Parent File | Name | Number | Package |
---|---|---|---|
BILL/CLAIMS(#399) | PROVIDER | 399.0222 | Integrated Billing |
Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | FUNCTION | 0;1 | SET | ************************REQUIRED FIELD************************
|
.02 | PERFORMED BY | 0;2 | VARIABLE POINTER | NEW PERSON(#200) IB NON/OTHER VA BILLING PROVIDER(#355.93)
|
.03 | CREDENTIALS | 0;3 | FREE TEXT |
|
.04 | STATE | 0;4 | POINTER TO STATE FILE (#5) | STATE(#5)
|
.05 | PRIMARY INS CO ID NUMBER | 0;5 | FREE TEXT |
|
.06 | SECONDARY INS CO ID NUMBER | 0;6 | FREE TEXT |
|
.07 | TERTIARY INS CO ID NUMBER | 0;7 | FREE TEXT |
|
.08 | SPECIALTY | 0;8 | FREE TEXT |
|
.09 | DELETE 2006 .09 | 0;9 | POINTER TO IB INS CO PROVIDER ID CARE UNIT FILE (#355.96) | ************************REQUIRED FIELD************************ IB INS CO PROVIDER ID CARE UNIT(#355.96)
|
.1 | DELETE 2006 .1 | 0;10 | POINTER TO IB INS CO PROVIDER ID CARE UNIT FILE (#355.96) | ************************REQUIRED FIELD************************ IB INS CO PROVIDER ID CARE UNIT(#355.96)
|
.11 | DELETE 2006 .11 | 0;11 | POINTER TO IB INS CO PROVIDER ID CARE UNIT FILE (#355.96) | ************************REQUIRED FIELD************************ IB INS CO PROVIDER ID CARE UNIT(#355.96)
|
.12 | PRIM INS PROVIDER ID TYPE | 0;12 | POINTER TO IB PROVIDER ID # TYPE FILE (#355.97) | IB PROVIDER ID # TYPE(#355.97)
|
.13 | SEC INS PROVIDER ID TYPE | 0;13 | POINTER TO IB PROVIDER ID # TYPE FILE (#355.97) | IB PROVIDER ID # TYPE(#355.97)
|
.14 | TERT INS PROVIDER ID TYPE | 0;14 | POINTER TO IB PROVIDER ID # TYPE FILE (#355.97) | IB PROVIDER ID # TYPE(#355.97)
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.15 | TAXONOMY | 0;15 | POINTER TO PERSON CLASS FILE (#8932.1) | PERSON CLASS(#8932.1)
|
1.01 | DELETE 2006 1.01 | 1;1 | POINTER TO IB INS CO PROVIDER ID CARE UNIT FILE (#355.96) | IB INS CO PROVIDER ID CARE UNIT(#355.96)
|
1.02 | DELETE 2006 1.02 | 1;2 | POINTER TO IB INS CO PROVIDER ID CARE UNIT FILE (#355.96) | IB INS CO PROVIDER ID CARE UNIT(#355.96)
|
1.03 | DELETE 2006 1.03 | 1;3 | POINTER TO IB INS CO PROVIDER ID CARE UNIT FILE (#355.96) | IB INS CO PROVIDER ID CARE UNIT(#355.96)
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