| Name | Value |
|---|---|
| FORM FIELD REFERENCE | IB 837 TRANSMISSION |
| SECURITY LEVEL | NATIONAL,NO EDIT |
| DATA ELEMENT | N-GET FROM PREVIOUS EXTRACT |
| PAD CHARACTER | NO PAD REQUIRED |
| REQUIRED | NO |
| FORMAT CODE | K IBXDATA D OTHPAYC^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,2,"72") |
| FORMAT CODE DESCRIPTION | HARD CODE "72" OTHER PAYER OPERATING PROVIDER NAME QUALIFIER |