| Name | Description | Type | Additional information |
|---|---|---|---|
| ProgramId | integer |
None. |
|
| EffectiveDate | string |
None. |
|
| EndDate | string |
None. |
|
| ServiceId | integer |
None. |
|
| HcpcsCode | string |
None. |
|
| ProcCodeQualifier | string |
None. |
|
| RevenueCode | string |
None. |
|
| PlaceOfService | string |
None. |
|
| ServiceCode | string |
None. |
|
| ServiceGroup | string |
None. |
|
| Modifier1 | string |
None. |
|
| Modifier2 | string |
None. |
|
| Modifier3 | string |
None. |
|
| Modifier4 | string |
None. |
|
| UnitType | integer |
None. |