VistA-WorldVistAEHR/g/IBA.zwr

FirstRelease WVEHR VER VOE1.0
Cache 31-Jan-2008 23:07:04 ZWR
^IBA(351.5,0)="TRICARE PHARMACY TRANSACTIONS^351.5^^"
^IBA(351.52,0)="TRICARE PHARMACY REJECTS^351.52^^"
^IBA(351.53,0)="PRODUCT SELECTION REASON^351.53I^10^10"
^IBA(351.53,1,0)="0^No Product Selection Indicated (Default)^DEFAULT"
^IBA(351.53,2,0)="1^Substitution Not Allowed by Prescriber^DOCTOR WANTS"
^IBA(351.53,3,0)="2^Subst. Allowed - Patient Requested Product Dispensed^PATIENT REQUEST"
^IBA(351.53,4,0)="3^Subst. Allowed - Pharmacist Selected Product Dispensed^PHARMACY REQUEST"
^IBA(351.53,5,0)="4^Subst. Allowed - Generic Drug Not In Stock^GENERIC NOT IN STOCK"
^IBA(351.53,6,0)="5^Subst. Allowed - Brand Drug Dispensed As Generic^BRAND AS GENERIC"
^IBA(351.53,7,0)="6^Override^OVERRIDE"
^IBA(351.53,8,0)="7^Subst. Not Allowed - Brand Drug Mandated By Law^BRAND MANDATED"
^IBA(351.53,9,0)="8^Subst. Allowed - Generic Not Available In Marketplace^GENERIC NOT AVAILABLE"
^IBA(351.53,10,0)="9^Other^OTHER"
^IBA(351.53,"B",0,1)=""
^IBA(351.53,"B",1,2)=""
^IBA(351.53,"B",2,3)=""
^IBA(351.53,"B",3,4)=""
^IBA(351.53,"B",4,5)=""
^IBA(351.53,"B",5,6)=""
^IBA(351.53,"B",6,7)=""
^IBA(351.53,"B",7,8)=""
^IBA(351.53,"B",8,9)=""
^IBA(351.53,"B",9,10)=""
^IBA(351.81,0)="LTC COPAY CLOCK^351.81I^^"
^IBA(351.9,0)="CLAIMSMANAGER BILLS^351.9P^^"
^IBA(351.91,0)="CLAIMSMANAGER STATUS^351.91^11^11"
^IBA(351.91,1,0)="LOGGED NOT SENT TO CLAIMSMANAGER^NOT SENT TO CM"
^IBA(351.91,2,0)="SENT TO CLAIMSMANAGER^SENT TO CM"
^IBA(351.91,3,0)="PASSED CLAIMSMANAGER - NO ERRORS^PASS CM W/O ERR"
^IBA(351.91,4,0)="RETURNED WITH ERRORS^ERRORS RETURNED"
^IBA(351.91,5,0)="ERRORS OVERRIDDEN^ERRORS OVERRIDEN"
^IBA(351.91,6,0)="ERROR - COMMUNICATION FAILURE^COMM FAILURE"
^IBA(351.91,7,0)="CLAIMSMANAGER NOT WORKING^CM NOT WORKING"
^IBA(351.91,8,0)="SENT TO CLAIMSMANAGER - HISTORICAL^CM HISTORICAL"
^IBA(351.91,9,0)="CANCELLED^CANCELLED"
^IBA(351.91,10,0)="CANCELLED - NOT UPDATED IN CLAIMSMANAGER^CANCEL PROBLEM"
^IBA(351.91,11,0)="OVERRIDDEN - NOT UPDATED IN CLAIMSMANAGER^OVERRIDE PROBLEM"
^IBA(351.91,"B","CANCELLED",9)=""
^IBA(351.91,"B","CANCELLED - NOT UPDATED IN CLA",10)=""
^IBA(351.91,"B","CLAIMSMANAGER NOT WORKING",7)=""
^IBA(351.91,"B","ERROR - COMMUNICATION FAILURE",6)=""
^IBA(351.91,"B","ERRORS OVERRIDDEN",5)=""
^IBA(351.91,"B","LOGGED NOT SENT TO CLAIMSMANAG",1)=""
^IBA(351.91,"B","OVERRIDDEN - NOT UPDATED IN CL",11)=""
^IBA(351.91,"B","PASSED CLAIMSMANAGER - NO ERRO",3)=""
^IBA(351.91,"B","RETURNED WITH ERRORS",4)=""
^IBA(351.91,"B","SENT TO CLAIMSMANAGER",2)=""
^IBA(351.91,"B","SENT TO CLAIMSMANAGER - HISTOR",8)=""
^IBA(354,0)="BILLING PATIENT^354PI^^"
^IBA(354.1,0)="BILLING EXEMPTIONS^354.1ID^^"
^IBA(354.4,0)="BILLING ALERTS^354.4P^^"
^IBA(355.3,0)="GROUP INSURANCE PLAN^355.3IP^^"
^IBA(355.32,0)="PLAN COVERAGE LIMITATIONS^355.32IP^^"
^IBA(355.33,0)="INSURANCE BUFFER^355.33D^^"
^IBA(355.34,0)="INSURANCE REMOTE QUERY RESULTS^355.34D^^"
^IBA(355.4,0)="ANNUAL BENEFITS^355.4ID^^"
^IBA(355.5,0)="INSURANCE CLAIMS YEAR TO DATE^355.5P^^"
^IBA(355.7,0)="PERSONAL POLICY^355.7PI^^"
^IBA(355.8,0)="SPONSOR^355.8V^^"
^IBA(355.81,0)="SPONSOR RELATIONSHIP^355.81P^^"
^IBA(355.82,0)="SPONSOR PERSON^355.82I^^"
^IBA(355.9,0)="IB BILLING PRACTITIONER ID^355.9IV^1^1"
^IBA(355.9,1,0)="21;VA(200,^^^0^0^22^987654321^^^^^^^^*ALL*^*N/A*"
^IBA(355.9,"AC",22,"*ALL*","21;VA(200,",1)=""
^IBA(355.9,"AD",22,"21;VA(200,","*ALL*",1)=""
^IBA(355.9,"AG","ALL","TBD",1)=""
^IBA(355.9,"AUNIQ","21;VA(200,","*ALL*","*N/A*",0,0,22,1)=""
^IBA(355.9,"B","21;VA(200,",1)=""
^IBA(355.9,"C",987654321,1)=""
^IBA(355.91,0)="IB INSURANCE CO LEVEL BILLING PROV ID^355.91IP^^"
^IBA(355.92,0)="FACILITY BILLING ID^355.92P^^"
^IBA(355.93,0)="IB NON/OTHER VA BILLING PROVIDER^355.93I^^0"
^IBA(355.95,0)="IB PROVIDER ID CARE UNIT^355.95I^^"
^IBA(355.96,0)="IB INS CO PROVIDER ID CARE UNIT^355.96IP^^"
^IBA(362.1,0)="IB AUTOMATED BILLING COMMENTS^362.1I^^"
^IBA(362.3,0)="IB BILL/CLAIMS DIAGNOSIS^362.3IP^^"
^IBA(362.4,0)="IB BILL/CLAIMS PRESCRIPTION REFILL^362.4I^^"
^IBA(362.5,0)="IB BILL/CLAIMS PROSTHETICS^362.5D^^"
^IBA(363.2,0)="CHARGE ITEM^363.2V^484^479"
^IBA(363.2,1,0)="1;DGCR(399.1,^1^2921001^^337"
^IBA(363.2,2,0)="2;DGCR(399.1,^1^2921001^^644"
^IBA(363.2,3,0)="3;DGCR(399.1,^1^2921001^^802"
^IBA(363.2,4,0)="4;DGCR(399.1,^1^2921001^^317"
^IBA(363.2,5,0)="5;DGCR(399.1,^1^2921001^^712"
^IBA(363.2,6,0)="6;DGCR(399.1,^1^2921001^^227"
^IBA(363.2,7,0)="9;DGCR(399.1,^1^2921001^^410"
^IBA(363.2,8,0)="10;DGCR(399.1,^1^2921001^^566"
^IBA(363.2,9,0)="11;DGCR(399.1,^1^2921001^^761"
^IBA(363.2,10,0)="12;DGCR(399.1,^1^2921001^^1164"
^IBA(363.2,11,0)="1;DGCR(399.1,^2^2921001^^204^101"
^IBA(363.2,12,0)="1;DGCR(399.1,^2^2921001^^70^240"
^IBA(363.2,13,0)="2;DGCR(399.1,^2^2921001^^241^101"
^IBA(363.2,14,0)="2;DGCR(399.1,^2^2921001^^317^240"
^IBA(363.2,15,0)="3;DGCR(399.1,^2^2921001^^450^101"
^IBA(363.2,16,0)="3;DGCR(399.1,^2^2921001^^197^240"
^IBA(363.2,17,0)="4;DGCR(399.1,^2^2921001^^227^101"
^IBA(363.2,18,0)="4;DGCR(399.1,^2^2921001^^44^240"
^IBA(363.2,19,0)="5;DGCR(399.1,^2^2921001^^397^101"
^IBA(363.2,20,0)="5;DGCR(399.1,^2^2921001^^227^240"
^IBA(363.2,21,0)="6;DGCR(399.1,^2^2921001^^184^101"
^IBA(363.2,22,0)="6;DGCR(399.1,^2^2921001^^32^240"
^IBA(363.2,23,0)="9;DGCR(399.1,^2^2921001^^291^101"
^IBA(363.2,24,0)="9;DGCR(399.1,^2^2921001^^64^240"
^IBA(363.2,25,0)="10;DGCR(399.1,^2^2921001^^327^101"
^IBA(363.2,26,0)="10;DGCR(399.1,^2^2921001^^173^240"
^IBA(363.2,27,0)="11;DGCR(399.1,^2^2921001^^447^101"
^IBA(363.2,28,0)="11;DGCR(399.1,^2^2921001^^223^240"
^IBA(363.2,29,0)="12;DGCR(399.1,^2^2921001^^642^101"
^IBA(363.2,30,0)="12;DGCR(399.1,^2^2921001^^304^240"
^IBA(363.2,31,0)="1;DGCR(399.1,^3^2921001^^63"
^IBA(363.2,32,0)="2;DGCR(399.1,^3^2921001^^86"
^IBA(363.2,33,0)="3;DGCR(399.1,^3^2921001^^155"
^IBA(363.2,34,0)="4;DGCR(399.1,^3^2921001^^46"
^IBA(363.2,35,0)="5;DGCR(399.1,^3^2921001^^88"
^IBA(363.2,36,0)="6;DGCR(399.1,^3^2921001^^11"
^IBA(363.2,37,0)="9;DGCR(399.1,^3^2921001^^55"
^IBA(363.2,38,0)="10;DGCR(399.1,^3^2921001^^66"
^IBA(363.2,39,0)="11;DGCR(399.1,^3^2921001^^91"
^IBA(363.2,40,0)="12;DGCR(399.1,^3^2921001^^218"
^IBA(363.2,41,0)="7;DGCR(399.1,^4^2921001^^163"
^IBA(363.2,42,0)="8;DGCR(399.1,^5^2921001^^20"
^IBA(363.2,43,0)="31;DGCR(399.1,^6^2921001^^97"
^IBA(363.2,45,0)="1;DGCR(399.1,^1^2931001^^339"
^IBA(363.2,46,0)="2;DGCR(399.1,^1^2931001^^674"
^IBA(363.2,47,0)="3;DGCR(399.1,^1^2931001^^827"
^IBA(363.2,48,0)="4;DGCR(399.1,^1^2931001^^343"
^IBA(363.2,49,0)="5;DGCR(399.1,^1^2931001^^764"
^IBA(363.2,50,0)="6;DGCR(399.1,^1^2931001^^240"
^IBA(363.2,51,0)="9;DGCR(399.1,^1^2931001^^357"
^IBA(363.2,52,0)="10;DGCR(399.1,^1^2931001^^587"
^IBA(363.2,53,0)="11;DGCR(399.1,^1^2931001^^779"
^IBA(363.2,54,0)="12;DGCR(399.1,^1^2931001^^1294"
^IBA(363.2,55,0)="1;DGCR(399.1,^2^2931001^^206^101"
^IBA(363.2,56,0)="1;DGCR(399.1,^2^2931001^^70^240"
^IBA(363.2,57,0)="2;DGCR(399.1,^2^2931001^^252^101"
^IBA(363.2,58,0)="2;DGCR(399.1,^2^2931001^^332^240"
^IBA(363.2,59,0)="3;DGCR(399.1,^2^2931001^^464^101"
^IBA(363.2,60,0)="3;DGCR(399.1,^2^2931001^^203^240"
^IBA(363.2,61,0)="4;DGCR(399.1,^2^2931001^^246^101"
^IBA(363.2,62,0)="4;DGCR(399.1,^2^2931001^^48^240"
^IBA(363.2,63,0)="5;DGCR(399.1,^2^2931001^^426^101"
^IBA(363.2,64,0)="5;DGCR(399.1,^2^2931001^^243^240"
^IBA(363.2,65,0)="6;DGCR(399.1,^2^2931001^^195^101"
^IBA(363.2,66,0)="6;DGCR(399.1,^2^2931001^^34^240"
^IBA(363.2,67,0)="9;DGCR(399.1,^2^2931001^^253^101"
^IBA(363.2,68,0)="9;DGCR(399.1,^2^2931001^^56^240"
^IBA(363.2,69,0)="10;DGCR(399.1,^2^2931001^^339^101"
^IBA(363.2,70,0)="10;DGCR(399.1,^2^2931001^^179^240"
^IBA(363.2,71,0)="11;DGCR(399.1,^2^2931001^^458^101"
^IBA(363.2,72,0)="11;DGCR(399.1,^2^2931001^^228^240"
^IBA(363.2,73,0)="12;DGCR(399.1,^2^2931001^^714^101"
^IBA(363.2,74,0)="12;DGCR(399.1,^2^2931001^^338^240"
^IBA(363.2,75,0)="1;DGCR(399.1,^3^2931001^^63"
^IBA(363.2,76,0)="2;DGCR(399.1,^3^2931001^^90"
^IBA(363.2,77,0)="3;DGCR(399.1,^3^2931001^^160"
^IBA(363.2,78,0)="4;DGCR(399.1,^3^2931001^^49"
^IBA(363.2,79,0)="5;DGCR(399.1,^3^2931001^^95"
^IBA(363.2,80,0)="6;DGCR(399.1,^3^2931001^^11"
^IBA(363.2,81,0)="9;DGCR(399.1,^3^2931001^^48"
^IBA(363.2,82,0)="10;DGCR(399.1,^3^2931001^^69"
^IBA(363.2,83,0)="11;DGCR(399.1,^3^2931001^^93"
^IBA(363.2,84,0)="12;DGCR(399.1,^3^2931001^^242"
^IBA(363.2,85,0)="7;DGCR(399.1,^4^2931001^^178"
^IBA(363.2,86,0)="8;DGCR(399.1,^5^2931001^^20"
^IBA(363.2,87,0)="31;DGCR(399.1,^6^2931001^^102"
^IBA(363.2,89,0)="1;DGCR(399.1,^1^2941001^^290"
^IBA(363.2,90,0)="2;DGCR(399.1,^1^2941001^^676"
^IBA(363.2,91,0)="3;DGCR(399.1,^1^2941001^^849"
^IBA(363.2,92,0)="4;DGCR(399.1,^1^2941001^^322"
^IBA(363.2,93,0)="5;DGCR(399.1,^1^2941001^^762"
^IBA(363.2,94,0)="6;DGCR(399.1,^1^2941001^^244"
^IBA(363.2,95,0)="9;DGCR(399.1,^1^2941001^^411"
^IBA(363.2,96,0)="10;DGCR(399.1,^1^2941001^^612"
^IBA(363.2,97,0)="11;DGCR(399.1,^1^2941001^^775"
^IBA(363.2,98,0)="12;DGCR(399.1,^1^2941001^^1350"
^IBA(363.2,99,0)="1;DGCR(399.1,^2^2941001^^175^101"
^IBA(363.2,100,0)="1;DGCR(399.1,^2^2941001^^61^240"
^IBA(363.2,101,0)="2;DGCR(399.1,^2^2941001^^253^101"
^IBA(363.2,102,0)="2;DGCR(399.1,^2^2941001^^333^240"
^IBA(363.2,103,0)="3;DGCR(399.1,^2^2941001^^477^101"
^IBA(363.2,104,0)="3;DGCR(399.1,^2^2941001^^208^240"
^IBA(363.2,105,0)="4;DGCR(399.1,^2^2941001^^231^101"
^IBA(363.2,106,0)="4;DGCR(399.1,^2^2941001^^45^240"
^IBA(363.2,107,0)="5;DGCR(399.1,^2^2941001^^425^101"
^IBA(363.2,108,0)="5;DGCR(399.1,^2^2941001^^243^240"
^IBA(363.2,109,0)="6;DGCR(399.1,^2^2941001^^198^101"
^IBA(363.2,110,0)="6;DGCR(399.1,^2^2941001^^35^240"
^IBA(363.2,111,0)="9;DGCR(399.1,^2^2941001^^292^101"
^IBA(363.2,112,0)="9;DGCR(399.1,^2^2941001^^64^240"
^IBA(363.2,113,0)="10;DGCR(399.1,^2^2941001^^354^101"
^IBA(363.2,114,0)="10;DGCR(399.1,^2^2941001^^187^240"
^IBA(363.2,115,0)="11;DGCR(399.1,^2^2941001^^456^101"
^IBA(363.2,116,0)="11;DGCR(399.1,^2^2941001^^227^240"
^IBA(363.2,117,0)="12;DGCR(399.1,^2^2941001^^745^101"
^IBA(363.2,118,0)="12;DGCR(399.1,^2^2941001^^354^240"
^IBA(363.2,119,0)="1;DGCR(399.1,^3^2941001^^54"
^IBA(363.2,120,0)="2;DGCR(399.1,^3^2941001^^90"
^IBA(363.2,121,0)="3;DGCR(399.1,^3^2941001^^164"
^IBA(363.2,122,0)="4;DGCR(399.1,^3^2941001^^46"
^IBA(363.2,123,0)="5;DGCR(399.1,^3^2941001^^94"
^IBA(363.2,124,0)="6;DGCR(399.1,^3^2941001^^11"
^IBA(363.2,125,0)="9;DGCR(399.1,^3^2941001^^55"
^IBA(363.2,126,0)="10;DGCR(399.1,^3^2941001^^71"
^IBA(363.2,127,0)="11;DGCR(399.1,^3^2941001^^92"
^IBA(363.2,128,0)="12;DGCR(399.1,^3^2941001^^251"
^IBA(363.2,129,0)="7;DGCR(399.1,^4^2941001^^194"
^IBA(363.2,130,0)="8;DGCR(399.1,^5^2941001^^21"
^IBA(363.2,131,0)="31;DGCR(399.1,^6^2941001^^119"
^IBA(363.2,133,0)="1;DGCR(399.1,^1^2951001^^295"
^IBA(363.2,134,0)="2;DGCR(399.1,^1^2951001^^859"
^IBA(363.2,135,0)="3;DGCR(399.1,^1^2951001^^966"
^IBA(363.2,136,0)="4;DGCR(399.1,^1^2951001^^337"
^IBA(363.2,137,0)="5;DGCR(399.1,^1^2951001^^847"
^IBA(363.2,138,0)="6;DGCR(399.1,^1^2951001^^266"
^IBA(363.2,139,0)="9;DGCR(399.1,^1^2951001^^458"
^IBA(363.2,140,0)="10;DGCR(399.1,^1^2951001^^712"
^IBA(363.2,141,0)="11;DGCR(399.1,^1^2951001^^855"
^IBA(363.2,142,0)="12;DGCR(399.1,^1^2951001^^1576"
^IBA(363.2,143,0)="1;DGCR(399.1,^2^2951001^^199^101"
^IBA(363.2,144,0)="1;DGCR(399.1,^2^2951001^^68^240"
^IBA(363.2,145,0)="2;DGCR(399.1,^2^2951001^^363^101"
^IBA(363.2,146,0)="2;DGCR(399.1,^2^2951001^^427^240"
^IBA(363.2,147,0)="3;DGCR(399.1,^2^2951001^^598^101"
^IBA(363.2,148,0)="3;DGCR(399.1,^2^2951001^^252^240"
^IBA(363.2,149,0)="4;DGCR(399.1,^2^2951001^^271^101"
^IBA(363.2,150,0)="4;DGCR(399.1,^2^2951001^^49^240"
^IBA(363.2,151,0)="5;DGCR(399.1,^2^2951001^^499^101"
^IBA(363.2,152,0)="5;DGCR(399.1,^2^2951001^^224^240"
^IBA(363.2,153,0)="6;DGCR(399.1,^2^2951001^^222^101"
^IBA(363.2,154,0)="6;DGCR(399.1,^2^2951001^^36^240"
^IBA(363.2,155,0)="9;DGCR(399.1,^2^2951001^^343^101"
^IBA(363.2,156,0)="9;DGCR(399.1,^2^2951001^^72^240"
^IBA(363.2,157,0)="10;DGCR(399.1,^2^2951001^^413^101"
^IBA(363.2,158,0)="10;DGCR(399.1,^2^2951001^^218^240"
^IBA(363.2,159,0)="11;DGCR(399.1,^2^2951001^^534^101"
^IBA(363.2,160,0)="11;DGCR(399.1,^2^2951001^^215^240"
^IBA(363.2,161,0)="12;DGCR(399.1,^2^2951001^^924^101"
^IBA(363.2,162,0)="12;DGCR(399.1,^2^2951001^^478^240"
^IBA(363.2,163,0)="1;DGCR(399.1,^3^2951001^^28"
^IBA(363.2,164,0)="2;DGCR(399.1,^3^2951001^^69"
^IBA(363.2,165,0)="3;DGCR(399.1,^3^2951001^^116"
^IBA(363.2,166,0)="4;DGCR(399.1,^3^2951001^^17"
^IBA(363.2,167,0)="5;DGCR(399.1,^3^2951001^^124"
^IBA(363.2,168,0)="6;DGCR(399.1,^3^2951001^^8"
^IBA(363.2,169,0)="9;DGCR(399.1,^3^2951001^^43"
^IBA(363.2,170,0)="10;DGCR(399.1,^3^2951001^^81"
^IBA(363.2,171,0)="11;DGCR(399.1,^3^2951001^^106"
^IBA(363.2,172,0)="12;DGCR(399.1,^3^2951001^^174"
^IBA(363.2,173,0)="7;DGCR(399.1,^4^2951001^^205"
^IBA(363.2,174,0)="8;DGCR(399.1,^5^2951001^^20"
^IBA(363.2,175,0)="31;DGCR(399.1,^6^2951001^^104"
^IBA(363.2,177,0)="1;DGCR(399.1,^1^2961001^^330"
^IBA(363.2,178,0)="2;DGCR(399.1,^1^2961001^^973"
^IBA(363.2,179,0)="3;DGCR(399.1,^1^2961001^^1046"
^IBA(363.2,180,0)="4;DGCR(399.1,^1^2961001^^428"
^IBA(363.2,181,0)="5;DGCR(399.1,^1^2961001^^1014"
^IBA(363.2,182,0)="6;DGCR(399.1,^1^2961001^^288"
^IBA(363.2,183,0)="9;DGCR(399.1,^1^2961001^^501"
^IBA(363.2,184,0)="10;DGCR(399.1,^1^2961001^^822"
^IBA(363.2,185,0)="11;DGCR(399.1,^1^2961001^^977"
^IBA(363.2,186,0)="12;DGCR(399.1,^1^2961001^^1923"
^IBA(363.2,187,0)="1;DGCR(399.1,^2^2961001^^223^101"
^IBA(363.2,188,0)="1;DGCR(399.1,^2^2961001^^76^240"
^IBA(363.2,189,0)="2;DGCR(399.1,^2^2961001^^412^101"
^IBA(363.2,190,0)="2;DGCR(399.1,^2^2961001^^483^240"
^IBA(363.2,191,0)="3;DGCR(399.1,^2^2961001^^648^101"
^IBA(363.2,192,0)="3;DGCR(399.1,^2^2961001^^273^240"
^IBA(363.2,193,0)="4;DGCR(399.1,^2^2961001^^344^101"
^IBA(363.2,194,0)="4;DGCR(399.1,^2^2961001^^63^240"
^IBA(363.2,195,0)="5;DGCR(399.1,^2^2961001^^598^101"
^IBA(363.2,196,0)="5;DGCR(399.1,^2^2961001^^268^240"
^IBA(363.2,197,0)="6;DGCR(399.1,^2^2961001^^240^101"
^IBA(363.2,198,0)="6;DGCR(399.1,^2^2961001^^39^240"
^IBA(363.2,199,0)="9;DGCR(399.1,^2^2961001^^375^101"
^IBA(363.2,200,0)="9;DGCR(399.1,^2^2961001^^79^240"
^IBA(363.2,201,0)="10;DGCR(399.1,^2^2961001^^478^101"
^IBA(363.2,202,0)="10;DGCR(399.1,^2^2961001^^251^240"
^IBA(363.2,203,0)="11;DGCR(399.1,^2^2961001^^610^101"
^IBA(363.2,204,0)="11;DGCR(399.1,^2^2961001^^246^240"
^IBA(363.2,205,0)="12;DGCR(399.1,^2^2961001^^1128^101"
^IBA(363.2,206,0)="12;DGCR(399.1,^2^2961001^^583^240"
^IBA(363.2,207,0)="1;DGCR(399.1,^3^2961001^^31"
^IBA(363.2,208,0)="2;DGCR(399.1,^3^2961001^^78"
^IBA(363.2,209,0)="3;DGCR(399.1,^3^2961001^^125"
^IBA(363.2,210,0)="4;DGCR(399.1,^3^2961001^^21"
^IBA(363.2,211,0)="5;DGCR(399.1,^3^2961001^^148"
^IBA(363.2,212,0)="6;DGCR(399.1,^3^2961001^^9"
^IBA(363.2,213,0)="9;DGCR(399.1,^3^2961001^^47"
^IBA(363.2,214,0)="10;DGCR(399.1,^3^2961001^^93"
^IBA(363.2,215,0)="11;DGCR(399.1,^3^2961001^^121"
^IBA(363.2,216,0)="12;DGCR(399.1,^3^2961001^^212"
^IBA(363.2,217,0)="7;DGCR(399.1,^4^2961001^^194"
^IBA(363.2,218,0)="8;DGCR(399.1,^5^2961001^^20"
^IBA(363.2,219,0)="31;DGCR(399.1,^6^2961001^^121"
^IBA(363.2,221,0)="1;DGCR(399.1,^8^2921201^^301"
^IBA(363.2,222,0)="2;DGCR(399.1,^8^2921201^^572"
^IBA(363.2,223,0)="3;DGCR(399.1,^8^2921201^^717"
^IBA(363.2,224,0)="4;DGCR(399.1,^8^2921201^^282"
^IBA(363.2,225,0)="5;DGCR(399.1,^8^2921201^^634"
^IBA(363.2,226,0)="6;DGCR(399.1,^8^2921201^^202"
^IBA(363.2,227,0)="9;DGCR(399.1,^8^2921201^^365"
^IBA(363.2,228,0)="10;DGCR(399.1,^8^2921201^^503"
^IBA(363.2,229,0)="11;DGCR(399.1,^8^2921201^^677"
^IBA(363.2,230,0)="12;DGCR(399.1,^8^2921201^^1041"
^IBA(363.2,231,0)="7;DGCR(399.1,^9^2921201^^147"
^IBA(363.2,232,0)="8;DGCR(399.1,^10^2921201^^18"
^IBA(363.2,233,0)="31;DGCR(399.1,^11^2921201^^86"
^IBA(363.2,234,0)="1;DGCR(399.1,^8^2931201^^298"
^IBA(363.2,235,0)="2;DGCR(399.1,^8^2931201^^588"
^IBA(363.2,236,0)="3;DGCR(399.1,^8^2931201^^730"
^IBA(363.2,237,0)="4;DGCR(399.1,^8^2931201^^301"
^IBA(363.2,238,0)="5;DGCR(399.1,^8^2931201^^671"
^IBA(363.2,239,0)="6;DGCR(399.1,^8^2931201^^211"
^IBA(363.2,240,0)="9;DGCR(399.1,^8^2931201^^311"
^IBA(363.2,241,0)="10;DGCR(399.1,^8^2931201^^513"
^IBA(363.2,242,0)="11;DGCR(399.1,^8^2931201^^682"
^IBA(363.2,243,0)="12;DGCR(399.1,^8^2931201^^1146"
^IBA(363.2,244,0)="7;DGCR(399.1,^9^2931201^^158"
^IBA(363.2,245,0)="8;DGCR(399.1,^10^2931201^^18"
^IBA(363.2,246,0)="31;DGCR(399.1,^11^2931201^^89"
^IBA(363.2,247,0)="1;DGCR(399.1,^8^2941201^^259"
^IBA(363.2,248,0)="2;DGCR(399.1,^8^2941201^^599"
^IBA(363.2,249,0)="3;DGCR(399.1,^8^2941201^^767"
^IBA(363.2,250,0)="4;DGCR(399.1,^8^2941201^^288"
^IBA(363.2,251,0)="5;DGCR(399.1,^8^2941201^^683"
^IBA(363.2,252,0)="6;DGCR(399.1,^8^2941201^^218"
^IBA(363.2,253,0)="9;DGCR(399.1,^8^2941201^^367"
^IBA(363.2,254,0)="10;DGCR(399.1,^8^2941201^^544"
^IBA(363.2,255,0)="11;DGCR(399.1,^8^2941201^^692"
^IBA(363.2,256,0)="12;DGCR(399.1,^8^2941201^^1228"
^IBA(363.2,257,0)="7;DGCR(399.1,^9^2941201^^177"
^IBA(363.2,258,0)="8;DGCR(399.1,^10^2941201^^20"
^IBA(363.2,259,0)="31;DGCR(399.1,^11^2941201^^108"
^IBA(363.2,260,0)="1;DGCR(399.1,^8^2951201^^264"
^IBA(363.2,261,0)="2;DGCR(399.1,^8^2951201^^774"
^IBA(363.2,262,0)="3;DGCR(399.1,^8^2951201^^873"
^IBA(363.2,263,0)="4;DGCR(399.1,^8^2951201^^302"
^IBA(363.2,264,0)="5;DGCR(399.1,^8^2951201^^761"
^IBA(363.2,265,0)="6;DGCR(399.1,^8^2951201^^238"
^IBA(363.2,266,0)="9;DGCR(399.1,^8^2951201^^409"
^IBA(363.2,267,0)="10;DGCR(399.1,^8^2951201^^640"
^IBA(363.2,268,0)="11;DGCR(399.1,^8^2951201^^768"
^IBA(363.2,269,0)="12;DGCR(399.1,^8^2951201^^1436"
^IBA(363.2,270,0)="7;DGCR(399.1,^9^2951201^^188"
^IBA(363.2,271,0)="8;DGCR(399.1,^10^2951201^^19"
^IBA(363.2,272,0)="31;DGCR(399.1,^11^2951201^^92"
^IBA(363.2,273,0)="1;DGCR(399.1,^8^2961201^^297"
^IBA(363.2,274,0)="2;DGCR(399.1,^8^2961201^^886"
^IBA(363.2,275,0)="3;DGCR(399.1,^8^2961201^^946"
^IBA(363.2,276,0)="4;DGCR(399.1,^8^2961201^^385"
^IBA(363.2,277,0)="5;DGCR(399.1,^8^2961201^^915"
^IBA(363.2,278,0)="6;DGCR(399.1,^8^2961201^^258"
^IBA(363.2,279,0)="9;DGCR(399.1,^8^2961201^^448"
^IBA(363.2,280,0)="10;DGCR(399.1,^8^2961201^^743"
^IBA(363.2,281,0)="11;DGCR(399.1,^8^2961201^^884"
^IBA(363.2,282,0)="12;DGCR(399.1,^8^2961201^^1761"
^IBA(363.2,283,0)="7;DGCR(399.1,^9^2961201^^178"
^IBA(363.2,284,0)="8;DGCR(399.1,^10^2961201^^19"
^IBA(363.2,285,0)="31;DGCR(399.1,^11^2961201^^107"
^IBA(363.2,286,0)="3;IBA(363.21,^7^2921001^^33"
^IBA(363.2,287,0)="4;IBA(363.21,^7^2921001^^33"
^IBA(363.2,288,0)="3;IBA(363.21,^7^2931001^^36"
^IBA(363.2,289,0)="4;IBA(363.21,^7^2931001^^36"
^IBA(363.2,290,0)="3;IBA(363.21,^7^2941001^^39"
^IBA(363.2,291,0)="4;IBA(363.21,^7^2941001^^39"
^IBA(363.2,292,0)="3;IBA(363.21,^7^2951001^^41"
^IBA(363.2,293,0)="4;IBA(363.21,^7^2951001^^41"
^IBA(363.2,294,0)="3;IBA(363.21,^7^2961001^^38.8"
^IBA(363.2,295,0)="4;IBA(363.21,^7^2961001^^38.8"
^IBA(363.2,296,0)="3;IBA(363.21,^7^2971001^^45.8"
^IBA(363.2,297,0)="4;IBA(363.21,^7^2971001^^45.8"
^IBA(363.2,298,0)="3;IBA(363.21,^7^2991001^^50.8"
^IBA(363.2,299,0)="4;IBA(363.21,^7^2991001^^50.8"
^IBA(363.2,300,0)="3;IBA(363.21,^7^3011206^^15"
^IBA(363.2,301,0)="4;IBA(363.21,^7^3011206^^50"
^IBA(363.2,302,0)="1;DGCR(399.1,^1^3040107^^1206"
^IBA(363.2,303,0)="2;DGCR(399.1,^1^3040107^^1254"
^IBA(363.2,304,0)="3;DGCR(399.1,^1^3040107^^1815"
^IBA(363.2,305,0)="4;DGCR(399.1,^1^3040107^^801"
^IBA(363.2,306,0)="5;DGCR(399.1,^1^3040107^^2289"
^IBA(363.2,307,0)="6;DGCR(399.1,^1^3040107^^451"
^IBA(363.2,308,0)="586;DGCR(399.1,^1^3040107^^276"
^IBA(363.2,309,0)="9;DGCR(399.1,^1^3040107^^971"
^IBA(363.2,310,0)="10;DGCR(399.1,^1^3040107^^1723"
^IBA(363.2,311,0)="11;DGCR(399.1,^1^3040107^^1237"
^IBA(363.2,312,0)="12;DGCR(399.1,^1^3040107^^3513"
^IBA(363.2,313,0)="1;DGCR(399.1,^2^3040107^^812^101"
^IBA(363.2,314,0)="1;DGCR(399.1,^2^3040107^^279^240"
^IBA(363.2,315,0)="2;DGCR(399.1,^2^3040107^^530^101"
^IBA(363.2,316,0)="2;DGCR(399.1,^2^3040107^^623^240"
^IBA(363.2,317,0)="3;DGCR(399.1,^2^3040107^^1125^101"
^IBA(363.2,318,0)="3;DGCR(399.1,^2^3040107^^473^240"
^IBA(363.2,319,0)="4;DGCR(399.1,^2^3040107^^644^101"
^IBA(363.2,320,0)="4;DGCR(399.1,^2^3040107^^118^240"
^IBA(363.2,321,0)="5;DGCR(399.1,^2^3040107^^1350^101"
^IBA(363.2,322,0)="5;DGCR(399.1,^2^3040107^^604^240"
^IBA(363.2,323,0)="6;DGCR(399.1,^2^3040107^^376^101"
^IBA(363.2,324,0)="6;DGCR(399.1,^2^3040107^^61^240"
^IBA(363.2,325,0)="586;DGCR(399.1,^2^3040107^^230^101"
^IBA(363.2,326,0)="586;DGCR(399.1,^2^3040107^^29^240"
^IBA(363.2,327,0)="9;DGCR(399.1,^2^3040107^^726^101"
^IBA(363.2,328,0)="9;DGCR(399.1,^2^3040107^^153^240"
^IBA(363.2,329,0)="10;DGCR(399.1,^2^3040107^^1001^101"
^IBA(363.2,330,0)="10;DGCR(399.1,^2^3040107^^526^240"
^IBA(363.2,331,0)="11;DGCR(399.1,^2^3040107^^773^101"
^IBA(363.2,332,0)="11;DGCR(399.1,^2^3040107^^311^240"
^IBA(363.2,333,0)="12;DGCR(399.1,^2^3040107^^2061^101"
^IBA(363.2,334,0)="12;DGCR(399.1,^2^3040107^^1065^240"
^IBA(363.2,335,0)="1;DGCR(399.1,^3^3040107^^115"
^IBA(363.2,336,0)="2;DGCR(399.1,^3^3040107^^101"
^IBA(363.2,337,0)="3;DGCR(399.1,^3^3040107^^217"
^IBA(363.2,338,0)="4;DGCR(399.1,^3^3040107^^39"
^IBA(363.2,339,0)="5;DGCR(399.1,^3^3040107^^335"
^IBA(363.2,340,0)="6;DGCR(399.1,^3^3040107^^14"
^IBA(363.2,341,0)="586;DGCR(399.1,^3^3040107^^17"
^IBA(363.2,342,0)="9;DGCR(399.1,^3^3040107^^92"
^IBA(363.2,343,0)="10;DGCR(399.1,^3^3040107^^196"
^IBA(363.2,344,0)="11;DGCR(399.1,^3^3040107^^153"
^IBA(363.2,345,0)="12;DGCR(399.1,^3^3040107^^387"
^IBA(363.2,346,0)="7;DGCR(399.1,^4^3040107^^300"
