Examples of Usual and Customary Retail Price in a sentence
According to Omniplus, the relevant emphasis to be placed on this provision is that it “shall collect from Members the lesser of the Usual and Customary Retail Price amount or the applicable Copayment indicated by [Express Scripts], or when applicable, the full Copayment when indicated by [Express Scripts], through its online processing system or if online processing isunavailable, in accordance with the Provider Manual.” (emphasis supplied by Omniplus).
Pharmacy agrees to submit its Usual and Customary Retail Price to Company’s designated claims processor.
The Provider Manual’s PBM Glossary defines the Usual and Customary Retail Price of a drug as “the usual and customary retail price of a Covered Medication in a cash transaction at the Pharmacy dispensing the Covered Medication (in the quantity dispensed) on the date that it is dispensed.” In the event a party defaults in the performance of any of its obligations under this Agreement .
Provider agrees that the administrative and billing practices applied and the prices charged for products and services to holders of Identification Cards shall be an amount no greater than the lower of (1) the Usual and Customary Retail Price or (2) the AWP plus six (6) dollars for dispensing charges.
The Usual and Customary Retail Price of the Participating Pharmacy dispensing the prescription drugs, plus applicable sales or excise tax or other governmental surcharge, if any.