Parent File | Name | Number | Package |
---|---|---|---|
399.0304 | LINE PROVIDER | 399.0404 | Integrated Billing |
Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | LINE FUNCTION | 0;1 | SET |
|
.02 | LINE 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 |
|
.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)
|
.15 | LINE TAXONOMY | 0;15 | POINTER TO PERSON CLASS FILE (#8932.1) | PERSON CLASS(#8932.1)
|