| Parent File | Name | Number | Package |
|---|---|---|---|
| FEE BASIS PATIENT(#161) | REPORT OF CONTACT | 161.02 | Fee Basis |
| Field # | Name | Loc | Type | Details |
|---|---|---|---|---|
| .01 | DATE OF CONTACT | 0;1 | DATE |
|
| 1 | VENDOR/PROVIDER | 0;2 | FREE TEXT |
|
| 1.5 | VENDOR/PROVIDER TELEPHONE NO. | 0;3 | FREE TEXT |
|
| 2 | NARRATIVE | 1;0 | WORD-PROCESSING #161.04 |
|
| 3 | DX | 0;4 | FREE TEXT |
|
| 3.5 | TYPE OF CONTACT | 0;6 | SET | ************************REQUIRED FIELD************************
|
| 5 | INPUT DATE | 0;5 | DATE |
|
| 100 | CLERK | 100;1 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|