| Name | Value |
|---|---|
| FORM FIELD REFERENCE | LEGACY HCFA-1500 |
| SECURITY LEVEL | NATIONAL,NO EDIT |
| DATA ELEMENT | N-HCFA BOX 24H FREE TEXT |
| PAD CHARACTER | NO PAD REQUIRED |
| FORMAT CODE | N Z,Q S Z=0 F S Z=$O(IBXDATA(Z)) Q:'Z S Q=$S('$G(IBXDATA(Z,"T")):" ",1:"")_IBXDATA(Z) S:Z'>12 IBXDATA(Z)=Q I Z>12 D PG^IBCEF3(Q,Z) |
| FORMAT CODE DESCRIPTION | If more than 6 service dates (12 lines) exists for the bill, this outputs the rest on additional bill pages. |