| Name | Value |
|---|---|
| FORM FIELD REFERENCE | CMS-1500 |
| SECURITY LEVEL | NATIONAL,NO EDIT |
| DATA ELEMENT | N-GET FROM PREVIOUS EXTRACT |
| PAD CHARACTER | NO PAD REQUIRED |
| FORMAT CODE | Q:'$G(IBXSAVE("SERVFACFLAG")) N Z S Z=$G(IBXSAVE("BPSFDATA")),IBXDATA=$$GETFAC^IBCEP8(+$P(Z,U,4),$P(Z,U,3),12) |
| FORMAT CODE DESCRIPTION | Box 32 - service facility address lines 1&2 Only print data if there is a service facility for this claim. |