UB-04 (1418)    IB FORM FIELD CONTENT (364.7)

Name Value
FORM FIELD REFERENCE UB-04
SECURITY LEVEL NATIONAL,NO EDIT
DATA ELEMENT N-GET FROM PREVIOUS EXTRACT
PAD CHARACTER NO PAD REQUIRED
FORMAT CODE K IBXDATA D DATE45^IBCF33(IBXIEN,.IBXDATA,$G(IBXSAVE("DATE")))
FORMAT CODE DESCRIPTION
This data element is a group data element where more than one occurrence
extracted from positions 41-47. Since only 22 lines of service line can
appear on one form, if there are more than 22 lines, subsequent pages are
forced for the remaining data lines after 22.
might be expected.  It relies on the presence of data in array
IBXSAVE("REV",n) extracted previously.  The first '^' piece of the array
indicates whether this is a 'normal' service data line (=1) or a text line
(=2 or =3).   For a normal service line, output the OUTPATIENT from date 
that was previously extracted into IBXSAVE("DATE"). For text line where
the first piece = 2, the text is assumed to start in column 1, so the data
is extracted from positions 46-52. For text line where the first piece =
3, the text is assumed to start in column 6, so the data for this field is