| Name | Value |
|---|---|
| FORM FIELD REFERENCE | LEGACY HCFA-1500 |
| SECURITY LEVEL | NATIONAL,NO EDIT |
| DATA ELEMENT | N-OTH INSURED DEMOGRAPHICS |
| PAD CHARACTER | NO PAD REQUIRED |
| FORMAT CODE | S IBXDATA="" I $O(IBXDATA("")) N Z S Z=$G(IBXDATA(1)) K IBXDATA S IBXSAVE("OIDEM")=Z,IBXDATA=$$DATE^IBCF2($P(Z,U),1) |
| FORMAT CODE DESCRIPTION | Save the other insured's demographic data in IBXSAVE for later use. Format the birthdate as MM DD YYYY. |