INELIG-RX (87)    RATE SCHEDULE (363)

Name Value
NAME INELIG-RX
RATE TYPE INELIGIBLE
BILL TYPE OUTPATIENT
BILLABLE SERVICE OUTPATIENT VISIT
EFFECTIVE DATE 2015-01-01 00:00:00
INACTIVE DATE 2015-12-31 00:00:00
DISPENSING FEE 13.10
ADJUSTMENT S X=X+13.10
CHARGE SET