| Parent File | Name | Number | Package |
|---|---|---|---|
| IB PATIENT COPAY ACCOUNT(#354.7) | MONTH/YEAR | 354.701 | Integrated Billing |
| Field # | Name | Loc | Type | Details |
|---|---|---|---|---|
| .01 | MONTH/YEAR | 0;1 | DATE |
|
| .02 | TOTAL AMOUNT BILLED | 0;2 | NUMBER |
|
| .03 | CAP REACHED | 0;3 | SET |
|
| .04 | TOTAL AMOUNT NON-BILLABLE | 0;4 | NUMBER |
|