
| Prompt | Response | Req | Len |
|---|---|---|---|
| Begin with Effective Date | This field defaults to the current date. Type the effective date of the fee schedule you want, click the calendar icon to select a date, or leave the field blank to start with the first effective date in the table. | 10 | |
| End with Effective Date | This field defaults to the current date. Type the effective date of the fee schedule you want, click the calendar icon to select a date, or leave the field blank to end with the last effective date in the table. | 10 | |
| Begin with Fee Schedule | Type the code you want to begin with or leave the field blank to start with the first code in the table. | 5 | |
| End with Fee Schedule | Type the code you want to end with or leave the field blank to end with the last code in the table. | 5 | |
| Begin with Procedure Code | Type the code you want to begin with or leave the field blank to start with the first code in the table. | 10 | |
| End with Procedure Code | Type the code you want to end with or leave the field blank to end with the last code in the table. | 10 | |
| Facility or Non Facility | Check 'F' for facility or 'N' for non facility prices | 1 |