| Name | Value |
|---|---|
| FORM FIELD REFERENCE | UB-04 |
| SECURITY LEVEL | NATIONAL,NO EDIT |
| DATA ELEMENT | N-ASSIGN OF BENEFITS INDICATOR |
| PAD CHARACTER | NO PAD REQUIRED |
| FORMAT CODE | N Z,Z0 S Z0=$S(IBXDATA=""!("Nn0"'[IBXDATA):"Y",1:"N") F Z=1:1:3 I $S(Z=1:1,1:$D(^DGCR(399,IBXIEN,"I"_Z))) S IBXDATA(Z)=Z0 |
| FORMAT CODE DESCRIPTION | For each insurance on file in the bill, print the ASSIGNMENT OF BENEFITS indicator = 'Y' if the data element value returned is null or is not 0,'n' or 'N', otherwise print 'N'. |