{"aaData": [["1", "<a href=\"../../vivian-data/399_1/399.1-1.html\">ALCOHOL AND DRUG TREATMENT</a>", "<dt>8</dt>\n", "<dt>ETOH/DRUG</dt>\n", "", "<dt>YES</dt>\n", "", "<dt><a href=\"../../vivian-data/350_1/350.1-23.html\">DG INPT COPAY (ALC) NEW</a></dt>\n", "<dt><a href=\"../../vivian-data/350_1/350.1-45.html\">DG INPT PER DIEM NEW</a></dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["10", "<a href=\"../../vivian-data/399_1/399.1-10.html\">REHABILITATION MEDICINE</a>", "<dt>6</dt>\n", "<dt>REHAB MED</dt>\n", "", "<dt>YES</dt>\n", "", "<dt><a href=\"../../vivian-data/350_1/350.1-20.html\">DG INPT COPAY (REH) NEW</a></dt>\n", "<dt><a href=\"../../vivian-data/350_1/350.1-45.html\">DG INPT PER DIEM NEW</a></dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["100", "<a href=\"../../vivian-data/399_1/399.1-100.html\">ARTERIAL BLOOD GAS (PO2/PA2)</a>", "<dt>58</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter arterial blood gas value at the beginning of \neach reporting period for oxygen therapy.  Code 58 \nor 59 required on the initial bill and the fourth \nmonth&#x27;s bill. Enter the nearest whole number \n(Example: 56.5 is entered as 57.)\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["101", "<a href=\"../../vivian-data/399_1/399.1-101.html\">OXYGEN SATURATION (02 SAT/OXIMETRY)</a>", "<dt>59</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter oxygen saturation value at the beginning of \neach reporting period for oxygen therapy.  Code 58 \nor 59 required on the initial bill and the fourth \nmonth&#x27;s bill. Enter the nearest whole percent \n(Example: 93.5 is entered as 94.)\n</pre>\n</dt>\n", "<dt>I $G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["102", "<a href=\"../../vivian-data/399_1/399.1-102.html\">HHA BRANCH MSA</a>", "<dt>60</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter the MSA number in which the HHA branch is located \nwhen the MSA&#x27;s branch location is different than the \nHHA&#x27;s. \n \nA value containing multiple zeroes (e.g. 00000 ) is not allowed.\n</pre>\n</dt>\n", "<dt>I $G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["103", "<a href=\"../../vivian-data/399_1/399.1-103.html\">EPO - DRUG</a>", "<dt>68</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter the number of units of EPO administered and/or\nsupplied related to this billing period. Enter amount\nin whole units.\n \nA value containing multiple zeroes (e.g. 00000 ) is not allowed.\n</pre>\n</dt>\n", "<dt>I $G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["104", "<a href=\"../../vivian-data/399_1/399.1-104.html\">ESTIMATED RESPONSIBILITY PATIENT</a>", "<dt>D3</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["105", "<a href=\"../../vivian-data/399_1/399.1-105.html\">INPATIENT</a>", "", "<dt>INPT</dt>\n", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", ""], ["106", "<a href=\"../../vivian-data/399_1/399.1-106.html\">OUTPATIENT VISIT</a>", "", "<dt>OPT VST</dt>\n", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", ""], ["107", "<a href=\"../../vivian-data/399_1/399.1-107.html\">PRESCRIPTION</a>", "", "<dt>RX</dt>\n", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", ""], ["108", "<a href=\"../../vivian-data/399_1/399.1-108.html\">PROSTHETICS</a>", "", "<dt>PROSTH</dt>\n", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", ""], ["109", "<a href=\"../../vivian-data/399_1/399.1-109.html\">INPATIENT BEDSECTION STAY</a>", "", "<dt>INPT BEDS</dt>\n", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", ""], ["11", "<a href=\"../../vivian-data/399_1/399.1-11.html\">SPINAL CORD INJURY CARE</a>", "<dt>11</dt>\n", "<dt>SCI CARE</dt>\n", "", "<dt>YES</dt>\n", "", "<dt><a href=\"../../vivian-data/350_1/350.1-17.html\">DG INPT COPAY (SPI) NEW</a></dt>\n", "<dt><a href=\"../../vivian-data/350_1/350.1-45.html\">DG INPT PER DIEM NEW</a></dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["110", "<a href=\"../../vivian-data/399_1/399.1-110.html\">OUTPATIENT VISIT DATE</a>", "", "<dt>OPT VST DT</dt>\n", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", ""], ["111", "<a href=\"../../vivian-data/399_1/399.1-111.html\">PRESCRIPTION FILL</a>", "", "<dt>RX FILL</dt>\n", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", ""], ["112", "<a href=\"../../vivian-data/399_1/399.1-112.html\">PROCEDURE</a>", "", "<dt>PROC</dt>\n", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", ""], ["113", "<a href=\"../../vivian-data/399_1/399.1-113.html\">PROSTHETICS ITEM</a>", "", "<dt>PROS ITEM</dt>\n", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", ""], ["114", "<a href=\"../../vivian-data/399_1/399.1-114.html\">START OF INFERTILITY TREATMENT CYCLE</a>", "<dt>09</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["115", "<a href=\"../../vivian-data/399_1/399.1-115.html\">DATE OF ONSET FOR A CHRONICALLY DEPENDENT INDIVIDUAL</a>", "<dt>12</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["116", "<a href=\"../../vivian-data/399_1/399.1-116.html\">DATE OUTPATIENT O.T. PLAN ESTABLISHED OR LAST REVIEWED</a>", "<dt>17</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["117", "<a href=\"../../vivian-data/399_1/399.1-117.html\">DATE OF RETIREMENT PATIENT/BENEFICIARY</a>", "<dt>18</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["118", "<a href=\"../../vivian-data/399_1/399.1-118.html\">DATE OF RETIREMENT SPOUSE</a>", "<dt>19</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["119", "<a href=\"../../vivian-data/399_1/399.1-119.html\">GUARANTEE OF PAYMENT BEGAN</a>", "<dt>20</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["12", "<a href=\"../../vivian-data/399_1/399.1-12.html\">SURGICAL CARE</a>", "<dt>2</dt>\n", "<dt>SURG CARE</dt>\n", "", "<dt>YES</dt>\n", "", "<dt><a href=\"../../vivian-data/350_1/350.1-16.html\">DG INPT COPAY (SUR) NEW</a></dt>\n", "<dt><a href=\"../../vivian-data/350_1/350.1-45.html\">DG INPT PER DIEM NEW</a></dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["120", "<a href=\"../../vivian-data/399_1/399.1-120.html\">UR NOTICE RECEIVED</a>", "<dt>21</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["121", "<a href=\"../../vivian-data/399_1/399.1-121.html\">DATE ACTIVE CARE ENDED</a>", "<dt>22</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["122", "<a href=\"../../vivian-data/399_1/399.1-122.html\">DATE INSURANCE DENIED</a>", "<dt>24</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["123", "<a href=\"../../vivian-data/399_1/399.1-123.html\">DATE BENEFITS TERMINATED BY PRIMARY PAYER</a>", "<dt>25</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["124", "<a href=\"../../vivian-data/399_1/399.1-124.html\">DATE SNF BED BECAME AVAILABLE</a>", "<dt>26</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["125", "<a href=\"../../vivian-data/399_1/399.1-125.html\">DATE OF HOSPICE CERTIFICATION OR RECERTIFICATION</a>", "<dt>27</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["126", "<a href=\"../../vivian-data/399_1/399.1-126.html\">DATE COMPREHENSIVE OUTPATIENT REHAB PLAN ESTAB/LAST REVIEWED</a>", "<dt>28</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["127", "<a href=\"../../vivian-data/399_1/399.1-127.html\">DATE OUTPATIENT P.T. PLAN ESTABLISHED OR LAST REVIEWED</a>", "<dt>29</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["128", "<a href=\"../../vivian-data/399_1/399.1-128.html\">DATE OF OP SPEECH-LANGUAGE PATH PLAN EST/LAST REVWD</a>", "<dt>30</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["129", "<a href=\"../../vivian-data/399_1/399.1-129.html\">DATE BENEFICIARY NOTIFIED OF INTENT TO BILL (ACCOMMODATIONS)</a>", "<dt>31</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["13", "<a href=\"../../vivian-data/399_1/399.1-13.html\">DISCHARGED TO ANOTHER SHORT-TERM GENERAL HOSPITAL</a>", "<dt>02</dt>\n", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["130", "<a href=\"../../vivian-data/399_1/399.1-130.html\">DATE BENEFICIARY NOTIFIED OF INTENT TO BILL (PRCS/TREATMNTS)</a>", "<dt>32</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["131", "<a href=\"../../vivian-data/399_1/399.1-131.html\">FIRST DAY THE COORD PD FOR ESRD BENEFICIARIES CVRD BY EGHP</a>", "<dt>33</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["132", "<a href=\"../../vivian-data/399_1/399.1-132.html\">DATE OF ELECTION OF EXTENDED CARE SERVICES</a>", "<dt>34</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["133", "<a href=\"../../vivian-data/399_1/399.1-133.html\">DATE TREATMENT STARTED FOR PHYSICAL THERAPY</a>", "<dt>35</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["134", "<a href=\"../../vivian-data/399_1/399.1-134.html\">DATE OF IP HOSP DISCHG FOR COVERED TRANSPLANT PATIENT</a>", "<dt>36</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["135", "<a href=\"../../vivian-data/399_1/399.1-135.html\">DATE OF IP HOSP DISCHG FOR NON-COVERED TRANSPLANT PATIENT</a>", "<dt>37</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["136", "<a href=\"../../vivian-data/399_1/399.1-136.html\">DATE TREATMENT STARTED FOR HOME IV THERAPY</a>", "<dt>38</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["137", "<a href=\"../../vivian-data/399_1/399.1-137.html\">DATE DISCHARGED ON A CONTINUOUS COURSE OF IV THERAPY</a>", "<dt>39</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["138", "<a href=\"../../vivian-data/399_1/399.1-138.html\">SCHEDULED DATE OF ADMISSION</a>", "<dt>40</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["139", "<a href=\"../../vivian-data/399_1/399.1-139.html\">DATE OF FIRST TEST FOR PRE-ADMISSION TESTING</a>", "<dt>41</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["14", "<a href=\"../../vivian-data/399_1/399.1-14.html\">DISCHARGED TO ANOTHER TYPE OF FACILITY</a>", "<dt>05</dt>\n", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["140", "<a href=\"../../vivian-data/399_1/399.1-140.html\">DATE OF DISCHARGE</a>", "<dt>42</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["141", "<a href=\"../../vivian-data/399_1/399.1-141.html\">SCHEDULED DATE OF CANCELLED SURGERY</a>", "<dt>43</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["142", "<a href=\"../../vivian-data/399_1/399.1-142.html\">DATE TREATMENT STARTED FOR OCCUPATIONAL THERAPY</a>", "<dt>44</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["143", "<a href=\"../../vivian-data/399_1/399.1-143.html\">DATE TREATMENT STARTED FOR SPEECH-LANGUAGE THERAPY</a>", "<dt>45</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["144", "<a href=\"../../vivian-data/399_1/399.1-144.html\">DATE TREATMENT STARTED FOR CARDIAC REHAB.</a>", "<dt>46</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["145", "<a href=\"../../vivian-data/399_1/399.1-145.html\">BIRTHDATE - INSURED A</a>", "<dt>A1</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["146", "<a href=\"../../vivian-data/399_1/399.1-146.html\">EFFECTIVE DATE - INSURED A POLICY</a>", "<dt>A2</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["147", "<a href=\"../../vivian-data/399_1/399.1-147.html\">BENEFITS EXHAUSTED</a>", "<dt>A3</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["148", "<a href=\"../../vivian-data/399_1/399.1-148.html\">BIRTHDATE - INSURED B</a>", "<dt>B1</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["149", "<a href=\"../../vivian-data/399_1/399.1-149.html\">EFFECTIVE DATE - INSURED B POLICY</a>", "<dt>B2</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["15", "<a href=\"../../vivian-data/399_1/399.1-15.html\">DISCHARGED TO HOME OR SELF CARE</a>", "<dt>01</dt>\n", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["150", "<a href=\"../../vivian-data/399_1/399.1-150.html\">BENEFITS EXHAUSTED</a>", "<dt>B3</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["151", "<a href=\"../../vivian-data/399_1/399.1-151.html\">BIRTHDATE - INSURED C</a>", "<dt>C1</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["152", "<a href=\"../../vivian-data/399_1/399.1-152.html\">EFFECTIVE DATE - INSURED C POLICY</a>", "<dt>C2</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["153", "<a href=\"../../vivian-data/399_1/399.1-153.html\">BENEFITS EXHAUSTED</a>", "<dt>C3</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["154", "<a href=\"../../vivian-data/399_1/399.1-154.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>E1</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["155", "<a href=\"../../vivian-data/399_1/399.1-155.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>E2</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["156", "<a href=\"../../vivian-data/399_1/399.1-156.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>E3</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["157", "<a href=\"../../vivian-data/399_1/399.1-157.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>F1</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["158", "<a href=\"../../vivian-data/399_1/399.1-158.