N-OTH INS FORM LOC 64 (56)    IB DATA ELEMENT DEFINITION (364.5)

Name Value
NAME N-OTH INS FORM LOC 64
SECURITY LEVEL NATIONAL,NO EDIT
TYPE OF ELEMENT EXTRACTED VIA CODE
ELEMENT CATEGORY GROUP ELEMENT
BASE FILE BILL/CLAIMS
EXTRACT CODE N Z,Z0,Z1,IBZ I $D(^DGCR(399,IBXIEN,"I2")) S Z=$$COBN^IBCEF(IBXIEN) S Z1=$S(Z>1:"^"_$E(" CB",Z),1:"B^C") F Z0=1,2 D F^IBCEF("N-UB-04 FORM LOCATOR 64"_$P(Z1,U,Z0),"IBZ",,IBXIEN) S IBXDATA(Z0)=$G(IBZ)
DESCRIPTION
The form locator 64 data for all other insurance companies for bill entry
IBXIEN.  Data is returned in array IBXDATA(n).  This is a group element and
up to 2 data elements are returned in the IBXDATA(n) array.  If the primary
insurance is the current responsible, the secondary and tertiary insurance
form locator 64 data are returned.  If the secondary insurance is the
current responsible, the primary and tertiary insurance form locator 64 data
are returned. If the tertiary insurance is the current responsible, the
primary and secondary insurance form locator 64 data are returned.