Parent File | Name | Number | Package |
---|---|---|---|
BT PATIENT ALTERNATE INCOME(#392.9) | ALTERNATE INCOME | 392.91 | Beneficiary Travel |
Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | ALTERNATE INCOME DATE | 0;1 | DATE | ************************REQUIRED FIELD************************
|
1 | ALTERNATE INCOME | 0;2 | NUMBER | ************************REQUIRED FIELD************************
|
2 | ALTERNATE INCOME REASON | 0;3 | SET | ************************REQUIRED FIELD************************
|
3 | ALTERNATE INCOME EXPIRATION | 0;4 | DATE | ************************REQUIRED FIELD************************
|