PTCB - Pharmacy Billing and Reimbursement Exam with
all Correct & 100% Verified Answers |Already Graded A+
medicare advantage (medicare part C) ✔Correct Answer-allows participants in Medicare Part
A and B to obtain coverage through a Health Maintenance Organization or Preferred Provider
Organization that provides additional services at a higher cost.
medicare part A ✔Correct Answer-a federally funded health care program that pays for a
patient's inpatient hospital care, skilled nursing care, hospice care, and home health care
medicare part B ✔Correct Answer-a federally funded health care program that provides a
patient with coverage for physician visits, outpatient care, physical therapy, and occupational
therapy.
medicare part D ✔Correct Answer-a federally funded health care program that provides a
patient with coverage for select prescription medications, medical supplies, insulin, and
vaccinations.
Medicaid ✔Correct Answer-a federal program based on income as well as other
circumstances. eligibility is determined on a month by month basis. it generally covers doctors
visits, emergency care, hospital care, vaccinations, prescriptions, vision, hearing, and
preventative care for children
average wholesale price ✔Correct Answer-the average price that wholesalers sell a
medication
actual acquisition cost ✔Correct Answer-actual cost a pharmacy paid for a medication
formulary ✔Correct Answer-a list of medications approved for use or reimbursement under a
prescription plan.
open formulary ✔Correct Answer-a variety of several medications in each therapeutic
classification
closed formulary ✔Correct Answer-a very limited number of medications available in each
therapeutic classification, and sometimes no medications in certain classifications.
restricted formulary ✔Correct Answer-a selective, limited, partially closed formulary in which
some non-formulary medications are available.
online adjudication ✔Correct Answer-the process by which a pharmacy submits prescription
claims electronically to a third party provider when filling a prescription to ensure accurate
all Correct & 100% Verified Answers |Already Graded A+
medicare advantage (medicare part C) ✔Correct Answer-allows participants in Medicare Part
A and B to obtain coverage through a Health Maintenance Organization or Preferred Provider
Organization that provides additional services at a higher cost.
medicare part A ✔Correct Answer-a federally funded health care program that pays for a
patient's inpatient hospital care, skilled nursing care, hospice care, and home health care
medicare part B ✔Correct Answer-a federally funded health care program that provides a
patient with coverage for physician visits, outpatient care, physical therapy, and occupational
therapy.
medicare part D ✔Correct Answer-a federally funded health care program that provides a
patient with coverage for select prescription medications, medical supplies, insulin, and
vaccinations.
Medicaid ✔Correct Answer-a federal program based on income as well as other
circumstances. eligibility is determined on a month by month basis. it generally covers doctors
visits, emergency care, hospital care, vaccinations, prescriptions, vision, hearing, and
preventative care for children
average wholesale price ✔Correct Answer-the average price that wholesalers sell a
medication
actual acquisition cost ✔Correct Answer-actual cost a pharmacy paid for a medication
formulary ✔Correct Answer-a list of medications approved for use or reimbursement under a
prescription plan.
open formulary ✔Correct Answer-a variety of several medications in each therapeutic
classification
closed formulary ✔Correct Answer-a very limited number of medications available in each
therapeutic classification, and sometimes no medications in certain classifications.
restricted formulary ✔Correct Answer-a selective, limited, partially closed formulary in which
some non-formulary medications are available.
online adjudication ✔Correct Answer-the process by which a pharmacy submits prescription
claims electronically to a third party provider when filling a prescription to ensure accurate
