CCN-WC-RX (256)    RATE SCHEDULE (363)

Name Value
NAME CCN-WC-RX
RATE TYPE CCN WORKERS' COMP
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