CC-NF-RX (168)    RATE SCHEDULE (363)

Name Value
NAME CC-NF-RX
RATE TYPE CC NO-FAULT AUTO
BILL TYPE OUTPATIENT
EFFECTIVE DATE 2018-01-01 00:00:00
INACTIVE DATE 2018-12-31 00:00:00
DISPENSING FEE 16.64
ADMINISTRATIVE FEE S X=X+16.64
CHARGE SET