| Name | Value |
|---|---|
| FORM FIELD REFERENCE | LEGACY HCFA-1500 |
| SECURITY LEVEL | NATIONAL,NO EDIT |
| DATA ELEMENT | N-CURRENT INS POLICY TYPE |
| PAD CHARACTER | NO PAD REQUIRED |
| FORMAT CODE | N Z S Z=IBXDATA D F^IBCEF("N-CURRENT INSURANCE CO TYPE") S IBXDATA=$J("",$S(Z=16!(Z="MB")!(Z="MA"):0,Z="TV"!(Z="MC"):7,Z="CH":14,$$CHAMPVA^IBCEU3(IBXIEN)&($P($G(^DIC(36,+$$CURR^IBCEF2(IBXIEN),0)),U,2)="Y"):23,IBXDATA=5:30,1:44))_"X" |
| FORMAT CODE DESCRIPTION | Check appropriate box for type of insurance |