FEE BASIS FILE 161 R ICR (5777)

Name

Value

NUMBER

5777

IA #

5777

FILE NUMBER

161

GLOBAL ROOT

FBAAA(

DATE CREATED

2012/03/05

CUSTODIAL PACKAGE

FEE BASIS

USAGE

Controlled Subscription

TYPE

File

DBIC APPROVAL STATUS

APPROVED

NAME

FEE BASIS FILE 161 R

GENERAL DESCRIPTION

NwHIN Direct accesses the FEE BASIS PATIENT (#161) file to read.

GLOBAL REFERENCE

FIELD NUMBER

FBAAA(DA,0)

FIELD NUMBER	ACCESS	FIELD NAME	LOCATION
.01	Read w/Fileman	NAME	0;1

FBAAA(D0,1,0)

FIELD NUMBER	ACCESS	FIELD NAME	LOCATION
1	Read w/Fileman	AUTHORIZATION	0;4

FBAAA(D0,1,D1,0)

FIELD NUMBER	ACCESS	FIELD NAME	LOCATION
.01	Read w/Fileman	FROM DATE	0;1
.02	Read w/Fileman	TO DATE	0;2
.03	Read w/Fileman	FEE PROGRAM	0;3
.04	Read w/Fileman	VENDOR	0;4
.07	Read w/Fileman	PURPOSE OF VISIT CODE	0;7
.08	Read w/Fileman	DX LINE 1	0;8
.095	Read w/Fileman	TREATMENT TYPE CODE	0;13
.06	Read w/Fileman	DISCHARGE TYPE	0;15
.065	Read w/Fileman	PATIENT TYPE CODE	0;18
.096	Read w/Fileman	ACCIDENT RELATED (Y/N)	0;19
.097	Read w/Fileman	POTENTIAL COST RECOV	0;20
2	Read w/Fileman	TYPE OF CARE	0;14
101	Read w/Fileman	PRIMARY SERVICE AREA	0;5
104	Read w/Fileman	REFERRING PROVIDER	0;21

FBAAA(D0,1,D1,1)

FIELD NUMBER	ACCESS	FIELD NAME	LOCATION
3	Read w/Fileman	DATED PRINTED	1;2

FBAAA(D0,1,D1,2,0)

FIELD NUMBER	ACCESS	FIELD NAME
.021	Read w/Fileman	AUTHORIZATION REMARKS

FBAAA(D0,1,D1,2,D2,0)

FIELD NUMBER	ACCESS	FIELD NAME	LOCATION
.01	Read w/Fileman	AUTHORIZATION REMARK	0;1

FBAAA(D0,1,D1,3)

FIELD NUMBER	ACCESS	FIELD NAME	LOCATION
.086	Read w/Fileman	DX LINE 3	3;2
.085	Read w/Fileman	DX LINE 2	3;1

FBAAA(D0,1,D1,100)

FIELD NUMBER	ACCESS	FIELD NAME	LOCATION
100	Read w/Fileman	CLERK	100;1

FBAAA(D0,1,D1,'C')

FIELD NUMBER	ACCESS	FIELD NAME	LOCATION
1	Read w/Fileman	PRINT AUTHORIZATION	'C';1

FBAAA(D0,4)

FIELD NUMBER	ACCESS	FIELD NAME	LOCATION
.5	Read w/Fileman	FEE ID CARD NUMBER	4;1
.6	Read w/Fileman	FEE ID CARD ISSUE DATE	4;2

STATUS

Active

KEYWORDS

FEE BASIS
NwHIN

DURATION

Till Otherwise Agreed

FBAAA(

SUBSCRIBING PACKAGE

NATIONAL HEALTH INFO NETWORK

DATE ACTIVATED

2012/03/29