FB*3.5*103 (7661)    BUILD (9.6)

Name Value
NAME FB*3.5*103
DATE DISTRIBUTED 2008-05-30 00:00:00
PACKAGE FILE LINK FEE BASIS
REQUIRED BUILD
  • XU*8.0*480
    ACTION:   Don't install, leave global
  • FB*3.5*101
    ACTION:   Don't install, leave global
  • FB*3.5*51
    ACTION:   Don't install, leave global
  • FB*3.5*43
    ACTION:   Don't install, leave global
TYPE SINGLE PACKAGE
DESCRIPTION OF ENHANCEMENTS 
Add the Referring Provider NPI Information to 10-7078 and 10-7079
Fee Authorization Forms.
TRACK PACKAGE NATIONALLY YES
XPI1 NO
XPZ1 YES
FILE
  • DD NUMBER:
    • AUTHORIZATION (sub-file)
      FIELD NUMBER:
      • REFERRING PROVIDER
    UPDATE THE DATA DICTIONARY:   YES
    SEND SECURITY CODE:   NO
    SEND FULL OR PARTIAL DD:   PARTIAL
    DATA COMES WITH FILE:   NO
    MAY USER OVERRIDE DATA UPDATE:   NO
  • DD NUMBER:
    • FEE NOTIFICATION/REQUEST (File-top level)
      FIELD NUMBER:
      • REFERRING PROVIDER
    UPDATE THE DATA DICTIONARY:   YES
    SEND SECURITY CODE:   NO
    SEND FULL OR PARTIAL DD:   PARTIAL
    DATA COMES WITH FILE:   NO
    MAY USER OVERRIDE DATA UPDATE:   NO
  • DD NUMBER:
    • VA FORM 10-7078 (File-top level)
      FIELD NUMBER:
      • REFERRING PROVIDER
      • REFERRING PROVIDER NPI
    UPDATE THE DATA DICTIONARY:   YES
    SEND SECURITY CODE:   NO
    SEND FULL OR PARTIAL DD:   PARTIAL
    DATA COMES WITH FILE:   NO
    MAY USER OVERRIDE DATA UPDATE:   NO
SEQ# 96
BUILD COMPONENTS
  • ENTRIES:
  • ENTRIES:
    • FB REF PROV NPI
      ACTION:   SEND TO SITE
  • ENTRIES:
    • FBNHEDAT
      ACTION:   SEND TO SITE
      CHECKSUM:   B13820385
    • FBCHP78
      ACTION:   SEND TO SITE
      CHECKSUM:   B33711436
    • FBAADEM1
      ACTION:   SEND TO SITE
      CHECKSUM:   B13894268
    • FBAAAUT
      ACTION:   SEND TO SITE
      CHECKSUM:   B13109090
    • FBPCR
      ACTION:   SEND TO SITE
      CHECKSUM:   B63936182
    • FBNHEAUT
      ACTION:   SEND TO SITE
      CHECKSUM:   B25443874
    • FBNHEAU1
      ACTION:   SEND TO SITE
      CHECKSUM:   B5124970
    • FBCHREQ1
      ACTION:   SEND TO SITE
      CHECKSUM:   B12310672
    • FBAA79A
      ACTION:   SEND TO SITE
      CHECKSUM:   B22503574
    • FBCH78A
      ACTION:   SEND TO SITE
      CHECKSUM:   B17933275
    • FBAA79
      ACTION:   SEND TO SITE
      CHECKSUM:   B22492731
    • FBCH78
      ACTION:   SEND TO SITE
      CHECKSUM:   B31111171