LEGACY UB-92 (727)    IB FORM FIELD CONTENT (364.7)

Name Value
FORM FIELD REFERENCE LEGACY UB-92
SECURITY LEVEL NATIONAL,NO EDIT
DATA ELEMENT N-ASSIGN OF BENEFITS INDICATOR
PAD CHARACTER NO PAD REQUIRED
FORMAT CODE N Z,Z0 S Z0=$S(IBXDATA=""!("Nn0"'[IBXDATA):"Y",1:"N") F Z=1:1:3 I $S(Z=1:1,1:$D(^DGCR(399,IBXIEN,"I"_Z))) S IBXDATA(Z)=Z0
FORMAT CODE DESCRIPTION
For each insurance on file in the bill, print the ASSIGNMENT OF BENEFITS
indicator = 'Y' if the data element value returned is null or is not 0,'n'
or 'N', otherwise print 'N'.