| Parent File | Name | Number | Package | 
|---|---|---|---|
| 3P FEE TABLE(#9002274.01) | DENTAL (ADA CODE) | 9002274.0121 | Third Party Billing | 
| Field # | Name | Loc | Type | Details | 
|---|---|---|---|---|
| .01 | DENTAL (ADA CODE) | 0;1 | POINTER TO ADA CODE FILE (#9999999.31) | ADA CODE(#9999999.31) 
 | 
| .02 | *CHARGE | 0;2 | NUMBER | ************************REQUIRED FIELD************************ 
 | 
| .03 | *FREE TXT CODE | 0;3 | FREE TEXT | 
 | 
| .04 | *LAST UPDATE | 0;4 | DATE | 
 | 
| 1 | EFFECTIVE DATE | 1;0 | DATE Multiple #9002274.1211 | 9002274.1211 |