
| Prompt | Response | Req | Len |
|---|---|---|---|
| Co-Payment Code | Type the code you want or click the magnifying glass to search the table. | ![]() |
5 |
| Description | Type a description of the co-payment code. | 40 | |
| Type of Service | Select the type of service associated with this co-payment code from the Type of Service list. | ![]() |
3 |