Parent File | Name | Number | Package |
---|---|---|---|
PROSTHETICS PATIENT(#665) | HOME OXYGEN PRESCRIPTION | 665.193 | Prosthetics |
Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | DATE | 0;1 | DATE |
|
2 | EXPIRATION DATE | 0;3 | DATE |
|
3 | DESCRIPTION | 1;0 | WORD-PROCESSING #665.1933 |
|
4 | A&B LETTERS SENT | 0;5 | FREE TEXT |
|
30 | PRIMARY ICD DIAGNOSIS CODE | BA1;1 | POINTER TO ICD DIAGNOSIS FILE (#80) | ICD DIAGNOSIS(#80)
|
30.1 | PRIMARY AGENT ORANGE | BA1;2 | SET |
|
30.2 | PRIMARY IONIZED RADIATION | BA1;3 | SET |
|
30.3 | PRIMARY SERVICE CONNECTED | BA1;4 | SET |
|
30.4 | PRIMARY ENVIRONMENTAL CONT. | BA1;5 | SET |
|
30.5 | PRIMARY MST | BA1;6 | SET |
|
30.6 | PRIMARY HEAD/NECK CANCER | BA1;7 | SET |
|
30.7 | PRIMARY COMBAT VET | BA1;8 | SET |
|
31 | SECONDARY ICD DIAGNOSIS CODE 1 | BA2;1 | POINTER TO ICD DIAGNOSIS FILE (#80) | ICD DIAGNOSIS(#80)
|
31.1 | SECONDARY AGENT ORANGE 1 | BA2;2 | SET |
|
31.2 | SECONDARY IONIZED RADIATION 1 | BA2;3 | SET |
|
31.3 | SECONDARY SERVICE CONNECTED 1 | BA2;4 | SET |
|
31.4 | SECONDARY ENVIRONMENTAL CONT 1 | BA2;5 | SET |
|
31.5 | SECONDARY MST 1 | BA2;6 | SET |
|
31.6 | SECONDARY HEAD/NECK CANCER 1 | BA2;7 | SET |
|
31.7 | SECONDARY COMBAT VET 1 | BA2;8 | SET |
|
32 | SECONDARY ICD DIAGNOSIS CODE 2 | BA3;1 | POINTER TO ICD DIAGNOSIS FILE (#80) | ICD DIAGNOSIS(#80)
|
32.1 | SECONDARY AGENT ORANGE 2 | BA3;2 | SET |
|
32.2 | SECONDARY IONIZED RADIATION 2 | BA3;3 | SET |
|
32.3 | SECONDARY SERVICE CONNECTED 2 | BA3;4 | SET |
|
32.4 | SECONDARY ENVIRONMENTAL CONT 2 | BA3;5 | SET |
|
32.5 | SECONDARY MST 2 | BA3;6 | SET |
|
32.6 | SECONDARY HEAD/NECK CANCER 2 | BA3;7 | SET |
|
32.7 | SECONDARY COMBAT VET 2 | BA3;8 | SET |
|
33 | SECONDARY ICD DIAGNOSIS CODE 3 | BA4;1 | POINTER TO ICD DIAGNOSIS FILE (#80) | ICD DIAGNOSIS(#80)
|
33.1 | SECONDARY AGENT ORANGE 3 | BA4;2 | SET |
|
33.2 | SECONDARY IONIZED RADIATION 3 | BA4;3 | SET |
|
33.3 | SECONDARY SERVICE CONNECTED 3 | BA4;4 | SET |
|
33.4 | SECONDARY ENVIRONMENTAL CONT 3 | BA4;5 | SET |
|
33.5 | SECONDARY MST 3 | BA4;6 | SET |
|
33.6 | SECONDARY HEAD/NECK CANCER 3 | BA4;7 | SET |
|
33.7 | SECONDARY COMBAT VET 3 | BA4;8 | SET |
|
100 | PFSS NEW PRESCRIPTION FLAG | PFSS;1 | SET |
|
101 | REQUESTOR | PFSS;2 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|