Home   Package List   Routine Alphabetical List   Global Alphabetical List   FileMan Files List   FileMan Sub-Files List   Package Component Lists   Package-Namespace Mapping  
Info |  Source |  Entry Points |  Interaction Calls
Print Page as PDF
Routine: EASEZRP1

Package: Enrollment Application System

Routine: EASEZRP1


Information

EASEZRP1 ;ALB/AMA,TDM - Print 1010EZR ; 3/14/13 10:52am

Source Information

Source file <EASEZRP1.m>

Entry Points

Name Comments DBIA/ICR reference
EN(EALNE,EAINFO) ;Entry point for VA 10-10EZR, page 1
; Called from EN^EASEZRPF
DEM ; Print VA 10-10EZR Section I, Demographic information
II ; Print VA 10-10EZR SECTION II - INSURANCE INFORMATION
EI ; Print VA 10-10EZR SECTION III - EMPLOYMENT INFORMATION

Interaction Calls

Name Line Occurrences
Function Call: WRITE
  • Prompt: !?50,"SECTION I - GENERAL INFORMATION"
  • Line Location: DEM+2
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: DEM+3
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: DEM+3
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: DEM+3
Function Call: WRITE
  • Prompt: !?18,"Federal law provides criminal penalties, including a fine and/or imprisonment for up to 5 years,"
  • Line Location: DEM+4
Function Call: WRITE
  • Prompt: !?20,"for concealing a material fact or making a materially false statement. (See 18 U.S.C. 1001)"
  • Line Location: DEM+5
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: DEM+6
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: DEM+6
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: DEM+6
Function Call: WRITE
  • Prompt: !,"1. VETERAN'S NAME (Last, First, Middle Name)",?95,"|2. OTHER NAMES USED"
  • Line Location: DEM+8
Function Call: WRITE
  • Prompt: !?3,@EASD@(2),?95,"| ",@EASD@(3)
  • Line Location: DEM+9
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: DEM+10
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: DEM+10
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: DEM+10
Function Call: WRITE
  • Prompt: !,"3. GENDER",?20,"|4. SOCIAL SECURITY NUMBER",?95,"|5. DATE OF BIRTH (mm/dd/yyyy)"
  • Line Location: DEM+12
Function Call: WRITE
  • Prompt: !?3,@EASD@(4),?20,"| ",@EASD@(5),?95,"| ",@EASD@(7)
  • Line Location: DEM+13
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: DEM+14
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: DEM+14
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: DEM+14
Function Call: WRITE
  • Prompt: !,"6. PERMANENT ADDRESS (Street)",?46,"|6A. CITY",?85,"|6B. STATE",?105,"|6C. ZIP"
  • Line Location: DEM+18
Function Call: WRITE
  • Prompt: !?3,@EASD@("9A"),?46,"| ",@EASD@("9B"),?85,"| ",@EASD@("9C"),?105,"| ",@EASD@("9D")
  • Line Location: DEM+19
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: DEM+20
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: DEM+20
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: DEM+20
Function Call: WRITE
  • Prompt: !,"6D. COUNTY",?66,"|6E. HOME TELEPHONE NUMBER (Include area code)"
  • Line Location: DEM+22
Function Call: WRITE
  • Prompt: !?4,@EASD@("9E"),?66,"| ",@EASD@(10)
  • Line Location: DEM+23
Function Call: WRITE
  • Prompt: !,"6. PERMANENT ADDRESS (Street)",?46,"|6A. CITY",?85,"|6B. PROVINCE",?105,"|6C. POSTAL CODE"
  • Line Location: DEM+26
Function Call: WRITE
  • Prompt: !?3,@EASD@("9A"),?46,"| ",@EASD@("9B"),?85,"| ",@EASD@("9F"),?105,"| ",@EASD@("9G")
  • Line Location: DEM+27
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: DEM+28
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: DEM+28
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: DEM+28
Function Call: WRITE
  • Prompt: !,"6D. COUNTRY",?66,"|6E. HOME TELEPHONE NUMBER (Include area code)"
  • Line Location: DEM+30
Function Call: WRITE
  • Prompt: !?4,@EASD@("9H"),?34,"| ",@EASD@(10)
  • Line Location: DEM+31
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: DEM+32
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: DEM+32
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: DEM+32
