CCC-RI-RX (404) RATE SCHEDULE (363)

Name	Value
NAME	CCC-RI-RX
RATE TYPE	CHOICE REIMB INS
BILL TYPE	OUTPATIENT
EFFECTIVE DATE	2024-01-01 00:00:00
INACTIVE DATE	2024-12-31 00:00:00
ADJUSTMENT	S X=X+17.01
CHARGE SET	RX COST AUTO ADD: YES