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>F2</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["159", "<a href=\"../../vivian-data/399_1/399.1-159.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>F3</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["16", "<a href=\"../../vivian-data/399_1/399.1-16.html\">DISCHARGED TO HOME UNDER CARE OF HOME HEALTH CARE SERVICE</a>", "<dt>06</dt>\n", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["160", "<a href=\"../../vivian-data/399_1/399.1-160.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>G1</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["161", "<a href=\"../../vivian-data/399_1/399.1-161.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>G2</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["162", "<a href=\"../../vivian-data/399_1/399.1-162.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>G3</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["163", "<a href=\"../../vivian-data/399_1/399.1-163.html\">MILITARY SERVICE RELATED</a>", "<dt>01</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["164", "<a href=\"../../vivian-data/399_1/399.1-164.html\">CONDITION IS EMPLOYMENT RELATED</a>", "<dt>02</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["165", "<a href=\"../../vivian-data/399_1/399.1-165.html\">PATIENT COVERED BY INSURANCE NOT REFLECTED HERE</a>", "<dt>03</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["166", "<a href=\"../../vivian-data/399_1/399.1-166.html\">INFORMATION ONLY BILL</a>", "<dt>04</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["167", "<a href=\"../../vivian-data/399_1/399.1-167.html\">LIEN HAS BEEN FILED</a>", "<dt>05</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["168", "<a href=\"../../vivian-data/399_1/399.1-168.html\">ESRD PATIENT IN FIRST 30 MONTHS OF ENTITLE CVRD BY EGHP</a>", "<dt>06</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["169", "<a href=\"../../vivian-data/399_1/399.1-169.html\">TREATMENT OF NON-TERMINAL CONDITION FOR HOSPICE PATIENT</a>", "<dt>07</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["17", "<a href=\"../../vivian-data/399_1/399.1-17.html\">DISCHARGED TO INTERMEDIATE CARE FACILITY</a>", "<dt>04</dt>\n", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["170", "<a href=\"../../vivian-data/399_1/399.1-170.html\">BENEFICIARY WOULD NOT PROVIDE INFO ON OTHER INS COVERAGE</a>", "<dt>08</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["171", "<a href=\"../../vivian-data/399_1/399.1-171.html\">NEITHER PATIENT NOR SPOUSE IS EMPLOYED</a>", "<dt>09</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["172", "<a href=\"../../vivian-data/399_1/399.1-172.html\">PATIENT AND/OR SPOUSE IS EMPLOYED BUT NO EGHP EXISTS</a>", "<dt>10</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["173", "<a href=\"../../vivian-data/399_1/399.1-173.html\">DISABLED BENEFICIARY BUT NO LGHP</a>", "<dt>11</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["174", "<a href=\"../../vivian-data/399_1/399.1-174.html\">PATIENT IS HOMELESS</a>", "<dt>17</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["175", "<a href=\"../../vivian-data/399_1/399.1-175.html\">MAIDEN NAME RETAINED</a>", "<dt>18</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["176", "<a href=\"../../vivian-data/399_1/399.1-176.html\">CHILD RETAINS MOTHER'S NAME</a>", "<dt>19</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["177", "<a href=\"../../vivian-data/399_1/399.1-177.html\">BENEFICIARY REQUESTED BILLING</a>", "<dt>20</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["178", "<a href=\"../../vivian-data/399_1/399.1-178.html\">BILLING FOR DENIAL NOTICE</a>", "<dt>21</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["179", "<a href=\"../../vivian-data/399_1/399.1-179.html\">PATIENT ON MULTIPLE DRUG REGIMEN</a>", "<dt>22</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["18", "<a href=\"../../vivian-data/399_1/399.1-18.html\">DISCHARGED TO SKILLED NURSING FACILITY</a>", "<dt>03</dt>\n", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["180", "<a href=\"../../vivian-data/399_1/399.1-180.html\">HOMECAREGIVER AVAILABLE</a>", "<dt>23</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["181", "<a href=\"../../vivian-data/399_1/399.1-181.html\">HOME IV PATIENT ALSO RECEIVING-HHA SERVICES</a>", "<dt>24</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["182", "<a href=\"../../vivian-data/399_1/399.1-182.html\">VA ELIGIBLE PATIENT CHOOSES A MEDICARE CERTIFIED FACILITY</a>", "<dt>26</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["183", "<a href=\"../../vivian-data/399_1/399.1-183.html\">PATIENT REFERRED TO A SOLE COMMUNITY HOSP FOR DIAGNOSTIC LAB</a>", "<dt>27</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["184", "<a href=\"../../vivian-data/399_1/399.1-184.html\">PATIENT AND/OR SPOUSE'S EGHP IS SECONDARY TO MEDICARE</a>", "<dt>28</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["185", "<a href=\"../../vivian-data/399_1/399.1-185.html\">DISABLED BENEFICIARY/FAMILY MEMBER LGHP SECONDARY TO MEDICAR</a>", "<dt>29</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["186", "<a href=\"../../vivian-data/399_1/399.1-186.html\">PATIENT IS STUDENT (FULL TIME - DAY)</a>", "<dt>31</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["187", "<a href=\"../../vivian-data/399_1/399.1-187.html\">PATIENT IS STUDENT (COOPERATIVE/WORK STUDY PROGRAM)</a>", "<dt>32</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["188", "<a href=\"../../vivian-data/399_1/399.1-188.html\">PATIENT IS STUDENT (FULL TIME - NIGHT)</a>", "<dt>33</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["189", "<a href=\"../../vivian-data/399_1/399.1-189.html\">PATIENT IS STUDENT (PART TIME)</a>", "<dt>34</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["19", "<a href=\"../../vivian-data/399_1/399.1-19.html\">EXPIRED</a>", "<dt>20</dt>\n", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["190", "<a href=\"../../vivian-data/399_1/399.1-190.html\">GENERAL CARE PATIENT IN A SPECIAL UNIT</a>", "<dt>36</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["191", "<a href=\"../../vivian-data/399_1/399.1-191.html\">WARD ACCOMMODATION AT PATIENT REQUEST</a>", "<dt>37</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["192", "<a href=\"../../vivian-data/399_1/399.1-192.html\">SEMI-PRIVATE ROOM NOT AVAILABLE</a>", "<dt>38</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["193", "<a href=\"../../vivian-data/399_1/399.1-193.html\">PRIVATE ROOM MEDICALLY NECESSARY</a>", "<dt>39</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["194", "<a href=\"../../vivian-data/399_1/399.1-194.html\">SAME DAY TRANSFER</a>", "<dt>40</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["195", "<a href=\"../../vivian-data/399_1/399.1-195.html\">PARTIAL HOSPITALIZATION</a>", "<dt>41</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["196", "<a href=\"../../vivian-data/399_1/399.1-196.html\">NON-AVAILABILITY STATEMENT ON FILE</a>", "<dt>46</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["197", "<a href=\"../../vivian-data/399_1/399.1-197.html\">PSYCH RESIDENTIAL TREATMENT CENTERS CHILDREN AND ADOLESCENTS</a>", "<dt>48</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["198", "<a href=\"../../vivian-data/399_1/399.1-198.html\">SNF BED NOT AVAILABLE</a>", "<dt>55</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["199", "<a href=\"../../vivian-data/399_1/399.1-199.html\">MEDICAL APPROPRIATENESS</a>", "<dt>56</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["2", "<a href=\"../../vivian-data/399_1/399.1-2.html\">BLIND REHABILITATION</a>", "<dt>7</dt>\n", "<dt>BLIND REHAB</dt>\n", "", "<dt>YES</dt>\n", "", "<dt><a href=\"../../vivian-data/350_1/350.1-21.html\">DG INPT COPAY (BLI) NEW</a></dt>\n", "<dt><a href=\"../../vivian-data/350_1/350.1-45.html\">DG INPT PER DIEM NEW</a></dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["20", "<a href=\"../../vivian-data/399_1/399.1-20.html\">LEFT AGAINST MEDICAL ADVICE</a>", "<dt>07</dt>\n", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["200", "<a href=\"../../vivian-data/399_1/399.1-200.html\">SNF READMISSION</a>", "<dt>57</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["201", "<a href=\"../../vivian-data/399_1/399.1-201.html\">DAY OUTLIER</a>", "<dt>60</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["202", "<a href=\"../../vivian-data/399_1/399.1-202.html\">COST OUTLIER</a>", "<dt>61</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["203", "<a href=\"../../vivian-data/399_1/399.1-203.html\">PROVIDER DOES NOT WISH COST OUTLIER PAYMENT</a>", "<dt>66</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["204", "<a href=\"../../vivian-data/399_1/399.1-204.html\">BENEFICIARY ELECTS NOT TO USE LIFE TIME RESERVE (LTR) DAYS</a>", "<dt>67</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["205", "<a href=\"../../vivian-data/399_1/399.1-205.html\">BENEFICIARY ELECTS TO USE LIFE TIME RESERVE (LTR) DAYS</a>", "<dt>68</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["206", "<a href=\"../../vivian-data/399_1/399.1-206.html\">SELF ADMINISTERED ANEMIA MANAGEMENT DRUG</a>", "<dt>70</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["207", "<a href=\"../../vivian-data/399_1/399.1-207.html\">FULL CARE IN UNIT</a>", "<dt>71</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["208", "<a href=\"../../vivian-data/399_1/399.1-208.html\">SELF CARE IN UNIT</a>", "<dt>72</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["209", "<a href=\"../../vivian-data/399_1/399.1-209.html\">SELF CARE TRAINING</a>", "<dt>73</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["21", "<a href=\"../../vivian-data/399_1/399.1-21.html\">STILL PATIENT</a>", "<dt>30</dt>\n", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["210", "<a href=\"../../vivian-data/399_1/399.1-210.html\">HOME</a>", "<dt>74</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["211", "<a href=\"../../vivian-data/399_1/399.1-211.html\">HOME - 100% REIMBURSEMENT</a>", "<dt>75</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["212", "<a href=\"../../vivian-data/399_1/399.1-212.html\">BACK-UP IN FACILITY DIALYSIS</a>", "<dt>76</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["213", "<a href=\"../../vivian-data/399_1/399.1-213.html\">PROVIDER REQUIRED/ACCEPTS PAYMENT BY PRIMARY AS FULL PAYMENT</a>", "<dt>77</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["214", "<a href=\"../../vivian-data/399_1/399.1-214.html\">NEW COVERAGE NOT IMPLEMENTED BY MANAGED CARE PLAN</a>", "<dt>78</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["215", "<a href=\"../../vivian-data/399_1/399.1-215.html\">CORF SERVICES PROVIDED OFFSITE</a>", "<dt>79</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["216", "<a href=\"../../vivian-data/399_1/399.1-216.html\">TRICARE EXTERNAL PARTNERSHIP PROGRAM</a>", "<dt>A0</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["217", "<a href=\"../../vivian-data/399_1/399.1-217.html\">EPSDT/CHAP</a>", "<dt>A1</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["218", "<a href=\"../../vivian-data/399_1/399.1-218.html\">PHYSICALLY HANDICAPPED CHILDREN'S PROGRAM</a>", "<dt>A2</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["219", "<a href=\"../../vivian-data/399_1/399.1-219.html\">SPECIAL FEDERAL FUNDING</a>", "<dt>A3</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["22", "<a href=\"../../vivian-data/399_1/399.1-22.html\">LAST MENSTRUAL PERIOD</a>", "<dt>10</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["220", "<a href=\"../../vivian-data/399_1/399.1-220.html\">FAMILY PLANNING</a>", "<dt>A4</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["221", "<a href=\"../../vivian-data/399_1/399.1-221.html\">DISABILITY</a>", "<dt>A5</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["222", "<a href=\"../../vivian-data/399_1/399.1-222.html\">VACCINES/MEDICARE 100% PAYMENT</a>", "<dt>A6</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["225", "<a href=\"../../vivian-data/399_1/399.1-225.html\">SECONDARY OPINION SURGERY</a>", "<dt>A9</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["226", "<a href=\"../../vivian-data/399_1/399.1-226.html\">APPROVED AS BILLED</a>", "<dt>C1</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["227", "<a href=\"../../vivian-data/399_1/399.1-227.html\">AUTOMATIC APPROVAL AS BILLED BASED ON FOCUSED REVIEW</a>", "<dt>C2</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["228", "<a href=\"../../vivian-data/399_1/399.1-228.html\">PARTIAL APPROVAL</a>", "<dt>C3</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["229", "<a href=\"../../vivian-data/399_1/399.1-229.html\">ADMISSION/SERVICES DENIED</a>", "<dt>C4</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["23", "<a href=\"../../vivian-data/399_1/399.1-23.html\">ONSET OF SYMPTOMS/ILLNESS</a>", "<dt>11</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["230", "<a href=\"../../vivian-data/399_1/399.1-230.html\">POSTPAYMENT