CCC-RI-RX (180) RATE SCHEDULE (363)

Name	Value
NAME	CCC-RI-RX
RATE TYPE	CHOICE REIMB INS
BILL TYPE	OUTPATIENT
EFFECTIVE DATE	2014-01-01 00:00:00
INACTIVE DATE	2014-12-31 00:00:00
DISPENSING FEE	13.07
ADMINISTRATIVE FEE	S X=X+13.07
CHARGE SET	RX COST AUTO ADD: YES