Covered Prescription Services definition

Covered Prescription Services means the services usually and customarily rendered by a pharmacy in the normal course of business, including but not limited to dispensing, counseling, pharmaceutical care, product consultation, and pharmacy services as otherwise defined by the state in which the pharmacy is licensed.
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Covered Prescription Services means those Prescription Drugs and other pharmaceutical products, services and supplies dispensed by Administrator to a Member for which coverage is provided pursuant to the terms and conditions of the Benefit Plan. Covered Prescription Services shall not include any Drug Product that satisfies the definition of a Specialty Drug.
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Covered Prescription Services means the prescriptions and other products and services that may be dispensed or provided by Pharmacy to which a Member is entitled to receive in accordance with and subject to the terms and conditions of the Plan.
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Examples of Covered Prescription Services in a sentence

  • Subrogation — To the extent permitted under applicable law and the applicableBenefit Plan, the Administrator reserves the right to recover benefits paid for a Member’s Covered Prescription Services when a third (3rd) party causes the Member’s injury or illness.

  • 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.

  • This section shall be considered a part of the Agreement by and between Administrator and Network Pharmacy Provider (including all amendments, addenda or Compensation Exhibits) to the extent the Network Pharmacy Provider provides Covered Prescription Services to Members in applicable states.

  • Some Covered Prescription Services may have additional requirements or limits that help ensure safe and effective use.

  • Failure to submit all Part D Covered Prescription Services may impact Part D Sponsor’s STAR ratings as well as individual Medicare Drug Plan Member’s benefit calculations.

  • 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.

  • A major example in a film set in Greco-Roman antiquity, although not a mys- tery, occurs with the detailed overview of the racetrack in William Wyler’s Ben-Hur (1959).

  • Network Pharmacy Providers shall at all times submit Part D Covered Prescription Services to Medicare Drug Plan Members via the POS System to Claims Processor and furnish Part D Covered Prescription Drugs in a manner that permits the Part D Sponsor to comply with Medicare laws and regulations.

  • Certain state or local jurisdictions may impose a tax on Covered Prescription Services.

  • However, LTC Network Pharmacy Providers must have delivery logs, manifests or other Administrator approved proof of delivery of Covered Prescription Services to facilities readily available during an audit.Abuse of the Short Cycle Dispensing regulations as defined by CMS and implemented on 1/1/2013, will be subject to audit and recovery of overpayments resulting from abuse and any attempt to achieve multiple dispensing fees based on days’ supply manipulation.

Related to Covered Prescription Services

  • Finished Services means complete end-to-end services offered by CenturyLink to wholesale customers or retail End User Customers. Finished Services do not include Unbundled Network Elements or combinations of Unbundled Network Elements. Finished Services include Access Services, private lines, retail services, and resold services.

  • Hosting Services means the provision, administration, and maintenance of servers and related equipment, the provision of bandwidth at the hosting facility, and the operation of the Application for access by Customer Users to be provided by the relevant hosting service provider.

  • Education Services means education and hostel facilities for students and scholars provided by -

  • Transportation Services means travel assistance given to an individual

  • Distribution Services means the service of distribution, as defined in section 5 of the Act;

  • Implementation Services has the meaning set forth in Section 2.1.

  • Cloud Services means SAP’s then-current cloud services offered under and described in detail in the applicable SAP PartnerEdge Model.

  • Family planning services means services for clients of child bearing age (including minors who can be considered to be sexually active) who desire such services and that are intended to prevent pregnancy or otherwise limit family size.

  • Transportation Service means a service for moving people and goods, such as intercity bus service and passenger rail service.

  • Training Services means access to Red Hat training courses, including online courses or courses provided at a site as may be agreed by the parties.

  • Passenger Services means the Franchisee's railway passenger services as specified in any Timetable and/or Plan of the Day including those railway passenger services which the Franchisee may delegate or subcontract or otherwise secure through any other person from time to time in accordance with the Franchise Agreement;

  • Educational Services means educational training provided to Entitled Students at a School;

  • Hospice services means palliative and supportive care and other services provided by an interdisciplinary team under the direction of an identifiable hospice administration to terminally ill hospice patients and their families to meet the physical, nutritional, emotional, social, spiritual, and special needs experienced during the final stages of illness, dying, and bereavement, as defined in Minnesota Statutes, § 144A.75, subd. 8, and includes the set of services as determined by the Medicare program under §1861(dd) of the Social Security Act and defined in 42 CFR § 418.3.

  • Covered Services means all or a part of those medical and health services set forth in rule 441—86.14(514I).

  • Network plan means a policy of group health insurance offered by an insurer under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the insurer. The term does not include an arrangement for the financing of premiums.

  • Administration Services means the services required for the effective and efficient administration of Bonitas and includes, but are not necessarily limited to, member record management, contribution management, benefit option management, claims processing and management, management of members’ personal, claims and financial information and any other services that are required for the administration of Bonitas;

  • Nursing services means the provision of individual-specific advice, plans, or interventions by a nurse at a home based on the nursing process as outlined by the Oregon State Board of Nursing. Nursing services differ from administrative nursing services.

  • Support Services the support services, as described in the Support Services Description, that We provide to You in respect of the Cloud Service.

  • Basic health plan services means that schedule of covered

  • Application Services means the hosted applications and related services as described in Exhibit A.

  • Manufacturing Services means the manufacturing, quality control, quality assurance, stability testing, packaging, and related services, set forth in this Agreement, required to manufacture Product or Products from Active Materials and Components;

  • Family support services means providing opportunities for

  • Contract Services means the Services to be supplied by the Supplier to the Customer as set out in the Letter of Appointment;

  • Advertising Services means the advertising services selected on the front pages of this Agreement.

  • Homemaker services means the professionally directed or supervised simple household maintenance or management services provided by trained homemakers or individuals to families in their own homes.

  • Pharmacy services means the practice of pharmacy as defined in chapter 18.64 RCW and includes any drugs or devices as defined in chapter 18.64 RCW.