REVIEW APPLICABLE</a>", "<dt>C5</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["231", "<a href=\"../../vivian-data/399_1/399.1-231.html\">ADMISSION PREAUTHORIZATION</a>", "<dt>C6</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["232", "<a href=\"../../vivian-data/399_1/399.1-232.html\">EXTENDED AUTHORIZATION</a>", "<dt>C7</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["233", "<a href=\"../../vivian-data/399_1/399.1-233.html\">CHANGES TO SERVICE DATES</a>", "<dt>D0</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["234", "<a href=\"../../vivian-data/399_1/399.1-234.html\">CHANGES TO CHARGES</a>", "<dt>D1</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["235", "<a href=\"../../vivian-data/399_1/399.1-235.html\">CHANGES IN REVENUE CODES/HCPCS/HIPPS RATE CODES</a>", "<dt>D2</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["236", "<a href=\"../../vivian-data/399_1/399.1-236.html\">SECOND OR SUBSEQUENT INTERIM PPS BILL</a>", "<dt>D3</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["237", "<a href=\"../../vivian-data/399_1/399.1-237.html\">CHANGE IN CLINICAL CODES (ICD) FOR DX AND/OR PROCEDURE CODES</a>", "<dt>D4</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["238", "<a href=\"../../vivian-data/399_1/399.1-238.html\">CANCEL TO CORRECT INSURED OR PROVIDER ID</a>", "<dt>D5</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["239", "<a href=\"../../vivian-data/399_1/399.1-239.html\">CANCEL ONLY TO REPAY A DUPLICATE OR OIG OVERPAYMENT</a>", "<dt>D6</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["24", "<a href=\"../../vivian-data/399_1/399.1-24.html\">ACCIDENT/MEDICAL COVERAGE</a>", "<dt>01</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "<dt>AUTO ACCIDENT</dt>\n", "", "", "", "", "", "", "", "", "", "", "", ""], ["240", "<a href=\"../../vivian-data/399_1/399.1-240.html\">CHANGE TO MAKE MEDICARE THE SECONDARY PAYER</a>", "<dt>D7</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["241", "<a href=\"../../vivian-data/399_1/399.1-241.html\">CHANGE TO MAKE MEDICARE THE PRIMARY PAYER</a>", "<dt>D8</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["242", "<a href=\"../../vivian-data/399_1/399.1-242.html\">ANY OTHER CHANGE</a>", "<dt>D9</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["243", "<a href=\"../../vivian-data/399_1/399.1-243.html\">CHANGE IN PATIENT STATUS</a>", "<dt>E0</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["244", "<a href=\"../../vivian-data/399_1/399.1-244.html\">SWINGBED</a>", "<dt>8</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>1</dt>\n", "", "", "", ""], ["245", "<a href=\"../../vivian-data/399_1/399.1-245.html\">RURAL HEALTH CLINIC</a>", "<dt>1</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>7</dt>\n", "", "", "", ""], ["246", "<a href=\"../../vivian-data/399_1/399.1-246.html\">HOSP BASED/INDEP RENL DIALYSIS</a>", "<dt>2</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>7</dt>\n", "", "", "", ""], ["247", "<a href=\"../../vivian-data/399_1/399.1-247.html\">FREE STANDING CLINIC</a>", "<dt>3</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>7</dt>\n", "", "", "", ""], ["248", "<a href=\"../../vivian-data/399_1/399.1-248.html\">OTHER</a>", "<dt>9</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>7,8</dt>\n", "", "", "", 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"", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>1,2</dt>\n", "", "", "", ""], ["253", "<a href=\"../../vivian-data/399_1/399.1-253.html\">HUMANIT. EMERG (INPT/MCARE-B)</a>", "<dt>2</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>1,2,3</dt>\n", "", "", "", ""], ["254", "<a href=\"../../vivian-data/399_1/399.1-254.html\">OUTPATIENT</a>", "<dt>3</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>1,2,3</dt>\n", "", "", "", ""], ["255", "<a href=\"../../vivian-data/399_1/399.1-255.html\">HUMANIT. EMERG (OPT/ESRD)</a>", "<dt>4</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>1,3</dt>\n", "", "", "", ""], ["256", "<a href=\"../../vivian-data/399_1/399.1-256.html\">SKILLED NURSING/SUB-ACUTE CARE</a>", "", "<dt>SN/SA</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["257", "<a href=\"../../vivian-data/399_1/399.1-257.html\">OBSERVATION CARE</a>", "", "<dt>OBSERVATION</dt>\n", "", "<dt>YES</dt>\n", "", "<dt><a href=\"../../vivian-data/350_1/350.1-74.html\">DG OBSERVATION COPAY NEW</a></dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["258", "<a href=\"../../vivian-data/399_1/399.1-258.html\">INPATIENT DRG</a>", "", "<dt>DRG</dt>\n", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", ""], ["259", "<a href=\"../../vivian-data/399_1/399.1-259.html\">UNASSOCIATED</a>", "", "<dt>UA</dt>\n", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", ""], ["26", "<a href=\"../../vivian-data/399_1/399.1-26.html\">ACCIDENT/TORT LIABILITY</a>", "<dt>03</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["260", "<a href=\"../../vivian-data/399_1/399.1-260.html\">PATIENT IS NON-U.S. RESIDENT</a>", "<dt>25</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["261", "<a href=\"../../vivian-data/399_1/399.1-261.html\">CONTINUING CARE NOT RELATED TO INPATIENT ADMISSION</a>", "<dt>42</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["262", "<a href=\"../../vivian-data/399_1/399.1-262.html\">CONTINUING CARE NOT WITHIN PRESCRIBED POSTDISCHARGE WINDOW</a>", "<dt>43</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["263", "<a href=\"../../vivian-data/399_1/399.1-263.html\">IME/DGME/N&AH PAYMENT ONLY</a>", "<dt>69</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["264", "<a href=\"../../vivian-data/399_1/399.1-264.html\">PROVIDER LIABILITY - NO UTILIZATION</a>", "<dt>M1</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["265", "<a href=\"../../vivian-data/399_1/399.1-265.html\">UNITS OF BLOOD REPLACED</a>", "<dt>39</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter the total number of pints of whole blood or\nunits of packed red cells furnished to the patient.\n</pre>\n</dt>\n", ""], ["266", "<a href=\"../../vivian-data/399_1/399.1-266.html\">LOCATION WHERE SERVICE IS FURNISHED (HHA AND HOSPICE)</a>", "<dt>61</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter MSA or Core Based Statistical Area (CBSA)\nnumber (or rural state code) of the location\nwhere the home health or hospice service was \ndelivered. Do not include travel time. Enter a \nwhole number rounded to the nearest whole hour.\n \nA value containing multiple zeroes (e.g. 00000 ) is not allowed.\n</pre>\n</dt>\n", "<dt>I $G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["267", "<a href=\"../../vivian-data/399_1/399.1-267.html\">PERITONEAL DIALYSIS</a>", "<dt>67</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter the number of hours of peritoneal dialysis\nprovided during the billing period.   \n \nA value containing multiple zeroes (e.g. 00000 ) is not allowed.\n</pre>\n</dt>\n", "<dt>I $G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["268", "<a href=\"../../vivian-data/399_1/399.1-268.html\">COVERED SELF-ADMINISTRABLE DRUGS - EMERGENCY</a>", "<dt>A4</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["269", "<a href=\"../../vivian-data/399_1/399.1-269.html\">COVERED SELF-ADMINISTRABLE DRUGS - NOT AS GIVEN TO PATIENT</a>", "<dt>A5</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["27", "<a href=\"../../vivian-data/399_1/399.1-27.html\">ACCIDENT/EMPLOYMENT RELATED</a>", "<dt>04</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "<dt>EMPLOYMENT</dt>\n", "", "", "", "", "", "", "", "", "", "", "", ""], ["270", "<a href=\"../../vivian-data/399_1/399.1-270.html\">COVERED SELF-ADMINISTRABLE DRUGS - DIAGNOSTIC STUDY/OTHER</a>", "<dt>A6</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["271", "<a href=\"../../vivian-data/399_1/399.1-271.html\">RESERVED FOR ASSIGNMENT BY THE NUBC</a>", "<dt>E1</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "<dt>2007-03-01 00:00:00</dt>\n", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["272", "<a href=\"../../vivian-data/399_1/399.1-272.html\">RESERVED FOR ASSIGNMENT BY THE NUBC</a>", "<dt>E2</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "<dt>2007-03-01 00:00:00</dt>\n", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["273", "<a href=\"../../vivian-data/399_1/399.1-273.html\">RESERVED FOR ASSIGNMENT BY THE NUBC</a>", "<dt>E3</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "<dt>2007-03-01 00:00:00</dt>\n", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["274", "<a href=\"../../vivian-data/399_1/399.1-274.html\">RESERVED FOR ASSIGNMENT BY THE NUBC</a>", "<dt>F1</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "<dt>2007-03-01 00:00:00</dt>\n", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["275", "<a href=\"../../vivian-data/399_1/399.1-275.html\">RESERVED FOR ASSIGNMENT BY THE NUBC</a>", "<dt>F2</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "<dt>2007-03-01 00:00:00</dt>\n", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["276", "<a href=\"../../vivian-data/399_1/399.1-276.html\">RESERVED FOR ASSIGNMENT BY THE NUBC</a>", "<dt>F3</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "<dt>2007-03-01 00:00:00</dt>\n", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["277", "<a href=\"../../vivian-data/399_1/399.1-277.html\">RESERVED FOR ASSIGNMENT BY THE NUBC</a>", "<dt>G1</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "<dt>2007-03-01 00:00:00</dt>\n", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["278", "<a href=\"../../vivian-data/399_1/399.1-278.html\">RESERVED FOR ASSIGNMENT BY THE NUBC</a>", "<dt>G2</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "<dt>2007-03-01 00:00:00</dt>\n", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["279", "<a href=\"../../vivian-data/399_1/399.1-279.html\">RESERVED FOR ASSIGNMENT BY THE NUBC</a>", "<dt>G3</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "<dt>2007-03-01 00:00:00</dt>\n", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["28", "<a href=\"../../vivian-data/399_1/399.1-28.html\">ACCIDENT/NO MEDICAL OR LIABILITY COVERAGE</a>", "<dt>05</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "<dt>OTHER ACCIDENT</dt>\n", "", "", "", "", "", "", "", "", "", "", "", ""], ["280", "<a href=\"../../vivian-data/399_1/399.1-280.html\">ADMITTED AS AN INPATIENT TO THIS HOSPITAL</a>", "<dt>09</dt>\n", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["281", "<a href=\"../../vivian-data/399_1/399.1-281.html\">EXPIRED AT HOME</a>", "<dt>40</dt>\n", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["282", "<a href=\"../../vivian-data/399_1/399.1-282.html\">EXPIRED IN A MEDICAL FACILITY</a>", "<dt>41</dt>\n", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["283", "<a href=\"../../vivian-data/399_1/399.1-283.html\">EXPIRED - PLACE UNKNOWN</a>", "<dt>42</dt>\n", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["284", "<a href=\"../../vivian-data/399_1/399.1-284.html\">HOSPICE - HOME</a>", "<dt>50</dt>\n", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["285", "<a href=\"../../vivian-data/399_1/399.1-285.html\">HOSPICE - MEDICAL FACILITY</a>", "<dt>51</dt>\n", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["286", "<a href=\"../../vivian-data/399_1/399.1-286.html\">DISCHARGED WITHIN FACILITY TO MEDICARE APPROVED SWING BED</a>", "<dt>61</dt>\n", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["287", "<a href=\"../../vivian-data/399_1/399.1-287.html\">DISCHARGED TO ANOTHER FACILITY FOR OPT SV PER DISCHARGE PLAN</a>", "<dt>71</dt>\n", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["288", "<a href=\"../../vivian-data/399_1/399.1-288.html\">DISCHARGED TO THIS FACILITY FOR OPT SV PER DISCHARGE PLAN</a>", "<dt>72</dt>\n", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["289", "<a href=\"../../vivian-data/399_1/399.1-289.html\">TERMINATED MEDICARE ADVANTAGE ENROLLEE</a>", "<dt>58</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["29", "<a href=\"../../vivian-data/399_1/399.1-29.html\">CRIME VICTIM</a>", "<dt>06</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["290", "<a href=\"../../vivian-data/399_1/399.1-290.html\">DISTINCT MEDICAL VISIT</a>", "<dt>G0</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["291", "<a href=\"../../vivian-data/399_1/399.1-291.html\">DATE OF LAST THERAPY</a>", "<dt>16</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["292", "<a href=\"../../vivian-data/399_1/399.1-292.html\">DATE OF CANCELLATION OF HOSPICE ELECTION PERIOD</a>", "<dt>23</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["293", "<a href=\"../../vivian-data/399_1/399.1-293.html\">DATE COST OUTLIER STATUS BEGINS</a>", "<dt>47</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["294", "<a href=\"../../vivian-data/399_1/399.1-294.html\">PAYER CODES</a>", "<dt>48</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["295", "<a href=\"../../vivian-data/399_1/399.1-295.html\">PAYER CODES</a>", "<dt>49</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["296", "<a href=\"../../vivian-data/399_1/399.1-296.html\">PATIENT RESPITE DATES</a>", "<dt>M2</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["297", "<a href=\"../../vivian-data/399_1/399.1-297.html\">ASSESSMENT DATE</a>", "<dt>50</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["298", "<a href=\"../../vivian-data/399_1/399.1-298.html\">DATE OF LAST KT/V READING</a>", "<dt>51</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["299", "<a href=\"../../vivian-data/399_1/399.1-299.html\">MEDICAL CERTIFICATION/RECERTIFICATION DATE</a>", "<dt>52</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["3", "<a href=\"../../vivian-data/399_1/399.1-3.html\">GENERAL MEDICAL CARE</a>", "<dt>1</dt>\n", "<dt>GEN MED CARE</dt>\n", "", "<dt>YES</dt>\n", "", "<dt><a href=\"../../vivian-data/350_1/350.1-15.html\">DG INPT COPAY (MED) NEW</a></dt>\n", "<dt><a href=\"../../vivian-data/350_1/350.1-45.html\">DG INPT PER DIEM NEW</a></dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["30", "<a href=\"../../vivian-data/399_1/399.1-30.html\">NON-VA CARE</a>", "", "<dt>NON-VA</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["300", "<a href=\"../../vivian-data/399_1/399.1-300.