definiens: means, with respect to any Product for any period, the amount invoiced by Buyer, its Affiliates and their sublicensees withrespect to the sale of the Product, less the following deductions, which shall be calculated by Buyer in accordance with GAAP, consistently applied;provided, that the cumulative amount of the following deductions may not exceed nineteen percent ( 19 % ) of gross amounts collected with respect to thesale of the Product : ( i ) normal, customary trade discounts ( including volume discounts ), credits, chargebacks, reductions and rebates ; ( ii ) actualadjustments for rejections, recalls, outdated products or returns ( in each event whether voluntary or required ) ; ( iii ) credits actually given for wastagereplacement, Medicare / Medicaid or other governmental rebates, ( iv ) annual fees due under Section 9008 of the United States Patient Protection andAffordable Care Act of 2010 ( Pub . L. No . 111 - 48 ) ( or any successor legislation ) allocable to sales of such Product ; and ( v ) normal and customary servicefees paid to Third Party distributors and wholesalers for maintaining agreed inventory levels and providing other bona fide services . In addition, Productsutilized in clinical trials and Products provided at no cost pursuant to indigent patient, compassionate use and similar programs will not be counted as NetSales