Cost Sharing Provisions. The following co-payments will apply at the time services are to be rendered. OUTPATIENT SERVICES COPAYMENTS Primary Care Office Visits $0 per visit Prescription generic medications $4.00 per prescriptions (When dispensed at contracted medical centers only, refer to covered formulary) Surgical Procedures and Application of Plaster Casts $0 ($200.00 per procedure for services in the first 92 days of enrollment) (services at physician's offices or clinics) Laboratory examinations and services $0 Periodic physical examinations $0 Well child care and pediatric services $0 Health Education $0 Routine Vision and Hearing Examinations $0 Physical Therapy $0 Therapeutic and Diagnostic Services: 24 Xxxxxx Monitor $0 ($100.00 per procedure for services in the first 92 days of enrollment) Audiometry $0 ($25.00 per procedure for services in the first 92 days of enrollment) Cardiac Stress Test $1200.00 per procedure CT Scan with or without contrast $500.00 per procedure Diagnostic Ultrasound $0 ($100.00 per procedure for services in the first 92 days of enrollment) Echocardiogram with Doppler $0 ($200.00 per procedure for services in the first 92 days of enrollment) Mammogram $100.00 per procedure MRI with or without contrast $800.00 per procedure Nuclear medicine $800.00 per procedure Vascular ultrasonography $0 ($200.00 per procedure for services in the first 92 days of enrollment) X-Ray Contrast $100.00 per procedure X-Ray Plain $0 ($30.00 per procedure for services in the first 92 days of enrollment) Urgently Needed Care (at contracted medical centers) $0 per visit SECTION X GENERAL PROVISIONS
Cost Sharing Provisions. PHP agrees to comply with all cost sharing restrictions imposed on FHKC participants by federal or state laws and regulations, including the following specific provisions:
Cost Sharing Provisions. INSURER agrees to comply with all Cost Sharing restrictions imposed on FHKC Participants by federal or state laws and regulations, including the following specific provisions:
Cost Sharing Provisions. INSURER shall comply with all cost sharing restrictions imposed on Enrollees by federal or state laws and regulations, including the following specific provisions:
Cost Sharing Provisions. HEALTH PLAN agrees to comply with all cost sharing restrictions imposed on FHKC participants by federal or state laws and regulations, including the following specific provisions:
Cost Sharing Provisions. 5.1 In consideration of the services provided by Manager, each of GLR and Senior Care LLC agree to contribute to the operating costs and expenses of Manager in proportion to the extent to which they and their respective subsidiaries make use of Manager’s services, with the intention that each year 100%, but no more than 100%, of the costs and expenses of the Manager are recouped from GLR and Senior Care LLC on such a proportional basis. In other words, it is intended that Manager be operated on a break even basis, and not as a profit center for GLR. Such amounts shall be funded by GLR and Senior Care LLC monthly in arrears, as billed by Manager, as determined by Manager in its sole discretion, in accordance with this Agreement. All payments shall be made not less than thirty (30) days of billing. Notwithstanding the above, Manager may elect to maintain cash reserves so as to have at all times not less than one nor more than three months working capital available to it, in which case the amounts needed to fund such working capital reserve shall be paid by GLR and Senior Care LLC within thirty (30) days of demand by Manager, such amounts to be funded in proportion to the allocation ratios of GLR and Senior Care LLC then in effect.
