CCC-NF-RX (159)    RATE SCHEDULE (363)

Name Value
NAME CCC-NF-RX
RATE TYPE CHOICE NO-FAULT AUTO
BILL TYPE OUTPATIENT
EFFECTIVE DATE 2017-01-01 00:00:00
INACTIVE DATE 2017-12-31 00:00:00
DISPENSING FEE 16.36
ADMINISTRATIVE FEE S X=X+16.36
CHARGE SET