^IBA(363.2,347,0)="8;DGCR(399.1,^5^3040107^^45"
^IBA(363.2,348,0)="31;DGCR(399.1,^6^3040107^^185"
^IBA(363.2,349,0)="1;DGCR(399.1,^8^3040107^^1106"
^IBA(363.2,350,0)="2;DGCR(399.1,^8^3040107^^1162"
^IBA(363.2,351,0)="3;DGCR(399.1,^8^3040107^^1668"
^IBA(363.2,352,0)="4;DGCR(399.1,^8^3040107^^733"
^IBA(363.2,353,0)="5;DGCR(399.1,^8^3040107^^2098"
^IBA(363.2,354,0)="6;DGCR(399.1,^8^3040107^^411"
^IBA(363.2,355,0)="586;DGCR(399.1,^8^3040107^^252"
^IBA(363.2,356,0)="9;DGCR(399.1,^8^3040107^^888"
^IBA(363.2,357,0)="10;DGCR(399.1,^8^3040107^^1574"
^IBA(363.2,358,0)="11;DGCR(399.1,^8^3040107^^1136"
^IBA(363.2,359,0)="12;DGCR(399.1,^8^3040107^^3255"
^IBA(363.2,360,0)="7;DGCR(399.1,^9^3040107^^282"
^IBA(363.2,361,0)="8;DGCR(399.1,^10^3040107^^45"
^IBA(363.2,362,0)="31;DGCR(399.1,^11^3040107^^167"
^IBA(363.2,363,0)="1;DGCR(399.1,^1^3051001^^1952"
^IBA(363.2,364,0)="2;DGCR(399.1,^1^3051001^^1178"
^IBA(363.2,365,0)="3;DGCR(399.1,^1^3051001^^2037"
^IBA(363.2,366,0)="4;DGCR(399.1,^1^3051001^^1324"
^IBA(363.2,367,0)="5;DGCR(399.1,^1^3051001^^2633"
^IBA(363.2,368,0)="6;DGCR(399.1,^1^3051001^^504"
^IBA(363.2,369,0)="586;DGCR(399.1,^1^3051001^^293"
^IBA(363.2,370,0)="9;DGCR(399.1,^1^3051001^^1211"
^IBA(363.2,371,0)="10;DGCR(399.1,^1^3051001^^1670"
^IBA(363.2,372,0)="11;DGCR(399.1,^1^3051001^^1383"
^IBA(363.2,373,0)="12;DGCR(399.1,^1^3051001^^4117"
^IBA(363.2,374,0)="1;DGCR(399.1,^2^3051001^^1314^101"
^IBA(363.2,375,0)="1;DGCR(399.1,^2^3051001^^452^240"
^IBA(363.2,376,0)="2;DGCR(399.1,^2^3051001^^498^101"
^IBA(363.2,377,0)="2;DGCR(399.1,^2^3051001^^585^240"
^IBA(363.2,378,0)="3;DGCR(399.1,^2^3051001^^1262^101"
^IBA(363.2,379,0)="3;DGCR(399.1,^2^3051001^^531^240"
^IBA(363.2,380,0)="4;DGCR(399.1,^2^3051001^^1065^101"
^IBA(363.2,381,0)="4;DGCR(399.1,^2^3051001^^194^240"
^IBA(363.2,382,0)="5;DGCR(399.1,^2^3051001^^1553^101"
^IBA(363.2,383,0)="5;DGCR(399.1,^2^3051001^^695^240"
^IBA(363.2,384,0)="6;DGCR(399.1,^2^3051001^^420^101"
^IBA(363.2,385,0)="6;DGCR(399.1,^2^3051001^^68^240"
^IBA(363.2,386,0)="586;DGCR(399.1,^2^3051001^^244^101"
^IBA(363.2,387,0)="586;DGCR(399.1,^2^3051001^^31^240"
^IBA(363.2,388,0)="9;DGCR(399.1,^2^3051001^^906^101"
^IBA(363.2,389,0)="9;DGCR(399.1,^2^3051001^^191^240"
^IBA(363.2,390,0)="10;DGCR(399.1,^2^3051001^^970^101"
^IBA(363.2,391,0)="10;DGCR(399.1,^2^3051001^^510^240"
^IBA(363.2,392,0)="11;DGCR(399.1,^2^3051001^^864^101"
^IBA(363.2,393,0)="11;DGCR(399.1,^2^3051001^^348^240"
^IBA(363.2,394,0)="12;DGCR(399.1,^2^3051001^^2414^101"
^IBA(363.2,395,0)="12;DGCR(399.1,^2^3051001^^1249^240"
^IBA(363.2,396,0)="1;DGCR(399.1,^3^3051001^^186"
^IBA(363.2,397,0)="2;DGCR(399.1,^3^3051001^^95"
^IBA(363.2,398,0)="3;DGCR(399.1,^3^3051001^^244"
^IBA(363.2,399,0)="4;DGCR(399.1,^3^3051001^^65"
^IBA(363.2,400,0)="5;DGCR(399.1,^3^3051001^^385"
^IBA(363.2,401,0)="6;DGCR(399.1,^3^3051001^^16"
^IBA(363.2,402,0)="586;DGCR(399.1,^3^3051001^^18"
^IBA(363.2,403,0)="9;DGCR(399.1,^3^3051001^^114"
^IBA(363.2,404,0)="10;DGCR(399.1,^3^3051001^^190"
^IBA(363.2,405,0)="11;DGCR(399.1,^3^3051001^^171"
^IBA(363.2,406,0)="12;DGCR(399.1,^3^3051001^^454"
^IBA(363.2,407,0)="7;DGCR(399.1,^4^3051001^^298"
^IBA(363.2,408,0)="8;DGCR(399.1,^5^3051001^^51"
^IBA(363.2,409,0)="31;DGCR(399.1,^6^3051001^^202"
^IBA(363.2,410,0)="1;DGCR(399.1,^8^3051001^^1832"
^IBA(363.2,411,0)="2;DGCR(399.1,^8^3051001^^1112"
^IBA(363.2,412,0)="3;DGCR(399.1,^8^3051001^^1914"
^IBA(363.2,413,0)="4;DGCR(399.1,^8^3051001^^1241"
^IBA(363.2,414,0)="5;DGCR(399.1,^8^3051001^^2465"
^IBA(363.2,415,0)="6;DGCR(399.1,^8^3051001^^470"
^IBA(363.2,416,0)="586;DGCR(399.1,^8^3051001^^273"
^IBA(363.2,417,0)="9;DGCR(399.1,^8^3051001^^1132"
^IBA(363.2,418,0)="10;DGCR(399.1,^8^3051001^^1564"
^IBA(363.2,419,0)="11;DGCR(399.1,^8^3051001^^1292"
^IBA(363.2,420,0)="12;DGCR(399.1,^8^3051001^^3894"
^IBA(363.2,421,0)="7;DGCR(399.1,^9^3051001^^284"
^IBA(363.2,422,0)="8;DGCR(399.1,^10^3051001^^51"
^IBA(363.2,423,0)="31;DGCR(399.1,^11^3051001^^188"
^IBA(363.2,424,0)="1;DGCR(399.1,^1^3051103^^1952"
^IBA(363.2,425,0)="2;DGCR(399.1,^1^3051103^^1178"
^IBA(363.2,426,0)="3;DGCR(399.1,^1^3051103^^2037"
^IBA(363.2,427,0)="4;DGCR(399.1,^1^3051103^^1324"
^IBA(363.2,428,0)="5;DGCR(399.1,^1^3051103^^2633"
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^IBA(363.2,"B","8;DGCR(399.1,",218)=""
^IBA(363.2,"B","8;DGCR(399.1,",232)=""
^IBA(363.2,"B","8;DGCR(399.1,",245)=""
^IBA(363.2,"B","8;DGCR(399.1,",258)=""
^IBA(363.2,"B","8;DGCR(399.1,",271)=""
^IBA(363.2,"B","8;DGCR(399.1,",284)=""
^IBA(363.2,"B","8;DGCR(399.1,",347)=""
^IBA(363.2,"B","8;DGCR(399.1,",361)=""
^IBA(363.2,"B","8;DGCR(399.1,",408)=""
^IBA(363.2,"B","8;DGCR(399.1,",422)=""
^IBA(363.2,"B","8;DGCR(399.1,",469)=""
^IBA(363.2,"B","8;DGCR(399.1,",483)=""
^IBA(363.2,"B","9;DGCR(399.1,",7)=""
^IBA(363.2,"B","9;DGCR(399.1,",23)=""
^IBA(363.2,"B","9;DGCR(399.1,",24)=""
^IBA(363.2,"B","9;DGCR(399.1,",37)=""
^IBA(363.2,"B","9;DGCR(399.1,",51)=""
^IBA(363.2,"B","9;DGCR(399.1,",67)=""
^IBA(363.2,"B","9;DGCR(399.1,",68)=""
^IBA(363.2,"B","9;DGCR(399.1,",81)=""
^IBA(363.2,"B","9;DGCR(399.1,",95)=""
^IBA(363.2,"B","9;DGCR(399.1,",111)=""
^IBA(363.2,"B","9;DGCR(399.1,",112)=""
^IBA(363.2,"B","9;DGCR(399.1,",125)=""
^IBA(363.2,"B","9;DGCR(399.1,",139)=""
^IBA(363.2,"B","9;DGCR(399.1,",155)=""
^IBA(363.2,"B","9;DGCR(399.1,",156)=""
^IBA(363.2,"B","9;DGCR(399.1,",169)=""
^IBA(363.2,"B","9;DGCR(399.1,",183)=""
^IBA(363.2,"B","9;DGCR(399.1,",199)=""
^IBA(363.2,"B","9;DGCR(399.1,",200)=""
^IBA(363.2,"B","9;DGCR(399.1,",213)=""
^IBA(363.2,"B","9;DGCR(399.1,",227)=""
^IBA(363.2,"B","9;DGCR(399.1,",240)=""
^IBA(363.2,"B","9;DGCR(399.1,",253)=""
^IBA(363.2,"B","9;DGCR(399.1,",266)=""
^IBA(363.2,"B","9;DGCR(399.1,",279)=""
^IBA(363.2,"B","9;DGCR(399.1,",309)=""
^IBA(363.2,"B","9;DGCR(399.1,",327)=""
^IBA(363.2,"B","9;DGCR(399.1,",328)=""
^IBA(363.2,"B","9;DGCR(399.1,",342)=""
^IBA(363.2,"B","9;DGCR(399.1,",356)=""
^IBA(363.2,"B","9;DGCR(399.1,",370)=""
^IBA(363.2,"B","9;DGCR(399.1,",388)=""
^IBA(363.2,"B","9;DGCR(399.1,",389)=""
^IBA(363.2,"B","9;DGCR(399.1,",403)=""
^IBA(363.2,"B","9;DGCR(399.1,",417)=""
^IBA(363.2,"B","9;DGCR(399.1,",431)=""
^IBA(363.2,"B","9;DGCR(399.1,",449)=""
^IBA(363.2,"B","9;DGCR(399.1,",450)=""
^IBA(363.2,"B","9;DGCR(399.1,",464)=""
^IBA(363.2,"B","9;DGCR(399.1,",478)=""
^IBA(363.21,0)="BILLING ITEMS^363.21I^5^5"
^IBA(363.21,1,0)="SKILLED NURSING CARE^9"
^IBA(363.21,2,0)="SUB-ACUTE CARE^9"
^IBA(363.21,3,0)="BASIC CARE^9"
^IBA(363.21,4,0)="SPECIALTY CARE^9"
^IBA(363.21,5,0)="PARTIAL HOSPITALIZATION^9"
^IBA(363.21,"B","BASIC CARE",3)=""
^IBA(363.21,"B","PARTIAL HOSPITALIZATION",5)=""
^IBA(363.21,"B","SKILLED NURSING CARE",1)=""
^IBA(363.21,"B","SPECIALTY CARE",4)=""
^IBA(363.21,"B","SUB-ACUTE CARE",2)=""
^IBA(364,0)="EDI TRANSMIT BILL^364IP^^"
^IBA(364.1,0)="EDI TRANSMISSION BATCH^364.1I^^"
^IBA(364.2,0)="EDI MESSAGES^364.2I^^0"
^IBA(364.5,0)="IB DATA ELEMENT DEFINITION^364.5I^253^282"
^IBA(364.5,2,0)="N-CURR INSURED FULL NAME^N^E^G^399^^^"
^IBA(364.5,2,1)="N IBZ D F^IBCEF(""N-ALL INSURED FULL NAMES"",""IBZ"",,IBXIEN) S IBZ=$G(IBZ(+$$COBN^IBCEF(IBXIEN))) I IBZ'="""" S IBXDATA=IBZ"
^IBA(364.5,2,3,0)="^^2^2^2990610^^^^"
^IBA(364.5,2,3,1,0)="The full name of current insured for bill entry IBXIEN."
^IBA(364.5,2,3,2,0)="Format is lastname,firstname middle."
^IBA(364.5,3,0)="N-CURR INSURED ID^N^E^I^399^^^"
^IBA(364.5,3,1)="N Z,Z0,IBZ D F^IBCEF(""N-ALL INSURANCE NUMBER"",""IBZ"",,IBXIEN) S Z0=+$$COBN^IBCEF(IBXIEN),Z=$G(IBZ(Z0)) I Z'="""" S IBXDATA=Z"
^IBA(364.5,3,3,0)="^364.53^1^1^3010612^^^^"
^IBA(364.5,3,3,1,0)="The id number of the current insured for bill IBXIEN."
^IBA(364.5,4,0)="N-CURR INSURED FULL ADDRESS^N^E^G^399^^^"
^IBA(364.5,4,1)="S IBXDATA=$$INSADDR^IBCEF(IBXIEN)"
^IBA(364.5,4,3,0)="^^2^2^2990607^^^^"
^IBA(364.5,4,3,1,0)="The current insured's full street address^city^state^zip^street address 1"
^IBA(364.5,4,3,2,0)="street address 2^street address 3 for bill entry IBXIEN."
^IBA(364.5,5,0)="N-GET FROM PREVIOUS EXTRACT^N^C^I^399^"
^IBA(364.5,5,1)=""
^IBA(364.5,5,3,0)="^364.53^3^3^3001020^^^^"
^IBA(364.5,5,3,1,0)="Field used when a group element has previously been defined that included"
^IBA(364.5,5,3,2,0)="this data element and a hard-coded extract from the group element output is"
^IBA(364.5,5,3,3,0)="to be done for bill entry IBXIEN."
^IBA(364.5,6,0)="N-CURR INSURED DEMOGRAPHICS^N^E^G^399^^^"
^IBA(364.5,6,1)="S IBXDATA=$$INSDEM^IBCEF(IBXIEN),IBXSAVE(""IDEM"")=IBXDATA"
^IBA(364.5,6,3,0)="^^3^3^2991018^^^^"
^IBA(364.5,6,3,1,0)="The current insured's birthdate^sex^phone^branch pointer^rank (sex only if"
^IBA(364.5,6,3,2,0)="insured is patient or spouse) for bill entry IBXIEN.  Save data in IBXSAVE"
^IBA(364.5,6,3,3,0)="for later use."
^IBA(364.5,7,0)="N-CURR INSURED EMPLOYER INFO^N^E^G^399^^^"
^IBA(364.5,7,1)="N Z,Z1,Z2 S Z=$$COBN^IBCEF(IBXIEN),Z2=$$ESGHPNL^IBCEF21(IBXIEN,Z),Z1=$P(Z2,U,2,99) S:'Z2 Z1=$$INSEMPL^IBCEF(IBXIEN) S IBXDATA=Z1"
^IBA(364.5,7,3,0)="^^6^6^2990614^^^^"
^IBA(364.5,7,3,1,0)="Extracts the current insured's employment info into the IBXDATA for bill"
^IBA(364.5,7,3,2,0)="entry IBXIEN."
^IBA(364.5,7,3,3,0)="Format is employer name^city^state abbreviation^state ien."
^IBA(364.5,7,3,4,0)="If the plan is Employer Sponsored (ESGHP) then extracts Employer"
^IBA(364.5,7,3,5,0)="Name/Location of the employer that sponsors the plan.  Otherwise extracts"
^IBA(364.5,7,3,6,0)="the insured's current employer name/location (if spouse or veteran only)."
^IBA(364.5,8,0)="N-UB-04 SERVICE LINE (EDI)^N^E^G^399^^^"
^IBA(364.5,8,1)="S IBXDATA="""" I $$FT^IBCEF(IBXIEN)=3 K:$$INSPRF^IBCEF(IBXIEN)=1 IBXSAVE(""DATE"") S:'$$INPAT^IBCEF(IBXIEN,1) IBXSAVE(""DATE"")=$$SERVDT^IBCEF(IBXIEN,8,1) D HOS^IBCEF2(IBXIEN)"
^IBA(364.5,8,3,0)="^364.53^6^6^3010501^^^^"
^IBA(364.5,8,3,1,0)="The data to be included in the institutional service claim segment for"
^IBA(364.5,8,3,2,0)="bill entry IBXIEN.  Format is revenue code pointer^procedure code pointer^"
^IBA(364.5,8,3,3,0)="unit charge^units^total charge^total uncovered charge^form locator 49^"
^IBA(364.5,8,3,4,0)="ien of revenue code multiple^iens of modifiers for the CPT code"
^IBA(364.5,8,3,5,0)="Data is returned in an array IBXDATA(n) and IBXSAVE(""DATE"")=service date"
^IBA(364.5,8,3,6,0)="for outpatient institution charges"
^IBA(364.5,9,0)="N-PATIENT STATUS^N^F^I^399^DISCHARGE STATUS:CODE^I^"
^IBA(364.5,9,1)=""
^IBA(364.5,9,3,0)="^^1^1^2991115^^^^"
^IBA(364.5,9,3,1,0)="The discharge status for the patient for bill entry IBXIEN."
^IBA(364.5,10,0)="N-MEDICAL RECORD NUMBER^N^E^I^399^^^"
^IBA(364.5,10,1)="N DFN,VADM S DFN=$P($G(^DGCR(399,IBXIEN,0)),U,2) D DEM^VADPT S IBXDATA=$P(VADM(2),U,2)"
^IBA(364.5,10,3,0)="^^1^1^2990901^^^^"
^IBA(364.5,10,3,1,0)="The patient's SSN for bill IBXIEN."
^IBA(364.5,11,0)="N-CONDITION CODES^N^E^G^399^^^"
^IBA(364.5,11,1)="N IBI,IBX,IBY S (IBI,IBX)=0 F  S IBX=$O(^DGCR(399,IBXIEN,""CC"",IBX)) Q:'IBX  S IBY=+$G(^(IBX,0)),IBY=$P($G(^DGCR(399.1,+IBY,0)),U,2) I IBY'="""" S IBI=IBI+1,IBFL(24,IBI)=IBY"
^IBA(364.5,11,2)="IBFL(24)"
^IBA(364.5,11,3,0)="^^2^2^2970923^^^^"
^IBA(364.5,11,3,1,0)="The condition codes 0-nodes for bill IBXIEN."
^IBA(364.5,11,3,2,0)="Data (external) is returned in an array IBFL(24,1-n)."
^IBA(364.5,12,0)="N-VALUE CODES^N^E^G^399^^^"
^IBA(364.5,12,1)="N IBI,IBX,Z,Z0 S (IBI,IBX)=0 F  S IBX=$O(^DGCR(399,IBXIEN,""CV"",IBX)) Q:'IBX  S Z=$G(^(IBX,0)),Z0=$G(^DGCR(399.1,+Z,0)) I Z0'="""" S IBI=IBI+1,IBFL(39,IBI)=$P(Z0,U,2)_U_$P(Z,U,2)_U_$P(Z0,U,12)"
^IBA(364.5,12,2)="IBFL(39)"
^IBA(364.5,12,3,0)="^364.53^3^3^3001207^^^^"
^IBA(364.5,12,3,1,0)="The value codes associated with bill IBXIEN."
^IBA(364.5,12,3,2,0)="Format is code^amount^dollar amt flag (1=amt,0=quantity)"
^IBA(364.5,12,3,3,0)="Data is returned in an array IBFL(39,1-n)."
^IBA(364.5,13,0)="N-UB92 FORM LOCATOR 56^N^E^I^399^^^"
^IBA(364.5,13,1)="S IBXDATA=$P($G(^DGCR(399,IBXIEN,""UF3"")),U,7) D:IBXDATA="""" F^IBCEF(""N-PRIOR BILLS"")"
^IBA(364.5,13,3,0)="^^2^2^2990608^^^^"
^IBA(364.5,13,3,1,0)="The UB92 data for FORM LOCATOR 56 for bill IBXIEN.  If the data field for "
^IBA(364.5,13,3,2,0)="free text in form locator 56 is null, output prior bills."
^IBA(364.5,14,0)="N-UB92 FORM LOCATOR 57^N^F^I^399^*FORM LOCATOR 57^^"
^IBA(364.5,14,1)=""
^IBA(364.5,14,3,0)="^^1^1^2991115^^^^"
^IBA(364.5,14,3,1,0)="The UB92 data for FORM LOCATOR 57 for bill IBXIEN."
^IBA(364.5,15,0)="N-UB92 FORM LOCATOR 31^N^F^I^399^*FORM LOCATOR 31^^"
^IBA(364.5,15,1)=""
^IBA(364.5,15,3,0)="^^1^1^2991115^^^^"
^IBA(364.5,15,3,1,0)="The UB92 data for FORM LOCATOR 31 for bill IBXIEN."
^IBA(364.5,16,0)="N-UB-04 PROCEDURES^N^E^G^399^^^"
^IBA(364.5,16,1)="N IB,IBPROC,Z D PROCX^IBCVA1 S (IB,Z)=0 F  S IB=$O(IBPROC(IB)) Q:'IB  S Z=Z+1,IBXDATA(Z)=IBPROC(IB) D SETMODS^IBCVA1($P(IBPROC(IB),U,15),Z,.IBXSAVE)"
^IBA(364.5,16,3,0)="^364.53^4^4^3061219^^^^"
^IBA(364.5,16,3,1,0)="The procedures associated with bill IBXIEN.  Format is:"
^IBA(364.5,16,3,2,0)="procedure code;ICPT( or ICD0(^procedure date in fileman format."
^IBA(364.5,16,3,3,0)="Data is returned in an array IBXDATA(1-n) and modifiers on the procedures"
^IBA(364.5,16,3,4,0)="are returned in IBXSAVE(""PROCMODS"",1-n)=modifiers separated by comma."
^IBA(364.5,23,0)="N-ROI INDICATOR^N^F^I^399^IS THIS A SENSITIVE RECORD?^I^"
^IBA(364.5,23,1)=""
^IBA(364.5,23,3,0)="^^3^3^2991115^^^^"
^IBA(364.5,23,3,1,0)="Release of information indicator based on sensitive record field.  Returns"
^IBA(364.5,23,3,2,0)="1 to indicate 'RESTRICTED' or anything else means 'YES' for bill entry"
^IBA(364.5,23,3,3,0)="IBXIEN."
^IBA(364.5,24,0)="N-ASSIGN OF BENEFITS INDICATOR^N^F^I^399^ASSIGNMENT OF BENEFITS^I^"
^IBA(364.5,24,1)=""
^IBA(364.5,24,3,0)="^^2^2^2991115^^^^"
^IBA(364.5,24,3,1,0)="Assignment of benefits indicator for bill entry IBXIEN.  If field returns"
^IBA(364.5,24,3,2,0)="'N' or 'n' or '0', assignment is (N)o.  Anything else, assignment is (Y)es."
^IBA(364.5,25,0)="N-CURR INSURED PT RELATION^N^E^I^399^^^"
^IBA(364.5,25,1)="N IBZ D F^IBCEF(""N-ALL INSURED PT RELATION"",""IBZ"",,IBXIEN) S IBZ=$G(IBZ(+$$COBN^IBCEF(IBXIEN))) I IBZ'="""" S IBXDATA=IBZ"
^IBA(364.5,25,3,0)="1^^1^1^2990614"
^IBA(364.5,25,3,1,0)="The current insured's relationship to patient code for bill entry IBXIEN."
^IBA(364.5,26,0)="N-CURR INSURED GROUP NAME^N^E^I^399^^^"
^IBA(364.5,26,1)="N IBZ D F^IBCEF(""N-ALL INSURANCE GROUP NAME"",""IBZ"",,IBXIEN) S IBZ=$G(IBZ(+$$COBN^IBCEF(IBXIEN))) I IBZ'="""" S IBXDATA=IBZ"
^IBA(364.5,26,3,0)="^364.53^1^1^3010612^^^^"
^IBA(364.5,26,3,1,0)="The current insured's group name for bill entry IBXIEN."
^IBA(364.5,27,0)="N-CURR INSURED GROUP NUMBER^N^E^I^399^^^"
^IBA(364.5,27,1)="N IBZ D F^IBCEF(""N-ALL INSURANCE GROUP NUMBER"",""IBZ"",,IBXIEN) S IBZ=$G(IBZ(+$$COBN^IBCEF(IBXIEN))) I IBZ'="""" S IBXDATA=IBZ"
^IBA(364.5,27,3,0)="^364.53^1^1^3010612^^^^"
^IBA(364.5,27,3,1,0)="The current insured's group number for bill entry IBXIEN."
^IBA(364.5,28,0)="N-OTH INSURED DEMOGRAPHICS^N^E^G^399^^^"
^IBA(364.5,28,1)="N Z,Z0 S Z=$P($G(^DGCR(399,IBXIEN,0)),U,21) I $D(^(""I2""))!$D(^(""I3"")) F Z0=1,2 S IBXDATA(Z0)=$S($D(^DGCR(399,IBXIEN,""I""_(Z0+1))):$$INSDEM^IBCEF(IBXIEN,$S(""P""[Z:$P(""S^T"",U,Z0),Z=""S"":$P(""P^T"",U,Z0),1:$P(""P^S"",U,Z0))),1:"""")"
^IBA(364.5,28,3,0)="^^9^9^2980625"
^IBA(364.5,28,3,1,0)="All other insured's birthdate^sex^phone^branch pointer^rank (sex/phone"
^IBA(364.5,28,3,2,0)="only if insured is patient or spouse) for bill entry IBXIEN. Data is"
^IBA(364.5,28,3,3,0)="returned in an array IBXDATA(n). This is a group element and up to 2 data"
^IBA(364.5,28,3,4,0)="elements are returned in the IBXDATA(n) array.  If the primary insurance"
^IBA(364.5,28,3,5,0)="is the current responsible, the secondary and tertiary insurance insured's"
^IBA(364.5,28,3,6,0)="demographics are returned. If the secondary insurance is the current"
^IBA(364.5,28,3,7,0)="responsible, the primary and tertiary insurance insured's demographics are"
^IBA(364.5,28,3,8,0)="returned. If the tertiary insurance is the current responsible, the"
^IBA(364.5,28,3,9,0)="primary and secondary insurance insured's demographics are returned."
^IBA(364.5,30,0)="N-OTH INSURED EMPLOYR INFO^N^E^G^399^^^"
^IBA(364.5,30,1)="N Z,Z0,Z1,IBZ D F^IBCEF(""N-ALL INSURED EMPLOYER INFO"",""IBZ"") S Z=$$COBN^IBCEF(IBXIEN) S Z0=0 F Z1=1:1:3 I Z1'=Z,$D(^DGCR(399,IBXIEN,""I""_Z1)) S Z0=Z0+1,IBXDATA(Z0)=$G(IBZ(Z1))"
^IBA(364.5,30,3,0)="^^12^12^2990611^^^^"
^IBA(364.5,30,3,1,0)="All other insured's employer name^city^state abbreviation^state ien if the"
^IBA(364.5,30,3,2,0)="insured is the patient or the patient's spouse for bill entry IBXIEN."
^IBA(364.5,30,3,3,0)="If the plan is Employer Sponsored (ESGHP) then extracts Employer"
^IBA(364.5,30,3,4,0)="Name/Location of the employer that sponsors the plan.  Otherwise extracts"
^IBA(364.5,30,3,5,0)="the insured's current employer name/location (if spouse or veteran only)."
^IBA(364.5,30,3,6,0)="Data is returned in an array IBXDATA(n).  This is a group element and"
^IBA(364.5,30,3,7,0)="up to 2 data elements are returned in the IBXDATA(n) array.  If the primary"
^IBA(364.5,30,3,8,0)="insurance is the current responsible, the secondary and tertiary insurance"
^IBA(364.5,30,3,9,0)="insured employer info are returned.  If the secondary insurance is the"
^IBA(364.5,30,3,10,0)="current responsible, the primary and tertiary insurance insured employer"
^IBA(364.5,30,3,11,0)="info are returned. If the tertiary insurance is the current responsible, the"
^IBA(364.5,30,3,12,0)="primary and secondary insurance insured employer info are returned."
^IBA(364.5,31,0)="N-OTH INSURED GRP NAME^N^E^G^399^^^"
^IBA(364.5,31,1)="N Z,Z0,Z1,IBZ D F^IBCEF(""N-ALL INSURANCE GROUP NAME"",""IBZ"") S Z=$$COBN^IBCEF(IBXIEN) S Z0=0 F Z1=1:1:3 I Z1'=Z,$D(^DGCR(399,IBXIEN,""I""_Z1)) S Z0=Z0+1,IBXDATA(Z0)=$G(IBZ(Z1))"
^IBA(364.5,31,3,0)="13^^12^12^2990614^^^^"
^IBA(364.5,31,3,1,0)="All other insured's group names for bill entry IBXIEN.  The data is"
^IBA(364.5,31,3,2,0)="extracted from the old group name field in the policy record if the old"
^IBA(364.5,31,3,3,0)="group number data exists.  If the old group number data doesn't exist or"
^IBA(364.5,31,3,4,0)="the old group name data is missing, the data is taken from the GROUP NAME"
^IBA(364.5,31,3,5,0)="in the GROUP INSURANCE PLAN file. Data is returned in an array"
^IBA(364.5,31,3,6,0)="IBXDATA(n).  This is a group data element and up to 2 data elements are"
^IBA(364.5,31,3,7,0)="returned in the IBXDATA(n) array.  If the primary insurance is the current"
^IBA(364.5,31,3,8,0)="responsible, the secondary and tertiary insurance insured's group names are"
^IBA(364.5,31,3,9,0)="returned.  If the secondary insurance is the current responsible, the"
^IBA(364.5,31,3,10,0)="primary and tertiary insurance insured's group names are returned. If the"
^IBA(364.5,31,3,11,0)="tertiary insurance is the current responsible, the primary and secondary"
^IBA(364.5,31,3,12,0)="insurance insured's group names are returned."
^IBA(364.5,32,0)="N-OTH INSURED FULL NAME^N^E^G^399^^^"
^IBA(364.5,32,1)="N Z,Z0,Z1,IBZ D F^IBCEF(""N-ALL INSURED FULL NAMES"",""IBZ"") S Z=$$COBN^IBCEF(IBXIEN) S Z0=0 F Z1=1:1:3 I Z1'=Z,$D(^DGCR(399,IBXIEN,""I""_Z1)) S Z0=Z0+1,IBXDATA(Z0)=$G(IBZ(Z1))"
^IBA(364.5,32,3,0)="^^9^9^2990825^^^^"
^IBA(364.5,32,3,1,0)="The full name of all other insured for bill entry IBXIEN."
^IBA(364.5,32,3,2,0)="Format is free text as the user entered it into the insured's name field."
^IBA(364.5,32,3,3,0)="Data is returned in an array IBXDATA(n).  This is a group element and"
^IBA(364.5,32,3,4,0)="up to 2 data elements are returned in the IBXDATA(n) array.  If the primary"
^IBA(364.5,32,3,5,0)="insurance is the current responsible, the secondary and tertiary insurance"
^IBA(364.5,32,3,6,0)="insured's name are returned.  If the secondary insurance is the"
^IBA(364.5,32,3,7,0)="current responsible, the primary and tertiary insurance insured's name"
^IBA(364.5,32,3,8,0)="are returned. If the tertiary insurance is the current responsible, the"
^IBA(364.5,32,3,9,0)="primary and secondary insurance insured's name are returned."
^IBA(364.5,33,0)="N-OTH INSURED GRP NUMBER^N^E^G^399^^^"
^IBA(364.5,33,1)="N Z,Z0,Z1,IBZ D F^IBCEF(""N-ALL INSURANCE GROUP NUMBER"",""IBZ"") S Z=$$COBN^IBCEF(IBXIEN) S Z0=0 F Z1=1:1:3 I Z1'=Z,$D(^DGCR(399,IBXIEN,""I""_Z1)) S Z0=Z0+1,IBXDATA(Z0)=$G(IBZ(Z1))"
^IBA(364.5,33,3,0)="12^^11^11^2990611^^^^"
^IBA(364.5,33,3,1,0)="All other insured's group numbers for bill entry IBXIEN.  The data is"
^IBA(364.5,33,3,2,0)="extracted from the old group number field in the policy record or the"
^IBA(364.5,33,3,3,0)="GROUP NUMBER from the GROUP INSURANCE PLAN file if no old group number is"
^IBA(364.5,33,3,4,0)="available.  Data is returned in an array IBXDATA(n).  This is a group data"
^IBA(364.5,33,3,5,0)="element and up to 2 data elements are returned in the IBXDATA(n) array.  If"
^IBA(364.5,33,3,6,0)="the primary insurance is the current responsible, the secondary and"
^IBA(364.5,33,3,7,0)="tertiary insurance insured's group numbers are returned.  If the secondary"
^IBA(364.5,33,3,8,0)="insurance is the current responsible, the primary and tertiary insurance"
^IBA(364.5,33,3,9,0)="insured's group numbers are returned. If the tertiary insurance is the"
^IBA(364.5,33,3,10,0)="current responsible, the primary and secondary insurance insured's group"
^IBA(364.5,33,3,11,0)="numbers are returned."
