definiens: means, for any period, the amo unt invoiced by Buyer, its Affiliates and their sublicensees with respect to the sale of the Product, less the following deductions, which shall be calculated by Buyer in accordance with GAAP, consistently appl ied ; provided, that the cumulative amount of the fo llowing deductions may not exceed nineteen percent ( 19 % ) of gross amounts collected with respect to the sale o f the Product : ( i ) normal, customary trade discounts ( inc luding volume discounts ), credits, chargebacks, red uctions and rebates ; ( ii ) actual adjustments for rejections, recalls, outdated products or returns ( in each ev ent whether voluntary or required ) ; ( iii ) credits actually give n for wastage replacement, Medicare / Medicaid or oth er governmental rebates, ( iv ) annual fees due under Se ction 9008 of PPACA allocable to sales of such Prod uct ; and ( v ) normal and customary service fees paid to Third Party distributors and wholesalers for maintaining agreed inventory levels and providing other bona fide serv ices . In addition, Products utilized in clinical tr ials and Products provided at no cost pursuant to indigent p atient, compassionate use and similar programs will not be counted as Net Sales