INELIG-RX (67)    RATE SCHEDULE (363)

Name Value
NAME INELIG-RX
RATE TYPE INELIGIBLE
BILL TYPE OUTPATIENT
BILLABLE SERVICE OUTPATIENT VISIT
EFFECTIVE DATE 2013-08-13 00:00:00
INACTIVE DATE 2013-12-31 00:00:00
ADJUSTMENT S X=X+13.18
CHARGE SET