Contractor pays to the pharmacy on behalf of the Board, less any and all income streams, to reflect complete financial transparency as defined in the RFP.
Ingredient cost means the amount charged to Sponsor by ESI for Covered Drugs dispensed under the Plan, excluding Dispensing Fees and Administrative Fees.
Ingredient cost means the amount required to be paid to a Network Participant for a prescription drug and which, when combined with the applicable Dispensing Fee, constitutes the full amount payable to such Network Participant for the given prescription drug and the professional service of dispensing such drug.
Ingredient cost means the ingredient cost amount charged to Group for each Claim subject to the provision set forth in section IV.