^IBA(364.5,34,0)="N-OTH INSURED ID^N^E^G^399^^^"
^IBA(364.5,34,1)="N Z,Z0,Z1,IBZ D F^IBCEF(""N-ALL INSURANCE NUMBER"",""IBZ"") S Z=$$COBN^IBCEF(IBXIEN) S Z0=0 F Z1=1:1:3 I Z1'=Z,$D(^DGCR(399,IBXIEN,""I""_Z1)) S Z0=Z0+1,IBXDATA(Z0)=$G(IBZ(Z1))"
^IBA(364.5,34,3,0)="^^10^10^2991018^^^^"
^IBA(364.5,34,3,1,0)="All id numbers of other insured for bill IBXIEN. Search for number by"
^IBA(364.5,34,3,2,0)="first of three fields not null: other insurance SUBSCRIBER ID, the"
^IBA(364.5,34,3,3,0)="other insurance GROUP NUMBER, the patient's SSN."
^IBA(364.5,34,3,4,0)="Data is returned in an array IBXDATA(n).  This is a group data element and"
^IBA(364.5,34,3,5,0)="up to 2 data elements are returned in the IBXDATA(n) array.  If the primary"
^IBA(364.5,34,3,6,0)="insurance is the current responsible, the secondary and tertiary insurance"
^IBA(364.5,34,3,7,0)="insured's id numbers are returned.  If the secondary insurance is the"
^IBA(364.5,34,3,8,0)="current responsible, the primary and tertiary insurance insured's id numbers"
^IBA(364.5,34,3,9,0)="are returned. If the tertiary insurance is the current responsible, the"
^IBA(364.5,34,3,10,0)="primary and secondary insurance insured's id numbers are returned."
^IBA(364.5,35,0)="N-OTH INSURED PT RELATION^N^E^G^399^^^"
^IBA(364.5,35,1)="N Z,Z0,Z1,IBZ D F^IBCEF(""N-ALL INSURED PT RELATION"",""IBZ"") S Z=$$COBN^IBCEF(IBXIEN) S Z0=0 F Z1=1:1:3 I Z1'=Z,$D(^DGCR(399,IBXIEN,""I""_Z1)) S Z0=Z0+1,IBXDATA(Z0)=$G(IBZ(Z1))"
^IBA(364.5,35,3,0)="^^8^8^2990614^^^^"
^IBA(364.5,35,3,1,0)="All other insured's relationship to patient codes for bill entry IBXIEN."
^IBA(364.5,35,3,2,0)="Data is returned in an array IBXDATA(1-n).  This is a group element and"
^IBA(364.5,35,3,3,0)="up to 2 data elements are returned in the IBXDATA(n) array.  If the primary"
^IBA(364.5,35,3,4,0)="insurance is the current responsible, the secondary and tertiary insurance"
^IBA(364.5,35,3,5,0)="insured relation to pt are returned.  If the secondary insurance is the"
^IBA(364.5,35,3,6,0)="current responsible, the primary and tertiary insurance insured relation to"
^IBA(364.5,35,3,7,0)="pt are returned. If the tertiary insurance is the current responsible, the"
^IBA(364.5,35,3,8,0)="primary and secondary insurance insured relation to pt are returned."
^IBA(364.5,44,0)="N-PRIMARY AUTH CODE^N^F^I^399^TREATMENT AUTHORIZATION CODE^I^"
^IBA(364.5,44,1)=""
^IBA(364.5,44,3,0)="^^1^1^2991115^^^^"
^IBA(364.5,44,3,1,0)="The treatment authorization code for the primary bill holder for bill IBXIEN."
^IBA(364.5,45,0)="N-CURR INSURANCE COMPANY NAME^N^E^I^399^^^"
^IBA(364.5,45,1)="N IBZ D F^IBCEF(""N-ALL INSURANCE COMPANIES"",""IBZ"",,IBXIEN) S IBZ=$P($G(IBZ(+$$COBN^IBCEF(IBXIEN))),U) I IBZ'="""" S IBXDATA=IBZ"
^IBA(364.5,45,3,0)="^^2^2^2991006^^^^"
^IBA(364.5,45,3,1,0)="The mailing name (or if this is null, the insurance co name) of the current"
^IBA(364.5,45,3,2,0)="insurance company for bill entry IBXIEN."
^IBA(364.5,46,0)="N-OTH INSURANCE CO. NAME^N^E^G^399^^^"
^IBA(364.5,46,1)="N Z,Z0,Z1,IBZ D F^IBCEF(""N-ALL INSURANCE COMPANIES"",""IBZ"") S Z=$$COBN^IBCEF(IBXIEN) S Z0=0 F Z1=1:1:3 I Z1'=Z,$D(^DGCR(399,IBXIEN,""I""_Z1)) S Z0=Z0+1,IBXDATA(Z0)=$G(IBZ(Z1))"
^IBA(364.5,46,3,0)="^^8^8^2990611^^^^"
^IBA(364.5,46,3,1,0)="The ien of all other insurance companies for bill entry IBXIEN."
^IBA(364.5,46,3,2,0)="Data is returned in an array IBXDATA(n).  This is a group element and"
^IBA(364.5,46,3,3,0)="up to 2 data elements are returned in the IBXDATA(n) array.  If the primary"
^IBA(364.5,46,3,4,0)="insurance is the current responsible, the secondary and tertiary insurance"
^IBA(364.5,46,3,5,0)="co ien's are returned.  If the secondary insurance is the current"
^IBA(364.5,46,3,6,0)="responsible, the primary and tertiary insurance co ien's are returned. If"
^IBA(364.5,46,3,7,0)="the tertiary insurance is the current responsible, the primary and"
^IBA(364.5,46,3,8,0)="secondary insurance co ien's are returned."
^IBA(364.5,48,0)="N-CURR INS EMPLOYMENT STAT^N^E^I^399^^^"
^IBA(364.5,48,1)="N IBZ D F^IBCEF(""N-ALL INSURED EMPLOY STATUS"",""IBZ"",,IBXIEN) S IBZ=$G(IBZ(+$$COBN^IBCEF(IBXIEN))) I IBZ'="""" S IBXDATA=IBZ"
^IBA(364.5,48,3,0)="^^1^1^2990614^^^^"
^IBA(364.5,48,3,1,0)="The current insured's employment status code for bill entry IBXIEN."
^IBA(364.5,49,0)="N-OTHER INSURED EMPLOY STATUS^N^E^G^399^^^"
^IBA(364.5,49,1)="N Z,Z0,Z1,IBZ D F^IBCEF(""N-ALL INSURED EMPLOY STATUS"",""IBZ"") S Z=$$COBN^IBCEF(IBXIEN) S Z0=0 F Z1=1:1:3 I Z1'=Z,$D(^DGCR(399,IBXIEN,""I""_Z1)) S Z0=Z0+1,IBXDATA(Z0)=$G(IBZ(Z1))"
^IBA(364.5,49,3,0)="3^^8^8^2990825^^"
^IBA(364.5,49,3,1,0)="All other insured employment status' for bill entry IBXIEN. This is a group"
^IBA(364.5,49,3,2,0)="element and up to 2 data elements are returned in the IBXDATA(n) array.  "
^IBA(364.5,49,3,3,0)="If the primary insurance is the current responsible, the secondary and"
^IBA(364.5,49,3,4,0)="tertiary insured's employment status are returned.  If the"
^IBA(364.5,49,3,5,0)="secondary insurance is the current responsible, the primary and tertiary"
^IBA(364.5,49,3,6,0)="insured's employment status are returned. If the tertiary"
^IBA(364.5,49,3,7,0)="insurance is the current responsible, the primary and secondary"
^IBA(364.5,49,3,8,0)="insured's employment status are returned."
^IBA(364.5,53,0)="N-UB92 FORM LOCATOR 78^N^F^I^399^*FORM LOCATOR 78^^"
^IBA(364.5,53,1)=""
^IBA(364.5,53,3,0)="^^1^1^2991115^^^^"
^IBA(364.5,53,3,1,0)="The UB92 data for FORM LOCATOR 78 for bill IBXIEN."
^IBA(364.5,54,0)="N-BILL DESIGNATION^N^F^I^399^CURRENT BILL PAYER SEQUENCE^^"
^IBA(364.5,54,1)=""
^IBA(364.5,54,3,0)="^^2^2^2991115^^^^"
^IBA(364.5,54,3,1,0)="'P' for primary, 'S' for secondary, 'T' for Tertiary bill for bill entry"
^IBA(364.5,54,3,2,0)="IBXIEN."
^IBA(364.5,55,0)="N-CURR INS FORM LOC 64^N^E^I^399^^^"
^IBA(364.5,55,1)="N Z S Z=$$COBN^IBCEF(IBXIEN) D F^IBCEF(""N-UB-04 FORM LOCATOR 64""_$P(""^B^C"",U,Z)) S:$$WNRBILL^IBEFUNC(IBXIEN) IBXDATA="""""
^IBA(364.5,55,3,0)="^364.53^2^2^3070122^^"
^IBA(364.5,55,3,1,0)="The form locator 64 data for the current insurance company for bill entry"
^IBA(364.5,55,3,2,0)="IBXIEN."
^IBA(364.5,56,0)="N-OTH INS FORM LOC 64^N^E^G^399^^^"
^IBA(364.5,56,1)="N Z,Z0,Z1,IBZ I $D(^DGCR(399,IBXIEN,""I2"")) S Z=$$COBN^IBCEF(IBXIEN) S Z1=$S(Z>1:""^""_$E("" CB"",Z),1:""B^C"") F Z0=1,2 D F^IBCEF(""N-UB-04 FORM LOCATOR 64""_$P(Z1,U,Z0),""IBZ"",,IBXIEN) S IBXDATA(Z0)=$G(IBZ)"
^IBA(364.5,56,3,0)="^^8^8^3070605^"
^IBA(364.5,56,3,1,0)="The form locator 64 data for all other insurance companies for bill entry"
^IBA(364.5,56,3,2,0)="IBXIEN.  Data is returned in array IBXDATA(n).  This is a group element and"
^IBA(364.5,56,3,3,0)="up to 2 data elements are returned in the IBXDATA(n) array.  If the primary"
^IBA(364.5,56,3,4,0)="insurance is the current responsible, the secondary and tertiary insurance"
^IBA(364.5,56,3,5,0)="form locator 64 data are returned.  If the secondary insurance is the"
^IBA(364.5,56,3,6,0)="current responsible, the primary and tertiary insurance form locator 64 data"
^IBA(364.5,56,3,7,0)="are returned. If the tertiary insurance is the current responsible, the"
^IBA(364.5,56,3,8,0)="primary and secondary insurance form locator 64 data are returned."
^IBA(364.5,58,0)="N-PROVIDER SIGNATURE ON FILE^N^E^I^399^^^"
^IBA(364.5,58,1)="S IBXDATA=$P($G(^IBE(350.9,1,1)),U)'="""",IBXDATA=$P(""Y"",U,IBXDATA)"
^IBA(364.5,58,3,0)="^^2^2^2960307^^^^"
^IBA(364.5,58,3,1,0)="'Y' if the provider signature is on file in the site parameters file"
^IBA(364.5,58,3,2,0)="(Does not rely on bill entry number)."
^IBA(364.5,59,0)="N-PATIENT STREET ADDRESS LN 1^N^E^I^399^^^"
^IBA(364.5,59,1)="N IBZ D F^IBCEF(""N-PATIENT STREET ADDRESS 1-3"",""IBZ"",,IBXIEN) K IBXDATA S IBXDATA=$G(^UTILITY(""VAPA"",$J,1))"
^IBA(364.5,59,3,0)="^^1^1^2960614^^^^"
^IBA(364.5,59,3,1,0)="The first line of the patient's street address for bill entry IBXIEN."
^IBA(364.5,60,0)="N-PATIENT STREET ADDRESS LN 2^N^E^I^399^^^"
^IBA(364.5,60,1)="N IBZ D F^IBCEF(""N-PATIENT STREET ADDRESS 1-3"",""IBZ"",,IBXIEN) K IBXDATA S IBXDATA=$G(^UTILITY(""VAPA"",$J,2))"
^IBA(364.5,60,3,0)="^^1^1^2960614^^^^"
^IBA(364.5,60,3,1,0)="The second line of the patient's street address for bill entry IBXIEN."
^IBA(364.5,61,0)="N-PATIENT CITY^N^E^I^399^^^"
^IBA(364.5,61,1)="S IBXDATA=$$PTADDR^IBCEF(IBXIEN,4)"
^IBA(364.5,61,3,0)="^^1^1^2960814^^^^"
^IBA(364.5,61,3,1,0)="The patient's city for bill entry IBXIEN."
^IBA(364.5,62,0)="N-PATIENT STATE^N^E^I^399^^^"
^IBA(364.5,62,1)="S IBXDATA=$$PTADDR^IBCEF(IBXIEN,5)"
^IBA(364.5,62,3,0)="^^1^1^2960814^^^^"
^IBA(364.5,62,3,1,0)="The internal entry number of the patient's state for bill entry IBXIEN."
^IBA(364.5,63,0)="N-PATIENT ZIP CODE^N^E^I^399^^^"
^IBA(364.5,63,1)="S IBXDATA=$$PTADDR^IBCEF(IBXIEN,11)"
^IBA(364.5,63,3,0)="^^1^1^2960814^^^^"
^IBA(364.5,63,3,1,0)="The patient's zip code +4 for bill entry IBXIEN."
^IBA(364.5,64,0)="N-PATIENT PHONE^N^E^I^399^^^"
^IBA(364.5,64,1)="S IBXDATA=$$PTADDR^IBCEF(IBXIEN,8)"
^IBA(364.5,64,3,0)="^^1^1^2960814^^^^"
^IBA(364.5,64,3,1,0)="The phone number for the patient for bill entry IBXIEN."
^IBA(364.5,65,0)="N-PATIENT NAME^N^E^I^399^^^"
^IBA(364.5,65,1)="S IBXDATA=$$PTDEM^IBCEF(IBXIEN,1)"
^IBA(364.5,65,3,0)="^^1^1^2960814^^^^"
^IBA(364.5,65,3,1,0)="The name of the patient as it exists in patient file for bill entry IBXIEN."
^IBA(364.5,66,0)="N-PATIENT BIRTHDATE^N^E^I^399^^^"
^IBA(364.5,66,1)="S IBXDATA=$$PTDEM^IBCEF(IBXIEN,3)"
^IBA(364.5,66,3,0)="^^1^1^2960814^^^^"
^IBA(364.5,66,3,1,0)="The fileman format of the birth date for the patient for bill entry IBXIEN."
^IBA(364.5,67,0)="N-PATIENT SEX^N^E^I^399^^^"
^IBA(364.5,67,1)="S IBXDATA=$$PTDEM^IBCEF(IBXIEN,5)"
^IBA(364.5,67,3,0)="^^1^1^2960814^^^^"
^IBA(364.5,67,3,1,0)="The internal code of the sex for the patient for bill entry IBXIEN."
^IBA(364.5,68,0)="N-PATIENT MARITAL STATUS^N^E^I^399^^^"
^IBA(364.5,68,1)="S IBXDATA=$$PTDEM^IBCEF(IBXIEN,10)"
^IBA(364.5,68,3,0)="^^2^2^2960814^^^^"
^IBA(364.5,68,3,1,0)="The internal code of the marital status for the patient for bill entry"
^IBA(364.5,68,3,2,0)="IBXIEN."
^IBA(364.5,69,0)="N-BILL NUMBER^N^F^I^399^BILL NUMBER^I^"
^IBA(364.5,69,1)=""
^IBA(364.5,69,3,0)="^^1^1^2991115^^^^"
^IBA(364.5,69,3,1,0)="Bill number for the bill entry IBXIEN."
^IBA(364.5,70,0)="N-PATIENT EMPLOYER NAME^N^E^I^399^^^"
^IBA(364.5,70,1)="S IBXDATA=$$PTEMPL^IBCEF(IBXIEN,9)"
^IBA(364.5,70,3,0)="^^1^1^2960307^^^^"
^IBA(364.5,70,3,1,0)="The name of the patient's employer for bill entry IBXIEN."
^IBA(364.5,71,0)="N-STATEMENT COVERS FROM DATE^N^F^I^399^STATEMENT COVERS FROM^I^"
^IBA(364.5,71,1)=""
^IBA(364.5,71,3,0)="^^1^1^2991115^^^^"
^IBA(364.5,71,3,1,0)="The internal fileman date for statement from date for bill entry IBXIEN."
^IBA(364.5,72,0)="N-UB92 FORM LOCATOR 2^N^E^I^399^^^"
^IBA(364.5,72,1)="S IBXDATA=$P($G(^DGCR(399,IBXIEN,""UF3"")),U) ;Same name on 2 fileman fields in this file - can't extract with FM type field"
^IBA(364.5,72,3,0)="^^3^3^2960814^^^^"
^IBA(364.5,72,3,1,0)="The UB92 data for FORM LOCATOR 2 for bill IBXIEN."
^IBA(364.5,72,3,2,0)="There are 2 fields in file 399 with the same name - can't extract with FM"
^IBA(364.5,72,3,3,0)="type field."
^IBA(364.5,73,0)="N-TYPE OF BILL^N^E^I^399^^^"
^IBA(364.5,73,1)="S IBXDATA=$P($G(^DGCR(399,IBXIEN,0)),U,4)_$P($G(^(0)),U,5)"
^IBA(364.5,73,3,0)="^^1^1^2960612^^^^"
^IBA(364.5,73,3,1,0)="The type of bill for bill entry IBXIEN."
^IBA(364.5,74,0)="N-BILL FREQUENCY^N^F^I^399^TIMEFRAME OF BILL^^"
^IBA(364.5,74,1)=""
^IBA(364.5,74,3,0)="^^1^1^2991115^^^^"
^IBA(364.5,74,3,1,0)="The internal code for the frequency of the bill entry IBXIEN."
^IBA(364.5,75,0)="N-COVERED DAYS^N^F^I^399^COVERED DAYS^I^"
^IBA(364.5,75,1)=""
^IBA(364.5,75,3,0)="^^1^1^2991115^^^^"
^IBA(364.5,75,3,1,0)="The number of covered days for bill entry IBXIEN."
^IBA(364.5,76,0)="N-NON-COVERED DAYS^N^F^I^399^NON-COVERED DAYS^I^"
^IBA(364.5,76,1)=""
^IBA(364.5,76,3,0)="^^1^1^2991115^^^^"
^IBA(364.5,76,3,1,0)="The number of non-covered days for bill entry IBXIEN."
^IBA(364.5,78,0)="N-ADMISSION DATE^N^E^I^399^^^"
^IBA(364.5,78,1)="D ADMDT^IBCEF2(IBXIEN)"
^IBA(364.5,78,3,0)="^364.53^6^6^3000918^^^^"
^IBA(364.5,78,3,1,0)="FOR INPATIENT BILLS: use the admission date if PTF record exists or else"
^IBA(364.5,78,3,2,0)="event date for bill entry IBXIEN.  For non-PTF admissions, also appends the"
^IBA(364.5,78,3,3,0)="time of admission.  Return format is internal Fileman format"
^IBA(364.5,78,3,4,0)="FOR OUTPATIENT BILLS: use event date to check for admission covering that"
^IBA(364.5,78,3,5,0)="date.  If any, use its ADMISSION DATE. Return format is internal Fileman "
^IBA(364.5,78,3,6,0)="format."
^IBA(364.5,79,0)="N-TYPE OF ADMISSION^N^E^I^399^^^"
^IBA(364.5,79,1)="S IBXDATA="""" I $$INPAT^IBCEF(IBXIEN,1) S IBXDATA=$P($G(^DGCR(399,IBXIEN,""U"")),U,8) S:'IBXDATA IBXDATA=9"
^IBA(364.5,79,3,0)="^^2^2^2990602^^^^"
^IBA(364.5,79,3,1,0)="The type of admission (if an inpatient type bill) for bill entry IBXIEN."
^IBA(364.5,79,3,2,0)="If none found on the bill, asssume 9."
^IBA(364.5,80,0)="N-SOURCE OF ADMISSION^N^E^I^399^^^"
^IBA(364.5,80,1)="S IBXDATA=+$P($G(^DGCR(399,IBXIEN,""U"")),U,9) S:'$$INPAT^IBCEF(IBXIEN,1)&'IBXDATA IBXDATA=2 S:'IBXDATA IBXDATA=9"
^IBA(364.5,80,3,0)="^364.53^2^2^3010530^^^^"
^IBA(364.5,80,3,1,0)="The source of admission for bill entry IBXIEN. Default for outpatient"
^IBA(364.5,80,3,2,0)="is 2 (CLINIC REFERRAL), for inpatient it's 9 (UNKNOWN)."
^IBA(364.5,81,0)="N-DISCHARGE DATE^N^E^I^399^^^"
^IBA(364.5,81,1)="D DISDT^IBCEF2(IBXIEN)"
^IBA(364.5,81,3,0)="^^5^5^2960814^^^^"
^IBA(364.5,81,3,1,0)="FOR INPATIENT BILLS: the discharge date for bill entry IBXIEN. If no PTF"
^IBA(364.5,81,3,2,0)="discharge date found on the bill, use NON-VA DISCHARGE DATE on bill."
^IBA(364.5,81,3,3,0)=" "
^IBA(364.5,81,3,4,0)="FOR OUTPATIENT BILLS: use event date to check for admission covering that"
^IBA(364.5,81,3,5,0)="date.  If any, use its DISCHARGE DATE."
^IBA(364.5,82,0)="N-BILL REMARKS^N^E^G^399^^^"
^IBA(364.5,82,1)="D REMARKS^IBCEF21(IBXIEN)"
^IBA(364.5,82,3,0)="^^5^5^2960327^^^^"
^IBA(364.5,82,3,1,0)="Includes remarks to appear on every form from the IB site parameters file"
^IBA(364.5,82,3,2,0)="for all bills, the bill comment on the bill entry IBXIEN, and the list of"
^IBA(364.5,82,3,3,0)="Prosthetics on the bill.  Data is returned in an array IBXDATA(1-n)."
^IBA(364.5,83,0)="N-ATT/REND PHYSICIAN NAME^N^E^I^399^^^"
^IBA(364.5,83,1)="N IBZ,IBT S IBT=$S($$FT^IBCEF(IBXIEN)=2:3,1:4) D GETPRV^IBCEU(IBXIEN,IBT,.IBZ) S IBXDATA=$P($G(IBZ(IBT,1)),U)_U_$P($G(IBZ(IBT,1)),U,3)_U_$P($G(IBZ(IBT,1)),U,4)"
^IBA(364.5,83,3,0)="^364.53^3^3^3000919^^^^"
^IBA(364.5,83,3,1,0)="The name of the attending (inpatient) or rendering (outpatient) physician"
^IBA(364.5,83,3,2,0)="for bill entry IBXIEN.  inpatient type=4, outpatient=3"
^IBA(364.5,83,3,3,0)="1st '^'-piece is name, 2nd is new person file ien, 3rd is credentials"
^IBA(364.5,84,0)="N-OTHER PHYSICIAN^N^E^I^399^^^"
^IBA(364.5,84,1)="N IBZ D GETPRV^IBCEU(IBXIEN,9,.IBZ) S IBXDATA=$P($G(IBZ(9,1)),U) I IBXDATA="""" S IBXDATA=$P($G(^DGCR(399,IBXIEN,""U1"")),U,14)"
^IBA(364.5,84,3,0)="^364.53^2^2^3000822^^^^"
^IBA(364.5,84,3,1,0)="The physician name for the OTHER function provider or if none, the id in"
^IBA(364.5,84,3,2,0)="field 214 (FORM LOCATOR 93) of the Bill/Claims file for bill entry IBXIEN."
^IBA(364.5,85,0)="N-ADMITTING DIAGNOSIS^N^E^I^399^^^"
^IBA(364.5,85,1)="S IBXDATA=+$G(^DGCR(399,IBXIEN,""U2"")),IBXDATA=$S(IBXDATA:$P($G(^ICD9(+IBXDATA,0)),U),1:"""")"
^IBA(364.5,85,3,0)="^^1^1^3070220^"
^IBA(364.5,85,3,1,0)="The admitting diagnosis for bill entry IBXIEN."
^IBA(364.5,86,0)="N-DIAGNOSES^N^E^G^399^^^"
^IBA(364.5,86,1)="N IBNDXX,IBDXX D SET^IBCSC4D(IBXIEN,.IBDXX,.IBNDXX) S IBNDXX=0 F  S IBNDXX=$O(IBNDXX(IBNDXX)) Q:'IBNDXX  S IBXDATA(IBNDXX)=+IBNDXX(IBNDXX)_U_$G(IBDXX(+IBNDXX(IBNDXX))) K ^TMP(""IBXSAVE"",$J,""DX"",IBXIEN)"
^IBA(364.5,86,3,0)="^^5^5^2980420^^^^"
^IBA(364.5,86,3,1,0)="The array of diagnoses for bill entry IBXIEN.  Principal diagnosis is in"
^IBA(364.5,86,3,2,0)="IBXDATA(1).  Data is in internal (pointer value) format."
^IBA(364.5,86,3,3,0)="Array ^TMP(""IBXSAVE"",$J,""DX"",ib diagnosis file ptr (file 362.3))=ctr is used"
^IBA(364.5,86,3,4,0)="to determine the associated diagnosis positional pointer (box 24E on HCFA"
^IBA(364.5,86,3,5,0)="1500).  Data is returned in an array IBXDATA(1-n)."
^IBA(364.5,87,0)="N-CONDITION RELATED TO EMPLOY^N^E^I^399^^^"
^IBA(364.5,87,1)="X ""N Z,Z1 S Z=0 F  S Z=$O(^DGCR(399,IBXIEN,""""CC"""",Z)) Q:'Z  S Z1=+$G(^(Z,0)),Z1=$P($G(^DGCR(399.1,+Z1,0)),U,2) I Z1=""""02"""" S IBXDATA=1 Q"" I '$G(IBXDATA),$$OCC^IBCEF1(IBXIEN,1) S IBXDATA=1"
^IBA(364.5,87,3,0)="^^2^2^2970922^^^^"
^IBA(364.5,87,3,1,0)="If any condition codes are 02, this field is 1 (yes) for bill entry IBXIEN."
^IBA(364.5,87,3,2,0)="If no 02 condition codes, check occurrence codes for OCCUR RELATED TO = 1."
^IBA(364.5,88,0)="N-CONDITION RELATED TO AUTO^N^E^G^399^^^"
^IBA(364.5,88,1)="N Z S Z=$$OCC^IBCEF1(IBXIEN,2) I Z S IBXDATA=Z"
^IBA(364.5,88,3,0)="^^2^2^2960814^^^^"
^IBA(364.5,88,3,1,0)="Check occurrence codes for OCCUR RELATED TO = 2 for bill entry IBXIEN.  If"
^IBA(364.5,88,3,2,0)="any, field is returned as 1^state code pointer."
^IBA(364.5,89,0)="N-CONDITION RELATED TO OTH ACC^N^E^I^399^^^"
^IBA(364.5,89,1)="S IBXDATA="""" I $$OCC^IBCEF1(IBXIEN,3) S IBXDATA=1"
^IBA(364.5,89,3,0)="^^2^2^2960814^^^^"
^IBA(364.5,89,3,1,0)="Check occurrence codes for OCCUR RELATED TO = 3 for bill entry IBXIEN."
^IBA(364.5,89,3,2,0)="Flag is returned as 1 if this condition is TRUE."
^IBA(364.5,90,0)="N-SIMILAR ILLNESS DATE^N^E^I^399^^^"
^IBA(364.5,90,1)="S IBXDATA=$P($$OCC^IBCEF1(IBXIEN,"""",""ONSET OF SYMPTOMS/ILLNESS""),U,2) I 'IBXDATA N Z S Z=$P($G(^DGCR(399,IBXIEN,0)),U,17) I Z'=IBXIEN S IBXDATA=$P($G(^DGCR(399,+Z,0)),U,3)"
^IBA(364.5,90,3,0)="^^4^4^2960814^^^^"
^IBA(364.5,90,3,1,0)="The fileman format of 'onset' date for bill entry IBXIEN as retrieved from"
^IBA(364.5,90,3,2,0)="the occurrence codes.  If not in occurrence codes and there is a PRIMARY"
^IBA(364.5,90,3,3,0)="BILL for the bill IBXIEN, use the EVENT DATE of the PRIMARY BILL bill entry."
^IBA(364.5,90,3,4,0)="Box 15 of HCFA 1500 form."
^IBA(364.5,92,0)="N-DATE OF CURRENT ILLNESS^N^F^I^399^EVENT DATE^I^"
^IBA(364.5,92,1)=""
^IBA(364.5,92,3,0)="^^2^2^2991122^^^^"
^IBA(364.5,92,3,1,0)="Fileman formatted date.  The data for box 14 on HCFA-1500 for bill entry"
^IBA(364.5,92,3,2,0)="IBXIEN.  This data element has been replaced by N-EVENT DATE."
^IBA(364.5,93,0)="N-DATE UNABLE TO WORK FROM^N^F^I^399^UNABLE TO WORK FROM^I^"
^IBA(364.5,93,1)=""
^IBA(364.5,93,3,0)="^^1^1^2991115^^^^"
^IBA(364.5,93,3,1,0)="The internal date for unable to work from for bill entry IBXIEN."
^IBA(364.5,94,0)="N-DATE UNABLE TO WORK TO^N^F^I^399^UNABLE TO WORK TO^I^"
^IBA(364.5,94,1)=""
^IBA(364.5,94,3,0)="^^1^1^2991115^^^^"
^IBA(364.5,94,3,1,0)="The internal date for unable to work to for bill entry IBXIEN."
^IBA(364.5,95,0)="N-TOTAL CHARGES^N^F^I^399^TOTAL CHARGES^I^"
^IBA(364.5,95,1)=""
^IBA(364.5,95,3,0)="^^1^1^2991115^^^^"
^IBA(364.5,95,3,1,0)="The total charges on the bill for bill entry IBXIEN."
^IBA(364.5,97,0)="N-NON-INSTITUTIONAL CLAIM TYPE^N^E^I^399^^^"
^IBA(364.5,97,1)="S IBXDATA="""" I $$FT^IBCEF(IBXIEN)=2 S IBXDATA=$S($O(^IBA(362.4,""AIFN""_IBXIEN,0)):""RX"",1:""MD"")"
^IBA(364.5,97,3,0)="^364.53^2^2^3000822^^^^"
^IBA(364.5,97,3,1,0)="If an outpatient bill-'MD'; if a prescription bill-'RX' for bill entry"
^IBA(364.5,97,3,2,0)="IBXIEN."
^IBA(364.5,98,0)="N-BILL SUBMISSION STATUS^N^E^I^399^^^"
^IBA(364.5,98,1)="S IBXDATA=$S('$$NEEDMRA^IBEFUNC(IBXIEN):""00"",$P($G(^DGCR(399,IBXIEN,""S"")),U,12)'="""":""00"",1:""15"")"
^IBA(364.5,98,3,0)="^^3^3^2980624^^^^"
^IBA(364.5,98,3,1,0)="If bill not being submitted for MRA and FIRST PRINTED has a value for bill"
^IBA(364.5,98,3,2,0)="entry IBXIEN, this is a resubmission ('15'), otherwise, it is the original"
^IBA(364.5,98,3,3,0)="bill ('00')."
^IBA(364.5,99,0)="N-PATIENT EMPLOYMENT STATUS^N^E^I^399^^^"
^IBA(364.5,99,1)="S IBXDATA=$$EMPSTAT^IBCEF(IBXIEN,""v"")"
^IBA(364.5,99,3,0)="^^1^1^2990614^^^^"
^IBA(364.5,99,3,1,0)="The employment status code for the patient for bill entry IBXIEN."
^IBA(364.5,100,0)="N-KILL IBXSAVE^N^E^I^399^^^"
^IBA(364.5,100,1)="K IBXSAVE"
^IBA(364.5,100,3,0)="^^1^1^2960307^^^^"
^IBA(364.5,100,3,1,0)="Used to clean up the IBXSAVE array as processing occurs."
^IBA(364.5,101,0)="N-OTH INSURANCE SEQUENCE^N^E^G^399^^^"
^IBA(364.5,101,1)="K IBXSAVE(1) N Z,C,D,Q S Z=$P($G(^DGCR(399,IBXIEN,0)),U,21) I $D(^(""I2""))!$D(^(""I3"")) S IBXSAVE(1)=Z,Q=$S(""P""[Z:""23"",""S""[Z:""13"",1:""12"") F C=1,2 S D=$E(Q,C),IBXDATA(C)=$E(""PST"",D) S:$D(^DGCR(399,IBXIEN,""I""_D)) IBXSAVE(1,D)=IBXDATA(C)"
^IBA(364.5,101,3,0)="^364.53^8^8^3040706^^^^"
^IBA(364.5,101,3,1,0)="The sequence (P)rimary, (S)econdary, (T)ertiary indicators for all other"
^IBA(364.5,101,3,2,0)="insurance for bill entry IBXIEN.  This is a group element and up to"
^IBA(364.5,101,3,3,0)="up to 2 data elements are returned in the IBXDATA(n) array.  If the primary"
^IBA(364.5,101,3,4,0)="insurance is the current responsible, the secondary and tertiary insurance"
^IBA(364.5,101,3,5,0)="sequence indicators are returned.  If the secondary insurance is the"
^IBA(364.5,101,3,6,0)="current responsible, the primary and tertiary insurance sequence indicators"
^IBA(364.5,101,3,7,0)="are returned. If the tertiary insurance is the current responsible, the"
^IBA(364.5,101,3,8,0)="primary and secondary insurance sequence indicators are returned."
^IBA(364.5,102,0)="N-PRESCRIPTIONS^N^E^G^399^^^"
^IBA(364.5,102,1)="S IBXDATA=$$RX^IBCEF1(IBXIEN)"
^IBA(364.5,102,3,0)="^364.53^4^4^3000822^^^^"
^IBA(364.5,102,3,1,0)="The array for prescriptions to be billed for bill entry IBXIEN.  Format is"
^IBA(364.5,102,3,2,0)="  PRESCRIPTION #  ^ DRUG NAME ^ NDC # ^ REFILL # ^ REFILL DATE ^ QUANTITY "
^IBA(364.5,102,3,3,0)="  DAYS SUPPLY ^ CHARGE, IF KNOWN ^ IEN OF ENTRY IN FILE 362.4."
^IBA(364.5,102,3,4,0)="Data is returned in an array IBXDATA(n)."
^IBA(364.5,103,0)="N-AGENT CASHIER MAIL SYMBOL^N^E^I^399^^^"
^IBA(364.5,103,1)="S IBXDATA=$P($G(^IBE(350.9,1,2)),U)"
^IBA(364.5,103,3,0)="^^2^2^2990413^^"
^IBA(364.5,103,3,1,0)="The agent cashier mail symbol from the site parameter file.  Not related"
^IBA(364.5,103,3,2,0)="to bill entry number."
^IBA(364.5,104,0)="N-AGENT CASHIER STREET ADDRESS^N^E^I^399^^^"
^IBA(364.5,104,1)="S IBXDATA=$P($G(^IBE(350.9,1,2)),U,2)"
^IBA(364.5,104,3,0)="^364.53^2^2^3001020^^"
^IBA(364.5,104,3,1,0)="The agent cashier street address from the site parameter file.  Not related"
^IBA(364.5,104,3,2,0)="to bill entry number."
