| Name | Value |
|---|---|
| NAME | TRICARE PHARMACY |
| BILL NAME | TRICARE PHARMACY |
| ABBREVIATION | TR RX |
| IS THIS A THIRD PARTY BILL? | YES |
| ACCOUNTS RECEIVABLE CATEGORY | TRICARE PHARMACY |
| WHO'S RESPONSIBLE | INSURER |
| REIMBURSABLE INSURANCE? | YES |
| NSC STATEMENT ON UB BILLS | YES |
| ELECTRONIC TRANSMIT | ALLOWED |
| BILL RESULTING FROM | HI |