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For instance, in cases where an investigation, settlement agreement, or judgement has determined inaccurate use of a higher paying code [523] that is reflected in payment amounts used in Shared Savings Program calculations, we may identify use of a code with lower reimbursement within a HCPCS or CPT code category that would result ( in a more precise adjustment to the ACO's payment determination
Their use must be monitored and tapered by the prescribing physician, as long-term use may have significant side effects
(2) If all NDCs in the billing and payment code have neither manufacturer-reported ASP nor Wholesale Acquisition Cost (WAC) price data available for the applicable calendar quarter, CMS will use WAC price data from other public sources, if available, to calculate 106 percent of WAC, which will serve as the specified amount
The Barn: Not a Gimmick, a Foundation In the dichotomy between raw plant matter and ready-to-dip pouches, the barn is where Black Buffalos ritual begins