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>53</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["301", "<a href=\"../../vivian-data/399_1/399.1-301.html\">PHYSICIAN FOLLOW-UP DATE</a>", "<dt>54</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["302", "<a href=\"../../vivian-data/399_1/399.1-302.html\">DATE OF DEATH</a>", "<dt>55</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["303", "<a href=\"../../vivian-data/399_1/399.1-303.html\">ORIGINAL HOSPICE ELECTION OR REVOCATION DATE</a>", "<dt>56</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["304", "<a href=\"../../vivian-data/399_1/399.1-304.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>57</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["305", "<a href=\"../../vivian-data/399_1/399.1-305.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>58</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["306", "<a href=\"../../vivian-data/399_1/399.1-306.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>59</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["307", "<a href=\"../../vivian-data/399_1/399.1-307.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>60</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["308", "<a href=\"../../vivian-data/399_1/399.1-308.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>61</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["309", "<a href=\"../../vivian-data/399_1/399.1-309.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>62</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["31", "<a href=\"../../vivian-data/399_1/399.1-31.html\">OUTPATIENT DENTAL</a>", "", "<dt>OPT DNTL</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["310", "<a href=\"../../vivian-data/399_1/399.1-310.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>63</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["311", "<a href=\"../../vivian-data/399_1/399.1-311.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>64</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["312", "<a href=\"../../vivian-data/399_1/399.1-312.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>65</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["313", "<a href=\"../../vivian-data/399_1/399.1-313.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>66</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["314", "<a href=\"../../vivian-data/399_1/399.1-314.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>67</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["315", "<a href=\"../../vivian-data/399_1/399.1-315.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>68</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["316", "<a href=\"../../vivian-data/399_1/399.1-316.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>69</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["317", "<a href=\"../../vivian-data/399_1/399.1-317.html\">PRIOR SAME-SNF STAY DATES FOR PAYMENT BAN PURPOSES</a>", "<dt>80</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["318", "<a href=\"../../vivian-data/399_1/399.1-318.html\">ANTEPARTUM DAYS AT REDUCED LEVEL OF CARE</a>", "<dt>81</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["319", "<a href=\"../../vivian-data/399_1/399.1-319.html\">HOSP AT HOME CARE DATES</a>", "<dt>82</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["32", "<a href=\"../../vivian-data/399_1/399.1-32.html\">DISCHARGED TO HOME UNDER CARE OF A HOME IV PROVIDER</a>", "<dt>08</dt>\n", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["320", "<a href=\"../../vivian-data/399_1/399.1-320.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>83</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["321", "<a href=\"../../vivian-data/399_1/399.1-321.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>84</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["322", "<a href=\"../../vivian-data/399_1/399.1-322.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>85</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["323", "<a href=\"../../vivian-data/399_1/399.1-323.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>86</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", 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href=\"../../vivian-data/399_1/399.1-332.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>95</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["333", "<a href=\"../../vivian-data/399_1/399.1-333.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>96</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["334", "<a href=\"../../vivian-data/399_1/399.1-334.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>97</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["335", "<a href=\"../../vivian-data/399_1/399.1-335.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>98</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["336", "<a href=\"../../vivian-data/399_1/399.1-336.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>99</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", 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"<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["341", "<a href=\"../../vivian-data/399_1/399.1-341.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>J4</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["342", "<a href=\"../../vivian-data/399_1/399.1-342.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>J5</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["343", "<a href=\"../../vivian-data/399_1/399.1-343.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>J6</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["344", "<a href=\"../../vivian-data/399_1/399.1-344.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>J7</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["345", "<a href=\"../../vivian-data/399_1/399.1-345.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>J8</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["346", "<a href=\"../../vivian-data/399_1/399.1-346.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>J9</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["347", "<a href=\"../../vivian-data/399_1/399.1-347.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>K0</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["348", "<a href=\"../../vivian-data/399_1/399.1-348.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>K1</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["349", "<a href=\"../../vivian-data/399_1/399.1-349.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>K2</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["35", "<a href=\"../../vivian-data/399_1/399.1-35.html\">FIRST/LAST DAY</a>", "<dt>72</dt>\n", "", "<dt>YES</dt>\n", 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"<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["36", "<a href=\"../../vivian-data/399_1/399.1-36.html\">BENEFITS ELIGIBILITY PERIOD</a>", "<dt>73</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["360", "<a href=\"../../vivian-data/399_1/399.1-360.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>L3</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["361", "<a href=\"../../vivian-data/399_1/399.1-361.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>L4</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["362", "<a href=\"../../vivian-data/399_1/399.1-362.html\">RZD FOR STATE ASSIGNMENT</a>", "<dt>L5</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["363", "<a href=\"../../vivian-data/399_1/399.1-363.html\">RZD FOR STATE ASSIGNMENT</a>", 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href=\"../../vivian-data/399_1/399.1-398.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>08</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["399", "<a href=\"../../vivian-data/399_1/399.1-399.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>13</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["4", "<a href=\"../../vivian-data/399_1/399.1-4.html\">INTERMEDIATE CARE</a>", "<dt>4</dt>\n", "<dt>INTERMED CARE</dt>\n", "", "<dt>YES</dt>\n", "", "<dt><a href=\"../../vivian-data/350_1/350.1-19.html\">DG INPT COPAY (INT) NEW</a></dt>\n", "<dt><a href=\"../../vivian-data/350_1/350.1-45.html\">DG INPT PER DIEM NEW</a></dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["40", "<a href=\"../../vivian-data/399_1/399.1-40.html\">PROVIDER LIABILITY PERIOD</a>", "<dt>77</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["400", "<a href=\"../../vivian-data/399_1/399.1-400.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>14</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["401", "<a href=\"../../vivian-data/399_1/399.1-401.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>15</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["402", "<a href=\"../../vivian-data/399_1/399.1-402.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>A0</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["403", "<a href=\"../../vivian-data/399_1/399.1-403.html\">SPLIT BILL DATE</a>", "<dt>A4</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["404", "<a href=\"../../vivian-data/399_1/399.1-404.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>A5</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["405", "<a href=\"../../vivian-data/399_1/399.1-405.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>A6</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["406", "<a href=\"../../vivian-data/399_1/399.1-406.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>A7</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["407", "<a href=\"../../vivian-data/399_1/399.1-407.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>A8</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["408", "<a href=\"../../vivian-data/399_1/399.1-408.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>A9</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["409", "<a href=\"../../vivian-data/399_1/399.1-409.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>B0</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["41", "<a href=\"../../vivian-data/399_1/399.1-41.html\">SNF PRIOR STAY DATES</a>", "<dt>78</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["410", "<a href=\"../../vivian-data/399_1/399.1-410.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>B4</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["411", "<a href=\"../../vivian-data/399_1/399.1-411.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>B5</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["412", "<a href=\"../../vivian-data/399_1/399.1-412.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>B6</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["413", "<a href=\"../../vivian-data/399_1/399.1-413.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>B7</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["414", "<a href=\"../../vivian-data/399_1/399.1-414.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>B8</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["415", "<a href=\"../../vivian-data/399_1/399.1-415.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>B9</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["416", "<a href=\"../../vivian-data/399_1/399.1-416.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>C0</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["417", "<a href=\"../../vivian-data/399_1/399.1-417.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>C4</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["418", "<a href=\"../../vivian-data/399_1/399.1-418.