Function Call: WRITE
  • Prompt: !,"6F. E-MAIL ADDRESS",?66,"|6G. CELLULAR TELEPHONE NUMBER (Include area code)"
  • Line Location: DEM+33
Function Call: WRITE
  • Prompt: !,?4,@EASD@("11A"),?66,"| ",@EASD@("11G")
  • Line Location: DEM+34
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: DEM+36
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: DEM+36
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: DEM+36
Function Call: WRITE
  • Prompt: !,"7. CURRENT MARITAL STATUS"
  • Line Location: DEM+38
Function Call: WRITE
  • Prompt: !,?3,@EASD@(12)
  • Line Location: DEM+39
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: DEM+40
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: DEM+40
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: DEM+40
Function Call: WRITE
  • Prompt: !,"8. NAME, ADDRESS AND RELATIONSHIP OF NEXT OF KIN",?83,"|8A. NEXT OF KIN'S HOME TELEPHONE NUMBER"
  • Line Location: DEM+42
Function Call: WRITE
  • Prompt: !?3,$P(@EASD@("19A"),U)," - ",$P(@EASD@("19A"),U,4),?83,"| (Include area code) ",@EASD@("19B")
  • Line Location: DEM+43
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: DEM+44
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: DEM+44
Function Call: WRITE
  • Prompt: " "
  • Line Location: DEM+44
Function Call: WRITE
  • Prompt: $E(EALNE("UL"),1,48)
  • Line Location: DEM+45
Function Call: WRITE
  • Prompt: !?3,$P(@EASD@("19A"),U,2),?83,"|8B. NEXT OF KIN'S WORK TELEPHONE NUMBER"
  • Line Location: DEM+46
Function Call: WRITE
  • Prompt: !?3,$P(@EASD@("19A"),U,3),?83,"| (Include area code) ",@EASD@("19C")
  • Line Location: DEM+47
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: DEM+48
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: DEM+48
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: DEM+48
Function Call: WRITE
  • Prompt: !,"9. NAME, ADDRESS AND RELATIONSHIP OF EMERGENCY CONTACT",?83,"|9A. EMERGENCY CONTACT'S HOME TELEPHONE NUMBER"
  • Line Location: DEM+50
Function Call: WRITE
  • Prompt: !?3,$P(@EASD@("20A"),U)," - ",$P(@EASD@("20A"),U,4),?83,"| (Include area code) ",@EASD@("20B")
  • Line Location: DEM+51
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: DEM+52
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: DEM+52
Function Call: WRITE
  • Prompt: " "
  • Line Location: DEM+52
Function Call: WRITE
  • Prompt: $E(EALNE("UL"),1,48)
  • Line Location: DEM+53
Function Call: WRITE
  • Prompt: !?3,$P(@EASD@("20A"),U,2),?83,"|9B. EMERGENCY CONTACT'S WORK TELEPHONE NUMBER"
  • Line Location: DEM+54
Function Call: WRITE
  • Prompt: !?3,$P(@EASD@("20A"),U,3),?83,"| (Include area code) ",@EASD@("20C")
  • Line Location: DEM+55
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: DEM+56
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: DEM+56
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: DEM+56
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: DEM+60
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: DEM+60
Function Call: WRITE
  • Prompt: !?23,"SECTION II - INSURANCE INFORMATION (Use a separate sheet for additional information)"
  • Line Location: II+2
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: II+3
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: II+3
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: II+3
Function Call: WRITE
  • Prompt: !,"1. ARE YOU COVERED BY HEALTH INSURANCE,",?49,"|2. HEALTH INSURANCE COMPANY NAME, ADDRESS AND TELEPHONE NUMBER"
  • Line Location: II+5
Function Call: WRITE
  • Prompt: !?3,"INCLUDING COVERAGE THROUGH A SPOUSE",?49,"| ",@EASD@("17A")
  • Line Location: II+6
Function Call: WRITE
  • Prompt: !?3,"OR ANOTHER PERSON? ",@EASD@(17),?49,"| "
  • Line Location: II+7
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: II+8
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: II+8
Function Call: WRITE
  • Prompt: $E(EALNE("UL"),1,49)
  • Line Location: II+8
Function Call: WRITE
  • Prompt: !,"3. NAME OF POLICY HOLDER",?49,"| ",$P(@EASD@("17E"),U,2)
  • Line Location: II+10
Function Call: WRITE
