If a patient has HMO insurance, the pharmacy bills the __________ first.
What is insurance company?
100
Reference book listing NDC numbers, manufacturers, and average wholesale pricing of drug products
What is Red Book (Drug Topics)?
100
Sets limitations on payments
What is Medicare Modernization Act (MMA)?
100
25% of $9.00
What is $2.25?
100
Oral medication tablets that can be crushed
What is effervescent?
200
Medicare services were broadened in 1980 with the creation of the ____________ plan.
What is Medigap?
200
Electronic insurance billing for medication payment
What is adjudication?
200
A list of preapproved medications that are covered under a prescription plan or within an institution
What is formulary?
200
If a medication is to be discounted by 20% and the cost is $16.00, the final cost of the medication is _______.
What is $12.80?
200
Safety, ease of administration, and generally accepted are all advantages of this route of administration
What is oral route?
300
Health insurance program for people 65 and older
What is Medicare?
300
Number assigned to health care provider; used for the purpose of standardizing health data transmissions
What is National Provider Identifier (NPI)?
300
Similar to a preauthorization form but us the process used for Medicare and Medicaid
What is Treatment Authorization Request (TAR)?
300
$2.50 is what percent of $75.00
What is 3.33%?
300
Route by which drugs are absorbed in the GI tract via oral or rectal administration
What is enteral route?
400
Both Medicaid and Medicare were implemented in
What is 1965?
400
A list that is essentially unrestricted in the types of drug choices offered or that can be prescribed and then reimbursed under the health provider plan or pharmacy benefit plan
What is open formulary?
400
Information sheets supplied to the pharmacy from the manufacturer of chemical products that list hazards and how to handle them if exposed to the chemicals
What is Material Safety Data Sheets (MSDS)?
400
If a discount of 15% is to be given on a medication that costs $26.00, the final cost will be _______.
What is $22.10?
400
Available as suppositories, enemas, creams, and ointments
What is rectal medications?
500
Following HIPAA regulations in ___________, the pharmacy does not have access to information regarding the reason for insurance rejection and is disclosed only a termination date.
What is 2003?
500
Medication use is tightly restricted to those medications provided on the list
What is closed formulary?
500
Ten-digit number given to all drugs for identification purposes; in health and drug databases
What is National Drug Code (NDC)?
500
25% of $32.00
What is $22.10?
500
The ability to swallow, food and digestive disorders, GI tract secretions, and consciousness of the person can all alter this route of administration