Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key


Play button


Play button




Click to flip

13 Cards in this Set

  • Front
  • Back
The Maximum Allowable Cost is usually (greater than or less than) the Usual and Customary (U&C) price.
less than
What is meant by Maximum Allowable Cost or MAC?
the maximum price per tablet (or other dispensing unit) an insurer or PBM will pay for a given product
What is meant by U&C or UCR?
the maximum amount of payment for a given prescription, determined by the insurer to be a usual and customary (and reasonable) price
What does the DAW code 0 indicate?
What does the DAW code 1 indicate?
DAW handwritten on the prescription by the prescriber
What does the DAW code 2 indicate?
Patient requested brand
What does the DAW code 3 indicate?
Pharmacist selected brand
What does the DAW code 4 indicate?
Generic not in stock
What does the DAW code 5 indicate?
Brand name dispensed but priced as generic
What does the DAW code 6 indicate?
What does the DAW code 7 indicate?
Substitution not allowed; brand mandated by law
What does the DAW code 8 indicate?
Generic not available
What does it mean when "Refills Not Covered" is the reason for a rejected claim?
The patient has a mail order pharmacy for maintenance medications.