CCC-TF-RX (216)    RATE SCHEDULE (363)

Name Value
NAME CCC-TF-RX
RATE TYPE CHOICE TORT FEASOR
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