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>C5</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["419", "<a href=\"../../vivian-data/399_1/399.1-419.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>C6</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["42", "<a href=\"../../vivian-data/399_1/399.1-42.html\">PAYER CODE</a>", "<dt>79</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["420", "<a href=\"../../vivian-data/399_1/399.1-420.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>C7</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["421", "<a href=\"../../vivian-data/399_1/399.1-421.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>C8</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["422", "<a href=\"../../vivian-data/399_1/399.1-422.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>C9</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["423", "<a href=\"../../vivian-data/399_1/399.1-423.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>D0</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["424", "<a href=\"../../vivian-data/399_1/399.1-424.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>D1</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["425", "<a href=\"../../vivian-data/399_1/399.1-425.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>D2</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["426", "<a href=\"../../vivian-data/399_1/399.1-426.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>D3</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["427", "<a href=\"../../vivian-data/399_1/399.1-427.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>D4</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["428", "<a href=\"../../vivian-data/399_1/399.1-428.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>D5</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["429", "<a href=\"../../vivian-data/399_1/399.1-429.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>D6</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["43", "<a href=\"../../vivian-data/399_1/399.1-43.html\">QIO/UR APPROVED STAY DATES</a>", "<dt>M0</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["430", "<a href=\"../../vivian-data/399_1/399.1-430.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>D7</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["431", "<a href=\"../../vivian-data/399_1/399.1-431.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>D8</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["432", "<a href=\"../../vivian-data/399_1/399.1-432.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>D9</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["433", "<a href=\"../../vivian-data/399_1/399.1-433.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>E0</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["434", "<a href=\"../../vivian-data/399_1/399.1-434.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>E4</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["435", "<a href=\"../../vivian-data/399_1/399.1-435.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>E5</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["436", "<a href=\"../../vivian-data/399_1/399.1-436.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>E6</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["437", "<a href=\"../../vivian-data/399_1/399.1-437.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>E7</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["438", "<a href=\"../../vivian-data/399_1/399.1-438.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>E8</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["439", "<a href=\"../../vivian-data/399_1/399.1-439.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>E9</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["44", "<a href=\"../../vivian-data/399_1/399.1-44.html\">PROFESSIONAL COMPONENT CHARGES, COMBINED BILLED</a>", "<dt>04</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["440", "<a href=\"../../vivian-data/399_1/399.1-440.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>F0</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["441", "<a href=\"../../vivian-data/399_1/399.1-441.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>F4</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["442", "<a href=\"../../vivian-data/399_1/399.1-442.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>F5</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["443", "<a href=\"../../vivian-data/399_1/399.1-443.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>F6</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["444", "<a href=\"../../vivian-data/399_1/399.1-444.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>F7</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["445", "<a href=\"../../vivian-data/399_1/399.1-445.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>F8</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["446", "<a href=\"../../vivian-data/399_1/399.1-446.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>F9</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["447", "<a href=\"../../vivian-data/399_1/399.1-447.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>G0</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["448", "<a href=\"../../vivian-data/399_1/399.1-448.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>G4</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["449", "<a href=\"../../vivian-data/399_1/399.1-449.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>G5</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["45", "<a href=\"../../vivian-data/399_1/399.1-45.html\">NO FAULT, INCLUDING AUTO/OTHER</a>", "<dt>14</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["450", "<a href=\"../../vivian-data/399_1/399.1-450.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>G6</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["451", "<a href=\"../../vivian-data/399_1/399.1-451.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>G7</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["452", "<a href=\"../../vivian-data/399_1/399.1-452.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>G8</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["453", "<a href=\"../../vivian-data/399_1/399.1-453.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>G9</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["454", "<a href=\"../../vivian-data/399_1/399.1-454.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>H0</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["455", "<a href=\"../../vivian-data/399_1/399.1-455.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>H1</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["456", "<a href=\"../../vivian-data/399_1/399.1-456.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>H2</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["457", "<a href=\"../../vivian-data/399_1/399.1-457.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>H3</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["458", "<a href=\"../../vivian-data/399_1/399.1-458.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>H4</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["459", "<a href=\"../../vivian-data/399_1/399.1-459.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>H5</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["46", "<a href=\"../../vivian-data/399_1/399.1-46.html\">WORKER'S COMPENSATION</a>", "<dt>15</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["460", "<a href=\"../../vivian-data/399_1/399.1-460.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>H6</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["461", "<a href=\"../../vivian-data/399_1/399.1-461.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>H7</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["462", "<a href=\"../../vivian-data/399_1/399.1-462.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>H8</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["463", "<a href=\"../../vivian-data/399_1/399.1-463.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>H9</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["464", "<a href=\"../../vivian-data/399_1/399.1-464.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>I0</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["465", "<a href=\"../../vivian-data/399_1/399.1-465.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>I1</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["466", "<a href=\"../../vivian-data/399_1/399.1-466.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>I2</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["467", "<a href=\"../../vivian-data/399_1/399.1-467.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>I3</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["468", "<a href=\"../../vivian-data/399_1/399.1-468.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>I4</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["469", "<a href=\"../../vivian-data/399_1/399.1-469.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>I5</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["47", "<a href=\"../../vivian-data/399_1/399.1-47.html\">ACCIDENT HOUR</a>", "<dt>45</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter the hour when the accident occurred that caused\n05      05:00-05:59 AM\n06      06:00-06:59 AM\n07      07:00-07:59 AM\n08      08:00-08:59 AM\n09      09:00-09:59 AM\n10      10:00-10:59 AM\n11      11:00-11:59 AM\n12      12:00-12:59 (Noon)\n13      01:00-01:59 PM\n14      02:00-02:59 PM\nthe need for medical treatment. \n15      03:00-03:59 PM\n16      04:00-04:59 PM\n17      05:00-05:59 PM\n18      06:00-06:59 PM\n19      07:00-07:59 PM\n20      08:00-08:59 PM\n21      09:00-09:59 PM\n22      10:00-10:59 PM\n23      11:00-11:59 PM\n99      Unknown\n \nEnter correct code.\n00      12:00-12:59 (Midnight)\n01      01:00-01:59 AM\n02      02:00-02:59 AM\n03      03:00-03:59 AM\n04      04:00-04:59 AM\n</pre>\n</dt>\n", ""], ["470", "<a href=\"../../vivian-data/399_1/399.1-470.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>I6</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["471", "<a href=\"../../vivian-data/399_1/399.1-471.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>I7</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["472", "<a href=\"../../vivian-data/399_1/399.1-472.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>I8</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["473", "<a href=\"../../vivian-data/399_1/399.1-473.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>I9</dt>\n", "", 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href=\"../../vivian-data/399_1/399.1-478.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>M7</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["479", "<a href=\"../../vivian-data/399_1/399.1-479.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>M8</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["480", "<a href=\"../../vivian-data/399_1/399.1-480.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>M9</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["481", "<a href=\"../../vivian-data/399_1/399.1-481.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>N0</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["482", "<a href=\"../../vivian-data/399_1/399.1-482.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>N1</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", 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href=\"../../vivian-data/399_1/399.1-559.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>U8</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["560", "<a href=\"../../vivian-data/399_1/399.1-560.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>U9</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["561", "<a href=\"../../vivian-data/399_1/399.1-561.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>V0</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["562", "<a href=\"../../vivian-data/399_1/399.1-562.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>V1</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["563", "<a href=\"../../vivian-data/399_1/399.1-563.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>V2</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["564", "<a href=\"../../vivian-data/399_1/399.1-564.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>V3</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["565", "<a href=\"../../vivian-data/399_1/399.1-565.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>V4</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["566", "<a href=\"../../vivian-data/399_1/399.1-566.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>V5</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["567", "<a href=\"../../vivian-data/399_1/399.1-567.