CCC-TF-RX (213)    RATE SCHEDULE (363)

Name Value
NAME CCC-TF-RX
RATE TYPE CHOICE TORT FEASOR
BILL TYPE OUTPATIENT
EFFECTIVE DATE 2015-01-01 00:00:00
INACTIVE DATE 2015-12-31 00:00:00
DISPENSING FEE 13.10
ADMINISTRATIVE FEE S X=X+13.10
CHARGE SET