^IBA(364.5,105,0)="N-AGENT CASHIER CITY^N^E^I^399^^^"
^IBA(364.5,105,1)="S IBXDATA=$P($G(^IBE(350.9,1,2)),U,3)"
^IBA(364.5,105,3,0)="^364.53^2^2^3001020^^"
^IBA(364.5,105,3,1,0)="The agent cashier city from the site parameter file.  Not related to"
^IBA(364.5,105,3,2,0)="bill entry number."
^IBA(364.5,106,0)="N-AGENT CASHIER STATE^N^E^I^399^^^"
^IBA(364.5,106,1)="S IBXDATA=$P($G(^IBE(350.9,1,2)),U,4)"
^IBA(364.5,106,3,0)="^^2^2^2960814^"
^IBA(364.5,106,3,1,0)="The agent cashier state pointer from the site parameter file.  Not related"
^IBA(364.5,106,3,2,0)="bill to entry number."
^IBA(364.5,107,0)="N-AGENT CASHIER ZIP CODE^N^E^I^399^^^"
^IBA(364.5,107,1)="S IBXDATA=$P($G(^IBE(350.9,1,2)),U,5)"
^IBA(364.5,107,3,0)="^^2^2^2960814^"
^IBA(364.5,107,3,1,0)="The agent cashier zip code from the site parameter file.  Not related to"
^IBA(364.5,107,3,2,0)="bill entry number."
^IBA(364.5,108,0)="N-AGENT CASHIER PHONE^N^E^I^399^^^"
^IBA(364.5,108,1)="S IBXDATA=$P($G(^IBE(350.9,1,2)),U,6)"
^IBA(364.5,108,3,0)="^^2^2^2960814^"
^IBA(364.5,108,3,1,0)="The agent cashier phone # from the site parameter file.  Not related to"
^IBA(364.5,108,3,2,0)="bill entry number."
^IBA(364.5,109,0)="N-FEDERAL TAX ID^N^E^I^399^^^"
^IBA(364.5,109,1)="S IBXDATA=$P($G(^IBE(350.9,1,1)),U,5)"
^IBA(364.5,109,3,0)="^364.53^2^2^3001121^^^^"
^IBA(364.5,109,3,1,0)="The federal tax id number from the site parameters file.  Not related to"
^IBA(364.5,109,3,2,0)="bill entry number.  Only has to be extracted for first bill in each batch."
^IBA(364.5,111,0)="N-MAMMOGRAPHY CERT#^N^F^I^399^MAMMOGRAPHY CERT NUMBER^I^"
^IBA(364.5,111,1)=""
^IBA(364.5,111,3,0)="^^2^2^3060116^"
^IBA(364.5,111,3,1,0)="Data element used to retrieve the mammography certification number for "
^IBA(364.5,111,3,2,0)="the claim."
^IBA(364.5,112,0)="N-LAB CLIA NUMBER^N^F^I^399^LAB CLIA NUMBER^E^"
^IBA(364.5,112,1)=""
^IBA(364.5,112,3,0)="^364.53^2^2^3060111^^"
^IBA(364.5,112,3,1,0)="This CLIA# data element replaces IEN 271 for SUB-8 processing."
^IBA(364.5,112,3,2,0)="Just retrieve the CLIA# from field 235 in file 399."
^IBA(364.5,113,0)="N-LAB OR FACILITY PRIMARY ID^N^E^I^399^^^"
^IBA(364.5,113,1)="S IBXDATA=$$EIN^IBCEP8A(IBXIEN)"
^IBA(364.5,113,3,0)="^^3^3^3060116^"
^IBA(364.5,113,3,1,0)="This data element is the Federal tax ID for either the VA facility or the "
^IBA(364.5,113,3,2,0)="non-VA facility.  Used for 837 flat file SUB-9.  Also used as the data "
^IBA(364.5,113,3,3,0)="element for Hcfa-1500, Box 32, Line 4 printed form."
^IBA(364.5,114,0)="N-FACILITY NAME^N^E^I^399^^^"
^IBA(364.5,114,1)="S IBXDATA=$P($G(^DIC(4,+$P($G(^IBE(350.9,1,0)),U,2),0)),U)"
^IBA(364.5,114,3,0)="^^2^2^2990825^^^^"
^IBA(364.5,114,3,1,0)="The facility name from the INSTITUTION file.  Not related to bill entry"
^IBA(364.5,114,3,2,0)="number."
^IBA(364.5,115,0)="N-SET 837 HEADER NODE^N^E^I^399^^^"
^IBA(364.5,115,1)="D:'$D(^TMP(""IBHDR"",$J)) SETHDR^IBCE837"
^IBA(364.5,115,3,0)="^^2^2^2960307^^^^"
^IBA(364.5,115,3,1,0)="Sets the header node for the first bill in batch, doesn't extract any more"
^IBA(364.5,115,3,2,0)="header info for remaining bills in batch if this node is set."
^IBA(364.5,116,0)="N-FACILITY STREET ADDRESS 1^N^E^I^399^^^"
^IBA(364.5,116,1)="N IBZ S IBZ=$G(^TMP(""IBXSITE"",$J)) D:'IBZ F^IBCEF(""N-SITE NUMBER"",""IBZ"",,IBXIEN) S:IBZ IBXDATA=$P($G(^DIC(4,+IBZ,1)),U)"
^IBA(364.5,116,3,0)="^^2^2^2990611^^^^"
^IBA(364.5,116,3,1,0)="The facility street address line 1 from the INSTITUTION file.  Only has to"
^IBA(364.5,116,3,2,0)="be extracted for the first bill in the batch."
^IBA(364.5,117,0)="N-FACILITY CITY^N^E^I^399^^^"
^IBA(364.5,117,1)="N IBZ S IBZ=$G(^TMP(""IBXSITE"",$J)) D:'IBZ F^IBCEF(""N-SITE NUMBER"",""IBZ"",,IBXIEN) S:IBZ IBXDATA=$P($G(^DIC(4,+IBZ,1)),U,3)"
^IBA(364.5,117,3,0)="^^2^2^2990611^^^^"
^IBA(364.5,117,3,1,0)="The facility city from the INSTITUTION file.  Only has to be extracted for"
^IBA(364.5,117,3,2,0)="the first bill in the batch."
^IBA(364.5,118,0)="N-FACILITY STATE^N^E^I^399^^^"
^IBA(364.5,118,1)="N IBZ S IBZ=$G(^TMP(""IBXSITE"",$J)) D:'IBZ F^IBCEF(""N-SITE NUMBER"",""IBZ"",,IBXIEN) S:IBZ IBXDATA=$P($G(^DIC(4,+IBZ,1)),U,2)"
^IBA(364.5,118,3,0)="^^2^2^2990611^^^^"
^IBA(364.5,118,3,1,0)="The internal file number of the facility state from the INSTITUTION file."
^IBA(364.5,118,3,2,0)="Only has to be extracted for the first bill in the batch."
^IBA(364.5,119,0)="N-FACILITY ZIP CODE^N^E^I^399^^^"
^IBA(364.5,119,1)="N IBZ S IBZ=$G(^TMP(""IBXSITE"",$J)) D:'IBZ F^IBCEF(""N-SITE NUMBER"",""IBZ"",,IBXIEN) S:IBZ IBXDATA=$P($G(^DIC(4,+IBZ,1)),U,4)"
^IBA(364.5,119,3,0)="^^2^2^2990225^^^^"
^IBA(364.5,119,3,1,0)="The facility zip code from the INSTITUTION file.  Only has to be extracted"
^IBA(364.5,119,3,2,0)="for the first bill in the batch."
^IBA(364.5,120,0)="N-BATCH NUMBER^N^E^I^399^^^"
^IBA(364.5,120,1)="S IBXDATA="""" I '$D(^TMP(""IBHDR"",$J)) S IBXDATA=$$BATCH^IBCEF1()"
^IBA(364.5,120,3,0)="^^2^2^2960307^^^^"
^IBA(364.5,120,3,1,0)="The batch number for this batch of bills.  Not related to bill entry number."
^IBA(364.5,120,3,2,0)="Only has to be extracted for the first bill in the batch."
^IBA(364.5,121,0)="N-BATCH DATE^N^E^I^399^^^"
^IBA(364.5,121,1)="S IBXDATA=$G(DT)"
^IBA(364.5,121,3,0)="^^2^2^2960307^^^^"
^IBA(364.5,121,3,1,0)="Today's date for the batch date.  Not related to bill entry number.  Only"
^IBA(364.5,121,3,2,0)="has to be extracted for the first bill in the batch."
^IBA(364.5,123,0)="N-CURR INSURANCE CO ID NUM^N^E^I^399^^^"
^IBA(364.5,123,1)="N IBZ,Z D F^IBCEF(""N-ALL INSURANCE CO 837 ID"",""IBZ"",,IBXIEN) S Z=+$$COBN^IBCEF(IBXIEN) I $G(IBZ(Z))'="""" S IBXDATA=IBZ(Z)"
^IBA(364.5,123,3,0)="^^3^3^2990629^^^^"
^IBA(364.5,123,3,1,0)="The national insurance file id number for the insurance company for the"
^IBA(364.5,123,3,2,0)="batch of bills.  Only needs to be extracted once for a batch of bills."
^IBA(364.5,123,3,3,0)="Uses insurance company from current insurance company on bill entry IBXIEN."
^IBA(364.5,124,0)="N-RECEIVER ID NUMBER^N^E^I^399^^^"
^IBA(364.5,124,1)="S IBXDATA=$$RECVR^IBCEF2(IBXIEN)"
^IBA(364.5,124,3,0)="^^4^4^2960307^^^^"
^IBA(364.5,124,3,1,0)="The V.A. identified id for the entity to receive the 837 transmission"
^IBA(364.5,124,3,2,0)="from Austin.  Only needs to be extracted once for a batch of bills."
^IBA(364.5,124,3,3,0)="Uses insurance company from current insurance company on bill entry IBXIEN"
^IBA(364.5,124,3,4,0)="to determine the receiver."
^IBA(364.5,125,0)="N-OTH INSURANCE PRIOR PAYMENT^N^E^G^399^^^"
^IBA(364.5,125,1)="N Z,Z0,Z1,IBZ D F^IBCEF(""N-PRIOR PAYMENTS"",""IBZ"") S Z=$$COBN^IBCEF(IBXIEN) S Z0=0 F Z1=1:1:3 I Z1'=Z,$D(^DGCR(399,IBXIEN,""I""_Z1)) S Z0=Z0+1,IBXDATA(Z0)=$G(IBZ(Z1))"
^IBA(364.5,125,3,0)="^^8^8^2990608^^^^"
^IBA(364.5,125,3,1,0)="The prior payments made by each insurance company for bill entry IBXIEN."
^IBA(364.5,125,3,2,0)="Data is returned in an array IBXDATA(1-n).  This is a group element and"
^IBA(364.5,125,3,3,0)="up to 2 data elements are returned in the IBXDATA(n) array.  If the primary"
^IBA(364.5,125,3,4,0)="insurance is the current responsible, no prior payments are returned.  If"
^IBA(364.5,125,3,5,0)="the secondary insurance is the current responsible, the primary insurance "
^IBA(364.5,125,3,6,0)="prior payments are returned. If the tertiary insurance is the current "
^IBA(364.5,125,3,7,0)="responsible, the primary and secondary insurance prior payments are "
^IBA(364.5,125,3,8,0)="returned."
^IBA(364.5,126,0)="N-HCFA 1500 SERVICE LINE (EDI)^N^E^G^399^^^"
^IBA(364.5,126,1)="S IBXDATA="""" I $$FT^IBCEF(IBXIEN)=2 D OUTPT^IBCEF11(IBXIEN,0)"
^IBA(364.5,126,3,0)="^^13^13^3000120^^^^"
^IBA(364.5,126,3,1,0)="The elements of the outpatient services line on the HCFA 1500 (BOX 24) for"
^IBA(364.5,126,3,2,0)="bill entry IBXIEN.  Format is begin date^end date^place of service code"
^IBA(364.5,126,3,3,0)=" type of service code^procedure or revenue code^type of code^ diagnosis"
^IBA(364.5,126,3,4,0)=" pointers^unit charge^units^modifier pointer ien(s) separated by commas"
^IBA(364.5,126,3,5,0)=" purchased charge amount ^ anesthesia minutes^emergency indicator^lab type"
^IBA(364.5,126,3,6,0)="of service flag. Data is returned in an array IBXDATA(1-n).  Also returns"
^IBA(364.5,126,3,7,0)="the arrays IBXDATA(n,""AUX"")=the 'AUX' node for the procedure entry on the"
^IBA(364.5,126,3,8,0)="claim IBXDATA(""ITEM"",item type,item pointer)=n^ctr if this data can be"
^IBA(364.5,126,3,9,0)="gathered.  "
^IBA(364.5,126,3,10,0)="For COB data at a line level, the array IBXDATA(n,""COB"",COBSEQ,m)=cob line"
^IBA(364.5,126,3,11,0)="level adjustment data (0-node) and IBXDATA(n,""COB"",COBSEQ,m,z,p) = the"
^IBA(364.5,126,3,12,0)="reasons for the adj m,p are sequence #'s, z = ' PR' for deductible and"
^IBA(364.5,126,3,13,0)="co-insurance entries and = Reason Group Code for the rest."
^IBA(364.5,127,0)="N-CURR INSURANCE CO PROV #^N^E^I^399^^^"
^IBA(364.5,127,1)="N IBZ,Z D F^IBCEF(""N-ALL INSURANCE CO PROV NUM"",""IBZ"",,IBXIEN) S Z=+$$COBN^IBCEF(IBXIEN) I $G(IBZ(Z))'="""" S IBXDATA=IBZ(Z)"
^IBA(364.5,127,3,0)="^364.53^1^1^3040617^^^^"
^IBA(364.5,127,3,1,0)="The provider number for the current insurance company for bill entry IBXIEN."
^IBA(364.5,128,0)="N-OTH INSURANCE PROVIDER #^N^E^G^399^^^"
^IBA(364.5,128,1)="N Z,Z0,Z1,IBZ D F^IBCEF(""N-ALL INSURANCE CO PROV NUM"",""IBZ"") S Z=$$COBN^IBCEF(IBXIEN) S Z0=0 F Z1=1:1:3 I Z1'=Z,$D(^DGCR(399,IBXIEN,""I""_Z1)) S Z0=Z0+1,IBXDATA(Z0)=$G(IBZ(Z1))"
^IBA(364.5,128,3,0)="^^11^11^2990611^^^^"
^IBA(364.5,128,3,1,0)="This data element returns the provider numbers from bill entry IBXIEN for"
^IBA(364.5,128,3,2,0)="the insurance companies on the bill that are not currently the company"
^IBA(364.5,128,3,3,0)="responsible for the payment of the bill.  This is a group element and up to"
^IBA(364.5,128,3,4,0)="2 data elements are returned in the IBXDATA(n) array.  If the primary"
^IBA(364.5,128,3,5,0)="insurance is the current responsible,  the secondary and tertiary insurance"
^IBA(364.5,128,3,6,0)="co #'s are returned.  If the secondary insurance is the current responsible,"
^IBA(364.5,128,3,7,0)="the primary and tertiary insurance co #'s are returned.  If the tertiary"
^IBA(364.5,128,3,8,0)="insurance is the current responsible, the primary and secondary insurance"
^IBA(364.5,128,3,9,0)="co #'s are returned."
^IBA(364.5,128,3,10,0)="If any of the insurance company's do not have this data, the site's tax"
^IBA(364.5,128,3,11,0)="id is used."
^IBA(364.5,129,0)="N-CURRENT INSURANCE CO 837 ID^N^E^I^399^^^"
^IBA(364.5,129,1)="S IBXDATA=$$PAYERID^IBCEF2(IBXIEN)"
^IBA(364.5,129,3,0)="^^2^2^2990608^^^^"
^IBA(364.5,129,3,1,0)="The internal code number to identify the current insurance company to the"
^IBA(364.5,129,3,2,0)="ENVOY system."
^IBA(364.5,131,0)="N-RECORD ID^N^E^I^399^^^"
^IBA(364.5,131,1)="S IBXDATA="""""
^IBA(364.5,131,3,0)="^^1^1^2960307^^^^"
^IBA(364.5,131,3,1,0)="The hard-coded record id for each segment of the 837 transmission string."
^IBA(364.5,133,0)="N-STATEMENT COVERS TO DATE^N^F^I^399^STATEMENT COVERS TO^I^"
^IBA(364.5,133,1)=""
^IBA(364.5,133,3,0)="^^1^1^2991115^^^^"
^IBA(364.5,133,3,1,0)="The internal fileman date for statement to date for bill entry IBXIEN."
^IBA(364.5,134,0)="N-SITE NUMBER^N^E^I^399^^^"
^IBA(364.5,134,1)="S IBXDATA=+$$SITE^VASITE()"
^IBA(364.5,134,3,0)="^^1^1^2960311^^^^"
^IBA(364.5,134,3,1,0)="This is the 3-digit number that identifies the site."
^IBA(364.5,135,0)="N-COMMON BILL REMARKS^N^E^G^399^^^"
^IBA(364.5,135,1)="D CREM^IBCEF21(IBXIEN)"
^IBA(364.5,135,3,0)="^^3^3^2960327^^^^"
^IBA(364.5,135,3,1,0)="Common remarks to appear on every bill from the IB site parameters file"
^IBA(364.5,135,3,2,0)="for all bills, the standard non-service connected disclaimer and the"
^IBA(364.5,135,3,3,0)="MEDICARE non-payment explanation."
^IBA(364.5,136,0)="N-SEGMENT DELIMITER^N^C^I^399^^^~"
^IBA(364.5,136,1)=""
^IBA(364.5,136,3,0)="^^2^2^2960417^^"
^IBA(364.5,136,3,1,0)="The character that will be used to indicate the end of each segment.  Must"
^IBA(364.5,136,3,2,0)="be included in the BGN segment."
^IBA(364.5,137,0)="N-MAILING ADDRESS NAME^N^F^I^399^MAILING ADDRESS NAME^I^"
^IBA(364.5,137,1)=""
^IBA(364.5,137,3,0)="^364.53^1^1^3001020^^^^"
^IBA(364.5,137,3,1,0)="The mailing address name from the bill."
^IBA(364.5,138,0)="N-MAILING ADDRESS FULL^N^E^G^399^^^"
^IBA(364.5,138,1)="N Z,A K IB S Z=$G(^DGCR(399,IBXIEN,""M"")),A=0 S:$P(Z,U,5)'="""" A=A+1,IB(A)=$P(Z,U,5) S:$P(Z,U,6)'="""" A=A+1,IB(A)=$P(Z,U,6) S:$L($P($G(^(""M1"")),U)) A=A+1,IB(A)=$P(^(""M1""),U) S IB(""C"")=$P(Z,U,7),IB(""S"")=$P(Z,U,8),IB(""Z"")=$TR($P(Z,U,9),""-"")"
^IBA(364.5,138,2)="IB"
^IBA(364.5,138,3,0)="2^364.53^5^5^3000918^^^^"
^IBA(364.5,138,3,1,0)="Replaced by data element #192 - N-CURR INS CO FULL ADDRESS 9/2000"
^IBA(364.5,138,3,2,0)="The street mailing addresses for the bill returned as a group element"
^IBA(364.5,138,3,3,0)="in IB(1-3) and then the mailing address city, state and zip returned in"
^IBA(364.5,138,3,4,0)="IB(""C""), IB(""S"") and IB(""Z"").  Note the zip code is stripped of any 'dashes'"
^IBA(364.5,138,3,5,0)="it may contain."
^IBA(364.5,142,0)="N-PRINT BILL SUBMIT STATUS^N^E^I^399^^^"
^IBA(364.5,142,1)="S:'$D(IBPNT) IBPNT=0 S IBXDATA=$S($$NEEDMRA^IBEFUNC(IBXIEN):""*** NOT A BILL-MRA NEEDED ***"",IBPNT=0:""*** COPY OF ORIGINAL BILL ***"",IBPNT=2:""*** SECOND NOTICE ***"",IBPNT=3:""*** THIRD NOTICE ***"",1:"""")"
^IBA(364.5,142,3,0)="^^3^3^3061103^"
^IBA(364.5,142,3,1,0)="The bill type to print at the top of either the CMS-1500 or the UB-04.  "
^IBA(364.5,142,3,2,0)="This element assumes that the variable IBPNT has been previously set by a"
^IBA(364.5,142,3,3,0)="pre-processor routine or by some other method."
^IBA(364.5,143,0)="N-PATIENT SSN^N^E^I^399^^^"
^IBA(364.5,143,1)="S IBXDATA=$$PTDEM^IBCEF(IBXIEN,2)"
^IBA(364.5,143,3,0)="^^1^1^2960815^"
^IBA(364.5,143,3,1,0)="Unformatted social security number for the patient for bill IBXIEN."
^IBA(364.5,144,0)="N-OTHER INSURANCE EXISTS^N^E^I^399^^^"
^IBA(364.5,144,1)="N Z,Z0 S (IBXDATA,Z0)=0 F Z=1:1:3 I $D(^DGCR(399,IBXIEN,""I""_Z)) S Z0=Z0+1 S:Z0>1 IBXDATA=1 Q:IBXDATA"
^IBA(364.5,144,3,0)="^^2^2^2960814"
^IBA(364.5,144,3,1,0)="Returns a 0 if only one insurance found for bill IBXIEN, returns a 1 if more"
^IBA(364.5,144,3,2,0)="than one insurance found."
^IBA(364.5,145,0)="N-HCFA 1500 BOX 12^N^C^I^399^^^SIGNATURE ON FILE"
^IBA(364.5,145,1)=""
^IBA(364.5,145,3,0)="^^1^1^2960814"
^IBA(364.5,145,3,1,0)="PATIENT'S OR AUTHORIZED SIGNATURE FOR RELEASE OF INFORMATION TEXT"
^IBA(364.5,146,0)="N-HCFA 1500 BOX 13^N^C^I^399^^^SIGNATURE ON FILE"
^IBA(364.5,146,1)=""
^IBA(364.5,146,3,0)="^364.53^2^2^3000918^"
^IBA(364.5,146,3,1,0)="Statement proclaiming the insured's or authorized person's signature for"
^IBA(364.5,146,3,2,0)="assignment of benefits is on file."
^IBA(364.5,147,0)="N-HCFA 1500 BOX 18 (FR)^N^E^I^399^^^"
^IBA(364.5,147,1)="D F^IBCEF(""N-ADMISSION DATE"") S:IBXDATA IBXDATA=IBXDATA\1 I 'IBXDATA,'$$INPAT^IBCEF(IBXIEN,1) D F^IBCEF(""N-STATEMENT COVERS FROM DATE"")"
^IBA(364.5,147,3,0)="^364.53^2^2^3000918^"
^IBA(364.5,147,3,1,0)="Get admission date from N-ADMISSION DATE data element and strip off the"
^IBA(364.5,147,3,2,0)="time."
^IBA(364.5,148,0)="N-HCFA 1500 BOX 19^N^E^I^399^^^"
^IBA(364.5,148,1)="S IBXDATA=$$BOX19^IBCEU3(IBXIEN)"
^IBA(364.5,148,3,0)="^^22^22^2991130^^^^"
^IBA(364.5,148,3,1,0)="The data for BOX 19 on the HCFA 1500.  This data is derived from a"
^IBA(364.5,148,3,2,0)="combination of different data throughout the system and is limited to 80"
^IBA(364.5,148,3,3,0)="characters.  The hierarchy for including data is as follows (until 80"
^IBA(364.5,148,3,4,0)="characters have been used):"
^IBA(364.5,148,3,5,0)="   "
^IBA(364.5,148,3,6,0)="   DATE LAST SEEN and REFERRING PHYSICIAN ID# (physical therapy)"
^IBA(364.5,148,3,7,0)="   X-RAY DATE (chiropractic)"
^IBA(364.5,148,3,8,0)="   HOMEBOUND INDICATOR (independent lab renders an EKG or obtains specimen"
^IBA(364.5,148,3,9,0)="                        from a homebound patient)"
^IBA(364.5,148,3,10,0)="   NO ASSIGNMENT OF BENEFITS (if no assignment of benefits indicated)"
^IBA(364.5,148,3,11,0)="   Hearing aid testing (if applicable)"
^IBA(364.5,148,3,12,0)="   DENTAL SURGERY (if applicable)"
^IBA(364.5,148,3,13,0)="   ATTENDING PHYSICIAN NOT HOSPICE EMPLOYEE (if applicable)"
^IBA(364.5,148,3,14,0)="   LOW OSMOLAR CONTRAST MATERIAL (if applicable)"
^IBA(364.5,148,3,15,0)="   SHARED POST-OP CARE TRANSITION DATE (if applicable)"
^IBA(364.5,148,3,16,0)="   COMMENTS IN BOX 19 DATA FIELD"
^IBA(364.5,148,3,17,0)="   REMARKS IN BILL COMMENTS"
^IBA(364.5,148,3,18,0)=" "
^IBA(364.5,148,3,19,0)="You will need to use the Medicare manual to determine when these data"
^IBA(364.5,148,3,20,0)="elements are needed and specifically what data is to be reported.  If the"
^IBA(364.5,148,3,21,0)="individual data elements cannot be entered into VistA in unique fields,"
^IBA(364.5,148,3,22,0)="you will need to enter the corresponding text into the free text box 19"
^IBA(364.5,148,3,23,0)="field."
^IBA(364.5,150,0)="N-HCFA 1500 OUTSIDE LAB^N^E^I^399^^^"
^IBA(364.5,150,1)="S IBXDATA=$$OLAB^IBCEU(IBXIEN)"
^IBA(364.5,150,3,0)="^^1^1^2991209^^^^"
^IBA(364.5,150,3,1,0)="Field that BOX 20 of the HCFA 1500 should always check the NO box."
^IBA(364.5,151,0)="N-HCFA 1500 EIN FLAG (BOX 25)^N^C^I^399^^^X"
^IBA(364.5,151,1)=""
^IBA(364.5,151,3,0)="^^1^1^2960814^^"
^IBA(364.5,151,3,1,0)="'X' to indicate the federal tax id # is of type EIN, not SSN."
^IBA(364.5,152,0)="N-TOTAL CHARGES LESS OFFSET^N^E^I^399^^^"
^IBA(364.5,152,1)="N Z S Z=$G(^DGCR(399,IBXIEN,""U1"")),IBXDATA=$P(Z,U)-$P(Z,U,2)"
^IBA(364.5,152,3,0)="^^1^1^2960814^^"
^IBA(364.5,152,3,1,0)="The value of total charges minus the offset."
^IBA(364.5,153,0)="N-HCFA 1500 BOX 31^N^E^I^399^^^"
^IBA(364.5,153,1)=""
^IBA(364.5,153,3,0)="^^1^1^2991209^^^^"
^IBA(364.5,153,3,1,0)="No longer used."
^IBA(364.5,154,0)="N-HCFA 1500 SERVICES (PRINT)^N^E^G^399^^^"
^IBA(364.5,154,1)="K IBXSAVE(""BOX24"") D OUTPT^IBCEF11(IBXIEN,1)"
^IBA(364.5,154,3,0)="^364.53^14^14^3000105^^^^"
^IBA(364.5,154,3,1,0)="The elements of the outpatient services line on the HCFA 1500 (BOX 24) for"
^IBA(364.5,154,3,2,0)="bill entry IBXIEN.  Format is begin date (MMDDYYYY)^ end date (MMDDYYYY) or"
^IBA(364.5,154,3,3,0)=" null if not different from start date^ place of service code^ type of"
^IBA(364.5,154,3,4,0)=" service code^procedure or bedsection name^type of code^ diagnosis pointers"
^IBA(364.5,154,3,5,0)=" ^ unit charge ^ units ^ modifier pointer ien(s) separated by commas"
^IBA(364.5,154,3,6,0)=" ^ purchased charge amount ^ anesthesia minutes ^ emergency indicator"
^IBA(364.5,154,3,7,0)=" ^ lab type of service flag."
^IBA(364.5,154,3,8,0)="Data is returned in an array IBXDATA(n) for the above data, and"
^IBA(364.5,154,3,9,0)="IBXDATA(n,""AUX"")=box 24K data ^ last chiropractic xray date ^ attending,"
^IBA(364.5,154,3,10,0)=" not hospice physician flag ^ chiro - level of subluxation"
^IBA(364.5,154,3,11,0)=" ^ chiro - treatment series # ^ chiro - quantity ^ EPSDT indicator"
^IBA(364.5,154,3,12,0)="IBXDATA(n,""A"") for revenue code description (abbreviated) if no  procedure."
^IBA(364.5,154,3,13,0)="IBXDATA(n,""TEXT"") for lines of text that will span the entire block 24."
^IBA(364.5,154,3,14,0)="IBXDATA(n,""RX"")=rx#^drug name^NDC#^refill#^refil dt^qty^days^charg^ien 362.4"
^IBA(364.5,155,0)="N-FACILITY STREET ADDRESS 2^N^E^I^399^^^"
^IBA(364.5,155,1)="N IBZ S IBZ=$G(^TMP(""IBXSITE"",$J)) D:'IBZ F^IBCEF(""N-SITE NUMBER"",""IBZ"",,IBXIEN) S:IBZ IBXDATA=$P($G(^DIC(4,+IBZ,1)),U,2)"
^IBA(364.5,155,3,0)="^^2^2^2990225^^^^"
^IBA(364.5,155,3,1,0)="The facility street address line 2 from the INSTITUTION file.  Only has to"
^IBA(364.5,155,3,2,0)="be extracted for the first bill in the batch."
^IBA(364.5,156,0)="N-PRIOR PAYMENTS^N^E^G^399^^^"
^IBA(364.5,156,1)="N Z,Z0 S IBXSAVE(""PTOT"")=0 F Z=1:1:3 I $D(^DGCR(399,IBXIEN,""I""_Z)) S IBXDATA(Z)=$$OTHPAY^IBCEF1(IBXIEN,Z),IBXSAVE(""PTOT"")=IBXSAVE(""PTOT"")+IBXDATA(Z)"
^IBA(364.5,156,3,0)="^^3^3^2960814^^"
^IBA(364.5,156,3,1,0)="This data element contains the primary, secondary, and tertiary prior"
^IBA(364.5,156,3,2,0)="payments in array data elements IBXDATA(1), IBXDATA(2), and IBXDATA(3)."
^IBA(364.5,156,3,3,0)="Store the total prior payments in IBXSAVE array for later use."
^IBA(364.5,157,0)="N-PATIENT STREET ADDRESS 1-3^N^E^I^399^^^"
^IBA(364.5,157,1)="N Z S Z=$$PTADDR^IBCEF(IBXIEN,0),IBXDATA="""""
^IBA(364.5,157,3,0)="^^2^2^2960814^^^^"
^IBA(364.5,157,3,1,0)="Returns the array ^UTILITY(""VAPA"",$J,Z) where Z=1,2,3 and contains the pt's"
^IBA(364.5,157,3,2,0)="3 street addresses."
^IBA(364.5,158,0)="N-CURRENT INSURED RELATIONSHIP^N^E^I^399^^^"
^IBA(364.5,158,1)="N IBZ D F^IBCEF(""N-ALL INSURED PT RELATION"",""IBZ"",,IBXIEN) S IBZ=$G(IBZ(+$$COBN^IBCEF(IBXIEN))) I IBZ'="""" S IBXDATA=IBZ"
^IBA(364.5,158,3,0)="^^3^3^2960814"
^IBA(364.5,158,3,1,0)="The relationship of the current insured from the policy nodes in the bill"
^IBA(364.5,158,3,2,0)="file for bill IBXIEN.  This is used to determine if the address of the"
^IBA(364.5,158,3,3,0)="insured is the 'SAME' as the patient's."
^IBA(364.5,159,0)="N-AUTO ACCIDENT STATE^N^E^I^399^^^"
^IBA(364.5,159,1)="D:'$D(IBXSAVE(""CONDA"")) F^IBCEF(""N-CONDITION RELATED TO AUTO"") S IBXDATA=$S($D(IBXSAVE(""CONDA"")):$P($G(IBXSAVE(""CONDA"")),U,2),1:$P(IBXDATA,U,2))"
^IBA(364.5,159,3,0)="^364.53^4^4^3061113^^^^"
^IBA(364.5,159,3,1,0)="This field relies on the existence of the IBXSAVE(""CONDA"") variable"
^IBA(364.5,159,3,2,0)="previously extracted for CONDITION RELATED TO AUTO.  If IBXSAVE(""CONDA"")"
^IBA(364.5,159,3,3,0)="does not exist, extract the field that sets it.  If IBXSAVE(""CONDA"")"
^IBA(364.5,159,3,4,0)="exists, the second piece contains the pointer to the state."
^IBA(364.5,160,0)="N-HCFA 1500 BOX 18 (TO)^N^E^I^399^^^"
^IBA(364.5,160,1)="D F^IBCEF(""N-DISCHARGE DATE"") S:IBXDATA IBXDATA=IBXDATA\1"
^IBA(364.5,162,0)="N-DIAGNOSIS CODE 2 (HCFA 1500)^N^E^I^399^^^"
^IBA(364.5,162,1)="D:'$D(IBXSAVE(""DX"")) F^IBCEF(""N-DIAGNOSES"") S IBXDATA=$G(IBXSAVE(""DX"",2))"
^IBA(364.5,162,3,0)="^^4^4^2960814^^"
^IBA(364.5,162,3,1,0)="Data element relies on previously extracted data in array IBXSAVE(""DX"")"
^IBA(364.5,162,3,2,0)="from the HCFA DIAGNOSES.  If IBXSAVE(""DX"") does not exist, extract the"
^IBA(364.5,162,3,3,0)="field that sets it.  The second in the sequence of diagnoses for bill"
^IBA(364.5,162,3,4,0)="IBXIEN for the HCFA 1500. This is the internal diagnosis code (ICD9)."
^IBA(364.5,163,0)="N-DIAGNOSIS CODE 3 (HCFA 1500)^N^E^I^399^^^"
^IBA(364.5,163,1)="D:'$D(IBXSAVE(""DX"")) F^IBCEF(""N-DIAGNOSES"") S IBXDATA=$G(IBXSAVE(""DX"",3))"
^IBA(364.5,163,3,0)="^^4^4^2960814^^"
^IBA(364.5,163,3,1,0)="Data element relies on previously extracted data in array IBXSAVE(""DX"")"
^IBA(364.5,163,3,2,0)="from the HCFA DIAGNOSES.  If IBXSAVE(""DX"") does not exist, extract the"
^IBA(364.5,163,3,3,0)="field that sets it.  The third in the sequence of diagnoses for bill"
^IBA(364.5,163,3,4,0)="IBXIEN for the HCFA 1500.  This is the internal diagnosis code (ICD9)."
^IBA(364.5,164,0)="N-DIAGNOSIS CODE 4 (HCFA 1500)^N^E^I^399^^^"
^IBA(364.5,164,1)="D:'$D(IBXSAVE(""DX"")) F^IBCEF(""N-DIAGNOSES"") S IBXDATA=$G(IBXSAVE(""DX"",4))"
^IBA(364.5,164,3,0)="^^4^4^2960814^^"
^IBA(364.5,164,3,1,0)="Data element relies on previously extracted data in array IBXSAVE(""DX"")"
^IBA(364.5,164,3,2,0)="from the HCFA DIAGNOSES.  If IBXSAVE(""DX"") does not exist, extract the"
^IBA(364.5,164,3,3,0)="field that sets it.  The fourth in the sequence of diagnoses for bill"
^IBA(364.5,164,3,4,0)="IBXIEN for the HCFA 1500.  This is the internal diagnosis code (ICD9)."
