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This displays the details of the extra service fees paid outside of the claim.
These fees includes include the
foil fees which is are paid by the patient and not claimable;.
the estimated LTC Monthly Service Fee and Case Mix Fees (Initial and repeat SF for Core and LTC) which are not paid via the claim channel.
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If you double click on the line, you will see more details e.g., the script numbers the fee is attached to.
Initial and Repeat Service Fees are based on the CPSA contract’s RVUs (Relative value units) i.e. the dollar $ , the dollar value changes with the number of initial or repeats scripts for a patient per day. E.g. If a patient had 2 initial scripts for the day, it will would show the number of scripts used for the calculation under quantity and then displays the total estimated fee amount for the day.