LEGACY HCFA-1500 (343)    IB FORM FIELD CONTENT (364.7)

Name Value
FORM FIELD REFERENCE LEGACY HCFA-1500
SECURITY LEVEL NATIONAL,NO EDIT
DATA ELEMENT N-HCFA 1500 UNITS
PAD CHARACTER NO PAD REQUIRED
FORMAT CODE N Z,Z0,IBZ M IBZ=IBXDATA K IBXDATA S Z=0 F S Z=$O(IBZ(Z)) Q:'Z S Z0=$S('$G(IBZ(Z,"T")):$S(IBZ(Z):$J(IBZ(Z),$S($L(IBZ)<3:2,1:3)),1:""),1:IBZ(Z)) S:Z'>12 IBXDATA(Z)=Z0 D:Z>12 PG^IBCEF3(Z0,Z)
FORMAT CODE DESCRIPTION
Right justify numeric values in 3 spaces.  If more than 6 service dates
(12 lines) exist for the bill, this outputs the rest on additional
bill pages.  If the units are being output and they are less than 1, 1 is
the default.