Table 4: Assessment Questions Yes No N/A Unsure Is the split-billing software default account accumulator set as (WAC)? If response is or explain: (Identify and discuss each outlier) “No” “Unsure,” For each drug tested in Table 4 that was dispensed/administered to an inpatient, was the drug accumulated on the GPO account? Answer to the question only if YES is marked in columns 3 and 6, “Yes” and respectively, in Table 4. “Inpatient” “GPO,” If response is or explain: (Identify and discuss each outlier) “No” “Unsure,” For each drug tested in Table 4 that was dispensed/administered to a outpatient, was the drug accumulated on the 340B account? Answer to the question only if YES is marked in columns 4 and 7, Eligible “Yes” “340B Outpatient” and respectively, in Table 4. “340B,” If response is or explain: (Identify and discuss each outlier) “No” “Unsure,” For each drug tested in Table 4 that was dispensed/administered to a non-340B eligible outpatient, was the drug accumulated on the account? Answer to the question only if YES is marked in columns 5 and 8, “Yes” Eligible Outpatient” and respectively, in Table 4. “WAC,” If response is or explain: (Identify and discuss each outlier) “No” “Unsure,”
Table 4: Assessment Questions Yes No N/A Unsure Is the split-billing software default account accumulator set as (WAC)? If response is “No” or “Unsure,” explain: (Identify and discuss each outlier) For each drug tested in Table 4 that was dispensed/administered to an inpatient, was the drug accumulated on the GPO account? Answer “Yes” to the question only if YES is marked in columns 3 and 6, “Inpatient” and “GPO,” respectively, in Table 4. If response is “No” or “Unsure,” explain: (Identify and discuss each outlier) For each drug tested in Table 4 that was dispensed/administered to a outpatient, was the drug accumulated on the 340B account? Answer “Yes” to the question only if YES is marked in columns 4 and 7, “340B Eligible Outpatient” and “340B,” respectively, in Table 4. If response is “No” or “Unsure,” explain: (Identify and discuss each outlier) For each drug tested in Table 4 that was dispensed/administered to a non-340B eligible outpatient, was the drug accumulated on the account? Answer “Yes” to the question only if YES is marked in columns 5 and 8, Eligible Outpatient” and “WAC,” respectively, in Table 4. If response is “No” or “Unsure,” explain: (Identify and discuss each outlier)
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