^IBA(364.5,165,0)="N-DATE OF SERVICE FROM^N^E^G^399^^^"
^IBA(364.5,165,1)="D:'$D(IBXSAVE(""BOX24"")) B24^IBCEF3(.IBXSAVE,IBXIEN) D TEXT24^IBCEU3(""AF"",.IBXSAVE,.IBXDATA)"
^IBA(364.5,165,3,0)="^364.53^8^8^3000918^^^^"
^IBA(364.5,165,3,1,0)="Data element relies on the data previously extracted in array"
^IBA(364.5,165,3,2,0)="IBXSAVE(""BOX24"") from HCFA 1500 SERVICES PRINT.  Returns the array of"
^IBA(364.5,165,3,3,0)="service from dates for each procedure being billed in IBXDATA(n).  Since"
^IBA(364.5,165,3,4,0)="each procedure has 2 lines of data, if there is a text line present for a"
^IBA(364.5,165,3,5,0)="procedure (IBXSAVE(""BOX24"",n,""TEXT"") is defined), the data is returned on"
^IBA(364.5,165,3,6,0)="the upper line and the characters 1-9 of the text are returned on the"
^IBA(364.5,165,3,7,0)="bottom line.  If there is no text, the upper line is returned as null and"
^IBA(364.5,165,3,8,0)="the data extracted is returned on the second line."
^IBA(364.5,166,0)="N-DATE OF SERVICE TO^N^E^G^399^^^"
^IBA(364.5,166,1)="D:'$D(IBXSAVE(""BOX24"")) B24^IBCEF3(.IBXSAVE,IBXIEN) D TEXT24^IBCEU3(""AT"",.IBXSAVE,.IBXDATA)"
^IBA(364.5,166,3,0)="^364.53^8^8^3000918^"
^IBA(364.5,166,3,1,0)="Data element relies on the data previously extracted in array"
^IBA(364.5,166,3,2,0)="IBXSAVE(""BOX24"") from HCFA 1500 SERVICES PRINT.  Returns the array of"
^IBA(364.5,166,3,3,0)="service to dates for each procedure being billed in IBXDATA(n).  Since"
^IBA(364.5,166,3,4,0)="each procedure has 2 lines of data, if there is a text line present for a"
^IBA(364.5,166,3,5,0)="procedure (IBXSAVE(""BOX24"",n,""TEXT"") is defined), the data is returned on"
^IBA(364.5,166,3,6,0)="the upper line and the characters 10-18 of the text are returned on the"
^IBA(364.5,166,3,7,0)="bottom line.  If there is no text, the upper line is returned as null and"
^IBA(364.5,166,3,8,0)="the data extracted is returned on the second line."
^IBA(364.5,167,0)="N-HCFA 1500 PLACE OF SERVICE^N^E^G^399^^^"
^IBA(364.5,167,1)="D:'$D(IBXSAVE(""BOX24"")) B24^IBCEF3(.IBXSAVE,IBXIEN) D TEXT24^IBCEU3(""B"",.IBXSAVE,.IBXDATA)"
^IBA(364.5,167,3,0)="^364.53^8^8^3000918^^^"
^IBA(364.5,167,3,1,0)="Data element relies on the data previously extracted in array"
^IBA(364.5,167,3,2,0)="IBXSAVE(""BOX24"") from HCFA 1500 SERVICES PRINT.  Returns the array of"
^IBA(364.5,167,3,3,0)="place of service codes for each procedure being billed in IBXDATA(n).  Since"
^IBA(364.5,167,3,4,0)="each procedure has 2 lines of data, if there is a text line present for a"
^IBA(364.5,167,3,5,0)="procedure (IBXSAVE(""BOX24"",n,""TEXT"") is defined), the data is returned on"
^IBA(364.5,167,3,6,0)="the upper line and the characters 19-21 of the text are returned on the"
^IBA(364.5,167,3,7,0)="bottom line.  If there is no text, the upper line is returned as null and"
^IBA(364.5,167,3,8,0)="the data extracted is returned on the second line."
^IBA(364.5,168,0)="N-HCFA 1500 TYPE OF SERVICE^N^E^G^399^^^"
^IBA(364.5,168,1)="D:'$D(IBXSAVE(""BOX24"")) B24^IBCEF3(.IBXSAVE,IBXIEN) D TEXT24^IBCEU3(""C"",.IBXSAVE,.IBXDATA)"
^IBA(364.5,168,3,0)="^364.53^8^8^3000918^^^"
^IBA(364.5,168,3,1,0)="Data element relies on the data previously extracted in array"
^IBA(364.5,168,3,2,0)="IBXSAVE(""BOX24"") from HCFA 1500 SERVICES PRINT.  Returns the array of"
^IBA(364.5,168,3,3,0)="type of service codes for each procedure being billed in IBXDATA(n).  Since"
^IBA(364.5,168,3,4,0)="each procedure has 2 lines of data, if there is a text line present for a"
^IBA(364.5,168,3,5,0)="procedure (IBXSAVE(""BOX24"",n,""TEXT"") is defined), the data is returned on"
^IBA(364.5,168,3,6,0)="the upper line and the characters 22-24 of the text are returned on the"
^IBA(364.5,168,3,7,0)="bottom line.  If there is no text, the upper line is returned as null and"
^IBA(364.5,168,3,8,0)="the data extracted is returned on the second line."
^IBA(364.5,169,0)="N-HCFA 1500 PROCEDURES^N^E^G^399^^^"
^IBA(364.5,169,1)="D:'$D(IBXSAVE(""BOX24"")) B24^IBCEF3(.IBXSAVE,IBXIEN) D TEXT24^IBCEU3(""D"",.IBXSAVE,.IBXDATA)"
^IBA(364.5,169,3,0)="^364.53^8^8^3000918^^^^"
^IBA(364.5,169,3,1,0)="Data element relies on the data previously extracted in array"
^IBA(364.5,169,3,2,0)="IBXSAVE(""BOX24"") from HCFA 1500 SERVICES PRINT.  Returns the array of"
^IBA(364.5,169,3,3,0)="HCPCS codes for each procedure being billed in IBXDATA(n).  Since"
^IBA(364.5,169,3,4,0)="each procedure has 2 lines of data, if there is a text line present for a"
^IBA(364.5,169,3,5,0)="procedure (IBXSAVE(""BOX24"",n,""TEXT"") is defined), the data is returned on"
^IBA(364.5,169,3,6,0)="the upper line and the characters 26-41 of the text are returned on the"
^IBA(364.5,169,3,7,0)="bottom line.  If there is no text, the upper line is returned as null and"
^IBA(364.5,169,3,8,0)="the data extracted is returned on the second line."
^IBA(364.5,170,0)="N-DIAGNOSIS CODE REFS^N^E^G^399^^^"
^IBA(364.5,170,1)="D:'$D(IBXSAVE(""BOX24"")) B24^IBCEF3(.IBXSAVE,IBXIEN) D TEXT24^IBCEU3(""E"",.IBXSAVE,.IBXDATA)"
^IBA(364.5,170,3,0)="^364.53^8^8^3000918^^^"
^IBA(364.5,170,3,1,0)="Data element relies on the data previously extracted in array"
^IBA(364.5,170,3,2,0)="IBXSAVE(""BOX24"") from HCFA 1500 SERVICES PRINT.  Returns the array of"
^IBA(364.5,170,3,3,0)="Dx code references for each procedure being billed in IBXDATA(n).  Since"
^IBA(364.5,170,3,4,0)="each procedure has 2 lines of data, if there is a text line present for a"
^IBA(364.5,170,3,5,0)="procedure (IBXSAVE(""BOX24"",n,""TEXT"") is defined), the data is returned on"
^IBA(364.5,170,3,6,0)="the upper line and the characters 42-48 of the text are returned on the"
^IBA(364.5,170,3,7,0)="bottom line.  If there is no text, the upper line is returned as null and"
^IBA(364.5,170,3,8,0)="the data extracted is returned on the second line."
^IBA(364.5,171,0)="N-HCFA 1500 CHARGES^N^E^G^399^^^"
^IBA(364.5,171,1)="D:'$D(IBXSAVE(""BOX24"")) B24^IBCEF3(.IBXSAVE,IBXIEN) D TEXT24^IBCEU3(""F"",.IBXSAVE,.IBXDATA)"
^IBA(364.5,171,3,0)="^364.53^10^10^3000918^^^^"
^IBA(364.5,171,3,1,0)="Data element relies on the data previously extracted in array"
^IBA(364.5,171,3,2,0)="IBXSAVE(""BOX24"") from HCFA 1500 SERVICES PRINT.  Returns the array of"
^IBA(364.5,171,3,3,0)="raw charges (unformatted) for each procedure being billed in IBXDATA(n)."
^IBA(364.5,171,3,4,0)="This data is calculated by taking the unit charge * units to get the total"
^IBA(364.5,171,3,5,0)="charge for the line item.  Since each procedure has 2 lines of data, if"
^IBA(364.5,171,3,6,0)="there is a text line present for a procedure (IBXSAVE(""BOX24"",n,""TEXT"") is"
^IBA(364.5,171,3,7,0)="defined), the data is returned on the upper line and the characters 49-58"
^IBA(364.5,171,3,8,0)="of the text are returned on the bottom line.  If there is no text, the"
^IBA(364.5,171,3,9,0)="upper line is returned as null and the data extracted is returned on the"
^IBA(364.5,171,3,10,0)="second line."
^IBA(364.5,172,0)="N-HCFA 1500 UNITS^N^E^G^399^^^"
^IBA(364.5,172,1)="D:'$D(IBXSAVE(""BOX24"")) B24^IBCEF3(.IBXSAVE,IBXIEN) D TEXT24^IBCEU3(""G"",.IBXSAVE,.IBXDATA)"
^IBA(364.5,172,3,0)="^364.53^10^10^3000918^^^^"
^IBA(364.5,172,3,1,0)="Data element relies on the data previously extracted in array"
^IBA(364.5,172,3,2,0)="IBXSAVE(""BOX24"") from HCFA 1500 SERVICES PRINT.  Returns the array of"
^IBA(364.5,172,3,3,0)="units (unformatted) for each procedure being billed in IBXDATA(n)."
^IBA(364.5,172,3,4,0)="If the line item has a type of service = 7 (anesthesia), the units are"
^IBA(364.5,172,3,5,0)="always output as 1 and the actual minutes print as text on the text line."
^IBA(364.5,172,3,6,0)="Since each procedure has 2 lines of data, if there is a text line present"
^IBA(364.5,172,3,7,0)="for a procedure (IBXSAVE(""BOX24"",n,""TEXT"") is defined), the data is"
^IBA(364.5,172,3,8,0)="returned on the upper line and the characters 59-61 of the text are"
^IBA(364.5,172,3,9,0)="returned on the bottom line.  If there is no text, the upper line is"
^IBA(364.5,172,3,10,0)="returned as null and the data extracted is returned on the second line."
^IBA(364.5,173,0)="N-HCFA 1500 BALANCE DUE BOX^N^E^I^399^^^"
^IBA(364.5,173,1)="N Z S Z=$G(^DGCR(399,IBXIEN,""U1"")),IBXDATA=Z-$P(Z,U,2)"
^IBA(364.5,173,3,0)="^364.53^1^1^3000918^^^"
^IBA(364.5,173,3,1,0)="The total due on bill entry IBXIEN calculated: Total Charges - Offset Amount"
^IBA(364.5,174,0)="N-HCFA BOX 24H FREE TEXT^N^E^G^399^^^"
^IBA(364.5,174,1)="D:'$D(IBXSAVE(""BOX24"")) B24^IBCEF3(.IBXSAVE,IBXIEN) D TEXT24^IBCEU3(""H"",.IBXSAVE,.IBXDATA)"
^IBA(364.5,174,3,0)="^364.53^8^8^3000918^^^^"
^IBA(364.5,174,3,1,0)="Data element relies on the data previously extracted in array"
^IBA(364.5,174,3,2,0)="IBXSAVE(""BOX24"") from HCFA 1500 SERVICES PRINT.  Returns the array of"
^IBA(364.5,174,3,3,0)="EPSDT indicator for each procedure being billed in IBXDATA(n)."
^IBA(364.5,174,3,4,0)="Since each procedure has 2 lines of data, if there is a text line present"
^IBA(364.5,174,3,5,0)="for a procedure (IBXSAVE(""BOX24"",n,""TEXT"") is defined), the data is"
^IBA(364.5,174,3,6,0)="returned on the upper line and the characters 62-64 of the text are"
^IBA(364.5,174,3,7,0)="returned on the bottom line.  If there is no text, the upper line is"
^IBA(364.5,174,3,8,0)="returned as null and the data extracted is returned on the second line."
^IBA(364.5,175,0)="N-HCFA BOX 24I FREE TEXT^N^E^G^399^^^"
^IBA(364.5,175,1)="D:'$D(IBXSAVE(""BOX24"")) B24^IBCEF3(.IBXSAVE,IBXIEN) D TEXT24^IBCEU3(""I"",.IBXSAVE,.IBXDATA)"
^IBA(364.5,175,3,0)="^364.53^8^8^3000918^^^^"
^IBA(364.5,175,3,1,0)="Data element relies on the data previously extracted in array"
^IBA(364.5,175,3,2,0)="IBXSAVE(""BOX24"") from HCFA 1500 SERVICES PRINT.  Returns the array of"
^IBA(364.5,175,3,3,0)="emergency indicators for each procedure being billed in IBXDATA(n)."
^IBA(364.5,175,3,4,0)="Since each procedure has 2 lines of data, if there is a text line present"
^IBA(364.5,175,3,5,0)="for a procedure (IBXSAVE(""BOX24"",n,""TEXT"") is defined), the data is"
^IBA(364.5,175,3,6,0)="returned on the upper line and the characters 65-67 of the text are"
^IBA(364.5,175,3,7,0)="returned on the bottom line.  If there is no text, the upper line is"
^IBA(364.5,175,3,8,0)="returned as null and the data extracted is returned on the second line."
^IBA(364.5,176,0)="N-HCFA BOX 24J FREE TEXT^N^E^G^399^^^"
^IBA(364.5,176,1)="D:'$D(IBXSAVE(""BOX24"")) B24^IBCEF3(.IBXSAVE,IBXIEN) D TEXT24^IBCEU3(""J"",.IBXSAVE,.IBXDATA)"
^IBA(364.5,176,3,0)="^364.53^9^9^3000918^^^^"
^IBA(364.5,176,3,1,0)="Data element relies on the data previously extracted in array"
^IBA(364.5,176,3,2,0)="IBXSAVE(""BOX24"") from HCFA 1500 SERVICES PRINT.  Returns the array of"
^IBA(364.5,176,3,3,0)="null values (as this field is not currently supported) for each procedure"
^IBA(364.5,176,3,4,0)="being billed in IBXDATA(n). Since each procedure has 2 lines of data, if"
^IBA(364.5,176,3,5,0)="there is a text line present for a procedure (IBXSAVE(""BOX24"",n,""TEXT"") is"
^IBA(364.5,176,3,6,0)="defined), the data is returned on the upper line and the characters 68-70 of"
^IBA(364.5,176,3,7,0)="the text are returned on the bottom line.  If there is no text, the upper"
^IBA(364.5,176,3,8,0)="line is returned as null and the data extracted is returned on the second"
^IBA(364.5,176,3,9,0)="line."
^IBA(364.5,177,0)="N-HCFA BOX 24K FREE TEXT^N^E^G^399^^^"
^IBA(364.5,177,1)="N M,S D:'$D(IBXSAVE(""BOX24"")) B24^IBCEF3(.IBXSAVE,IBXIEN) S M=$$WNRBILL^IBEFUNC(IBXIEN),S="""" S:M S=$$MCRSPEC^IBCEU4(IBXIEN,1),IBXSAVE(""Q"")=$S(S'="""":""V""_S_$P($$SITE^VASITE,U,3),1:"""") D TEXT24^IBCEU3(""K"",.IBXSAVE,.IBXDATA) K IBXSAVE(""Q"")"
^IBA(364.5,177,3,0)="^364.53^8^8^3000823^^^^"
^IBA(364.5,177,3,1,0)="Data element relies on the data previously extracted in array"
^IBA(364.5,177,3,2,0)="IBXSAVE(""BOX24"") from HCFA 1500 SERVICES PRINT.  Returns the array of"
^IBA(364.5,177,3,3,0)="HCFA 1500 Box 24 data for each procedure being billed in IBXDATA(n)."
^IBA(364.5,177,3,4,0)="Since each procedure has 2 lines of data, if there is a text line present"
^IBA(364.5,177,3,5,0)="for a procedure (IBXSAVE(""BOX24"",n,""TEXT"") is defined), the data is"
^IBA(364.5,177,3,6,0)="returned on the upper line and the characters 71-80 of the text are"
^IBA(364.5,177,3,7,0)="returned on the bottom line.  If there is no text, the upper line is"
^IBA(364.5,177,3,8,0)="returned as null and the data extracted is returned on the second line."
^IBA(364.5,178,0)="N-HCFA 1500 MODIFIERS^N^E^G^399^^^"
^IBA(364.5,178,1)="N Z,Z0 S IBXDATA="""",Z0=$S('$G(^TMP(""IBTX"",$J,IBXIEN)):""BOX24"",1:""OUTPT"") D:'$D(IBXSAVE(Z0)) B24^IBCEF3(.IBXSAVE,IBXIEN) S Z=0 F  S Z=$O(IBXSAVE(Z0,Z)) Q:'Z  S IBXDATA(Z)=$P(IBXSAVE(Z0,Z),U,10)"
^IBA(364.5,178,3,0)="^364.53^8^8^3000823^^^^"
^IBA(364.5,178,3,1,0)="Data element relies on the data previously extracted in array"
^IBA(364.5,178,3,2,0)="IBXSAVE(""BOX24"") from HCFA 1500 SERVICES PRINT.  Returns the array of"
^IBA(364.5,178,3,3,0)="modifiers for each procedure being billed in IBXDATA(n)."
^IBA(364.5,178,3,4,0)="Since each procedure has 2 lines of data, if there is a text line present"
^IBA(364.5,178,3,5,0)="for a procedure (IBXSAVE(""BOX24"",n,""TEXT"") is defined), the data is"
^IBA(364.5,178,3,6,0)="returned on the upper line and the characters 7-16 of the text are"
^IBA(364.5,178,3,7,0)="returned on the bottom line.  If there is no text, the upper line is"
^IBA(364.5,178,3,8,0)="returned as null and the data extracted is returned on the second line."
^IBA(364.5,179,0)="N-LINES BOX 24 (HCFA 1500)^N^E^G^399^^^"
^IBA(364.5,179,1)="N IBXPARM D BILLPARM^IBCEFG0(IBXIEN,.IBXPARM),PARTEXT^IBCEFG0(1,1,""43^48"",IBXIEN,2,.IBXPARM,.IBXERR) K:$G(IBXERR)="""" IBXERR S IBXDATA="""""
^IBA(364.5,179,3,0)="^^4^4^2960712^^^^"
^IBA(364.5,179,3,1,0)="This data element extracts the box 24 data for the HCFA 1500.  It returns"
^IBA(364.5,179,3,2,0)="the array ^TMP(""IBXDISP"",$J,PG,LN) that 'looks' like the printed output"
^IBA(364.5,179,3,3,0)="of BOX 24 for the HCFA 1500 form for bill entry IBXIEN."
^IBA(364.5,179,3,4,0)="WARNING: This data element kills ^TMP(""IBXDATA"",$J) array."
^IBA(364.5,180,0)="N-COLUMNS BOX 24 (HCFA 1500)^N^E^G^399^^^"
^IBA(364.5,180,1)="N IBXPARM D BILLPARM^IBCEFG0(IBXIEN,.IBXPARM),PARTEXT^IBCEFG0(0,1,""43^48"",IBXIEN,2,.IBXPARM,.IBXERR) K:$G(IBXERR)="""" IBXERR S IBXDATA="""""
^IBA(364.5,180,3,0)="^^4^4^2960712^^^^"
^IBA(364.5,180,3,1,0)="This data element extracts the box 24 data for the HCFA 1500.  It returns"
^IBA(364.5,180,3,2,0)="the array ^TMP(""IBXDISP"",$J,PG,LN,COL) that 'looks' like the printed output"
^IBA(364.5,180,3,3,0)="of BOX 24 by pg/line/column for the HCFA 1500 form for bill entry IBXIEN."
^IBA(364.5,180,3,4,0)="WARNING: This data element kills ^TMP(""IBXDATA"",$J) array."
^IBA(364.5,181,0)="N-UB92 SIG REQ REMINDER^N^E^I^399^^^"
^IBA(364.5,181,1)="N Z,Z0 S Z=$P($G(^DGCR(399,IBXIEN,0)),U,21) S:Z="""" Z=""P"" S Z0=$P($G(^DIC(36,+$G(^DGCR(399,IBXIEN,""I""_($F(""PST"",Z)-1))),0)),U,3),IBXDATA=$S('Z0:"""",1:""##SR"")"
^IBA(364.5,181,3,0)="^^2^2^2960814^^^^"
^IBA(364.5,181,3,1,0)="This field is output if the bill's current insurance company indicates a"
^IBA(364.5,181,3,2,0)="manual signature is required on the bill."
^IBA(364.5,183,0)="N-LOCATION OF CARE^N^F^I^399^LOCATION OF CARE^I^"
^IBA(364.5,183,1)=""
^IBA(364.5,183,3,0)="^^6^6^2991115^^^^"
^IBA(364.5,183,3,1,0)="This data element will be the value of the location of care for the bill"
^IBA(364.5,183,3,2,0)="when the bill is created.  It cannot be edited.  The actual LOCATION OF CARE"
^IBA(364.5,183,3,3,0)="that is output on the UB92 in FORM LOCATOR 4 is in data element"
^IBA(364.5,183,3,4,0)="N-UB92 LOCATION OF CARE."
^IBA(364.5,183,3,5,0)="This field is used throughout the billing system to determine if the bill"
^IBA(364.5,183,3,6,0)="is inpatient or outpatient."
^IBA(364.5,184,0)="N-BILL CLASSIFICATION^N^F^I^399^BILL CLASSIFICATION^I^"
^IBA(364.5,184,1)=""
^IBA(364.5,184,3,0)="^^4^4^2991115^^^^"
^IBA(364.5,184,3,1,0)="This data element will be the value of the bill classification for the bill"
^IBA(364.5,184,3,2,0)="when the bill is created.  It cannot be edited.  The actual BILL"
^IBA(364.5,184,3,3,0)="CLASSIFICATION that is output on the UB92 in FORM LOCATOR 4 is in data"
^IBA(364.5,184,3,4,0)="element N-UB92 BILL CALSSIFICATION."
^IBA(364.5,185,0)="N-TIMEFRAME OF BILL^N^F^I^399^TIMEFRAME OF BILL^I^"
^IBA(364.5,185,1)=""
^IBA(364.5,185,3,0)="^^3^3^2991115^^^^"
^IBA(364.5,185,3,1,0)="This data element will be the value of the timeframe for the bill when the"
^IBA(364.5,185,3,2,0)="bill is created.  It cannot be edited.  The actual TIMEFRAME that is output"
^IBA(364.5,185,3,3,0)="on the UB92 in FORM LOCATOR 4 is in data element N-UB92 TIMEFRAME OF BILL."
^IBA(364.5,186,0)="N-UB92 FORM LOCATOR 11^N^F^I^399^*FORM LOCATOR 11^^"
^IBA(364.5,186,1)=""
^IBA(364.5,186,3,0)="^^2^2^2991115^^^^"
^IBA(364.5,186,3,1,0)="This returns the value of the Fileman field FORM LOCATOR 11 for bill entry"
^IBA(364.5,186,3,2,0)="IBXIEN."
^IBA(364.5,187,0)="N-PATIENT SHORT ADDRESS^N^F^I^399^*PATIENT SHORT MAILING ADDRESS^^"
^IBA(364.5,187,1)=""
^IBA(364.5,187,3,0)="^^1^1^2991115"
^IBA(364.5,187,3,1,0)="The Fileman extracted value of the short mailing address for the patient."
^IBA(364.5,188,0)="N-CMS-1500 BOX 24I ID QUAL^N^E^G^399^^^"
^IBA(364.5,188,1)="D:'$D(IBXSAVE(""BOX24"")) B24^IBCEF3(.IBXSAVE,IBXIEN) D TEXT24^IBCEU3(""I"",.IBXSAVE,.IBXDATA)"
^IBA(364.5,188,3,0)="^^3^3^3060816^"
^IBA(364.5,188,3,1,0)="Data element returns the IBXDATA array box 24I on the printed 1500 claim "
^IBA(364.5,188,3,2,0)="form.  This is the rendering provider ID qualifier.  Each claim line "
^IBA(364.5,188,3,3,0)="item has 2 lines in the IBXDATA array."
^IBA(364.5,189,0)="N-CMS-1500 24J REND PROV ID^N^E^G^399^^^"
^IBA(364.5,189,1)="D:'$D(IBXSAVE(""BOX24"")) B24^IBCEF3(.IBXSAVE,IBXIEN) D TEXT24^IBCEU3(""J"",.IBXSAVE,.IBXDATA)"
^IBA(364.5,189,3,0)="^^3^3^3060816^"
^IBA(364.5,189,3,1,0)="Data element returns the IBXDATA array for box 24J on the printed 1500 "
^IBA(364.5,189,3,2,0)="claim form.  This is the Rendering Provider secondary ID and NPI#.  Each "
^IBA(364.5,189,3,3,0)="service line on the claim form has 2 lines in the IBXDATA array."
^IBA(364.5,190,0)="N-OCCURRENCE CODES^N^E^G^399^^^"
^IBA(364.5,190,1)="N Z K IBXSAVE(""OCC""),IBXSAVE(""OCCS"") S Z=$$OCC^IBCEF1(IBXIEN)"
^IBA(364.5,190,3,0)="^^2^2^2990301^^^^"
^IBA(364.5,190,3,1,0)="The occurrence and occurrence span codes 0-nodes for bill IBXIEN."
^IBA(364.5,190,3,2,0)="The arrays IBXSAVE(""OCC"") and (""OCCS"") are returned."
^IBA(364.5,191,0)="N-UB-04 FORM LOCATOR 64^N^F^I^399^FORM LOCATOR 64A^^"
^IBA(364.5,191,1)=""
^IBA(364.5,191,3,0)="^^2^2^3070119^"
^IBA(364.5,191,3,1,0)="This returns the value for UB-04 FORM LOCATOR 64A in IBXDATA for bill"
^IBA(364.5,191,3,2,0)="entry IBXIEN."
^IBA(364.5,192,0)="N-CURR INS CO FULL ADDRESS^N^E^G^399^^^"
^IBA(364.5,192,1)="S IBXDATA="""" I $P($G(^DGCR(399,IBXIEN,""M"")),U,4)'="""" N Z,Z0,Q S Z=$G(^(""M"")),Z0=$G(^(""M1"")),IBXDATA(1)=$P(Z,U,5),IBXDATA(2)=$P(Z,U,6),IBXDATA(3)=$P(Z0,U) S IBXDATA(7)=$$COID^IBCEF2(IBXIEN) F Q=4:1:6 S IBXDATA(Q)=$P(Z,U,Q+3)"
^IBA(364.5,192,3,0)="^^5^5^2990622^^^^"
^IBA(364.5,192,3,1,0)="Extracts the bill mailing address street 1,2,3 into IBXDATA(1),(2),(3), the"
^IBA(364.5,192,3,2,0)="bill mailing address city into IBXDATA(4), the bill mailing address state"
^IBA(364.5,192,3,3,0)="into IBXDATA(5), the bill mailing address zip code without dashes into"
^IBA(364.5,192,3,4,0)="IBXDATA(6) and the claim office id into IBXDATA(7) for bill entry IBXIEN"
^IBA(364.5,192,3,5,0)="only if the mailing address name is not null."
^IBA(364.5,193,0)="N-UB-04 SERVICE LINE (PRINT)^N^E^G^399^^^"
^IBA(364.5,193,1)="K ^TMP($J,""IBC-RC""),IBXSAVE(""DATE"") N IBIFN,IBFL,IBZ S IBIFN=IBXIEN X ""N A,B S A="""""""",B=6 F  S A=$O(^TMP($J,""""PROC"""",A)) Q:'A  S B=B+1,IBFL(80,B)=^(A),IBFL(80)=B"" S:'$$INPAT^IBCEF(IBXIEN,1) IBXSAVE(""DATE"")=$$SERVDT^IBCEF(IBXIEN,6,0) D ^IBCF33"
^IBA(364.5,193,3,0)="^364.53^11^11^3001114^^^^"
^IBA(364.5,193,3,1,0)="The data to be included in form locators 42-49 for bill entry IBXIEN."
^IBA(364.5,193,3,2,0)="Two formats of data are returned in ^TMP($J,""IBC-RC""):"
^IBA(364.5,193,3,3,0)=" ^TMP($J,""IBC-RC"",line #) = column flag=1^revenue code^revenue code std"
^IBA(364.5,193,3,4,0)="                         abbreviation^CPT code^unit charge^units^total"
^IBA(364.5,193,3,5,0)="                         charges^non-covered charges^form locator 49"
^IBA(364.5,193,3,6,0)="                         ^ien of revenue code multiple^modifiers"
^IBA(364.5,193,3,7,0)="    OR"
^IBA(364.5,193,3,8,0)=" ^TMP($J,""IBC-RC"",line #) = column flag=2 or 3^free text (2 prints text in"
^IBA(364.5,193,3,9,0)="                         column 1, 3 in column 6)"
^IBA(364.5,193,3,10,0)="Also, for outpatient UB-04 claims, it saves the statement from date in"
^IBA(364.5,193,3,11,0)="IBXSAVE(""DATE"")"
^IBA(364.5,194,0)="N-ALL INSURANCE COMPANIES^N^E^G^399^^^"
^IBA(364.5,194,1)="N Z,IBZ D F^IBCEF(""N-ALL INSURANCE CO 837 ID"",""IBZ"") F Z=1,2,3 S IBXDATA(Z)=$P($G(^DIC(36,+$$POLICY^IBCEF(IBXIEN,1,$E(""PST"",Z)),0)),U)_U_$$COID^IBCEF2(IBXIEN)_U_$G(IBZ(Z))"
^IBA(364.5,194,3,0)="^^4^4^2990611^^^^"
^IBA(364.5,194,3,1,0)="Extracts the primary, secondary, and tertiary insurance company internal"
^IBA(364.5,194,3,2,0)="entry numbers into the first '^' piece of IBXDATA(1),(2),(3) for bill entry"
^IBA(364.5,194,3,3,0)="IBXIEN.  The second '^' piece contains the claim office id number, if known"
^IBA(364.5,194,3,4,0)="and the third '^' piece contains the 837 ENVOY payer ID, if available."
^IBA(364.5,195,0)="N-ALL INSURANCE CO PROV NUM^N^E^G^399^^^"
^IBA(364.5,195,1)="N Z,Q,R,IBZ D F^IBCEF(""N-ALL INSURANCE CO TYPE"",""IBZ"",,IBXIEN) S Q=$P($G(^DGCR(399,IBXIEN,""M1"")),U,2,4),R=$P($G(^IBE(350.9,1,1)),U,5) F Z=1:1:3 I Z=1!$D(^DGCR(399,IBXIEN,""I""_Z)) S IBXDATA(Z)=$S($P(IBZ,U,Z)=2:R,$P(Q,U,Z)'="""":$P(Q,U,Z),1:R)"
^IBA(364.5,195,3,0)="^364.53^5^5^3010413^^^^"
^IBA(364.5,195,3,1,0)="Extracts the primary, secondary, and tertiary insurance company provider"
^IBA(364.5,195,3,2,0)="numbers into the IBXDATA(1),(2),(3) array for bill entry IBXIEN."
^IBA(364.5,195,3,3,0)="If the # does not exist use the site's Tax id number from the site "
^IBA(364.5,195,3,4,0)="parameters file (350.9)"
^IBA(364.5,195,3,5,0)=" "
^IBA(364.5,196,0)="N-ALL INSURED FULL NAMES^N^E^G^399^^^"
^IBA(364.5,196,1)="N Z F Z=1:1:3 S:$D(^DGCR(399,IBXIEN,""I""_Z)) IBXDATA(Z)=$$POLICY^IBCEF(IBXIEN,17,$E(""PST"",Z)) I Z=1,'$D(^DGCR(399,IBXIEN,""I1"")) S IBXDATA(1)=$P($G(^DPT(+$P($G(^DGCR(399,IBXIEN,0)),U,2),0)),U)"
^IBA(364.5,196,3,0)="^^2^2^2990611^^^^"
^IBA(364.5,196,3,1,0)="Extracts the primary, secondary, and tertiary insurance insured's full names"
^IBA(364.5,196,3,2,0)="into the IBXDATA(1),(2),(3) array for bill entry IBXIEN."
^IBA(364.5,197,0)="N-ALL INSURED PT RELATION^N^E^G^399^^^"
^IBA(364.5,197,1)="N Z,Q,T,R,DFN,VAEL S Q=IBXIEN,DFN=$P($G(^DGCR(399,Q,0)),U,2) F Z=1:1:3 K VAEL S (T,IBXDATA(Z))=$$POLICY^IBCEF(Q,16,Z) I +T,""12""[+T D ELIG^VADPT S R=$S('VAEL(4):"""",1:$$POLICY^IBCEF(Q,6,Z)),IBXDATA(Z)=$S(R=""v"":""01"",R=""s"":""02"",T:T,1:""09"")"
^IBA(364.5,197,3,0)="^^2^2^2990614^^^^"
^IBA(364.5,197,3,1,0)="Extracts the primary, secondary, and tertiary insurance insured's pt"
^IBA(364.5,197,3,2,0)="relation into the IBXDATA(1),(2),(3) array for bill entry IBXIEN."
^IBA(364.5,198,0)="N-ALL INSURANCE NUMBER^N^E^G^399^^^"
^IBA(364.5,198,1)="N Z,Z0 F Z=1:1:3 I $S(Z=1:1,1:$D(^DGCR(399,IBXIEN,""I""_Z))) S IBXDATA(Z)="""" F Z0=2,3,0 Q:$S(Z0=2:0,1:IBXDATA(Z)'="""")  S IBXDATA(Z)=$S(Z0:$$POLICY^IBCEF(IBXIEN,Z0,Z),1:$$PTDEM^IBCEF(IBXIEN,2,2))"
^IBA(364.5,198,3,0)="^^4^4^2991015^^^^"
^IBA(364.5,198,3,1,0)="Extracts the primary, secondary, and tertiary insurance number"
^IBA(364.5,198,3,2,0)="into the IBXDATA(1),(2),(3) array for bill entry IBXIEN.  Search for number"
^IBA(364.5,198,3,3,0)="by first of three fields not null: insurance SUBSCRIBER ID, the"
^IBA(364.5,198,3,4,0)="insurance GROUP NUMBER, the patient's SSN."
^IBA(364.5,199,0)="N-ALL INSURANCE GROUP NAME^N^E^G^399^^^"
^IBA(364.5,199,1)="N A,B,Z,Q S B=IBXIEN F Z=1:1:3 I $D(^DGCR(399,B,""I""_Z)) S IBXDATA(Z)="""" F Q=15,18,1 S A=$$POLICY^IBCEF(B,Q,Z) I A'="""" S:Q=18 A=$P($G(^IBA(355.3,+A,0)),U,3) S:Q=1 A=$P($G(^DIC(36,+A,0)),U) I A'="""" S IBXDATA(Z)=A Q"
^IBA(364.5,199,3,0)="^^6^6^2990614^^^^"
^IBA(364.5,199,3,1,0)="Extracts the primary, secondary, and tertiary insurance group name"
^IBA(364.5,199,3,2,0)="into the IBXDATA(1),(2),(3) array for bill entry IBXIEN."