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>V6</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["568", "<a href=\"../../vivian-data/399_1/399.1-568.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>V7</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["569", "<a href=\"../../vivian-data/399_1/399.1-569.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>V8</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["57", "<a href=\"../../vivian-data/399_1/399.1-57.html\">MOST COMMON SEMI-PRIVATE ROOM RATE</a>", "<dt>01</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["570", "<a href=\"../../vivian-data/399_1/399.1-570.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>V9</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["571", "<a href=\"../../vivian-data/399_1/399.1-571.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>W0</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["572", "<a href=\"../../vivian-data/399_1/399.1-572.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>W1</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["573", "<a href=\"../../vivian-data/399_1/399.1-573.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>W2</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["574", "<a href=\"../../vivian-data/399_1/399.1-574.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>W3</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["575", "<a href=\"../../vivian-data/399_1/399.1-575.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>W4</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["576", "<a href=\"../../vivian-data/399_1/399.1-576.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>W5</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["577", "<a href=\"../../vivian-data/399_1/399.1-577.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>W6</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["578", "<a href=\"../../vivian-data/399_1/399.1-578.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>W7</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["579", "<a href=\"../../vivian-data/399_1/399.1-579.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>W8</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["58", "<a href=\"../../vivian-data/399_1/399.1-58.html\">HOSPITAL HAS NO SEMI-PRIVATE ROOMS</a>", "<dt>02</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nOnly a zero amount may be entered for Value Code 02 HOSPITAL HAS NO \nSEMI-PRIVATE ROOMS.\n</pre>\n</dt>\n", ""], ["580", "<a href=\"../../vivian-data/399_1/399.1-580.html\">RZD FOR NATIONAL ASSIGNMENT</a>", "<dt>W9</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["581", "<a href=\"../../vivian-data/399_1/399.1-581.html\">SKILLED NURSING</a>", "", "<dt>SNF</dt>\n", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", ""], ["582", "<a href=\"../../vivian-data/399_1/399.1-582.html\">ICU</a>", "", "<dt>ICU</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["583", "<a href=\"../../vivian-data/399_1/399.1-583.html\">PARTIAL HOSPITALIZATION</a>", "", "<dt>PARTIAL HOSP</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["584", "<a href=\"../../vivian-data/399_1/399.1-584.html\">SKILLED NURSING CARE</a>", "", "<dt>SNF</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt><a href=\"../../vivian-data/399_1/399.1-581.html\">SKILLED NURSING</a></dt>\n", "", "", ""], ["585", "<a href=\"../../vivian-data/399_1/399.1-585.html\">SUB-ACUTE CARE</a>", "", "<dt>SUBACUTE</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt><a href=\"../../vivian-data/399_1/399.1-581.html\">SKILLED NURSING</a></dt>\n", "", "", ""], ["586", "<a href=\"../../vivian-data/399_1/399.1-586.html\">PRRTP</a>", "", "<dt>PRRTP</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["587", "<a href=\"../../vivian-data/399_1/399.1-587.html\">SPECIAL ZIP CODE REPORTING</a>", "<dt>A0</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter the 5 digit ZIP Code of the location at which \nthe beneficiary is initially placed on board the\nambulance.\n \nA value containing multiple zeroes (e.g. 00000 ) is not allowed.\n</pre>\n</dt>\n", "<dt>I $G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["588", "<a href=\"../../vivian-data/399_1/399.1-588.html\">COVERED DAYS</a>", "<dt>80</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter the number of days covered by the primary payer\nas qualified by the payer.\n \nA value containing multiple zeroes (e.g. 00000 ) is not allowed.\n</pre>\n</dt>\n", "<dt>I $G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["589", "<a href=\"../../vivian-data/399_1/399.1-589.html\">NON-COVERED DAYS</a>", "<dt>81</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter the number of days of care not covered by the primary payer.\n \nA value containing multiple zeroes (e.g. 00000 ) is not allowed.\n</pre>\n</dt>\n", "<dt>I $G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["59", "<a href=\"../../vivian-data/399_1/399.1-59.html\">MEDICARE LIFETIME RESERVE AMT IN FIRST CALENDAR YEAR</a>", "<dt>08</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["590", "<a href=\"../../vivian-data/399_1/399.1-590.html\">CO-INSURANCE DAYS</a>", "<dt>82</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter the number of inpatient Medicare days occurring after\nthe 60th day and before the 91st day or inpatient SNF/Swing\nBed days occurring after the 20th and before the 101st day\nin a single spell of illness.\n \nA value containing multiple zeroes (e.g. 00000 ) is not allowed.\n</pre>\n</dt>\n", "<dt>I $G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["591", "<a href=\"../../vivian-data/399_1/399.1-591.html\">PATIENT WEIGHT</a>", "<dt>A8</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "<dt><pre>\nEnter Weight of patient in kilograms. Report this data only when the \nhealth plan has a predefined change in reimbursement that is affected by \nweight. For newborns, use Value Code 54.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["592", "<a href=\"../../vivian-data/399_1/399.1-592.html\">PATIENT HEIGHT</a>", "<dt>A9</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "<dt><pre>\nEnter Height of patient in centimeters. Report this data only when the \nhealth plan has a predefined change in reimbursement that is affected by \nheight.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["593", "<a href=\"../../vivian-data/399_1/399.1-593.html\">PATIENT PAID AMOUNT</a>", "<dt>FC</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["594", "<a href=\"../../vivian-data/399_1/399.1-594.html\">CREDIT RECEVD FROM MANUFACTURER FOR REPLACED MEDICAL DEVICE</a>", "<dt>FD</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["595", "<a href=\"../../vivian-data/399_1/399.1-595.html\">PRODUCT REPLACEMENT WITHIN PRODUCT LIFECYCLE</a>", "<dt>49</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["596", "<a href=\"../../vivian-data/399_1/399.1-596.html\">PRODUCT REPLACEMENT FOR KNOWN RECALL OF A PRODUCT</a>", "<dt>50</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["597", "<a href=\"../../vivian-data/399_1/399.1-597.html\">DISCHARGE BY A HOSPICE PROVIDER FOR CAUSE</a>", "<dt>H2</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["598", "<a href=\"../../vivian-data/399_1/399.1-598.html\">LAST KT/V READING</a>", "<dt>D5</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "<dt><pre>\nEnter the last reading during billing period; peritoneal/home dialysis - \nwithin 4 months of claim date of service.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["599", "<a href=\"../../vivian-data/399_1/399.1-599.html\">QUALIFY CLINICAL TRIALS</a>", "<dt>30</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["6", "<a href=\"../../vivian-data/399_1/399.1-6.html\">NURSING HOME CARE</a>", "<dt>10</dt>\n", "<dt>NURSING HOME</dt>\n", "", "<dt>YES</dt>\n", "", "<dt><a href=\"../../vivian-data/350_1/350.1-24.html\">DG NHCU COPAY NEW</a></dt>\n", "<dt><a href=\"../../vivian-data/350_1/350.1-48.html\">DG NHCU PER DIEM NEW</a></dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["60", "<a href=\"../../vivian-data/399_1/399.1-60.html\">MEDICARE CO-INSURANCE AMT IN FIRST CALENDAR YEAR</a>", "<dt>09</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["600", "<a href=\"../../vivian-data/399_1/399.1-600.html\">INPATIENT ADMISSION CHANGED TO OUTPATIENT</a>", "<dt>44</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["601", "<a href=\"../../vivian-data/399_1/399.1-601.html\">AMBIGUOUS SEX CATEGORY</a>", "<dt>45</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["602", "<a href=\"../../vivian-data/399_1/399.1-602.html\">TRANSFER FROM ANOTHER HOME HEALTH AGENCY</a>", "<dt>47</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["603", "<a href=\"../../vivian-data/399_1/399.1-603.html\">NON-PRIMARY ESRD FACILITY</a>", "<dt>59</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["604", "<a href=\"../../vivian-data/399_1/399.1-604.html\">HOME DIALYSIS-NURSING FACILITY</a>", "<dt>80</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["605", "<a href=\"../../vivian-data/399_1/399.1-605.html\">ABORTION PERFORMED DUE TO RAPE</a>", "<dt>AA</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["606", "<a href=\"../../vivian-data/399_1/399.1-606.html\">ABORTION PERFORMED DUE TO INCEST</a>", "<dt>AB</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["607", "<a href=\"../../vivian-data/399_1/399.1-607.html\">ABORT PERF DUE TO SERIOUS FETAL GENE DEFCT, DEFORM OR ABNORM</a>", "<dt>AC</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["608", "<a href=\"../../vivian-data/399_1/399.1-608.html\">ABORT PERF DUE TO LIFE ENDANGERING PHYSICAL CONDITION</a>", "<dt>AD</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["609", "<a href=\"../../vivian-data/399_1/399.1-609.html\">ABORT PERF DUE TO PHYS HLTH OF MOTHER THAT NOT LIFE ENDANGER</a>", "<dt>AE</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["61", "<a href=\"../../vivian-data/399_1/399.1-61.html\">MEDICARE LIFETIME RESERVE AMT IN SECOND CALENDAR YEAR</a>", "<dt>10</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["610", "<a href=\"../../vivian-data/399_1/399.1-610.html\">ABORT PERF DUE TO EMOTIONAL/PSYCHOLOGICAL HLTH OF THE MOTHER</a>", "<dt>AF</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["611", "<a href=\"../../vivian-data/399_1/399.1-611.html\">ABORTION PERFORMED DUE TO SOCIAL OR ECONOMIC REASONS</a>", "<dt>AG</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["612", "<a href=\"../../vivian-data/399_1/399.1-612.html\">ELECTIVE ABORTION</a>", "<dt>AH</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["613", "<a href=\"../../vivian-data/399_1/399.1-613.html\">STERILIZATION</a>", "<dt>AI</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["614", "<a href=\"../../vivian-data/399_1/399.1-614.html\">PAYER RESPONSIBLE FOR COPAYMENT</a>", "<dt>AJ</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["615", "<a href=\"../../vivian-data/399_1/399.1-615.html\">AIR AMBULANCE REQUIRED</a>", "<dt>AK</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["616", "<a href=\"../../vivian-data/399_1/399.1-616.html\">SPECIALIZED TRMT/BED UNAVAILABLE-ALTERNATE FAC TRANSPORT</a>", "<dt>AL</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["617", "<a href=\"../../vivian-data/399_1/399.1-617.html\">NON-EMERGENCY MEDICALLY NECESSARY STRETCHER TRANSPORT REQ</a>", "<dt>AM</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["618", "<a href=\"../../vivian-data/399_1/399.1-618.html\">PREADMISSION SCREENING NOT REQUIRED</a>", "<dt>AN</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["619", "<a href=\"../../vivian-data/399_1/399.1-619.html\">ADMISSION UNRELATED TO DISCHARGE ON SAME DAY</a>", "<dt>B4</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["62", "<a href=\"../../vivian-data/399_1/399.1-62.html\">MEDICARE CO-INSURANCE AMT IN SECOND CALENDAR YEAR</a>", "<dt>11</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["620", "<a href=\"../../vivian-data/399_1/399.1-620.html\">DIRECT INPATIENT ADMISSION FROM EMERGENCY ROOM</a>", "<dt>P7</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["621", "<a href=\"../../vivian-data/399_1/399.1-621.html\">DISASTER RELATED</a>", "<dt>DR</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["622", "<a href=\"../../vivian-data/399_1/399.1-622.html\">DELAYED FILING, STATEMENT OF INTENT SUBMITTED</a>", "<dt>H0</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["623", "<a href=\"../../vivian-data/399_1/399.1-623.html\">REOCCURRENCE OF GI BLEED (MA) CATEGORY</a>", "<dt>H3</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["624", "<a href=\"../../vivian-data/399_1/399.1-624.html\">REOCCURRENCE OF PNEUMONIA (MB) CATEGORY</a>", "<dt>H4</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["625", "<a href=\"../../vivian-data/399_1/399.1-625.html\">REOCCURRENCE OF PERICARDITIS (MC) CATEGORY</a>", "<dt>H5</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["626", "<a href=\"../../vivian-data/399_1/399.1-626.html\">DUPLICATE OF ORIGINAL BILL</a>", "<dt>W2</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["627", "<a href=\"../../vivian-data/399_1/399.1-627.html\">LEVEL I APPEAL</a>", "<dt>W3</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["628", "<a href=\"../../vivian-data/399_1/399.1-628.html\">LEVEL II APPEAL</a>", "<dt>W4</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["629", "<a href=\"../../vivian-data/399_1/399.1-629.html\">LEVEL III APPEAL</a>", "<dt>W5</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["63", "<a href=\"../../vivian-data/399_1/399.1-63.html\">ESTIMATED RESPONSIBILITY PAYER A</a>", "<dt>A3</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "<dt>2011-10-26 00:00:00</dt>\n", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["630", "<a href=\"../../vivian-data/399_1/399.1-630.html\">POLYTRAUMA INPATIENT</a>", "", "<dt>POYLTRAUMA INPT</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["631", "<a href=\"../../vivian-data/399_1/399.1-631.html\">PM&RS OUTPATIENT VISIT</a>", "", "<dt>PM&RS OPT VISIT</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["632", "<a href=\"../../vivian-data/399_1/399.1-632.html\">POLYTRAUMA OUTPATIENT VISIT</a>", "", "<dt>OPT POLYTRI/TBI</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["633", "<a href=\"../../vivian-data/399_1/399.1-633.html\">MULTIPLE PATIENT AMBULANCE TRANSPORT</a>", "<dt>32</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "<dt><pre>\nIf more than one patient is transported in a single ambulance trip, \nreport the total number of patients transported.