| CAPTION LINE COLUMNS |
-
- ITEM NAME: SERVDATE
- COLUMN: 50
- WIDTH: 10
- DISPLAY TEXT: DOS
-
- ITEM NAME: PRIMINSUR
- COLUMN: 76
- WIDTH: 20
- DISPLAY TEXT: Primary Insurance
-
- ITEM NAME: SECINSUR
- COLUMN: 98
- WIDTH: 20
- DISPLAY TEXT: Secondary Insurance
-
- ITEM NAME: DAYSONGRPWL
- COLUMN: 60
- WIDTH: 4
- DISPLAY TEXT: Days
-
- ITEM NAME: PTNAME
- COLUMN: 9
- WIDTH: 20
- DISPLAY TEXT: Patient Name
- SCROLL LOCK: NO
-
- ITEM NAME: SSN
- COLUMN: 30
- WIDTH: 4
- DISPLAY TEXT: SSN
- SCROLL LOCK: YES
-
- ITEM NAME: REASCODE
- COLUMN: 181
- WIDTH: 45
- DISPLAY TEXT: Error Code Text
-
- ITEM NAME: PATTYPE
- COLUMN: 46
- WIDTH: 3
- DISPLAY TEXT: I/O
-
- ITEM NAME: PAIDAMT
- COLUMN: 65
- WIDTH: 10
- DISPLAY TEXT: Amt Paid
-
- ITEM NAME: DIVNAME
- COLUMN: 119
- WIDTH: 30
- DISPLAY TEXT: Division
-
- ITEM NAME: SERVFACNM
- COLUMN: 150
- WIDTH: 30
- DISPLAY TEXT: Service Facility
-
- ITEM NAME: LINENUM
- COLUMN: 1
- WIDTH: 6
-
- ITEM NAME: INDICATOR
- COLUMN: 7
- WIDTH: 2
-
- ITEM NAME: DOB
- COLUMN: 35
- WIDTH: 10
- DISPLAY TEXT: DOB
|