Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | INITIAL TREATMENT DATE | 0;1 | DATE | ************************REQUIRED FIELD************************
|
1.5 | *FEE PROGRAM | 0;3 | POINTER TO FEE BASIS PROGRAM FILE (#161.8) | ************************REQUIRED FIELD************************ FEE BASIS PROGRAM(#161.8)
|
2 | SERVICE PROVIDED | 1;0 | POINTER Multiple #162.03 | 162.03
|
3 | *AUTHORIZATION POINTER | 0;4 | NUMBER |
|