| CAPTION LINE COLUMNS |
-
- ITEM NAME: LINENUM
- COLUMN: 1
- WIDTH: 6
-
- ITEM NAME: SERVCON
- COLUMN: 182
- WIDTH: 5
- DISPLAY TEXT: SC/SA
-
- ITEM NAME: PROVNPI
- COLUMN: 143
- WIDTH: 10
- DISPLAY TEXT: ProvNPI
-
- ITEM NAME: REASCODE
- COLUMN: 56
- WIDTH: 30
- DISPLAY TEXT: Error Code Text
-
- ITEM NAME: DAYSONGRPWL
- COLUMN: 51
- WIDTH: 4
- DISPLAY TEXT: Days
-
- ITEM NAME: PROVIDER
- COLUMN: 127
- WIDTH: 15
- DISPLAY TEXT: Ren/Attn Prov
-
- ITEM NAME: SERVFACNM
- COLUMN: 154
- WIDTH: 16
- DISPLAY TEXT: SerFac
-
- ITEM NAME: FACNPI
- COLUMN: 171
- WIDTH: 10
- DISPLAY TEXT: FacNPI
-
- ITEM NAME: PTNAME
- COLUMN: 9
- WIDTH: 20
- DISPLAY TEXT: Patient Name
- SCROLL LOCK: NO
-
- ITEM NAME: INDICATOR
- COLUMN: 7
- WIDTH: 2
-
- ITEM NAME: BILLNUM
- COLUMN: 209
- WIDTH: 20
- DISPLAY TEXT: Bill/Enc #
-
- ITEM NAME: PAYERCON
- COLUMN: 188
- WIDTH: 20
- DISPLAY TEXT: Payer Control #
-
- ITEM NAME: PAIDAMT
- COLUMN: 230
- WIDTH: 10
- DISPLAY TEXT: Amt Paid
-
- ITEM NAME: SSN
- COLUMN: 30
- WIDTH: 9
- DISPLAY TEXT: SSN
- SCROLL LOCK: YES
-
- ITEM NAME: SERVDATE
- COLUMN: 40
- WIDTH: 10
- DISPLAY TEXT: DOS
-
- ITEM NAME: PRIMINSUR
- COLUMN: 87
- WIDTH: 20
- DISPLAY TEXT: Primary Insurance
-
- ITEM NAME: SECINSUR
- COLUMN: 108
- WIDTH: 18
- DISPLAY TEXT: Secondary Insurance
|