^IBA(364.5,199,3,3,0)="The data extracted is the old field *GROUP NAME from the policy data if"
^IBA(364.5,199,3,4,0)="there is also data in the old *GROUP NUMBER field and there is data in"
^IBA(364.5,199,3,5,0)="*GROUP NAME, otherwise, use the GROUP NAME field from the GROUP INSURANCE"
^IBA(364.5,199,3,6,0)="PLAN.  If none of these have data, use the insurance co's name."
^IBA(364.5,200,0)="N-ALL INSURANCE GROUP NUMBER^N^E^G^399^^^"
^IBA(364.5,200,1)="N A,Z,Z0 F Z=1:1:3 I $D(^DGCR(399,IBXIEN,""I""_Z)) S IBXDATA(Z)="""" F Z0=3,18 S A=$$POLICY^IBCEF(IBXIEN,Z0,Z) I A'="""" S:Z0=18 A=$P($G(^IBA(355.3,+A,0)),U,4) I A'="""" S IBXDATA(Z)=A Q"
^IBA(364.5,200,3,0)="^^5^5^2990614^^^^"
^IBA(364.5,200,3,1,0)="Extracts the primary, secondary, and tertiary insurance group number"
^IBA(364.5,200,3,2,0)="into the IBXDATA(1),(2),(3) array for bill entry IBXIEN."
^IBA(364.5,200,3,3,0)="The data extracted is the old field *GROUP NUMBER from the policy data if"
^IBA(364.5,200,3,4,0)="there is data in it, otherwise, the data comes from the GROUP NUMBER"
^IBA(364.5,200,3,5,0)="field in the GROUP INSURANCE PLAN."
^IBA(364.5,201,0)="N-ALL INSURED EMPLOYER INFO^N^E^G^399^^^"
^IBA(364.5,201,1)="N Z,Z1,Z2 F Z=1:1:3 I $S(Z=1:1,1:$D(^DGCR(399,IBXIEN,""I""_Z))) S Z2=$$ESGHPNL^IBCEF21(IBXIEN,Z),Z1=$P(Z2,U,2,999) S:'Z2 Z1=$$INSEMPL^IBCEF(IBXIEN,Z) S IBXDATA(Z)=Z1"
^IBA(364.5,201,3,0)="^^6^6^2991006^^^^"
^IBA(364.5,201,3,1,0)="Extracts the primary, secondary, and tertiary insurance company insured's"
^IBA(364.5,201,3,2,0)="employment info into the IBXDATA(1),(2),(3) array for bill entry IBXIEN."
^IBA(364.5,201,3,3,0)="Format is employer name^city^state abbreviation^state ien^street address 1."
^IBA(364.5,201,3,4,0)="If the plan is Employer Sponsored (ESGHP) then extracts Employer"
^IBA(364.5,201,3,5,0)="Name/Location of the employer that sponsors the plan.  Otherwise extracts"
^IBA(364.5,201,3,6,0)="the insured's current employer name/location (if spouse or veteran only)."
^IBA(364.5,202,0)="N-ALL INSURED EMPLOY STATUS^N^E^G^399^^^"
^IBA(364.5,202,1)="N Z,Z1,Z2,Q F Z=1:1:3 I $S(Z=1:1,1:$D(^DGCR(399,IBXIEN,""I""_Z))) S Z2=$$ESGHPST^IBCEF21(IBXIEN,Z),Z1=$P(Z2,U,2),Q="""" S:'Z2 Q=$$POLICY^IBCEF(IBXIEN,6,$E(""PST"",Z)) S:Q'="""" Z1=$$EMPSTAT^IBCEF(IBXIEN,Q) S:Q=""""&(Z1="""") Z1=9 S IBXDATA(Z)=$P(Z1,U)"
^IBA(364.5,202,3,0)="^^5^5^2991124^^^^"
^IBA(364.5,202,3,1,0)="Extracts the primary, secondary, and tertiary insurance company insured's"
^IBA(364.5,202,3,2,0)="employment status into the IBXDATA(1),(2),(3) array for bill entry IBXIEN."
^IBA(364.5,202,3,3,0)="If the plan is Employer Sponsored (ESGHP) then extracts Employment Status"
^IBA(364.5,202,3,4,0)="with the employer who sponsors the plan.  Otherwise extracts the insured's"
^IBA(364.5,202,3,5,0)="current employment status, or 9=unknown (if spouse or veteran only)."
^IBA(364.5,203,0)="N-PROCEDURE CODING METHD^N^F^I^399^PROCEDURE CODING METHOD^I^"
^IBA(364.5,203,1)=""
^IBA(364.5,203,3,0)="^^1^1^2991115"
^IBA(364.5,203,3,1,0)="The procedure coding method data from bill IBXIEN."
^IBA(364.5,204,0)="N-BILL RATE TYPE^N^F^I^399^RATE TYPE^I^"
^IBA(364.5,204,1)=""
^IBA(364.5,204,3,0)="^^1^1^2991115"
^IBA(364.5,204,3,1,0)="The rate type data field for bill entry IBXIEN."
^IBA(364.5,205,0)="N-CLAIM FORM SIGNER^N^E^I^399^^^"
^IBA(364.5,205,1)="S IBXDATA=$P($G(^IBE(350.9,1,1)),U)"
^IBA(364.5,205,3,0)="^^2^2^2960814^^^"
^IBA(364.5,205,3,1,0)="The claim form signer name defined as an IB system parameter.  Does not rely"
^IBA(364.5,205,3,2,0)="on bill entry number IBXIEN."
^IBA(364.5,206,0)="N-CLAIM FORM SIGNER TITLE^N^E^I^399^^^"
^IBA(364.5,206,1)="S IBXDATA=$P($G(^IBE(350.9,1,1)),U,2)"
^IBA(364.5,206,3,0)="^^2^2^2960814^^"
^IBA(364.5,206,3,1,0)="The claim form signer title defined as an IB system parameter.  Does not"
^IBA(364.5,206,3,2,0)="rely on bill entry number IBXIEN."
^IBA(364.5,207,0)="N-FORM REMARKS^N^E^I^399^^^"
^IBA(364.5,207,1)="S IBXDATA=$P($G(^IBE(350.9,1,1)),U,4)"
^IBA(364.5,207,3,0)="^^2^2^2960814^^"
^IBA(364.5,207,3,1,0)="The form remarks field defined as an IB system parameter.  Does not rely on"
^IBA(364.5,207,3,2,0)="bill entry number IBXIEN."
^IBA(364.5,208,0)="N-BILL COMMENT^N^F^I^399^BILL COMMENT^I^"
^IBA(364.5,208,1)=""
^IBA(364.5,208,3,0)="^^1^1^2960814^^"
^IBA(364.5,208,3,1,0)="Returns the data in the BILL COMMENT field for bill IBXIEN."
^IBA(364.5,209,0)="N-DATE FIRST PRINTED^N^F^I^399^DATE FIRST PRINTED^I^"
^IBA(364.5,209,1)=""
^IBA(364.5,209,3,0)="^^1^1^2991115"
^IBA(364.5,209,3,1,0)="Returns the value in the field for DATE FIRST PRINTED for bill IBXIEN."
^IBA(364.5,210,0)="N-AR BILL NUMBER^N^E^I^399^^^"
^IBA(364.5,210,1)="S IBXDATA=$$BN1^PRCAFN(IBXIEN)"
^IBA(364.5,210,3,0)="^^1^1^2960815^^"
^IBA(364.5,210,3,1,0)="This data element provides the AR bill number for bill entry IBXIEN."
^IBA(364.5,211,0)="N-INSURED SERVICE BRANCH^N^E^I^399^^^"
^IBA(364.5,211,1)="D:'$D(IBXSAVE(""IDEM"")) F^IBCEF(""N-CURR INSURED DEMOGRAPHICS"") S IBXDATA=$P(IBXSAVE(""IDEM""),U,4)"
^IBA(364.5,211,3,0)="^^3^3^2970516^^"
^IBA(364.5,211,3,1,0)="If the variable IBXSAVE(""IDEM"") exists, the 4th '^' piece of this data"
^IBA(364.5,211,3,2,0)="contains the value for this field.  If it doesn't exist, extract the"
^IBA(364.5,211,3,3,0)="field that sets it."
^IBA(364.5,212,0)="N-INSURED SERVICE RANK^N^E^I^399^^^"
^IBA(364.5,212,1)="D:'$D(IBXSAVE(""IDEM"")) F^IBCEF(""N-CURR INSURED DEMOGRAPHICS"") S IBXDATA=$P($G(IBXSAVE(""IDEM"")),U,5)"
^IBA(364.5,212,3,0)="^^3^3^2960814^"
^IBA(364.5,212,3,1,0)="If the variable IBXSAVE(""IDEM"") exists, the 5th '^' piece of this data"
^IBA(364.5,212,3,2,0)="contains the value for this field.  If it doesn't exist, extract the field"
^IBA(364.5,212,3,3,0)="that sets it."
^IBA(364.5,214,0)="N-CURR INSURED SSN^N^E^I^399^^^"
^IBA(364.5,214,1)="D:'$D(IBXSAVE(""IDEM"")) F^IBCEF(""N-CURR INSURED DEMOGRAPHICS"") S IBXDATA=$P(IBXSAVE(""IDEM""),U,6)"
^IBA(364.5,214,3,0)="^^3^3^2970519^"
^IBA(364.5,214,3,1,0)="If the variable IBXSAVE(""IDEM"") exists, the 6th '^' piece of this data"
^IBA(364.5,214,3,2,0)="contains the value for this field.  If it doesn't exist, extract the field"
^IBA(364.5,214,3,3,0)="that sets it."
^IBA(364.5,215,0)="N-CURR INSURED PHONE^N^E^I^399^^^"
^IBA(364.5,215,1)="D:'$D(IBXSAVE(""IDEM"")) F^IBCEF(""N-CURR INSURED DEMOGRAPHICS"") S IBXDATA=$P(IBXSAVE(""IDEM""),U,3)"
^IBA(364.5,215,3,0)="^^3^3^2970519^^"
^IBA(364.5,215,3,1,0)="If the variable IBXSAVE(""IDEM"") exists, the 3rd '^' piece of this data"
^IBA(364.5,215,3,2,0)="contains the value for this field.  If it doesn't exist, extract the field"
^IBA(364.5,215,3,3,0)="that sets it."
^IBA(364.5,216,0)="N-PRIOR BILLS^N^E^G^399^^^"
^IBA(364.5,216,1)="N Z,Z0,Z1 S Z0=$P($G(^DGCR(399,IBXIEN,""M1"")),U,5,7),IBXDATA=$J("""",13) F Z=1:1:3 I $D(^DGCR(399,IBXIEN,""I""_Z)) S Z1=$E($S($P(Z0,U,Z):$$BN1^PRCAFN($P(Z0,U,Z)),1:"""")_$J("""",14),1,14),IBXDATA=IBXDATA_Z1"
^IBA(364.5,216,3,0)="^^2^2^2990608^^^^"
^IBA(364.5,216,3,1,0)="Extracts the Prior Bill Numbers and places them in the proper format for"
^IBA(364.5,216,3,2,0)="printing in the UB-92 Form Locator 56."
^IBA(364.5,217,0)="N-OFFSET AMOUNT^N^F^I^399^OFFSET AMOUNT^I^"
^IBA(364.5,217,1)=""
^IBA(364.5,217,3,0)="^^2^2^2970922^"
^IBA(364.5,217,3,1,0)="The Offset Amount for the bill, including prior payments.  The Total"
^IBA(364.5,217,3,2,0)="Charges minus the Offset Amount is the actual charge for the bill."
^IBA(364.5,218,0)="N-COINSURANCE DAYS^N^F^I^399^CO-INSURANCE DAYS^I^"
^IBA(364.5,218,1)=""
^IBA(364.5,218,3,0)="^^1^1^2991115^^"
^IBA(364.5,218,3,1,0)="This is the value of the UB92, form locator 9."
^IBA(364.5,220,0)="N-MEDICARE PROVIDER NUMBER^N^E^I^399^^^"
^IBA(364.5,220,1)="S IBXDATA=$P($G(^IBA(350.9,+$O(^IBA(350.9,0)),1)),U,21)"
^IBA(364.5,220,3,0)="^^2^2^2990901"
^IBA(364.5,220,3,1,0)="This does not rely on the bill entry number.  It extracts the data from the"
^IBA(364.5,220,3,2,0)="IB SITE PARAMETER file."
^IBA(364.5,221,0)="N-UB-04 TIMEFRAME OF BILL^N^F^I^399^UB-04 TIMEFRAME OF BILL^I^"
^IBA(364.5,221,1)=""
^IBA(364.5,221,3,0)="^^4^4^2991115^^^^"
^IBA(364.5,221,3,1,0)="This data element will be the third digit in the 3 digit code required for"
^IBA(364.5,221,3,2,0)="form locator 4 on the UB-04 bill form for bill entry IBXIEN."
^IBA(364.5,221,3,3,0)="This was expanded from the original field (TIMEFRAME OF BILL - #.06) to"
^IBA(364.5,221,3,4,0)="enable a broader range of bill types to be generated."
^IBA(364.5,222,0)="N-UB-04 LOCATION OF CARE^N^F^I^399^UB-04 LOCATION OF CARE^I^"
^IBA(364.5,222,1)=""
^IBA(364.5,222,3,0)="^^4^4^2991115^^^^"
^IBA(364.5,222,3,1,0)="This data element will be the first digit in the 3 digit code required for"
^IBA(364.5,222,3,2,0)="form locator 4 on the UB-04 bill form for bill entry IBXIEN."
^IBA(364.5,222,3,3,0)="This was expanded from the original field (LOCATION OF CARE - #.04) to"
^IBA(364.5,222,3,4,0)="enable a broader range of bill types to be generated."
^IBA(364.5,223,0)="N-UB-04 BILL CLASSIFICATION^N^F^I^399^UB-04 BILL CLASSIFICATION:CODE^E^"
^IBA(364.5,223,1)=""
^IBA(364.5,223,3,0)="^^4^4^2991115^^^^"
^IBA(364.5,223,3,1,0)="This data element will be the second digit in the 3 digit code required for"
^IBA(364.5,223,3,2,0)="form locator 4 on the UB-04 bill form for bill entry IBXIEN."
^IBA(364.5,223,3,3,0)="This was expanded from the original field (BILL CLASSIFICATION - #.05) to"
^IBA(364.5,223,3,4,0)="enable a broader range of bill types to be generated."
^IBA(364.5,224,0)="N-SET 837 INS CO HDR NODE^N^E^I^399^^^"
^IBA(364.5,224,1)="D:'$D(^TMP(""IBHDR1"",$J)) SETHDR1^IBCE837"
^IBA(364.5,224,3,0)="^^3^3^2990218^^^^"
^IBA(364.5,224,3,1,0)="Sets the header node for the first time an insurance co appears in a batch,"
^IBA(364.5,224,3,2,0)="doesn't extract any more ins co header info for remaining bills in batch if"
^IBA(364.5,224,3,3,0)="this node is set."
^IBA(364.5,225,0)="N-COB CLAIM LEVEL AMOUNTS^N^E^G^399^^^"
^IBA(364.5,225,1)="K IBXSAVE(""CCOB"") D CCOB1^IBCEU1(IBXIEN,""0,1,2,4"")"
^IBA(364.5,225,3,0)="5^364.53^5^5^3030220^^^^"
^IBA(364.5,225,3,1,0)="This data element extracts all the claim level COB data from the EOB file"
^IBA(364.5,225,3,2,0)="for the current and its associated bills."
^IBA(364.5,225,3,3,0)="The data is returned in the array IBXDATA(n) and consists of the payer"
^IBA(364.5,225,3,4,0)="sequence (1-3) in the first '^' piece followed by the data on the 0-2 node"
^IBA(364.5,225,3,5,0)="of file 361.1 (1.01...1.99) for each accepted EOB in the COB sequence."
^IBA(364.5,226,0)="N-MEDICARE INPT CLAIM COB AMTS^N^E^G^399^^^"
^IBA(364.5,226,1)="D CCOB1^IBCEU1(IBXIEN,""4,5"")"
^IBA(364.5,226,3,0)="^364.53^6^6^3010524^^^^"
^IBA(364.5,226,3,1,0)="This data element extracts all the claim level MEDICARE inpatient COB"
^IBA(364.5,226,3,2,0)="data from the EOB file for the current and its associated bills."
^IBA(364.5,226,3,3,0)="The data is returned in the arrays IBXDATA(COB,n,4) and IBXDATA(COB,n,5) "
^IBA(364.5,226,3,4,0)="where COB = the COB sequence of the payer, n = the ien of the entry in file"
^IBA(364.5,226,3,5,0)="361.1 and equals the data on the '4' and '5' nodes respectively of file"
^IBA(364.5,226,3,6,0)="361.1 (4.01...5.99) for each accepted EOB in the COB sequence."
^IBA(364.5,227,0)="N-MEDICARE OUTPT CLAIM COB AMT^N^E^G^399^^^"
^IBA(364.5,227,1)="D CCOB1^IBCEU1(IBXIEN,3)"
^IBA(364.5,227,3,0)="^^6^6^2990901^^^^"
^IBA(364.5,227,3,1,0)="This data element extracts all the claim level MEDICARE outpatient COB"
^IBA(364.5,227,3,2,0)="data from the EOB file for the current and its associated bills."
^IBA(364.5,227,3,3,0)="The data is returned in the array IBXDATA(COB,n,3) where COB = the COB"
^IBA(364.5,227,3,4,0)="sequence of the payer, n = the ien of the entry in file 361.1 and equals"
^IBA(364.5,227,3,5,0)="the data on the '3' node of file 361.1 (3.01...3.99) for each accepted EOB"
^IBA(364.5,227,3,6,0)="in the COB sequence."
^IBA(364.5,228,0)="N-COB CLAIM LEVEL ADJUSTMENTS^N^E^G^399^^^"
^IBA(364.5,228,1)="D CCAS1^IBCEU1(IBXIEN)"
^IBA(364.5,228,3,0)="^^8^8^2990831^^^^"
^IBA(364.5,228,3,1,0)="This data element extracts all the claim level COB adjustment data from the"
^IBA(364.5,228,3,2,0)="EOB file for the current and its associated bills. The data is returned in"
^IBA(364.5,228,3,3,0)="the arrays IBXDATA(n,0) and IBXDATA(n,1,m) for each accepted EOB in the COB"
^IBA(364.5,228,3,4,0)="sequence."
^IBA(364.5,228,3,5,0)="IBXDATA(n,0) consists of the payer sequence (1-3) in the first '^' piece"
^IBA(364.5,228,3,6,0)="followed by the data on the '0' node of subfile 361.11 (.01) ."
^IBA(364.5,228,3,7,0)="IBXDATA(n,1,m) is returned where m is a sequential # and consists of the"
^IBA(364.5,228,3,8,0)="data on the 0-node of each entry in subfile 361.111 (.01-.99)"
^IBA(364.5,229,0)="N-HCFA EMERGENCY INDICATOR^N^E^G^399^^^"
^IBA(364.5,229,1)="D:'$D(IBXSAVE(""BOX24"")) B24^IBCEF3(.IBXSAVE,IBXIEN) D TEXT24^IBCEU3(""C"",.IBXSAVE,.IBXDATA)"
^IBA(364.5,229,3,0)="^^10^10^3060816^"
^IBA(364.5,229,3,1,0)="Data element relies on the data previously extracted in array"
^IBA(364.5,229,3,2,0)="IBXSAVE(""BOX24"") from HCFA 1500 SERVICES PRINT.  If IBXSAVE(""BOX24"")"
^IBA(364.5,229,3,3,0)="does not exist, extract the field that sets it.  Returns the array of "
^IBA(364.5,229,3,4,0)="emergency indicator flags for all lines on the claim as they would "
^IBA(364.5,229,3,5,0)="appear in Box 24C on the 1500 form (08/05 version).  If the array "
^IBA(364.5,229,3,6,0)="IBXSAVE(""BOX24"",n,""TEXT"") exists, then this means that the line also "
^IBA(364.5,229,3,7,0)="contains free text supplemental information which will print in the "
^IBA(364.5,229,3,8,0)="shaded gray area of Box 24 from columns 24A thru 24G.  For this data "
^IBA(364.5,229,3,9,0)="element, the field returns the extract of this text for columns 22-24.  "
^IBA(364.5,229,3,10,0)="Every 2 printed lines of this box constitute one service line."
^IBA(364.5,230,0)="N-BILLING SITE^N^E^I^399^^^"
^IBA(364.5,230,1)="N Z,Z0 S Z=$P($G(^DGCR(399,IBXIEN,0)),U,22),Z0=+$$SITE^VASITE(),IBXDATA=$$SITE^VASITE(DT,$S(Z:Z,1:Z0)) S $P(IBXDATA,U,4)=$S(+IBXDATA=Z0:"""",1:1)"
^IBA(364.5,230,3,0)="^^5^5^3000320^^^^"
^IBA(364.5,230,3,1,0)="If the bill has a division associated with it, retrieve the data associated"
^IBA(364.5,230,3,2,0)="with the division, otherwise, the facility's data is retrieved."
^IBA(364.5,230,3,3,0)="The data format is:"
^IBA(364.5,230,3,4,0)="    IBXDATA=institution file ien^name^site number (including suffix)"
^IBA(364.5,230,3,5,0)="            ^ 1 if not main facility"
^IBA(364.5,231,0)="N-FACILITY SITE NUMBER^N^E^I^399^^^"
^IBA(364.5,231,1)="N IBZ S IBZ=$G(^TMP(""IBXSITE"",$J)) D:'IBZ F^IBCEF(""N-SITE NUMBER"",""IBZ"",,IBXIEN) S:IBZ IBXDATA=IBZ"
^IBA(364.5,231,3,0)="^^2^2^2990611^^^^"
^IBA(364.5,231,3,1,0)="The billing site's site number.  Only has to be extracted for the first"
^IBA(364.5,231,3,2,0)="bill in the batch."
^IBA(364.5,232,0)="N-EVENT DATE^N^E^I^399^^^"
^IBA(364.5,232,1)="N IBZ S IBXDATA=$$EVENT^IBCF22(IBXIEN,.IBXSAVE,,.IBZ) I $D(IBZ) M IBXSAVE(""DATE"")=IBZ"
^IBA(364.5,232,3,0)="^^4^4^2991122^^^^"
^IBA(364.5,232,3,1,0)="Fileman formatted date.  The data for box 14 on HCFA-1500 for bill entry"
^IBA(364.5,232,3,2,0)="IBXIEN.  Check first for occurrence codes for illness date, or for accident"
^IBA(364.5,232,3,3,0)="date or for last menstrual period, then event date on bill.  When one of"
^IBA(364.5,232,3,4,0)="these is found, use it."
^IBA(364.5,233,0)="N-CURRENT INSURANCE CO TYPE^N^E^I^399^^^"
^IBA(364.5,233,1)="N IBZ,Z D F^IBCEF(""N-ALL INSURANCE CO TYPE"",""IBZ"",,IBXIEN) S IBXDATA="""",Z=+$$COBN^IBCEF(IBXIEN) I $P(IBZ,U,Z)'="""" S IBXDATA=$P(IBZ,U,Z)"
^IBA(364.5,233,3,0)="^364.53^1^1^3000516^^^^"
^IBA(364.5,233,3,1,0)="This is the electronic type of the current insurance for the bill."
^IBA(364.5,234,0)="N-OTHER INSURANCE CO TYPES^N^E^I^399^^^"
^IBA(364.5,234,1)="N Z,Z0 S Z=$$ALLTYP^IBCEF3(IBXIEN),Z0=$$COBN^IBCEF(IBXIEN) S IBXDATA=$S(Z0=1:$P(Z,U,2,3),Z0=2:$P(Z,U,1)_U_$P(Z,U,3),1:$P(Z,U,1,2))"
^IBA(364.5,234,3,0)="^^11^11^2990412^^^^"
^IBA(364.5,234,3,1,0)="This is the type of all 'other' insurance for the bill.  The format of the"
^IBA(364.5,234,3,2,0)="data returned in IBXDATA is:"
^IBA(364.5,234,3,3,0)="   if primary bill: type of secondary insurance^type of tertiary insurance"
^IBA(364.5,234,3,4,0)="   if secondary bill: type of primary insurance^type of tertiary insurance"
^IBA(364.5,234,3,5,0)="   if tertiary bill: type of primary insurance^type of secondary insurance"
^IBA(364.5,234,3,6,0)=" "
^IBA(364.5,234,3,7,0)="             type = 1: COMMERCIAL/BL CROSS"
^IBA(364.5,234,3,8,0)="                    2: MEDICARE"
^IBA(364.5,234,3,9,0)="                    3: MEDICAID"
^IBA(364.5,234,3,10,0)="                    4: TRICARE"
^IBA(364.5,234,3,11,0)="                    5: CHAMPVA"
^IBA(364.5,235,0)="N-CURRENT INS POLICY TYPE^N^E^I^399^^^"
^IBA(364.5,235,1)="S IBXDATA=$$POLTYP^IBCEF3(IBXIEN)"
^IBA(364.5,235,3,0)="^364.53^3^3^3000509^^^^"
^IBA(364.5,235,3,1,0)="This is the current insurance plan type for the bill.  The format of the"
^IBA(364.5,235,3,2,0)="data returned in IBXDATA is the X12 code for insurance plan type."
^IBA(364.5,235,3,3,0)="Also referred to as 'Source of pay' code."
^IBA(364.5,236,0)="N-OTH INS POL TYPES^N^E^I^399^^^"
^IBA(364.5,236,1)="N Z,Z0 S Z=$$ALLPTYP^IBCEF3(IBXIEN),Z0=$$COBN^IBCEF(IBXIEN) S IBXDATA=$S(Z0=1:$P(Z,U,2,3),Z0=2:$P(Z,U,1)_U_$P(Z,U,3),1:$P(Z,U,1,2))"
^IBA(364.5,236,3,0)="^^5^5^2991118^^^^"
^IBA(364.5,236,3,1,0)="This is the X12 code for the types of all 'other' insurance"
^IBA(364.5,236,3,2,0)="plans for the bill.  The format of the data returned in IBXDATA is:"
^IBA(364.5,236,3,3,0)="   if primary bill: type of secondary ins plan^type of tertiary ins plan"
^IBA(364.5,236,3,4,0)="   if secondary bill: type of primary ins plan^type of tertiary ins plan"
^IBA(364.5,236,3,5,0)="   if tertiary bill: type of primary ins plan^type of secondary ins plan"
^IBA(364.5,238,0)="N-EDI SITE CONTACT PHONE^N^E^I^399^^^"
^IBA(364.5,238,1)="S IBXDATA=$P($G(^IBE(350.9,1,2)),U,11)"
^IBA(364.5,238,3,0)="^^2^2^2990413^^"
^IBA(364.5,238,3,1,0)="The EDI site contact phone # from the site parameter file.  Not related to"
^IBA(364.5,238,3,2,0)="bill entry number."
^IBA(364.5,239,0)="N-ATTENDING PHYSICIAN ID^N^E^I^399^^^"
^IBA(364.5,239,1)="N IBZ,IBS S IBS=+$$COBN^IBCEF(IBXIEN) D GETPRV^IBCEU(IBXIEN,4,.IBZ) S IBXDATA=$S($P($G(IBZ(4,1,IBS)),U)'="""":$P(IBZ(4,1,IBS),U),1:$P($G(IBZ(4,1,1)),U))"
^IBA(364.5,239,3,0)="^^2^2^2991001^^^^"
^IBA(364.5,239,3,1,0)="The id # for the current insurance company of the attending physician for"
^IBA(364.5,239,3,2,0)="bill entry IBXIEN."
^IBA(364.5,240,0)="N-REFERRING PROVIDER NAME^N^E^I^399^^^"
^IBA(364.5,240,1)="N IBZ D GETPRV^IBCEU(IBXIEN,1,.IBZ) S IBXDATA=$P($G(IBZ(1,1)),U)"
^IBA(364.5,240,3,0)="^^1^1^2991001^^^^"
^IBA(364.5,240,3,1,0)="The name of the referring provider for bill entry IBXIEN."
^IBA(364.5,241,0)="N-REFERRING PROVIDER ID^N^E^I^399^^^"
^IBA(364.5,241,1)="N IBZ,IBS S IBS=+$$COBN^IBCEF(IBXIEN) D GETPRV^IBCEU(IBXIEN,1,.IBZ) S IBXDATA=$S($P($G(IBZ(1,1,IBS)),U)'="""":$P(IBZ(1,1,IBS),U),1:$P($G(IBZ(1,1,1)),U))"
^IBA(364.5,241,3,0)="^^1^1^2991001^^^^"
^IBA(364.5,241,3,1,0)="The id # of the referring provider for bill entry IBXIEN."
^IBA(364.5,242,0)="N-OPERATING PHYSICIAN NAME^N^E^I^399^^^"
^IBA(364.5,242,1)="N IBZ D GETPRV^IBCEU(IBXIEN,2,.IBZ) S IBXDATA=$P($G(IBZ(2,1)),U)"
^IBA(364.5,242,3,0)="^^1^1^2991001^^^^"
^IBA(364.5,242,3,1,0)="The name of the operating physician for bill entry IBXIEN."
^IBA(364.5,243,0)="N-OPERATING PHYSICIAN ID^N^E^I^399^^^"
^IBA(364.5,243,1)="N IBZ,IBS S IBS=+$$COBN^IBCEF(IBXIEN) D GETPRV^IBCEU(IBXIEN,2,.IBZ) S IBXDATA=$S($P($G(IBZ(2,1,IBS)),U)'="""":$P(IBZ(2,1,IBS),U),1:$P($G(IBZ(2,1,1)),U))"
^IBA(364.5,243,3,0)="^^1^1^2991001^^^^"
^IBA(364.5,243,3,1,0)="The id # of the operating physician for bill entry IBXIEN."
^IBA(364.5,244,0)="N-RENDERING PROVIDER NAME^N^E^I^399^^^"
^IBA(364.5,244,1)="N IBZ D GETPRV^IBCEU(IBXIEN,3,.IBZ) S IBXDATA=$P($G(IBZ(3,1)),U)"
^IBA(364.5,244,3,0)="^^1^1^2991001^^^^"
^IBA(364.5,244,3,1,0)="The name of the rendering provider for bill entry IBXIEN."
^IBA(364.5,245,0)="N-RENDERING PROVIDER ID^N^E^I^399^^^"
^IBA(364.5,245,1)="N IBZ,IBS S IBS=+$$COBN^IBCEF(IBXIEN) D GETPRV^IBCEU(IBXIEN,3,.IBZ) S IBXDATA=$S($P($G(IBZ(3,1,IBS)),U)'="""":$P(IBZ(3,1,IBS),U),1:$P($G(IBZ(3,1,1)),U))"
^IBA(364.5,245,3,0)="^^1^1^2991001^^^^"
^IBA(364.5,245,3,1,0)="The id # of the rendering provider for bill entry IBXIEN."
^IBA(364.5,246,0)="N-UB-04 FORM LOCATOR 64B^N^F^I^399^FORM LOCATOR 64B^^"
^IBA(364.5,246,1)=""
^IBA(364.5,246,3,0)="^^2^2^3070119^"
^IBA(364.5,246,3,1,0)="This returns the value for UB-04 FORM LOCATOR 64B in IBXDATA for bill"
^IBA(364.5,246,3,2,0)="entry IBXIEN."
^IBA(364.5,247,0)="N-UB-04 FORM LOCATOR 64C^N^F^I^399^FORM LOCATOR 64C^^"
^IBA(364.5,247,1)=""
^IBA(364.5,247,3,0)="^^2^2^3070119^"
^IBA(364.5,247,3,1,0)="This returns the value for UB-04 FORM LOCATOR 64C in IBXDATA for bill"
^IBA(364.5,247,3,2,0)="entry IBXIEN."
^IBA(364.5,248,0)="N-REFERRING PROVIDER SPECIALTY^N^E^I^399^^^"
^IBA(364.5,248,1)="N IBZ D GETPRV^IBCEU(IBXIEN,1,.IBZ) S IBXDATA=$$SPEC^IBCEU($P($G(IBZ(1,1)),U,3),+$G(^DGCR(399,IBXIEN,""U"")))"
^IBA(364.5,248,3,0)="^^2^2^2991202^^^^"
^IBA(364.5,248,3,1,0)="Find the specialty from the VA code of the person class attached to the"
^IBA(364.5,248,3,2,0)="referring provider for bill IBXIEN, if it can be determined."
^IBA(364.5,249,0)="N-ATT/REND PHYSICIAN SPEC^N^E^I^399^^^"
^IBA(364.5,249,1)="N IBZ,IBI S IBI=$S($$FT^IBCEF(IBXIEN)=2:3,1:4) D GETPRV^IBCEU(IBXIEN,IBI,.IBZ) S IBXDATA=$$SPEC^IBCEU($P($G(IBZ(IBI,1)),U,3),+$G(^DGCR(399,IBXIEN,""U"")))"
^IBA(364.5,249,3,0)="^^2^2^2991202^^^^"
^IBA(364.5,249,3,1,0)="Find the specialty from the VA code of the person class attached to the"
^IBA(364.5,249,3,2,0)="attending/rendering provider for bill IBXIEN, if it can be determined."
^IBA(364.5,250,0)="N-OTHER PHYSICIAN SPEC^N^E^I^399^^^"
^IBA(364.5,250,3,0)="^^2^2^2991202^^^^"
^IBA(364.5,250,3,1,0)="Find the specialty from the VA code of the person class attached to the"
^IBA(364.5,250,3,2,0)="other provider for bill IBXIEN, if it can be determined."
^IBA(364.5,251,0)="N-OPERATING PHYSICIAN SPEC^N^E^I^399^^^"
^IBA(364.5,251,1)="N IBZ D GETPRV^IBCEU(IBXIEN,2,.IBZ) S IBXDATA=$$SPEC^IBCEU($P($G(IBZ(2,1)),U,3),+$G(^DGCR(399,IBXIEN,""U"")))"
^IBA(364.5,251,3,0)="^^2^2^2991202^^^^"
^IBA(364.5,251,3,1,0)="Find the specialty from the VA code of the person class attached to the"
^IBA(364.5,251,3,2,0)="operating provider for bill IBXIEN, if it can be determined."
^IBA(364.5,252,0)="N-OTHER PROVIDER ID^N^E^I^399^^^"
^IBA(364.5,252,1)="N IBZ,IBS S IBS=+$$COBN^IBCEF(IBXIEN) D GETPRV^IBCEU(IBXIEN,9,.IBZ) S IBXDATA=$S($P($G(IBZ(9,1,IBS)),U)'="""":$P(IBZ(9,1,IBS),U),1:$P($G(IBZ(9,1,1)),U))"
^IBA(364.5,252,3,0)="^^1^1^2991001^^^^"
^IBA(364.5,252,3,1,0)="The id # of the other provider for bill entry IBXIEN."