  • Prompt: !?3,@EASD@("17B"),?49,"| ",@EASD@("17I")
  • Line Location: II+11
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: II+12
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: II+12
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: II+12
Function Call: WRITE
  • Prompt: !,"4. POLICY NUMBER",?41,"|5. GROUP CODE",?70,"|6. ARE YOU ELIGIBLE FOR MEDICAID?",?111,"|6A. EFFECTIVE DATE"
  • Line Location: II+14
Function Call: WRITE
  • Prompt: !?3,@EASD@("17C"),?41,"| ",@EASD@("17D"),?70,"| ",@EASD@("14J"),?111,"| "
  • Line Location: II+15
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: II+16
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: II+16
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: II+16
Function Call: WRITE
  • Prompt: !,"7. ARE YOU ENROLLED IN MEDICARE HOSPITAL INSURANCE PART A?",?70,"|7A. EFFECTIVE DATE (mm/dd/yyyy)"
  • Line Location: II+18
Function Call: WRITE
  • Prompt: !?3,@EASD@("14K"),?70,"| ",@EASD@("14K1")
  • Line Location: II+19
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: II+20
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: II+20
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: II+20
Function Call: WRITE
  • Prompt: !,"8. ARE YOU ENROLLED IN MEDICARE HOSPITAL INSURANCE PART B?",?70,"|8A. EFFECTIVE DATE (mm/dd/yyyy)"
  • Line Location: II+22
Function Call: WRITE
  • Prompt: !?3,@EASD@("14L"),?70,"| ",@EASD@("14L1")
  • Line Location: II+23
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: II+24
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: II+24
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: II+24
Function Call: WRITE
  • Prompt: !,"9. NAME EXACTLY AS IT APPEARS ON YOUR MEDICARE CARD",?70,"|10. MEDICARE CLAIM NUMBER"
  • Line Location: II+26
Function Call: WRITE
  • Prompt: !?3,@EASD@("14N"),?70,"| ",@EASD@("14M")
  • Line Location: II+27
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: II+28
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: II+28
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: II+28
Function Call: WRITE
  • Prompt: !?48,"SECTION III - EMPLOYMENT INFORMATION"
  • Line Location: EI+2
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: EI+3
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: EI+3
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: EI+3
Function Call: WRITE
  • Prompt: !,"1. VETERAN'S EMPLOYMENT STATUS",?47,"|1A. COMPANY NAME, ADDRESS AND TELEPHONE NUMBER"
  • Line Location: EI+5
Function Call: WRITE
  • Prompt: !?3,$P(@EASD@("15A"),U),?47,"| ",$P(@EASD@("15B"),U)
  • Line Location: EI+6
Function Call: WRITE
  • Prompt: !,"Date of retirement (mm/dd/yyyy) ",$P(@EASD@("15A"),U,2),?47,"| ",$P(@EASD@("15B"),U,2)
  • Line Location: EI+7
Function Call: WRITE
  • Prompt: !,"If employed or retired, complete item 1A",?47,"| ",$P(@EASD@("15B"),U,3)
  • Line Location: EI+8
Function Call: WRITE
  • Prompt: !?47," ",$P(@EASD@("15B"),U,4)
  • Line Location: EI+9
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: EI+10
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: EI+10
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: EI+10
Function Call: WRITE
  • Prompt: !,"2. SPOUSE'S EMPLOYMENT STATUS",?47,"|2A. COMPANY NAME, ADDRESS AND TELEPHONE NUMBER"
  • Line Location: EI+12
Function Call: WRITE
  • Prompt: !?3,$P(@EASD@("16A"),U),?47,"| ",$P(@EASD@("16B"),U)
  • Line Location: EI+13
Function Call: WRITE
  • Prompt: !,"Date of retirement (mm/dd/yyyy) ",$P(@EASD@("16A"),U,2),?47,"| ",$P(@EASD@("16B"),U,2)
  • Line Location: EI+14
Function Call: WRITE
  • Prompt: !,"If employed or retired, complete item 2A",?47,"| ",$P(@EASD@("16B"),U,3)
  • Line Location: EI+15
Function Call: WRITE
  • Prompt: !?47,"| ",$P(@EASD@("16B"),U,4)
  • Line Location: EI+16
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: EI+17
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: EI+17
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: EI+17
Info |  Source |  Entry Points |  Interaction Calls