\n</pre>\n</dt>\n", "<dt>I $G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["634", "<a href=\"../../vivian-data/399_1/399.1-634.html\">NEWBORN BIRTH WEIGHT IN GRAMS</a>", "<dt>54</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "<dt><pre>\nActual birth weight or weight at time of admission for an extramural \nbirth. Required on all claims with type of admission of 4 and on other \nclaims as required by State law.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["635", "<a href=\"../../vivian-data/399_1/399.1-635.html\">ELIGIBILITY THRESHOLD FOR CHARITY CARE</a>", "<dt>55</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.  Enter it in the \nformat of dollars and cents (00.00).\n  \nIf you enter only dollars (00), the system will add on .00 cents.  \nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["636", "<a href=\"../../vivian-data/399_1/399.1-636.html\">MEDICAID SPEND DOWN AMOUNT</a>", "<dt>66</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["637", "<a href=\"../../vivian-data/399_1/399.1-637.html\">STATE CHARITY CARE PERCENT</a>", "<dt>69</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "<dt><pre>\nEnter the Code indicates the percentage of charity care eligibility for \nthe patient. Report the whole number right justified to the left of the \ndollar/cents delimiter and fractional amounts to the right.\n \nA value containing multiple zeroes (e.g. 00000 ) is not allowed.\n</pre>\n</dt>\n", "<dt>I $G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["638", "<a href=\"../../vivian-data/399_1/399.1-638.html\">LIFETIME RESERVE DAYS</a>", "<dt>83</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "<dt><pre>\nUnder Medicare, each beneficiary has a lifetime reserve of 60 additional \ndays of inpatient hospital services after using 90 days of inpatient \nhospital services during a spell of illness.\n</pre>\n</dt>\n", "<dt>I $G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["639", "<a href=\"../../vivian-data/399_1/399.1-639.html\">CO-PAYMENT PAYER A</a>", "<dt>A7</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["64", "<a href=\"../../vivian-data/399_1/399.1-64.html\">ESTIMATED RESPONSIBILITY PAYER B</a>", "<dt>B3</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "<dt>2011-10-26 00:00:00</dt>\n", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["640", "<a href=\"../../vivian-data/399_1/399.1-640.html\">CO-PAYMENT PAYER B</a>", "<dt>B7</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter The amount the provider assumes will be applied toward the \npatient&#x27;s co-payment amount involving the indicated payer.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["641", "<a href=\"../../vivian-data/399_1/399.1-641.html\">CO-PAYMENT PAYER C</a>", "<dt>C7</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter The amount the provider assumes is applied to the patient&#x27;s \nco-payment amount involving the indicated payer.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["642", "<a href=\"../../vivian-data/399_1/399.1-642.html\">CLINICAL TRIAL NUMBER ASSIGNED BY THE NLM/NIH</a>", "<dt>D4</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "<dt><pre>\nThis field is used to report the eight-digit clinical trial number \nassigned by the National Library of Medicine (NLM) or the National \nInstitutes of Health (NIH).\n \nA value containing multiple zeroes (e.g. 00000 ) is not allowed.\n</pre>\n</dt>\n", "<dt>I $G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["643", "<a href=\"../../vivian-data/399_1/399.1-643.html\">FACILITY WHERE INPATIENT HOSPICE SERVICE IS DELIVERED</a>", "<dt>G8</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "<dt><pre>\nThis code indicates the MSA or CBSA number (or rural state code) of the \nfacility where inpatient hospice care is delivered.\n \nA value containing multiple zeroes (e.g. 00000 ) is not allowed.\n</pre>\n</dt>\n", "<dt>I $G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["644", "<a href=\"../../vivian-data/399_1/399.1-644.html\">DISASTER RELATED OCCURRENCE CODE</a>", "<dt>DR</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["645", "<a href=\"../../vivian-data/399_1/399.1-645.html\">ATTESTATION OF UNRELATED OUTPATIENT NONDIAGNOSTIC SERVICES</a>", "<dt>51</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["646", "<a href=\"../../vivian-data/399_1/399.1-646.html\">MEDICARE COORDINATED CARE DEMONSTRATION CLAIM</a>", "<dt>BO</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["647", "<a href=\"../../vivian-data/399_1/399.1-647.html\">BENEFICIARY INELIGIBLE FOR DEMONSTRATION PROGRAM</a>", "<dt>B1</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["648", "<a href=\"../../vivian-data/399_1/399.1-648.html\">CRITICAL ACCESS HOSPITAL AMBULANCE ATTESTATION</a>", "<dt>B2</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["649", "<a href=\"../../vivian-data/399_1/399.1-649.html\">PREGNANCY INDICATOR</a>", "<dt>B3</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["65", "<a href=\"../../vivian-data/399_1/399.1-65.html\">ESTIMATED RESPONSIBILITY PAYER C</a>", "<dt>C3</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "<dt>2011-10-26 00:00:00</dt>\n", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["650", "<a href=\"../../vivian-data/399_1/399.1-650.html\">GULF OIL SPILL OF 2010</a>", "<dt>BP</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["652", "<a href=\"../../vivian-data/399_1/399.1-652.html\">DO NOT RESUCITATE (DNR) FOR PUBLIC HEALTH REPORTING ONLY</a>", "<dt>P1</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["653", "<a href=\"../../vivian-data/399_1/399.1-653.html\">UNITED MINE WORKERS OF AMERICA (UMWA) DEMO INDICATOR</a>", "<dt>WO</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["656", "<a href=\"../../vivian-data/399_1/399.1-656.html\">OUT OF HOSPICE SERVICE AREA</a>", "<dt>52</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["657", "<a href=\"../../vivian-data/399_1/399.1-657.html\">OFFSET TO THE PATIENT-PAYMENT AMOUN-PRESCRIPTION DRUGS</a>", "<dt>25</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["658", "<a href=\"../../vivian-data/399_1/399.1-658.html\">OFFSET TO THE PATIENT-PAYMENT AMOUNT-HEARING & EAR SERVICES</a>", "<dt>26</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["659", "<a href=\"../../vivian-data/399_1/399.1-659.html\">OFFSET TO THE PATIENT-PAYMENT AMOUNT-VISION & EYE SERVICES</a>", "<dt>27</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["66", "<a href=\"../../vivian-data/399_1/399.1-66.html\">DEDUCTIBLE PAYER A</a>", "<dt>A1</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["660", "<a href=\"../../vivian-data/399_1/399.1-660.html\">OFFSET TO THE PATIENT-PAYMENT AMOUNT-DENTAL SERVICES</a>", "<dt>28</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["661", "<a href=\"../../vivian-data/399_1/399.1-661.html\">OFFSET TO THE PATIENT-PAYMENT AMOUNT-CHIROPRACTIC SERVICES</a>", "<dt>29</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["662", "<a href=\"../../vivian-data/399_1/399.1-662.html\">OFFSET TO THE PATIENT-PAYMENT AMOUNT-PODIATRIC SERVICES</a>", "<dt>33</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["663", "<a href=\"../../vivian-data/399_1/399.1-663.html\">OFFSET TO THE PATIENT-PAYMENT AMOUNT-OTHER MEDICAL SERVICES</a>", "<dt>34</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["664", "<a href=\"../../vivian-data/399_1/399.1-664.html\">C-SECT/INDUCTIONS PERF AT LESS THAN 39 WKS GEST FOR MED NEC</a>", "<dt>81</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["665", "<a href=\"../../vivian-data/399_1/399.1-665.html\">C-SECT/INDUCTIONS PERF AT LESS THAN 39 WEEKS GEST ELECTIVELY</a>", "<dt>82</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["666", "<a href=\"../../vivian-data/399_1/399.1-666.html\">C-SECT/INDUCTIONS PERFORMED AT 39 WKS GESTATION OR GREATER</a>", "<dt>83</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["667", "<a href=\"../../vivian-data/399_1/399.1-667.html\">LABORATORY SERVICES PROVIDED TO NON-PATIENTS</a>", "<dt>4</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>1,3</dt>\n", "", "", "", ""], ["668", "<a href=\"../../vivian-data/399_1/399.1-668.html\">REG FOR REOPN RSN CODE-MATH OR COMPUTE MISTAKES</a>", "<dt>R1</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["669", "<a href=\"../../vivian-data/399_1/399.1-669.html\">REG FOR REOPN RSN CODE-INACCURATE DATA ENTRY</a>", "<dt>R2</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["67", "<a href=\"../../vivian-data/399_1/399.1-67.html\">DEDUCTIBLE PAYER B</a>", "<dt>B1</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["670", "<a href=\"../../vivian-data/399_1/399.1-670.html\">REG FOR REOPN RSN CODE-MISAPPLICATION OF A FREE SCHEDULE</a>", "<dt>R3</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["671", "<a href=\"../../vivian-data/399_1/399.1-671.html\">REG FOR REOPN RSN CODE-COMPUTER ERRORS</a>", "<dt>R4</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["672", "<a href=\"../../vivian-data/399_1/399.1-672.html\">REG FOR REOPN RSN CODE-INCORRECT IDENTIFY DUPLICATE CLAIM</a>", "<dt>R5</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["673", "<a href=\"../../vivian-data/399_1/399.1-673.html\">REG FPR REOPN RSN CODE-OTH CLER ERR OMIT NOT SPEC IN R1-R5</a>", "<dt>R6</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["674", "<a href=\"../../vivian-data/399_1/399.1-674.html\">REG FOR REOPN CODE-CORRECT OTHER THAN CLERICAL ERRORS</a>", "<dt>R7</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["675", "<a href=\"../../vivian-data/399_1/399.1-675.html\">REG FOR REOPN CODE-NEW AND MATERIAL EVIDENCE</a>", "<dt>R8</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["676", "<a href=\"../../vivian-data/399_1/399.1-676.html\">REG FOR REOPN CODE-FAULTY EVIDENCE</a>", "<dt>R9</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["677", "<a href=\"../../vivian-data/399_1/399.1-677.html\">NO SKILL HH VISITS IN BILL PERIOD. POLICY EXCEPT DOC AT HHA.</a>", "<dt>54</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["678", "<a href=\"../../vivian-data/399_1/399.1-678.html\">SHORTER DURATION HEMODIALYSIS</a>", "<dt>84</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "<dt><pre>\nThe number of sessions per week as specified in the plan of care for \nhemodialysis that is shorter in duration (RC 0826) than conventional \nsessions (RC 0821). (Official UB-04 Data Specifications Manual, 2017, \nversion 11.00, July 1, 2016, National Uniform Billing Committee)\n \nA value containing multiple zeroes (e.g. 00000 ) is not allowed.