^IBA(364.5,253,0)="N-DIAGNOSIS E-CODE^N^E^I^399^^^"
^IBA(364.5,253,1)="S IBXDATA=$G(IBXSAVE(""DX-E"")) I '$D(IBXSAVE(""DX-E"")) N IBZ,Z,Z0,Z1 D F^IBCEF(""N-DIAGNOSES"",""IBZ"",,IBXIEN) S Z=0 F  S Z=$O(IBZ(Z)) Q:'Z  S Z0=$$ECODE^IBCEU4(+IBZ(Z),.Z1) I Z0,$G(Z1)'="""" S (IBXSAVE(""DX-E""),IBXDATA)=Z1 Q"
^IBA(364.5,253,3,0)="^364.53^2^2^3070523^^^^"
^IBA(364.5,253,3,1,0)="This data element finds the first 'E' code diagnosis for bill IBXIEN, if"
^IBA(364.5,253,3,2,0)="any.  An 'E' code is a diagnosis that starts with the letter 'E'."
^IBA(364.5,255,0)="N-SITE CONTACT PHONE^N^E^I^399^^^"
^IBA(364.5,255,1)="S IBXDATA=$P($G(^IBE(350.9,1,2)),U,11)"
^IBA(364.5,255,3,0)="^^2^2^2990607^^^^"
^IBA(364.5,255,3,1,0)="The site contact phone number from the site parameter file.  Not related"
^IBA(364.5,255,3,2,0)="to bill entry number."
^IBA(364.5,256,0)="N-ALL INSURANCE CO 837 ID^N^E^I^399^^^"
^IBA(364.5,256,1)="D ALLPAYID^IBCEF2(IBXIEN,.IBXDATA)"
^IBA(364.5,256,3,0)="^^3^3^2990608^^^^"
^IBA(364.5,256,3,1,0)="Extracts the primary, secondary, and tertiary insurance company's 837 ID"
^IBA(364.5,256,3,2,0)="into IBXDATA(1), IBXDATA(2) and IBXDATA(3).  This is the internal code"
^IBA(364.5,256,3,3,0)="number to identify the current insurance company to the ENVOY system."
^IBA(364.5,257,0)="N-DRG USED^N^E^I^399^^^"
^IBA(364.5,257,1)="N Z,Z0,Z1 S Z=$$COBN^IBCEF(IBXIEN) I Z>1 S Z=Z-1 I $D(^IBM(361.1,""ABS"",IBXIEN,Z)) S Z0="""" F  S Z0=$O(^IBM(361.1,""ABS"",IBXIEN,Z,Z0),-1) Q:'Z0  S Z1=$G(^IBM(361.1,Z0,0)) I $P(Z1,U,16)=3,$P(Z1,U,10)'="""" S IBXDATA=$P(Z1,U,10) Q"
^IBA(364.5,257,3,0)="^^2^2^2990901^^^^"
^IBA(364.5,257,3,1,0)="If there is a valid processed EOB on file for the previous insurance"
^IBA(364.5,257,3,2,0)="company, extract the last DRG code used to calculate payment."
^IBA(364.5,258,0)="N-MEDICARE GROUP NUMBER^N^E^I^399^^^"
^IBA(364.5,258,1)="S IBXDATA=""VA0""_$P($$SITE^VASITE,U,3)"
^IBA(364.5,258,3,0)="^^2^2^2990901^^"
^IBA(364.5,258,3,1,0)="The default group number for MEDICARE to be used in block 33 on the HCFA"
^IBA(364.5,258,3,2,0)="1500."
^IBA(364.5,260,0)="N-FIRST TRANSMIT DATE^N^E^I^399^^^"
^IBA(364.5,260,3,0)="^^1^1^2990629^"
^IBA(364.5,260,3,1,0)="This is the date the bill IBXIEN was first transmitted."
^IBA(364.5,261,0)="N-ATT/REND PROVIDER ID^N^E^I^399^^^"
^IBA(364.5,261,1)="N IBZ,IBI,IBS S IBS=+$$COBN^IBCEF(IBXIEN),IBI=$S($$FT^IBCEF(IBXIEN)=2:3,1:4) D GETPRV^IBCEU(IBXIEN,IBI,.IBZ) S IBXDATA=$S($P($G(IBZ(IBI,1,IBS)),U)'="""":$P(IBZ(IBI,1,IBS),U),1:$P($G(IBZ(IBI,1,1)),U))"
^IBA(364.5,261,3,0)="^^2^2^2991001^^^^"
^IBA(364.5,261,3,1,0)="The id # of the attending/rendering physician for the current insurance"
^IBA(364.5,261,3,2,0)="company for bill entry IBXIEN."
^IBA(364.5,262,0)="N-CURRENT AUTHORIZATION CODE^N^E^I^399^^^"
^IBA(364.5,262,1)="N Z S Z=$$COBN^IBCEF(IBXIEN) D F^IBCEF(""N-""_$P(""PRIMARY^SECONDARY^TERTIARY"",U,Z)_"" AUTH CODE"",,,IBXIEN)"
^IBA(364.5,262,3,0)="^^2^2^2990722^"
^IBA(364.5,262,3,1,0)="This data element finds the treatment authorization code for bill IBXIEN"
^IBA(364.5,262,3,2,0)="for the current insurance company."
^IBA(364.5,263,0)="N-SECONDARY AUTH CODE^N^F^I^399^SECONDARY AUTHORIZATION CODE^I^"
^IBA(364.5,263,1)=""
^IBA(364.5,264,0)="N-TERTIARY AUTH CODE^N^F^I^399^TERTIARY AUTHORIZATION CODE^I^"
^IBA(364.5,264,1)=""
^IBA(364.5,265,0)="N-ALL AUTH CODES^N^E^G^399^^^"
^IBA(364.5,265,1)="N Z,IBZ F Z=1:1:3 I $S(Z=1:1,1:$D(^DGCR(399,IBXIEN,""I""_Z))) D F^IBCEF(""N-""_$P(""PRIMARY^SECONDARY^TERTIARY"",U,Z)_"" AUTH CODE"",""IBZ"",,IBXIEN) S IBXDATA(Z)=IBZ K IBZ"
^IBA(364.5,265,3,0)="^^2^2^2990830^^"
^IBA(364.5,265,3,1,0)="Extracts the 3 authorization codes for bill IBXIEN into IBXDATA(1),"
^IBA(364.5,265,3,2,0)="IBXDATA(2), IBXDATA(3)."
^IBA(364.5,266,0)="N-OTHER INSURED AUTH CODES^N^E^G^399^^^"
^IBA(364.5,266,1)="N Z,Z0,Z1,IBZ D F^IBCEF(""N-ALL AUTH CODES"",""IBZ"") S Z=$$COBN^IBCEF(IBXIEN) S Z0=0 F Z1=1:1:3 I Z1'=Z,$D(^DGCR(399,IBXIEN,""I""_Z1)) S Z0=Z0+1,IBXDATA(Z0)=$G(IBZ(Z1))"
^IBA(364.5,266,3,0)="^^10^10^2990722^^"
^IBA(364.5,266,3,1,0)="The ien of all other insurance companies' authorization codes for bill entry"
^IBA(364.5,266,3,2,0)="IBXIEN. "
^IBA(364.5,266,3,3,0)=" "
^IBA(364.5,266,3,4,0)="Data is returned in an array IBXDATA(n).  This is a group element and up to"
^IBA(364.5,266,3,5,0)="2 data elements are returned in the IBXDATA(n) array.  If the primary"
^IBA(364.5,266,3,6,0)="insurance is the current responsible, the secondary and tertiary insurance"
^IBA(364.5,266,3,7,0)="co authorization codes are returned.  If the secondary insurance is the"
^IBA(364.5,266,3,8,0)="current responsible, the primary and tertiary insurance co authorization"
^IBA(364.5,266,3,9,0)="codes are returned. If the tertiary insurance is the current responsible,"
^IBA(364.5,266,3,10,0)="the primary and secondary insurance co authorization codes are returned.  "
^IBA(364.5,267,0)="N-DATE FIRST PRINTED OR SENT^N^F^I^399^DATE FIRST PRINTED^I^"
^IBA(364.5,267,1)=""
^IBA(364.5,267,3,0)="^^3^3^2991115^^^^"
^IBA(364.5,267,3,1,0)="This is the date the bill was first printed or sent via EDI to the"
^IBA(364.5,267,3,2,0)="clearinghouse for processing.  This date will print on the claim form if"
^IBA(364.5,267,3,3,0)="this bill is printed locally."
^IBA(364.5,268,0)="N-OUTSIDE FACILITY NAME^N^E^I^399^^^"
^IBA(364.5,268,1)="N IBZ D F^IBCEF(""N-NON VA FACILITY"",""IBZ"",,IBXIEN) I $G(IBZ) S IBXDATA=$P($G(^IBA(355.93,+IBZ,0)),U)"
^IBA(364.5,268,3,0)="^364.53^2^2^3030917^^^"
^IBA(364.5,268,3,1,0)="Finds the internal entry number of the outside facility for the bill and"
^IBA(364.5,268,3,2,0)="extracts the name from the non-VA provider file."
^IBA(364.5,270,0)="N-LAST MENSTRUAL PERIOD^N^E^I^399^^^"
^IBA(364.5,270,1)="D:'$D(IBXSAVE(""DATE"",""LMP"")) F^IBCEF(""N-EVENT DATE"",,,IBXIEN) K IBXDATA S IBXDATA=$G(IBXSAVE(""DATE"",""LMP""))"
^IBA(364.5,270,3,0)="^^1^1^2990825^"
^IBA(364.5,270,3,1,0)="Extract the last menstrual period from occurrence codes on bill IBXIEN."
^IBA(364.5,271,0)="N-LAB CLIA #^N^E^I^399^^^"
^IBA(364.5,271,1)="S IBXDATA=$P($G(^DGCR(399,IBXIEN,""U2"")),U,13) I IBXDATA="""" S IBXDATA=$$CLIANVA^IBCEP8(IBXIEN)"
^IBA(364.5,271,3,0)="^364.53^2^2^3040205^^^^"
^IBA(364.5,271,3,1,0)="Extract the CLIA # from the ids defined for the facility.  If an id cannot"
^IBA(364.5,271,3,2,0)="be found there, but the data exists in fld 235 in file 399, use that data."
^IBA(364.5,272,0)="N-NON VA PROVIDER ID^N^E^I^399^^^"
^IBA(364.5,272,1)="N Z,Z0 S Z=$$PSPRV^IBCEF7(IBXIEN),Z0=$P($$NONVAID^IBCEF72(IBXIEN,.IBXDATA,($E(Z,2)=0),1),U)"
^IBA(364.5,272,3,0)="^364.53^7^7^3030910^^^"
^IBA(364.5,272,3,1,0)="The non-VA id can be either the tax id/SSN for a non-VA provider.  If the"
^IBA(364.5,272,3,2,0)="provider is a non-VA provider and has a tax id # assigned, it will be used."
^IBA(364.5,272,3,3,0)="Otherwise, the non-VA provider person's SSN is used.  In the case of"
^IBA(364.5,272,3,4,0)="either a person or facility, if the id cannot be found as the tax id/SSN,"
^IBA(364.5,272,3,5,0)="the number is taken from the NON-VA CARE ID # field in the BILL/CLAIMS file."
^IBA(364.5,272,3,6,0)="If there is a non-VA provider AND a non-VA facility, this number must be"
^IBA(364.5,272,3,7,0)="assigned to the non-VA provider (person)."
^IBA(364.5,273,0)="N-PURCHASED SERVICE TYPE^N^E^I^399^^^"
^IBA(364.5,273,1)="S IBXDATA=+$P($G(^DGCR(399,IBXIEN,""U2"")),U,11)"
^IBA(364.5,273,3,0)="^^1^1^2990825^"
^IBA(364.5,273,3,1,0)="If outside VA care, then this is the flag for the type of care."
^IBA(364.5,274,0)="N-NON VA FACILITY^N^F^I^399^NON-VA FACILITY^I^"
^IBA(364.5,274,1)=""
^IBA(364.5,274,3,0)="^^2^2^2991202^^^^"
^IBA(364.5,274,3,1,0)="Extract the ien of the facility if a non-VA entity provided the care"
^IBA(364.5,274,3,2,0)="associated with bill IBXIEN."
^IBA(364.5,275,0)="N-RENDERING INSTITUTION^N^E^I^399^^^"
^IBA(364.5,275,1)="N IBZ,Z S Z=IBXIEN D F^IBCEF(""N-NON VA FACILITY"",""IBZ"",,Z) S:$G(IBZ) IBXDATA=+IBZ_U_1 I '$G(IBZ) D F^IBCEF(""N-BILLING SITE"",,,Z) S IBXDATA=+IBXDATA_U_$S($P(IBXDATA,U,4)'=1:"""",1:""0"")_U_$$FAC^IBCEU3(Z)_U_($$WNRBILL^IBEFUNC(Z)&($$FT^IBCEF(Z)=2))"
^IBA(364.5,275,3,0)="^364.53^8^8^3010413^^^^"
^IBA(364.5,275,3,1,0)="Check first for a non-VA provider.  If none, use the billing site (can be"
^IBA(364.5,275,3,2,0)="main VA facility or a remote VA site) for bill entry IBXIEN."
^IBA(364.5,275,3,3,0)="Returns the ien of the remote site or non-VA provider from the institution"
^IBA(364.5,275,3,4,0)="file in the first '^' piece of IBXDATA and a 0 or 1 in piece 2 to indicate"
^IBA(364.5,275,3,5,0)="it was a remote site (0) or outside facility (1).  The third ^ piece"
^IBA(364.5,275,3,6,0)="contains a 1 if the bills are generated by another facility other than"
^IBA(364.5,275,3,7,0)="the rendering one.  The fourth ^ piece is 1 if the bill is for MEDICARE"
^IBA(364.5,275,3,8,0)="WNR and the bill form is a HCFA 1500."
^IBA(364.5,276,0)="N-NON VA CARE TYPE^N^F^I^399^NON-VA CARE TYPE^I^"
^IBA(364.5,276,1)=""
^IBA(364.5,277,0)="N-ALL ATT/RENDERING PROV ID^N^E^G^399^^^"
^IBA(364.5,277,1)="N Z,IBZ,IBZ0 S IBZ0=$S($$FT^IBCEF(IBXIEN)=3:4,1:3) D GETPRV^IBCEU(IBXIEN,IBZ0,.IBZ) S IBXDATA=IBZ0 F Z=1:1:3 Q:'$D(^DGCR(399,IBXIEN,""I""_Z))  S IBXDATA=IBXDATA_U_$S($G(IBZ(IBZ0,1,Z))'="""":IBZ(IBZ0,1,Z),1:$P($G(IBZ(IBZ0)),U,2))"
^IBA(364.5,277,3,0)="^364.53^2^2^3011123^^^^"
^IBA(364.5,277,3,1,0)="Extracts the id numbers for all insurance companies for the attending"
^IBA(364.5,277,3,2,0)="(UB92) or rendering (HCFA 1500) provider."
^IBA(364.5,278,0)="N-ALL REFERRING PROV ID^N^E^G^399^^^"
^IBA(364.5,278,1)="N IBZ,IBS D GETPRV^IBCEU(IBXIEN,1,.IBZ) F IBS=1:1:3 Q:'$D(^DGCR(399,IBXIEN,""I""_IBS))  S IBXDATA(IBS)=$P($G(IBZ(1,1,IBS)),U)"
^IBA(364.5,278,3,0)="^^2^2^2991001^^"
^IBA(364.5,278,3,1,0)="Extracts the id numbers for all insurance companies for the referring"
^IBA(364.5,278,3,2,0)="provider."
^IBA(364.5,279,0)="N-ALL OPERATING PROV ID^N^E^G^399^^^"
^IBA(364.5,279,1)="N IBZ,IBS D GETPRV^IBCEU(IBXIEN,2,.IBZ) F IBS=1:1:3 Q:'$D(^DGCR(399,IBXIEN,""I""_IBS))  S IBXDATA(IBS)=$S($G(IBZ(2,1,IBS))'="""":IBZ(2,1,IBS),$$WNRBILL^IBEFUNC(IBXIEN):$P($G(IBZ(2,1)),U,2),1:"""")"
^IBA(364.5,279,3,0)="^^2^2^2991001^^"
^IBA(364.5,279,3,1,0)="Extracts the id numbers for all insurance companies for the operating"
^IBA(364.5,279,3,2,0)="provider."
^IBA(364.5,280,0)="N-CURR INSURANCE MAILING NAME^N^E^I^399^^^"
^IBA(364.5,280,1)="N Z S Z=$P($G(^DGCR(399,IBXIEN,""M"")),U,4) S:Z'="""" IBXDATA=Z I Z="""" D F^IBCEF(""N-CURR INSURANCE COMPANY NAME"")"
^IBA(364.5,280,3,0)="^^2^2^2991006^^^^"
^IBA(364.5,280,3,1,0)="The mailing name (or if this is null, the insurance co name) of the current"
^IBA(364.5,280,3,2,0)="insurance company for bill entry IBXIEN."
^IBA(364.5,281,0)="N-EOB ENTRIES^N^E^G^399^^^"
^IBA(364.5,281,1)="N Z,Z0,Z1 S Z=0 F  S Z=$O(^IBM(361.1,""ABS"",IBXIEN,Z)) Q:'Z  S (Z1,Z0)=0 F  S Z0=$O(^IBM(361.1,""ABS"",IBXIEN,Z,Z0)) Q:'Z0  S Z1=Z1+1,IBXDATA(Z,Z1)=Z0"
^IBA(364.5,281,3,0)="^^2^2^2991020^"
^IBA(364.5,281,3,1,0)="This element extracts the entry numbers for the bill in the EOB file.  Data"
^IBA(364.5,281,3,2,0)="is returned in IBXDATA(COB seq,n)."
^IBA(364.5,282,0)="N-PURCHASED SERVICE TOTAL^N^E^I^399^^^"
^IBA(364.5,282,1)="N Z,T S IBXDATA="""" I $$ONLAB^IBCEU3(IBXIEN) D:'$D(IBXSAVE(""BOX24"")) B24^IBCEF3(.IBXSAVE,IBXIEN) S IBXDATA="""",(Z,T)=0 F  S Z=$O(IBXSAVE(""BOX24"",Z)) Q:'Z  S T=T+$P(IBXSAVE(""BOX24"",Z),U,11),IBXDATA=T"
^IBA(364.5,282,3,0)="^^2^2^2991123^"
^IBA(364.5,282,3,1,0)="If the facility is an outside non-lab facility, this is the total of all"
^IBA(364.5,282,3,2,0)="the charges that the VA paid for the line items for this bill."
^IBA(364.5,283,0)="N-OUTSIDE LAB TOTAL^N^E^I^399^^^"
^IBA(364.5,283,1)="N Z,Q,L I $$OLAB^IBCEU(IBXIEN) S Q=""BOX24"",L=""OLAB"" D:'$D(IBXSAVE(Q)) B24^IBCEF3(.IBXSAVE,IBXIEN) K IBXDATA S IBXDATA="""",(Z,IBXSAVE(L))=0 F  S Z=$O(IBXSAVE(Q,Z)) Q:'Z  S IBXSAVE(L)=IBXSAVE(L)+$P(IBXSAVE(Q,Z),U,11),IBXDATA=IBXSAVE(L)"
^IBA(364.5,283,3,0)="^364.53^2^2^3010110^^^"
^IBA(364.5,283,3,1,0)="If the facility is an outside lab, this is the total of all the charges"
^IBA(364.5,283,3,2,0)="that the VA paid for the line items for this bill."
^IBA(364.5,284,0)="N-SPECIAL PROGRAM^N^F^I^399^SPECIAL PROGRAM INDICATOR^I^"
^IBA(364.5,284,1)=""
^IBA(364.5,285,0)="N-DATE LAST SEEN^N^F^I^399^DATE LAST SEEN^I^"
^IBA(364.5,285,1)=""
^IBA(364.5,286,0)="N-HOMEBOUND^N^F^I^399^HOMEBOUND^I^"
^IBA(364.5,286,1)=""
^IBA(364.5,287,0)="N-HCFA 1500 BOX 19 RAW DATA^N^F^I^399^FORM LOC 19-UNSPECIFIED DATA^^"
^IBA(364.5,287,1)=""
^IBA(364.5,288,0)="N-PROVIDER INFORMATION^N^E^G^399^^^"
^IBA(364.5,289,0)="N-SPECIALTY CODE^N^E^I^399^^^"
^IBA(364.5,289,1)="S IBXDATA=$$BILLSPEC^IBCEU3(IBXIEN)"
^IBA(364.5,290,0)="N-CURRENT INSURANCE CO EMC ID#^N^E^I^399^^^"
^IBA(364.5,290,1)="S IBXDATA=$$GETID^IBCEP2(IBXIEN,1,$$PERFPRV^IBCEP2A(IBXIEN),+$$COBN^IBCEF(IBXIEN))"
^IBA(364.5,290,3,0)="^364.53^1^1^3010605^^^^"
^IBA(364.5,290,3,1,0)="Extracts the current insurance company's EMC ID # from the insurance file."
^IBA(364.5,291,0)="N-UB92 FL 82 PROVIDER^N^E^I^399^^^"
^IBA(364.5,291,1)="N Z,Z0,IBZ S Z=$$INPAT^IBCEF(IBXIEN,1),Z0=$S(Z:4,1:1) D GETPRV^IBCEU(IBXIEN,Z0,.IBZ) S IBXDATA=$P($G(IBZ(Z0,1)),U,1,2),$P(IBXDATA,U,3)=Z0"
^IBA(364.5,291,3,0)="^^5^5^2991208^^^^"
^IBA(364.5,291,3,1,0)="Box 82 on the UB92 holds the attending physician for inpatient claims,"
^IBA(364.5,291,3,2,0)="but holds the referring or ordering provider for outpatient.  This data"
^IBA(364.5,291,3,3,0)="element determines the correct ien of the correct provider type to use."
^IBA(364.5,291,3,4,0)="Data returned is name of provider ^ ien of provider (file 200) ^ 1 for"
^IBA(364.5,291,3,5,0)="referring or 4 for attending."
^IBA(364.5,292,0)="N-PATIENT DATE OF DEATH^N^E^I^399^^^"
^IBA(364.5,292,1)="S IBXDATA=$P($$PTDEM^IBCEF(IBXIEN,6),U)"
^IBA(364.5,292,3,0)="^^1^1^3000303^"
^IBA(364.5,292,3,1,0)="The fileman format of the patient's date of death for bill entry IBXIEN."
^IBA(364.5,293,0)="N-ACCIDENT DATE^N^E^I^399^^^"
^IBA(364.5,293,1)="D:'$D(IBXSAVE(""DATE"",""ACC"")) F^IBCEF(""N-EVENT DATE"",,,IBXIEN) K IBXDATA S IBXDATA=$G(IBXSAVE(""DATE"",""ACC""))"
^IBA(364.5,293,3,0)="^^2^2^3000303^"
^IBA(364.5,293,3,1,0)="Fileman formatted date.  Gets the date of the first occurrence code for an"
^IBA(364.5,293,3,2,0)="accident."
^IBA(364.5,294,0)="N-ALL INSURANCE CO TYPE^N^E^I^399^^^"
^IBA(364.5,294,1)="S IBXDATA=$$ALLTYP^IBCEF3(IBXIEN)"
^IBA(364.5,294,3,0)="^364.53^2^2^3000516^^^^"
^IBA(364.5,294,3,1,0)="This is the electronic type of all of the insurance for the bill."
^IBA(364.5,294,3,2,0)="Format is primary type^secondary type^tertiary type"
^IBA(364.5,295,0)="N-ALL PROVIDERS^N^E^G^399^^^"
^IBA(364.5,295,1)="N IBZ,Z D GETPRV^IBCEU(IBXIEN,""ALL"",.IBZ) F Z=1:1:$O(IBZ(""""),-1) S:'$G(IBZ(Z)) IBZ(Z)="""" M IBXDATA(Z)=IBZ(Z)"
^IBA(364.5,295,3,0)="^364.53^6^6^3010124^^^^"
^IBA(364.5,295,3,1,0)="Extracts the primary, secondary, and tertiary insurance company provider"
^IBA(364.5,295,3,2,0)="names and numbers into the IBXDATA array for bill entry IBXIEN."
^IBA(364.5,295,3,3,0)="Array format is "
^IBA(364.5,295,3,4,0)="   IBXDATA(provider type)=PROV NAME^CURRENT INS CO ID^vp ien of PROV "
^IBA(364.5,295,3,5,0)="   IBXDATA(provider type,1-3)=the provider id for the COB seq (1-3) "
^IBA(364.5,295,3,6,0)="   IBXDATA(provider type,""NOTOPT"")=1 if provider type is required for bill"
^IBA(364.5,296,0)="N-FACILITY NAME FOR BILLING^N^E^I^399^^^"
^IBA(364.5,296,1)="S IBXDATA=$P($G(^IBE(350.9,1,2)),U,10)"
^IBA(364.5,296,3,0)="^364.53^1^1^3010124^^"
^IBA(364.5,296,3,1,0)="The facility name for billing from the Site Parameter File."
^IBA(364.5,297,0)="N-ALL PROCEDURES^N^E^G^399^^^"
^IBA(364.5,297,1)="N IB,IBPROC,Z D ALLPROC^IBCVA1(IBXIEN,.IBPROC) S (IB,Z)=0 F  S IB=$O(IBPROC(IB)) Q:'IB  S Z=Z+1,IBXDATA(Z)=IBPROC(IB) D SETMODS^IBCVA1($P(IBPROC(IB),U,15),Z,.IBXSAVE)"
^IBA(364.5,297,3,0)="^364.53^4^4^3010523^^^"
^IBA(364.5,297,3,1,0)="Extracts all procedures on a bill.  Returns group data IBXDATA(1-n)="
^IBA(364.5,297,3,2,0)="procedure code;ICPT( or ICD0(^procedure date in fileman format."
^IBA(364.5,297,3,3,0)="Modifiers on the procedures are returned in IBXSAVE(""PROCMODS"",1-n)="
^IBA(364.5,297,3,4,0)="modifiers separated by comma.  "
^IBA(364.5,298,0)="N-AGENT CASHIER STREET LINE 2^N^E^I^399^^^"
^IBA(364.5,298,1)="S IBXDATA="""""
^IBA(364.5,298,3,0)="^364.53^1^1^3030623^^"
^IBA(364.5,298,3,1,0)="The agent cashier street address form the site parameter file. Not related to bill entry. Note: New feild needing definition in ^IBE(350.9,1,2) piece 13"
^IBA(364.5,299,0)="N-TYPE INSURANCE CO ID^N^E^I^399^^^"
^IBA(364.5,299,1)="S IBXDATA="""""
^IBA(364.5,299,3,0)="^364.53^8^8^3030713^^^^"
^IBA(364.5,299,3,1,0)="Extracted from a set of codes. Could be 1A=Blue Cross ID-INst;"
^IBA(364.5,299,3,2,0)="1B=Blue Shiled ID-Prof;1H=Champus ID;X4=CLIA#;"
^IBA(364.5,299,3,3,0)="1A = Blue Cross Number;1B = Blue Shield Number;1C = Medicare Number;"
^IBA(364.5,299,3,4,0)="1D = Medicaid Number;1G = UPIN Number;1H = TRICARE ID Number;"
^IBA(364.5,299,3,5,0)="G2=Provider Commercail ID;24=Facility Fed Tax ID #;1C=Medicare Part A-Inst"
^IBA(364.5,299,3,6,0)="1C=Medicare Part B -Porf;B3=Network ID-HMO;BQ=Network ID-PPO;G5=Provider Site ID"
^IBA(364.5,299,3,7,0)="0B=State License;IG=Provider UPIN;EI=Employer's ID;LU=Location Number;"
^IBA(364.5,299,3,8,0)="X5=State Industrial Accident Provider Number;FH=Clinic Number;1D=Medicaid"
^IBA(364.5,300,0)="N-SPRVSING PROV FULL NAME^N^E^I^399^^^"
^IBA(364.5,300,1)="N IBZ D GETPRV^IBCEU(IBXIEN,5,.IBZ) S IBXDATA=$P($G(IBZ(5,1)),U)_U_$P($G(IBZ(5,1)),U,3)_U_$P($G(IBZ(5,1)),U,4)"
^IBA(364.5,300,3,0)="^364.53^2^2^3030814^^^^"
^IBA(364.5,300,3,1,0)="The name of the supervising physician for bill entry IBXIEN.  The pieces"
^IBA(364.5,300,3,2,0)="returned are: provider name^vp ien for provider (200/355.93)^credentials"
^IBA(364.5,301,0)="N-OTHER PAYER FULL ADDRESS^N^E^G^399^^^"
^IBA(364.5,301,1)="S IBXSAVE(""ARRAY"")="""""
^IBA(364.5,301,3,0)="^364.53^2^2^3030812^^^^"
^IBA(364.5,301,3,1,0)="Extract the address information for the OTHER PAYER to parse it for 837 "
^IBA(364.5,301,3,2,0)="transmission using File 364.7 ."
^IBA(364.5,302,0)="N-OUTSIDE LAB TOTAL (EDI)^N^E^I^399^^^"
^IBA(364.5,302,1)="N Z,Q,L I $$OLAB^IBCEU(IBXIEN) S Q=""OUTPT"",L=""OLAB"" D:'$D(IBXSAVE(Q)) B24^IBCEF3(.IBXSAVE,IBXIEN) K IBXDATA S IBXDATA="""",(Z,IBXSAVE(L))=0 F  S Z=$O(IBXSAVE(Q,Z)) Q:'Z  S IBXSAVE(L)=IBXSAVE(L)+$P(IBXSAVE(Q,Z),U,11),IBXDATA=IBXSAVE(L)"
^IBA(364.5,302,3,0)="^^8^8^3060915^"
^IBA(364.5,302,3,1,0)="Similar to data element N-OUTSIDE LAB TOTAL."
^IBA(364.5,302,3,2,0)="This one uses the proper subscript in the IBXSAVE array for EDI "
^IBA(364.5,302,3,3,0)="transmissions."
^IBA(364.5,302,3,4,0)="B24^IBCEF3 creates IBXSAVE(""BOX24"") for printed 1500 data and"
^IBA(364.5,302,3,5,0)="B24^IBCEF3 creates IBXSAVE(""OUTPT"") for EDI transmitted data."
^IBA(364.5,302,3,6,0)=" "
^IBA(364.5,302,3,7,0)="If the facility is an outside lab, this is the total of all the charges"
^IBA(364.5,302,3,8,0)="that the VA paid for the line items for this bill."
^IBA(364.5,303,0)="N-OTHER INSURED FULL ADDRESS^N^E^G^399^^^"
^IBA(364.5,303,1)="S IBXSAVE(""ARRAY"")=""8,113-LINE1|8,113-LINE2|8,113-CITY|ST-8,113|8,113-ZIP"""
^IBA(364.5,303,3,0)="^364.53^2^2^3030726^^^^"
^IBA(364.5,303,3,1,0)="Extract the address information for the OTHER INSURED to parse it for 837"
^IBA(364.5,303,3,2,0)="transmission using File 364.7 ."
^IBA(364.5,304,0)="N-OTHER INSURED QUALIF/ID ALL^N^E^G^399^^^"
^IBA(364.5,304,1)="K IBXDATA S IBZZ=$$SETSTR^VALM1($P($G(^DPT(+$P($G(^DGCR(399,IBXIEN,0)),U,2),0)),U),"""",2,39)"
^IBA(364.5,304,3,0)="^364.53^3^3^3030714^^^^"
^IBA(364.5,304,3,1,0)="Extracted form a set of codes, could be:"
^IBA(364.5,304,3,2,0)="1W = Member ID Number;23 = Client Number;SY = Social Security Number;"
^IBA(364.5,304,3,3,0)="1G = Insurance Policy Number also known as  UPIN Number;"
^IBA(364.5,305,0)="N-OTH PAYER PATIENT ID QUALIF^N^E^G^399^^^"
^IBA(364.5,305,1)="S IBXSAVE=""EI,MI,Find which one applies and pass value and qualifier"""
^IBA(364.5,305,3,0)="^364.53^2^2^3030714^^^^"
^IBA(364.5,305,3,1,0)="Find which is available, Employee ID or Member ID Number. Pass either"
^IBA(364.5,305,3,2,0)="EI=Employee ID Number or  MI=Member ID Number. Extract valeu and qualifier. Parse into seperate elements, 110,4 and 110,5."
^IBA(364.5,306,0)="N-OTH PAYER PAT ID QUALIF 1-3^N^E^G^399^^^"
^IBA(364.5,306,1)="S IBXSAVE=""1W|MEMBER ID NUMBER|1G|INSURANCE POLICY NUMBER|SY|SOCIAL SECURITY NUMBER|"""
^IBA(364.5,307,0)="N-TYPE INSURANCE CO ID-ALL^N^E^G^399^^^"
^IBA(364.5,307,1)="S IBXSAVE(""ID"")=""1A|1B|1H|G2|1C|"",YES=+$P($G(^DGCR(399,IBXIEN,""U2"")),U,11)"
^IBA(364.5,307,3,0)="^364.53^2^2^3030805^^^^"
^IBA(364.5,307,3,1,0)="Create an array so data can be parsed into the IBXDATA elements for TYPE "
^IBA(364.5,307,3,2,0)="OF INSURANCE COMPANY ID."
^IBA(364.5,308,0)="N-TYPE INSURANCE CO NUMBER-ALL^N^E^G^399^^^"
^IBA(364.5,308,1)="S (N,V,Z,I,IBXSAVE(""D""))="""" F  S N=$O(^IBE(355.97,N)) Q:N=""""&(I="""")  S I=$P($G(^(N,0)),U,1,4),Z=$P($G(I),U,1),V=$S(Z[""CROSS"":1,Z[""SHIE"":2,Z[""CHAM"":3,Z[""COMM"":4,Z[""ART A"":5,Z[""ARTB"":6,Z[""HMO"":7,1:""0"") S:V $P(IBXSAVE(""D""),""|"",V)=$P(I,U,4)"
^IBA(364.5,308,3,0)="^364.53^2^2^3030807^^^^"
^IBA(364.5,308,3,1,0)="Extract using appriate functions, the actual numbers associated with each "
^IBA(364.5,308,3,2,0)="category. To be parsed in 16,2 thru 13."
^IBA(364.5,309,0)="N-ALL ATT/RENDERING PROV SSN^N^E^G^399^^^"
^IBA(364.5,309,1)="S IBXDATA=$$PROVSSN^IBCEF7(IBXIEN)"
^IBA(364.5,309,3,0)="^364.53^4^4^3031014^^^^"
^IBA(364.5,309,3,1,0)="Extracts the SSN for all FUNCTION types"
^IBA(364.5,309,3,2,0)="IBXDATA - string with ""^"" delimiters that contains SSNs (if any)"
^IBA(364.5,309,3,3,0)="in the position that equal to FUNCTION number i.e."
