FEE SERV RX3 (138) IB ACTION CHARGE (350.2)
Name
Value
KEY
FEE SERV RX3
EFFECTIVE DATE
2014-03-12 00:00:00
IB TRANSACTION TYPE
CCN (RX) CANCEL
UNIT CHARGE, FIXED
8
ADDITIONAL AMOUNT
1
COPAYMENT TIER
2
ADDITIONAL AMOUNT LOGIC
I $G(DFN)>0,$$PRIORITY^
DGENA
(DFN)>6
