| Name | Value |
|---|---|
| FORM FIELD REFERENCE | LEGACY HCFA-1500 |
| SECURITY LEVEL | NATIONAL,NO EDIT |
| DATA ELEMENT | N-DATE FIRST PRINTED |
| PAD CHARACTER | NO PAD REQUIRED |
| FORMAT CODE | N A,P,Q,Z S Q=IBXIEN,Z=$$DATE31^IBCF2(IBXDATA,Q),A=$G(IBXSAVE("BOX31")) D GETPRV^IBCEU(Q,3,.P) S P=$G(P(3,1)),A=$S($P(P,U,4)'="":$P(P,U,4),'$D(^DGCR(399,Q,"PRV",0)):$E($P(P,U),22,42),1:$$CRED^IBCEU($P(P,U,3),Q,,3)),IBXDATA=A_$J("",11-$L(A))_Z |
| FORMAT CODE DESCRIPTION | Print credentials left justified and date right justified. Format date as MM/DD/YYYY. |