\n</pre>\n</dt>\n", "<dt>I $G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["679", "<a href=\"../../vivian-data/399_1/399.1-679.html\">INIT PLCMNT MED DEV PART CLINICAL TRIAL OR A FREE SAMPLE</a>", "<dt>53</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["68", "<a href=\"../../vivian-data/399_1/399.1-68.html\">DEDUCTIBLE PAYER C</a>", "<dt>C1</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["680", "<a href=\"../../vivian-data/399_1/399.1-680.html\">DIALYSIS FOR ACUTE KIDNEY INJURY (AKI)</a>", "<dt>84</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["681", "<a href=\"../../vivian-data/399_1/399.1-681.html\">DELAYED RECERTIFICATION OF HOSPICE TERMINAL ILLNESS</a>", "<dt>85</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["682", "<a href=\"../../vivian-data/399_1/399.1-682.html\">ADDNL HEMODIALYSIS TREATMENTS WITH MEDICAL JUSTIFICATION</a>", "<dt>86</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["683", "<a href=\"../../vivian-data/399_1/399.1-683.html\">ESRD SELF CARE RE-TRAINING</a>", "<dt>87</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["684", "<a href=\"../../vivian-data/399_1/399.1-684.html\">RESERVED FOR DISASTER RELATED OCCURRENCE SPAN CODE</a>", "<dt>MR</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", ""], ["685", "<a href=\"../../vivian-data/399_1/399.1-685.html\">NH HOSPICE</a>", "<dt>10</dt>\n", "<dt>NH HOSPICE</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["686", "<a href=\"../../vivian-data/399_1/399.1-686.html\">HOSPICE FOR ACUTE CARE</a>", "<dt>1</dt>\n", "<dt>HOSPICE GEN MED</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["687", "<a href=\"../../vivian-data/399_1/399.1-687.html\">SNF 3 DAY STAY BYPASS FOR NG/PIONEER ACD WAIVER</a>", "<dt>M3</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["688", "<a href=\"../../vivian-data/399_1/399.1-688.html\">GRANDFATHERED TRIBAL FQHC (MEDICARE ONLY CODE)</a>", "<dt>MG</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["689", "<a href=\"../../vivian-data/399_1/399.1-689.html\">HHA VISITS - PART A</a>", "<dt>62</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nThe number of visits determined by Medicare to be payable from the Part A \ntrust fund to reflect the shift of payments from the Part A to the Part B \nTrust Fund as mandated by 1812(a)(3) of the Social Security Act.\n \nA value containing multiple zeroes (e.g. 00000 ) is not allowed.\n</pre>\n</dt>\n", "<dt>I $G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["69", "<a href=\"../../vivian-data/399_1/399.1-69.html\">COINSURANCE PAYER A</a>", "<dt>A2</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["690", "<a href=\"../../vivian-data/399_1/399.1-690.html\">HHA VISITS - PART B</a>", "<dt>63</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nThe number of visits determined by Medicare to be payable from the Part A \ntrust fund to reflect the shift of payments from the Part A to the Part B \nTrust Fund as mandated by 1812(a)(3) of the Social Security Act.\n</pre>\n</dt>\n", "<dt>I $G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["691", "<a href=\"../../vivian-data/399_1/399.1-691.html\">HHA REIMBURSEMENT - PART A</a>", "<dt>64</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nThe dollar amounts determined to be associated with the HH visits \nidentified in a value code 62 amount. This Part A payment reflects the \nshift of payments from the Part A to the Part B Trust Fund as mandated \nby  1812(a)(3) of the Social Security Act.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["692", "<a href=\"../../vivian-data/399_1/399.1-692.html\">HHA REIMBURSEMENT - PART B</a>", "<dt>65</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nThe dollar amounts determined to be associated with the HH visits \nidentified in a value code 62 amount. This Part A payment reflects the \nshift of payments from the Part A to the Part B Trust Fund as mandated \nby  1812(a)(3) of the Social Security Act.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["693", "<a href=\"../../vivian-data/399_1/399.1-693.html\">GENE THERAPY INVOICE COST</a>", "<dt>87</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["694", "<a href=\"../../vivian-data/399_1/399.1-694.html\">CELL THERAPY INVOICE COST</a>", "<dt>90</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["695", "<a href=\"../../vivian-data/399_1/399.1-695.html\">HOSP SVCS PRVD IN A MBL FAC OR W PORT UNTS</a>", "<dt>A7</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["696", "<a href=\"../../vivian-data/399_1/399.1-696.html\">PACE ELIGIBLE PATIENT DISENROLLS DURING AN IP ADMISSION</a>", "<dt>35</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["697", "<a href=\"../../vivian-data/399_1/399.1-697.html\">INTENSIVE OUTPATIENT PROGRAM (IOP)</a>", "<dt>92</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["698", "<a href=\"../../vivian-data/399_1/399.1-698.html\">DOC ON FILE RQRMNTS SPECIFIED IN THE MED PLCY HVE BEEN MT</a>", "<dt>KX</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "", "", "", "", "", ""], ["7", "<a href=\"../../vivian-data/399_1/399.1-7.html\">OUTPATIENT VISIT</a>", "<dt>12</dt>\n", "<dt>OUTPATIENT</dt>\n", "", "<dt>YES</dt>\n", "", "<dt><a href=\"../../vivian-data/350_1/350.1-51.html\">DG OPT COPAY NEW</a></dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["70", "<a href=\"../../vivian-data/399_1/399.1-70.html\">COINSURANCE PAYER B</a>", "<dt>B2</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["71", "<a href=\"../../vivian-data/399_1/399.1-71.html\">COINSURANCE PAYER C</a>", "<dt>C2</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["72", "<a href=\"../../vivian-data/399_1/399.1-72.html\">PROF COMPONENT INCLUDED IN CHGS, BILLED SEPARATE TO CARRIER</a>", "<dt>05</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["73", "<a href=\"../../vivian-data/399_1/399.1-73.html\">MEDICARE BLOOD DEDUCTIBLE</a>", "<dt>06</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["74", "<a href=\"../../vivian-data/399_1/399.1-74.html\">WORKING AGED BENEF/SPOUSE WITH EMPLOYER GRP HEALTH PLAN</a>", "<dt>12</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["75", "<a href=\"../../vivian-data/399_1/399.1-75.html\">ESRD BENEF IN A MEDICARE COORD PD W/EMPLOYER GRP HEALTH</a>", "<dt>13</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["76", "<a href=\"../../vivian-data/399_1/399.1-76.html\">PHS OR OTHER FEDERAL AGENCY</a>", "<dt>16</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["77", "<a href=\"../../vivian-data/399_1/399.1-77.html\">CATASTROPHIC</a>", "<dt>21</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["78", "<a href=\"../../vivian-data/399_1/399.1-78.html\">SURPLUS</a>", "<dt>22</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["79", "<a href=\"../../vivian-data/399_1/399.1-79.html\">RECURRING MONTHLY INCOME</a>", "<dt>23</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["8", "<a href=\"../../vivian-data/399_1/399.1-8.html\">PRESCRIPTION</a>", "<dt>9</dt>\n", "<dt>PRESCRIPT</dt>\n", "", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["80", "<a href=\"../../vivian-data/399_1/399.1-80.html\">MEDICAID RATE CODE</a>", "<dt>24</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nMedicaid-eligibility requirements to be determined at state level.\n \nA value containing multiple zeroes (e.g. 00000 ) is not allowed.\n</pre>\n</dt>\n", "<dt>I $G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["81", "<a href=\"../../vivian-data/399_1/399.1-81.html\">PREADMISSION TESTING</a>", "<dt>30</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["82", "<a href=\"../../vivian-data/399_1/399.1-82.html\">PATIENT LIABILITY AMOUNT</a>", "<dt>31</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["83", "<a href=\"../../vivian-data/399_1/399.1-83.html\">UNITS OF BLOOD FURNISHED</a>", "<dt>37</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter the total number of pints of whole blood or\nunits of packed red cells furnished to the patient.\n</pre>\n</dt>\n", ""], ["84", "<a href=\"../../vivian-data/399_1/399.1-84.html\">BLOOD DEDUCTIBLE UNITS</a>", "<dt>38</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter the total number of pints of whole blood or\nunits of packed red cells furnished to the patient.\n</pre>\n</dt>\n", ""], ["85", "<a href=\"../../vivian-data/399_1/399.1-85.html\">NEW COVERAGE NOT IMPLEMENTED BY HMO (INPT ONLY)</a>", "<dt>40</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n \nZero not allowed.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["86", "<a href=\"../../vivian-data/399_1/399.1-86.html\">BLACK LUNG</a>", "<dt>41</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["87", "<a href=\"../../vivian-data/399_1/399.1-87.html\">VA</a>", "<dt>42</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["88", "<a href=\"../../vivian-data/399_1/399.1-88.html\">DISABLED BENEFICIARY UNDER AGE OF 65 WITH LGHP</a>", "<dt>43</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["89", "<a href=\"../../vivian-data/399_1/399.1-89.html\">AMT AGRED FRM PRIME<CHGS&>PYMT > THN PYMT REC, MSP CLMS</a>", "<dt>44</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["9", "<a href=\"../../vivian-data/399_1/399.1-9.html\">PSYCHIATRIC CARE</a>", "<dt>3</dt>\n", "<dt>PSYCH CARE</dt>\n", "", "<dt>YES</dt>\n", "", "<dt><a href=\"../../vivian-data/350_1/350.1-18.html\">DG INPT COPAY (PSY) NEW</a></dt>\n", "<dt><a href=\"../../vivian-data/350_1/350.1-45.html\">DG INPT PER DIEM NEW</a></dt>\n", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["90", "<a href=\"../../vivian-data/399_1/399.1-90.html\">NUMBER OF GRACE DAYS</a>", "<dt>46</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter the number of days determined by the QIO (medical\nnecessity reviewer) as needed to arrange for post-discharge\ncare.\n</pre>\n</dt>\n", ""], ["91", "<a href=\"../../vivian-data/399_1/399.1-91.html\">ANY LIABILITY INSURANCE</a>", "<dt>47</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>YES</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter a monetary amount associated with this value code.\nEnter it in the format of dollars and cents (00.00).\n \nIf you enter only dollars (00), the system will add on .00 cents.\nMaximum length INCLUDING the cents, is 9 numbers.\n</pre>\n</dt>\n", ""], ["92", "<a href=\"../../vivian-data/399_1/399.1-92.html\">HEMOGLOBIN READING</a>", "<dt>48</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter the most recent hemoglobin reading taken before\nthe start of this billing period.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["93", "<a href=\"../../vivian-data/399_1/399.1-93.html\">HEMATOCRIT READING</a>", "<dt>49</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter the most recent hematocrit reading taken before\nthe start of this billing period.\n</pre>\n</dt>\n", "<dt>I +$G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["94", "<a href=\"../../vivian-data/399_1/399.1-94.html\">PHYSICAL THERAPY VISIT</a>", "<dt>50</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter the number of physical therapy visits provided\nfrom the onset of treatment by this billing provider\nthrough this billing period.\n \nA value containing multiple zeroes (e.g. 00000 ) is not allowed.\n</pre>\n</dt>\n", "<dt>I $G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["95", "<a href=\"../../vivian-data/399_1/399.1-95.html\">OCCUPATIONAL THERAPY VISITS</a>", "<dt>51</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter the number of occupational therapy visits provided\nfrom the onset of treatment by this billing provider\nthrough this billing period.\n \nA value containing multiple zeroes (e.g. 00000 ) is not allowed.\n</pre>\n</dt>\n", "<dt>I $G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["96", "<a href=\"../../vivian-data/399_1/399.1-96.html\">SPEECH-LANGUAGE THERAPY VISITS</a>", "<dt>52</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter the number of speech therapy visits provided\nfrom the onset of treatment by this billing provider\nthrough this billing period.\n \nA value containing multiple zeroes (e.g. 00000 ) is not allowed.\n</pre>\n</dt>\n", "<dt>I $G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["97", "<a href=\"../../vivian-data/399_1/399.1-97.html\">CARDIAC REHAB VISITS</a>", "<dt>53</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter the number of cardiac rehabilitation visits provided\nfrom the onset of treatment by this billing provider\nthrough this billing period.\n \nA value containing multiple zeroes (e.g. 00000 ) is not allowed.\n</pre>\n</dt>\n", "<dt>I $G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["98", "<a href=\"../../vivian-data/399_1/399.1-98.html\">SKILLED NURSE - HOME VISIT HOURS (HHA ONLY)</a>", "<dt>56</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter the number of home visit hours of skilled\nnursing provided during the billing period. Do\nnot include travel time. Enter whole hours.\n \nA value containing multiple zeroes (e.g. 00000 ) is not allowed.\n</pre>\n</dt>\n", "<dt>I $G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"], ["99", "<a href=\"../../vivian-data/399_1/399.1-99.html\">HOME HEALTH AIDE - HOME VISIT HOURS (HHA ONLY)</a>", "<dt>57</dt>\n", "", "", "", "", "", "", "", "", "<dt>YES</dt>\n", "<dt>NO</dt>\n", "", "", "", "", "", "", "", "<dt><pre>\nEnter the number of home health aide hours of service\nprovided during the billing period. Do\nnot include travel time. Enter whole hours.\n \nA value containing multiple zeroes (e.g. 00000 ) is not allowed.\n</pre>\n</dt>\n", "<dt>I $G(IBVCVALUE)=0,$G(IBER)'[(\"916;\") S IBQUIT=$$IBER^IBCBB3(.IBER,916),IBVCERR=1</dt>\n"]]}