Drug pricing file containing the allowable price for each drug covered that is incident to a physician’s service, drugs furnished by independent dialysis facilities that are separately billable from the composite rate, and clotting factors to inpatients. The SDP is, in effect, a fee schedule, similar to other Centers for Medicare and Medicaid Services (CMS) fee schedules.

Examinations other than eye or psychiatric examinations should include performance and documentation of at least 12 elements identified in a table by a bullet (•), whether in a shaded or unshaded box. Eye and psychiatric examinations should include the performance and documentation of at least nine elements identified in a table by a bullet (•), whether in a shaded or unshaded box.

Physician or provider who does not practice in a group and does not share personnel, facilities, or equipment with another business. Also called solo practitioner .

State organization that administers and manages the state’s Medicaid program, a requirement of the Social Security Act.

Centralized system in which one organization, usually the government, sets reimbursement rates and pays all of the bills for health care to the providers (e.g., Canada, Germany, Great Britain). Individuals are not restricted as to which physicians or hospitals they can visit for medical services. Also known as socialized medicine and single-payer system .

Deferred or immediate annuity purchased with one premium payment. Also see annuity .

Group creditor insurance purchased either at the beginning of the loan, with the entire premium lump-sum amount being paid, or by adding the premium to the principal of the loan.