File FEE_BASIS_SITE_PARAMETERS(161.4) Data List
| NUMBER |
STATION OF JURISDICTION NAME |
STATION ADDRESS LINE 1 |
NEXT BATCH NUMBER |
NEXT INVOICE NUMBER |
MEDICAL PAYMENT VENDOR DISPLAY |
PHARMACY PAYMNT VENDOR DISPLAY |
DEFAULT AUTH. TIME RANGE |
ASK VENDOR DURING AUTH. |
STATION ADDRESS LINE 3 |
MAX # PAYMENT LINE ITEMS |
MAX # CH PAYMENT LINES |
MAX # CNH PAYMENT LINES |
*EDIT AUTH. DURING PAYMENT |
STATION ADDRESS LINE 2 |
*ASK PROGRAM SPECIFIC AUTH. |
APPROVING OFFICIAL FOR 7078 |
TITLE 7078 APPROVING OFFICIAL |
COPIES OF 7078 TO BE PRINTED |
PSA DEFAULT INSTITUTION |
7078 DEFAULT AUTH SERVICE TEXT |
DATE BATCH PURGE LAST RUN |
CITY |
OUTPATIENT MONTHLY LIMITATION |
TRANSMISSION HEADER |
TRACK INCOMPLETE UNAUTH CLAIM? |
'INITIAL ENTRY' STATUS FOR U/C |
UNAUTHORIZED CLAIM PRINTER |
UNAUTHORIZED CLAIM LETTER |
NUMBER OF COPIES |
PRINT U/C ON LETTERHEAD? |
STATION NAME (EDITABLE) |
UC LETTER LINES AFTER CC |
FPPS TRANSMIT START |
FPPS TRANSMIT END |
PROJECT ARCH REMINDER DELAY |
UNIQUE CLAIM IDENTIFIER SEQ |
STATE |
ALLOW FB PAID TO IB |
ZIP |
MAIL CODE |
STATION TELEPHONE NUMBER |
APPROVING OFFICIAL FOR 7079 |
TITLE OF APPROVING OFFICIAL |
LAST IPAC NUMBER |
MEDICAID DISPENSING FEE |