RI-RX (53)    RATE SCHEDULE (363)

Name Value
NAME RI-RX
RATE TYPE REIMBURSABLE INS.
BILL TYPE OUTPATIENT
EFFECTIVE DATE 2011-03-18 00:00:00
INACTIVE DATE 2011-12-31 00:00:00
DISPENSING FEE 11.40
ADJUSTMENT S X=X+11.4
CHARGE SET