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Code Description Effective Date Deactivation Date Last Modified Date Notes 1 Deductible Amount 1/1/1995 2 Coinsurance Amount 1/1/1995 3 Co-payment Amount 1/1/1995 4. The procedure code is inconsistent with the modifier used or a required modifier is missing. Note: Refer to the 835 Healthcare Policy

  Date, Modified, Modified date

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