CMS-1500 (1190)    IB FORM FIELD CONTENT (364.7)

Name Value
FORM FIELD REFERENCE CMS-1500
SECURITY LEVEL NATIONAL,NO EDIT
DATA ELEMENT N-CMS-1500 BOX 24I ID QUAL BR
PAD CHARACTER NO PAD REQUIRED
FORMAT CODE N Z S Z=12 F S Z=$O(IBXDATA(Z)) Q:'Z D PG^IBCEF3(IBXDATA(Z),Z)
FORMAT CODE DESCRIPTION
If more than 6 service dates (12 lines) exists for the bill, this outputs
the rest on additional bill pages.