| Name | Value |
|---|---|
| FORM FIELD REFERENCE | UB-04 |
| SECURITY LEVEL | NATIONAL,NO EDIT |
| DATA ELEMENT | N-ALL INSURANCE GROUP NAME |
| PAD CHARACTER | NO PAD REQUIRED |
| FORMAT CODE | N Z,Z0 S Z0=$$COBN^IBCEF(IBXIEN) F Z=1:1:3 S IBXDATA(Z)=$G(IBXDATA(Z))_" " I $D(^DGCR(399,IBXIEN,"I"_Z)),$$WNRBILL^IBEFUNC(IBXIEN,Z) S IBXDATA(Z)="" |
| FORMAT CODE DESCRIPTION | If the insurance is MEDICARE WNR, do not output the group name. Add a space to the end of the Group Name to separate it from the next field , Group Number. |