^IBA(364.5,309,3,4,0)="if RENDERING function # is 3 then SSN will be $P(IBXDATA,""^"",3)"
^IBA(364.5,310,0)="N-OPERATING PHYSICIAN DATA^N^E^G^399^^^"
^IBA(364.5,310,1)="N IBZ D GETPRV^IBCEU(IBXIEN,2,.IBZ) S IBXDATA=$G(IBZ(2,1)) S:IBXDATA="""" IBXDATA=""^^""_$$PROVPTR^IBCEF7(IBXIEN,2)"
^IBA(364.5,310,3,0)="^364.53^2^2^3031010^^^^"
^IBA(364.5,310,3,1,0)="Extracts the SSN for operating physician"
^IBA(364.5,310,3,2,0)="IBXDATA - string with ""^"" delimiters"
^IBA(364.5,311,0)="N-ALL OTH PROV SECONDARY ID^N^E^G^399^^^"
^IBA(364.5,311,1)="I +$G(IBXSAVE(""PROV2INF"",IBXIEN))=0 N IBZ D PROVINF^IBCEF7(IBXIEN,2,.IBZ) S IBXSAVE(""PROV2INF"",IBXIEN)=IBXIEN M IBXSAVE(""PROV2INF"",IBXIEN)=IBZ"
^IBA(364.5,311,3,0)="^364.53^2^2^3030825^^^^"
^IBA(364.5,311,3,1,0)="Secondary ID's first are there Insurance specific secondary id's #355.9 if #399,101 primary insurance carrier =#355.9,.02"
^IBA(364.5,311,3,2,0)="THEN #355.9,.07 is the provider id's"
^IBA(364.5,312,0)="N-ALL CUR/OTH PROVIDER INFO^N^E^G^399^^^"
^IBA(364.5,312,1)="D ALLPROV^IBCEF7"
^IBA(364.5,312,3,0)="^364.53^1^1^3040610^^^^"
^IBA(364.5,312,3,1,0)="check if data was already extracted if not then create an array with  current and other providers data, save in IBXSAVE(""PROVINF"",IBXIEN)"
^IBA(364.5,313,0)="N-PURCHASED SERVICE ALL^N^E^G^399^^^"
^IBA(364.5,313,1)="S A=$P($G(^DGCR(399,IBXIEN,""U2"")),U,10,11) S:$P(A,U,2)\2 I1=$P(A,U,1),N=$P(^IBA(355.93,I1,0),U,9),I4=+$P($Q(^IBA(355.9,""C"",N)),"","",4),I5=$P(^IBA(355.9,I4,0),U,6)"
^IBA(364.5,313,3,0)="^^2^2^3030803^"
^IBA(364.5,313,3,1,0)="USED IN 364.7 SEQUENCE 56 PICES 2 AND 3. cAN BE USED FOR THE REST ALSO."
^IBA(364.5,313,3,2,0)="I5 USED TO EXTRACT THE QUALIFIER FROM ^IBE(355.97) PIECE 3"
^IBA(364.5,314,0)="N-OTH INSURANCE CO IEN 36^N^E^G^399^^^"
^IBA(364.5,314,1)="N Z F Z=1,2,3 S IBXDATA(Z)=+$$POLICY^IBCEF(IBXIEN,1,$E(""PST"",Z))"
^IBA(364.5,314,3,0)="^364.53^1^1^3030805^^^^"
^IBA(364.5,314,3,1,0)="finds insurance iens in file #36"
^IBA(364.5,315,0)="N-OTH INSURANCE ADDRESS^N^E^G^399^^^"
^IBA(364.5,315,1)="D ELMADDR^IBCEF7(IBXIEN,0,.IBXDATA)"
^IBA(364.5,316,0)="N-OTH INSURED NAMES SUFF^N^E^G^399^^^"
^IBA(364.5,316,1)="N Z,Z0,Z1,IBZ D F^IBCEF(""N-ALL INSURED FULL NAMES"",""IBZ"") S Z=$$COBN^IBCEF(IBXIEN) S Z0=0 F Z1=1:1:3 I Z1'=Z,$D(^DGCR(399,IBXIEN,""I""_Z1)) S Z0=Z0+1,IBXDATA(Z0)=$$GETNMEL^IBCEF7($G(IBZ(Z1)),""SUFFIX"")"
^IBA(364.5,316,3,0)="^^1^1^3030806^"
^IBA(364.5,316,3,1,0)="returns array of suf for ""other insured"" names"
^IBA(364.5,317,0)="N-ALL OUTSIDE FAC PROVIDER INF^N^E^G^399^^^"
^IBA(364.5,317,1)="D ALLPRFAC^IBCEF71(IBXIEN,.IBXSAVE)"
^IBA(364.5,317,3,0)="^364.53^2^2^3030909^^"
^IBA(364.5,317,3,1,0)="If the IBXSAVE array for the bill has not yet been set for all outside"
^IBA(364.5,317,3,2,0)="facility provider ids, do the extract."
^IBA(364.5,318,0)="N-ALL ATT/REND PROV SSN/EI^N^E^I^399^^^"
^IBA(364.5,318,1)="S IBXDATA=$$PROVID^IBCEF73(IBXIEN)"
^IBA(364.5,318,3,0)="^364.53^1^1^3040527^^^^"
^IBA(364.5,318,3,1,0)="THIS WILL RETURN SSN OR TAX ID IF NO SSN"
^IBA(364.5,319,0)="N-STATION NUMBER^N^E^I^399^^^"
^IBA(364.5,319,1)="S IBXDATA=$P($$SITE^VASITE,U,3)"
^IBA(364.5,319,3,0)="^364.53^1^1^3051212^^"
^IBA(364.5,319,3,1,0)="This is the 3-digit number that identifies the site."
^IBA(364.5,320,0)="N-PROVIDER TAXONOMIES^N^E^I^399^^^"
^IBA(364.5,320,1)="S (IBXDATA,IBXSAVE(""TAX""))=$$PROVTAX^IBCEF73A(IBXIEN)"
^IBA(364.5,320,3,1,0)="This will return TAXONOMY codes for all providers"
^IBA(364.5,321,0)="N-ORGANIZATION NPI CODES^N^E^I^399^^^"
^IBA(364.5,321,1)="S (IBXDATA,IBXSAVE(""ORGNPI""))=$$ORGNPI^IBCEF73A(IBXIEN)"
^IBA(364.5,321,3,0)="^^1^1^3060420^"
^IBA(364.5,321,3,1,0)="This will return NPI for all organizations"
^IBA(364.5,322,0)="N-ORGANIZATION TAXONOMIES^N^E^I^399^^^"
^IBA(364.5,322,1)="S (IBXDATA,IBXSAVE(""ORGTAX""))=$$ORGTAX^IBCEF73A(IBXIEN)"
^IBA(364.5,322,3,0)="^^1^1^3060616^"
^IBA(364.5,322,3,1,0)="This will return TAXONOMY codes for all organizations"
^IBA(364.5,323,0)="N-PROVIDER NPI CODES^N^E^I^399^^^"
^IBA(364.5,323,1)="S (IBXDATA,IBXSAVE(""NPI""))=$$PROVNPI^IBCEF73A(IBXIEN)"
^IBA(364.5,323,3,0)="^364.53^1^1^3060629^^"
^IBA(364.5,323,3,1,0)="This will return NPI for all providers"
^IBA(364.5,"B","N-ACCIDENT DATE",293)=""
^IBA(364.5,"B","N-ADMISSION DATE",78)=""
^IBA(364.5,"B","N-ADMITTING DIAGNOSIS",85)=""
^IBA(364.5,"B","N-AGENT CASHIER CITY",105)=""
^IBA(364.5,"B","N-AGENT CASHIER MAIL SYMBOL",103)=""
^IBA(364.5,"B","N-AGENT CASHIER PHONE",108)=""
^IBA(364.5,"B","N-AGENT CASHIER STATE",106)=""
^IBA(364.5,"B","N-AGENT CASHIER STREET ADDRESS",104)=""
^IBA(364.5,"B","N-AGENT CASHIER STREET LINE 2",298)=""
^IBA(364.5,"B","N-AGENT CASHIER ZIP CODE",107)=""
^IBA(364.5,"B","N-ALL ATT/REND PROV SSN/EI",318)=""
^IBA(364.5,"B","N-ALL ATT/RENDERING PROV ID",277)=""
^IBA(364.5,"B","N-ALL ATT/RENDERING PROV SSN",309)=""
^IBA(364.5,"B","N-ALL AUTH CODES",265)=""
^IBA(364.5,"B","N-ALL CUR/OTH PROVIDER INFO",312)=""
^IBA(364.5,"B","N-ALL INSURANCE CO 837 ID",256)=""
^IBA(364.5,"B","N-ALL INSURANCE CO PROV NUM",195)=""
^IBA(364.5,"B","N-ALL INSURANCE CO TYPE",294)=""
^IBA(364.5,"B","N-ALL INSURANCE COMPANIES",194)=""
^IBA(364.5,"B","N-ALL INSURANCE GROUP NAME",199)=""
^IBA(364.5,"B","N-ALL INSURANCE GROUP NUMBER",200)=""
^IBA(364.5,"B","N-ALL INSURANCE NUMBER",198)=""
^IBA(364.5,"B","N-ALL INSURED EMPLOY STATUS",202)=""
^IBA(364.5,"B","N-ALL INSURED EMPLOYER INFO",201)=""
^IBA(364.5,"B","N-ALL INSURED FULL NAMES",196)=""
^IBA(364.5,"B","N-ALL INSURED PT RELATION",197)=""
^IBA(364.5,"B","N-ALL OPERATING PROV ID",279)=""
^IBA(364.5,"B","N-ALL OTH PROV SECONDARY ID",311)=""
^IBA(364.5,"B","N-ALL OUTSIDE FAC PROVIDER INF",317)=""
^IBA(364.5,"B","N-ALL PROCEDURES",297)=""
^IBA(364.5,"B","N-ALL PROVIDERS",295)=""
^IBA(364.5,"B","N-ALL REFERRING PROV ID",278)=""
^IBA(364.5,"B","N-AR BILL NUMBER",210)=""
^IBA(364.5,"B","N-ASSIGN OF BENEFITS INDICATOR",24)=""
^IBA(364.5,"B","N-ATT/REND PHYSICIAN NAME",83)=""
^IBA(364.5,"B","N-ATT/REND PHYSICIAN SPEC",249)=""
^IBA(364.5,"B","N-ATT/REND PROVIDER ID",261)=""
^IBA(364.5,"B","N-ATTENDING PHYSICIAN ID",239)=""
^IBA(364.5,"B","N-AUTO ACCIDENT STATE",159)=""
^IBA(364.5,"B","N-BATCH DATE",121)=""
^IBA(364.5,"B","N-BATCH NUMBER",120)=""
^IBA(364.5,"B","N-BILL CLASSIFICATION",184)=""
^IBA(364.5,"B","N-BILL COMMENT",208)=""
^IBA(364.5,"B","N-BILL DESIGNATION",54)=""
^IBA(364.5,"B","N-BILL FREQUENCY",74)=""
^IBA(364.5,"B","N-BILL NUMBER",69)=""
^IBA(364.5,"B","N-BILL RATE TYPE",204)=""
^IBA(364.5,"B","N-BILL REMARKS",82)=""
^IBA(364.5,"B","N-BILL SUBMISSION STATUS",98)=""
^IBA(364.5,"B","N-BILLING SITE",230)=""
^IBA(364.5,"B","N-CLAIM FORM SIGNER",205)=""
^IBA(364.5,"B","N-CLAIM FORM SIGNER TITLE",206)=""
^IBA(364.5,"B","N-CMS-1500 24J REND PROV ID",189)=""
^IBA(364.5,"B","N-CMS-1500 BOX 24I ID QUAL",188)=""
^IBA(364.5,"B","N-COB CLAIM LEVEL ADJUSTMENTS",228)=""
^IBA(364.5,"B","N-COB CLAIM LEVEL AMOUNTS",225)=""
^IBA(364.5,"B","N-COINSURANCE DAYS",218)=""
^IBA(364.5,"B","N-COLUMNS BOX 24 (HCFA 1500)",180)=""
^IBA(364.5,"B","N-COMMON BILL REMARKS",135)=""
^IBA(364.5,"B","N-CONDITION CODES",11)=""
^IBA(364.5,"B","N-CONDITION RELATED TO AUTO",88)=""
^IBA(364.5,"B","N-CONDITION RELATED TO EMPLOY",87)=""
^IBA(364.5,"B","N-CONDITION RELATED TO OTH ACC",89)=""
^IBA(364.5,"B","N-COVERED DAYS",75)=""
^IBA(364.5,"B","N-CURR INS CO FULL ADDRESS",192)=""
^IBA(364.5,"B","N-CURR INS EMPLOYMENT STAT",48)=""
^IBA(364.5,"B","N-CURR INS FORM LOC 64",55)=""
^IBA(364.5,"B","N-CURR INSURANCE CO ID NUM",123)=""
^IBA(364.5,"B","N-CURR INSURANCE CO PROV #",127)=""
^IBA(364.5,"B","N-CURR INSURANCE COMPANY NAME",45)=""
^IBA(364.5,"B","N-CURR INSURANCE MAILING NAME",280)=""
^IBA(364.5,"B","N-CURR INSURED DEMOGRAPHICS",6)=""
^IBA(364.5,"B","N-CURR INSURED EMPLOYER INFO",7)=""
^IBA(364.5,"B","N-CURR INSURED FULL ADDRESS",4)=""
^IBA(364.5,"B","N-CURR INSURED FULL NAME",2)=""
^IBA(364.5,"B","N-CURR INSURED GROUP NAME",26)=""
^IBA(364.5,"B","N-CURR INSURED GROUP NUMBER",27)=""
^IBA(364.5,"B","N-CURR INSURED ID",3)=""
^IBA(364.5,"B","N-CURR INSURED PHONE",215)=""
^IBA(364.5,"B","N-CURR INSURED PT RELATION",25)=""
^IBA(364.5,"B","N-CURR INSURED SSN",214)=""
^IBA(364.5,"B","N-CURRENT AUTHORIZATION CODE",262)=""
^IBA(364.5,"B","N-CURRENT INS POLICY TYPE",235)=""
^IBA(364.5,"B","N-CURRENT INSURANCE CO 837 ID",129)=""
^IBA(364.5,"B","N-CURRENT INSURANCE CO EMC ID#",290)=""
^IBA(364.5,"B","N-CURRENT INSURANCE CO TYPE",233)=""
^IBA(364.5,"B","N-CURRENT INSURED RELATIONSHIP",158)=""
^IBA(364.5,"B","N-DATE FIRST PRINTED",209)=""
^IBA(364.5,"B","N-DATE FIRST PRINTED OR SENT",267)=""
^IBA(364.5,"B","N-DATE LAST SEEN",285)=""
^IBA(364.5,"B","N-DATE OF CURRENT ILLNESS",92)=""
^IBA(364.5,"B","N-DATE OF SERVICE FROM",165)=""
^IBA(364.5,"B","N-DATE OF SERVICE TO",166)=""
^IBA(364.5,"B","N-DATE UNABLE TO WORK FROM",93)=""
^IBA(364.5,"B","N-DATE UNABLE TO WORK TO",94)=""
^IBA(364.5,"B","N-DIAGNOSES",86)=""
^IBA(364.5,"B","N-DIAGNOSIS CODE 2 (HCFA 1500)",162)=""
^IBA(364.5,"B","N-DIAGNOSIS CODE 3 (HCFA 1500)",163)=""
^IBA(364.5,"B","N-DIAGNOSIS CODE 4 (HCFA 1500)",164)=""
^IBA(364.5,"B","N-DIAGNOSIS CODE REFS",170)=""
^IBA(364.5,"B","N-DIAGNOSIS E-CODE",253)=""
^IBA(364.5,"B","N-DISCHARGE DATE",81)=""
^IBA(364.5,"B","N-DRG USED",257)=""
^IBA(364.5,"B","N-EDI SITE CONTACT PHONE",238)=""
^IBA(364.5,"B","N-EOB ENTRIES",281)=""
^IBA(364.5,"B","N-EVENT DATE",232)=""
^IBA(364.5,"B","N-FACILITY CITY",117)=""
^IBA(364.5,"B","N-FACILITY NAME",114)=""
^IBA(364.5,"B","N-FACILITY NAME FOR BILLING",296)=""
^IBA(364.5,"B","N-FACILITY SITE NUMBER",231)=""
^IBA(364.5,"B","N-FACILITY STATE",118)=""
^IBA(364.5,"B","N-FACILITY STREET ADDRESS 1",116)=""
^IBA(364.5,"B","N-FACILITY STREET ADDRESS 2",155)=""
^IBA(364.5,"B","N-FACILITY ZIP CODE",119)=""
^IBA(364.5,"B","N-FEDERAL TAX ID",109)=""
^IBA(364.5,"B","N-FIRST TRANSMIT DATE",260)=""
^IBA(364.5,"B","N-FORM REMARKS",207)=""
^IBA(364.5,"B","N-GET FROM PREVIOUS EXTRACT",5)=""
^IBA(364.5,"B","N-HCFA 1500 BALANCE DUE BOX",173)=""
^IBA(364.5,"B","N-HCFA 1500 BOX 12",145)=""
^IBA(364.5,"B","N-HCFA 1500 BOX 13",146)=""
^IBA(364.5,"B","N-HCFA 1500 BOX 18 (FR)",147)=""
^IBA(364.5,"B","N-HCFA 1500 BOX 18 (TO)",160)=""
^IBA(364.5,"B","N-HCFA 1500 BOX 19",148)=""
^IBA(364.5,"B","N-HCFA 1500 BOX 19 RAW DATA",287)=""
^IBA(364.5,"B","N-HCFA 1500 BOX 31",153)=""
^IBA(364.5,"B","N-HCFA 1500 CHARGES",171)=""
^IBA(364.5,"B","N-HCFA 1500 EIN FLAG (BOX 25)",151)=""
^IBA(364.5,"B","N-HCFA 1500 MODIFIERS",178)=""
^IBA(364.5,"B","N-HCFA 1500 OUTSIDE LAB",150)=""
^IBA(364.5,"B","N-HCFA 1500 PLACE OF SERVICE",167)=""
^IBA(364.5,"B","N-HCFA 1500 PROCEDURES",169)=""
^IBA(364.5,"B","N-HCFA 1500 SERVICE LINE (EDI)",126)=""
^IBA(364.5,"B","N-HCFA 1500 SERVICES (PRINT)",154)=""
^IBA(364.5,"B","N-HCFA 1500 TYPE OF SERVICE",168)=""
^IBA(364.5,"B","N-HCFA 1500 UNITS",172)=""
^IBA(364.5,"B","N-HCFA BOX 24H FREE TEXT",174)=""
^IBA(364.5,"B","N-HCFA BOX 24I FREE TEXT",175)=""
^IBA(364.5,"B","N-HCFA BOX 24J FREE TEXT",176)=""
^IBA(364.5,"B","N-HCFA BOX 24K FREE TEXT",177)=""
^IBA(364.5,"B","N-HCFA EMERGENCY INDICATOR",229)=""
^IBA(364.5,"B","N-HOMEBOUND",286)=""
^IBA(364.5,"B","N-INSURED SERVICE BRANCH",211)=""
^IBA(364.5,"B","N-INSURED SERVICE RANK",212)=""
^IBA(364.5,"B","N-KILL IBXSAVE",100)=""
^IBA(364.5,"B","N-LAB CLIA #",271)=""
^IBA(364.5,"B","N-LAB CLIA NUMBER",112)=""
^IBA(364.5,"B","N-LAB OR FACILITY PRIMARY ID",113)=""
^IBA(364.5,"B","N-LAST MENSTRUAL PERIOD",270)=""
^IBA(364.5,"B","N-LINES BOX 24 (HCFA 1500)",179)=""
^IBA(364.5,"B","N-LOCATION OF CARE",183)=""
^IBA(364.5,"B","N-MAILING ADDRESS FULL",138)=""
^IBA(364.5,"B","N-MAILING ADDRESS NAME",137)=""
^IBA(364.5,"B","N-MAMMOGRAPHY CERT#",111)=""
^IBA(364.5,"B","N-MEDICAL RECORD NUMBER",10)=""
^IBA(364.5,"B","N-MEDICARE GROUP NUMBER",258)=""
^IBA(364.5,"B","N-MEDICARE INPT CLAIM COB AMTS",226)=""
^IBA(364.5,"B","N-MEDICARE OUTPT CLAIM COB AMT",227)=""
^IBA(364.5,"B","N-MEDICARE PROVIDER NUMBER",220)=""
^IBA(364.5,"B","N-NON VA CARE TYPE",276)=""
^IBA(364.5,"B","N-NON VA FACILITY",274)=""
^IBA(364.5,"B","N-NON VA PROVIDER ID",272)=""
^IBA(364.5,"B","N-NON-COVERED DAYS",76)=""
^IBA(364.5,"B","N-NON-INSTITUTIONAL CLAIM TYPE",97)=""
^IBA(364.5,"B","N-OCCURRENCE CODES",190)=""
^IBA(364.5,"B","N-OFFSET AMOUNT",217)=""
^IBA(364.5,"B","N-OPERATING PHYSICIAN DATA",310)=""
^IBA(364.5,"B","N-OPERATING PHYSICIAN ID",243)=""
^IBA(364.5,"B","N-OPERATING PHYSICIAN NAME",242)=""
^IBA(364.5,"B","N-OPERATING PHYSICIAN SPEC",251)=""
^IBA(364.5,"B","N-ORGANIZATION NPI CODES",321)=""
^IBA(364.5,"B","N-ORGANIZATION TAXONOMIES",322)=""
^IBA(364.5,"B","N-OTH INS FORM LOC 64",56)=""
^IBA(364.5,"B","N-OTH INS POL TYPES",236)=""
^IBA(364.5,"B","N-OTH INSURANCE ADDRESS",315)=""
^IBA(364.5,"B","N-OTH INSURANCE CO IEN 36",314)=""
^IBA(364.5,"B","N-OTH INSURANCE CO. NAME",46)=""
^IBA(364.5,"B","N-OTH INSURANCE PRIOR PAYMENT",125)=""
^IBA(364.5,"B","N-OTH INSURANCE PROVIDER #",128)=""
^IBA(364.5,"B","N-OTH INSURANCE SEQUENCE",101)=""
^IBA(364.5,"B","N-OTH INSURED DEMOGRAPHICS",28)=""
^IBA(364.5,"B","N-OTH INSURED EMPLOYR INFO",30)=""
^IBA(364.5,"B","N-OTH INSURED FULL NAME",32)=""
^IBA(364.5,"B","N-OTH INSURED GRP NAME",31)=""
^IBA(364.5,"B","N-OTH INSURED GRP NUMBER",33)=""
^IBA(364.5,"B","N-OTH INSURED ID",34)=""
^IBA(364.5,"B","N-OTH INSURED NAMES SUFF",316)=""
^IBA(364.5,"B","N-OTH INSURED PT RELATION",35)=""
^IBA(364.5,"B","N-OTH PAYER PAT ID QUALIF 1-3",306)=""
^IBA(364.5,"B","N-OTH PAYER PATIENT ID QUALIF",305)=""
^IBA(364.5,"B","N-OTHER INSURANCE CO TYPES",234)=""
^IBA(364.5,"B","N-OTHER INSURANCE EXISTS",144)=""
^IBA(364.5,"B","N-OTHER INSURED AUTH CODES",266)=""
^IBA(364.5,"B","N-OTHER INSURED EMPLOY STATUS",49)=""
^IBA(364.5,"B","N-OTHER INSURED FULL ADDRESS",303)=""
^IBA(364.5,"B","N-OTHER INSURED QUALIF/ID ALL",304)=""
^IBA(364.5,"B","N-OTHER PAYER FULL ADDRESS",301)=""
^IBA(364.5,"B","N-OTHER PHYSICIAN",84)=""
^IBA(364.5,"B","N-OTHER PHYSICIAN SPEC",250)=""
^IBA(364.5,"B","N-OTHER PROVIDER ID",252)=""
^IBA(364.5,"B","N-OUTSIDE FACILITY NAME",268)=""
^IBA(364.5,"B","N-OUTSIDE LAB TOTAL",283)=""
^IBA(364.5,"B","N-OUTSIDE LAB TOTAL (EDI)",302)=""
^IBA(364.5,"B","N-PATIENT BIRTHDATE",66)=""
^IBA(364.5,"B","N-PATIENT CITY",61)=""
^IBA(364.5,"B","N-PATIENT DATE OF DEATH",292)=""
^IBA(364.5,"B","N-PATIENT EMPLOYER NAME",70)=""
^IBA(364.5,"B","N-PATIENT EMPLOYMENT STATUS",99)=""
^IBA(364.5,"B","N-PATIENT MARITAL STATUS",68)=""
^IBA(364.5,"B","N-PATIENT NAME",65)=""
^IBA(364.5,"B","N-PATIENT PHONE",64)=""
^IBA(364.5,"B","N-PATIENT SEX",67)=""
^IBA(364.5,"B","N-PATIENT SHORT ADDRESS",187)=""
^IBA(364.5,"B","N-PATIENT SSN",143)=""
^IBA(364.5,"B","N-PATIENT STATE",62)=""
^IBA(364.5,"B","N-PATIENT STATUS",9)=""
^IBA(364.5,"B","N-PATIENT STREET ADDRESS 1-3",157)=""
^IBA(364.5,"B","N-PATIENT STREET ADDRESS LN 1",59)=""
^IBA(364.5,"B","N-PATIENT STREET ADDRESS LN 2",60)=""
^IBA(364.5,"B","N-PATIENT ZIP CODE",63)=""
^IBA(364.5,"B","N-PRESCRIPTIONS",102)=""
^IBA(364.5,"B","N-PRIMARY AUTH CODE",44)=""
^IBA(364.5,"B","N-PRINT BILL SUBMIT STATUS",142)=""
^IBA(364.5,"B","N-PRIOR BILLS",216)=""
^IBA(364.5,"B","N-PRIOR PAYMENTS",156)=""
^IBA(364.5,"B","N-PROCEDURE CODING METHD",203)=""
^IBA(364.5,"B","N-PROVIDER INFORMATION",288)=""
^IBA(364.5,"B","N-PROVIDER NPI CODES",323)=""
^IBA(364.5,"B","N-PROVIDER SIGNATURE ON FILE",58)=""
^IBA(364.5,"B","N-PROVIDER TAXONOMIES",320)=""
^IBA(364.5,"B","N-PURCHASED SERVICE ALL",313)=""
^IBA(364.5,"B","N-PURCHASED SERVICE TOTAL",282)=""
^IBA(364.5,"B","N-PURCHASED SERVICE TYPE",273)=""
^IBA(364.5,"B","N-RECEIVER ID NUMBER",124)=""
^IBA(364.5,"B","N-RECORD ID",131)=""
^IBA(364.5,"B","N-REFERRING PROVIDER ID",241)=""
^IBA(364.5,"B","N-REFERRING PROVIDER NAME",240)=""
^IBA(364.5,"B","N-REFERRING PROVIDER SPECIALTY",248)=""
^IBA(364.5,"B","N-RENDERING INSTITUTION",275)=""
^IBA(364.5,"B","N-RENDERING PROVIDER ID",245)=""
^IBA(364.5,"B","N-RENDERING PROVIDER NAME",244)=""
^IBA(364.5,"B","N-ROI INDICATOR",23)=""
^IBA(364.5,"B","N-SECONDARY AUTH CODE",263)=""
^IBA(364.5,"B","N-SEGMENT DELIMITER",136)=""
^IBA(364.5,"B","N-SET 837 HEADER NODE",115)=""
^IBA(364.5,"B","N-SET 837 INS CO HDR NODE",224)=""
^IBA(364.5,"B","N-SIMILAR ILLNESS DATE",90)=""
^IBA(364.5,"B","N-SITE CONTACT PHONE",255)=""
^IBA(364.5,"B","N-SITE NUMBER",134)=""
^IBA(364.5,"B","N-SOURCE OF ADMISSION",80)=""
^IBA(364.5,"B","N-SPECIAL PROGRAM",284)=""
^IBA(364.5,"B","N-SPECIALTY CODE",289)=""
^IBA(364.5,"B","N-SPRVSING PROV FULL NAME",300)=""
^IBA(364.5,"B","N-STATEMENT COVERS FROM DATE",71)=""
^IBA(364.5,"B","N-STATEMENT COVERS TO DATE",133)=""
^IBA(364.5,"B","N-STATION NUMBER",319)=""
^IBA(364.5,"B","N-TERTIARY AUTH CODE",264)=""
^IBA(364.5,"B","N-TIMEFRAME OF BILL",185)=""
^IBA(364.5,"B","N-TOTAL CHARGES",95)=""
^IBA(364.5,"B","N-TOTAL CHARGES LESS OFFSET",152)=""
^IBA(364.5,"B","N-TYPE INSURANCE CO ID",299)=""
^IBA(364.5,"B","N-TYPE INSURANCE CO ID-ALL",307)=""
^IBA(364.5,"B","N-TYPE INSURANCE CO NUMBER-ALL",308)=""
^IBA(364.5,"B","N-TYPE OF ADMISSION",79)=""
^IBA(364.5,"B","N-TYPE OF BILL",73)=""
^IBA(364.5,"B","N-UB-04 BILL CLASSIFICATION",223)=""
^IBA(364.5,"B","N-UB-04 FORM LOCATOR 64",191)=""
^IBA(364.5,"B","N-UB-04 FORM LOCATOR 64B",246)=""
^IBA(364.5,"B","N-UB-04 FORM LOCATOR 64C",247)=""
^IBA(364.5,"B","N-UB-04 LOCATION OF CARE",222)=""
^IBA(364.5,"B","N-UB-04 PROCEDURES",16)=""
^IBA(364.5,"B","N-UB-04 SERVICE LINE (EDI)",8)=""
^IBA(364.5,"B","N-UB-04 SERVICE LINE (PRINT)",193)=""
^IBA(364.5,"B","N-UB-04 TIMEFRAME OF BILL",221)=""
^IBA(364.5,"B","N-UB92 FL 82 PROVIDER",291)=""
^IBA(364.5,"B","N-UB92 FORM LOCATOR 11",186)=""
^IBA(364.5,"B","N-UB92 FORM LOCATOR 2",72)=""
^IBA(364.5,"B","N-UB92 FORM LOCATOR 31",15)=""
^IBA(364.5,"B","N-UB92 FORM LOCATOR 56",13)=""
^IBA(364.5,"B","N-UB92 FORM LOCATOR 57",14)=""
^IBA(364.5,"B","N-UB92 FORM LOCATOR 78",53)=""
^IBA(364.5,"B","N-UB92 SIG REQ REMINDER",181)=""
^IBA(364.5,"B","N-VALUE CODES",12)=""
^IBA(364.6,0)="IB FORM SKELETON DEFINITION^364.6IP^1759^1277"
^IBA(364.6,1,0)="8^N^^30^1^^0^2^10^BILL DESIGNATION^^1^0"
^IBA(364.6,3,0)="8^N^^15^1^^0^11^25^BILLING PROVIDER ADDRESS L2^0^1"
^IBA(364.6,4,0)="8^N^^30^1^^0^2.9^^INSURED FULL NAME^1^1"
^IBA(364.6,5,0)="8^N^^30^1^^0^6^17^INSURED ID NUMBER^^1^0"
^IBA(364.6,6,0)="8^N^^30^1^^0^6.9^72^INSURED ADDR (STR/CITY/ST/ZIP)^1^1"
^IBA(364.6,7,0)="8^N^^30^1^^0^8^30^INSURED CITY^^1"
^IBA(364.6,9,0)="8^N^^30^1^^0^10^5^INSURED ZIP CODE^^1"
^IBA(364.6,10,0)="8^N^^30^1^^0^10.9^29^INSURED DEMO (BDT/SEX/PHONE)^1^1"
^IBA(364.6,11,0)="8^N^^30^1^^0^12^1^INSURED SEX^^1"
^IBA(364.6,12,0)="8^N^^30^1^^0^13^20^INSURED PHONE^^1"
^IBA(364.6,13,0)="8^N^^35^1^^0^4.9^62^INSURED EMPLR GRP (NM/CITY/ST)^1^1"
^IBA(364.6,14,0)="8^N^^35^1^^0^7^2^INSURED EMPLOYER STATE^^1"
^IBA(364.6,15,0)="8^N^^35^1^^0^6^30^INSURED EMPLOYER CITY^^1"
^IBA(364.6,16,0)="8^N^^30^1^^0^11^8^INSURED BIRTH DATE^^1"
^IBA(364.6,17,0)="8^N^^30^1^^0^7^35^INSURED STREET ADDRESS^^1"
^IBA(364.6,18,0)="8^N^^35^1^^0^5^30^INSURED EMPLOYER NAME^^1"
^IBA(364.6,22,0)="8^N^^30^1^^0^4^20^INSURED FIRST NAME^^1^0"
^IBA(364.6,26,0)="8^N^^30^1^^0^3^30^INSURED LAST NAME^^1^0"
^IBA(364.6,27,0)="8^N^^30^1^^0^5^25^INSURED MIDDLE NAME^^1"
^IBA(364.6,28,0)="8^N^^40^1^^0^2^2^INSURED RELATIONSHIP TO PT^^1^0"
^IBA(364.6,29,0)="8^N^^40^1^^0^3^2^PT EMPLOYMENT STATUS^^1"
^IBA(364.6,30,0)="8^N^^40^1^^0^4^30^PATIENT LAST NAME^^1^0"
^IBA(364.6,31,0)="8^N^^40^1^^0^5^20^PATIENT FIRST NAME^^1^0"
^IBA(364.6,32,0)="8^N^^40^1^^0^6^25^PATIENT MIDDLE NAME^^1"
^IBA(364.6,33,0)="8^N^^40^1^^0^7^35^PATIENT ADDRESS LINE 1^^1^0"
^IBA(364.6,34,0)="8^N^^40^1^^0^8^35^PATIENT ADDRESS LINE 2^^1"
^IBA(364.6,35,0)="8^N^^40^1^^0^9^30^PATIENT CITY^^1^0"
^IBA(364.6,36,0)="8^N^^40^1^^0^10^2^PATIENT STATE^^1^0"
^IBA(364.6,37,0)="8^N^^40^1^^0^11^5^PATIENT ZIP CODE^^1"
^IBA(364.6,38,0)="8^N^^40^1^^0^12^8^PATIENT BIRTHDATE^^1"
^IBA(364.6,39,0)="8^N^^40^1^^0^13^1^PATIENT SEX^^1"
^IBA(364.6,40,0)="8^N^^40^1^^0^14^1^PATIENT MARITAL STATUS^^1"
^IBA(364.6,41,0)="8^N^^40^1^^0^15^10^PATIENT SSN^^1^0"
^IBA(364.6,42,0)="8^N^^40^1^^0^16^20^HEALTH RECORD NUMBER^^1^0"
^IBA(364.6,43,0)="8^N^^45^1^^0^2^30^PATIENT EMPLOYER NAME^^1"
^IBA(364.6,44,0)="8^N^^50^1^^0^2^38^PATIENT CONTROL #^^1^0"
^IBA(364.6,45,0)="8^N^^50^1^^0^3^1^TYPE OF FACILITY^^1"
^IBA(364.6,46,0)="8^N^^50^1^^0^5^1^FREQUENCY^^1"
^IBA(364.6,47,0)="8^N^^50^1^^0^6^2^CLAIM TYPE^^1"
^IBA(364.6,48,0)="8^N^^50^1^^0^7^1^RELEASE OF INFORMATION^^1"
^IBA(364.6,49,0)="8^N^^50^1^^0^8^1^ASSIGNMENT OF BENEFITS^^1"
^IBA(364.6,50,0)="8^N^^50^1^^0^9^2^BILL STATUS^^1"
^IBA(364.6,51,0)="8^N^^50^1^^0^10^8^STATEMENT COVERS FROM DATE^^1^0"
^IBA(364.6,52,0)="8^N^^50^1^^0^12^15^BALANCE DUE^^1^0"
^IBA(364.6,53,0)="8^N^^50^1^^0^13^15^TOTAL CHARGES^^1^0"
^IBA(364.6,54,0)="8^N^^50^1^^0^14^8^ADMISSION/START OF CARE DATE^^1"
^IBA(364.6,55,0)="8^N^^50^1^^1^15^2^ADMISSION HOUR^^1"
^IBA(364.6,56,0)="8^N^^50^1^^0^16^8^DISCHARGE DATE^^1"
^IBA(364.6,57,0)="8^N^^50^1^^1^17^2^DISCHARGE HOUR^^1"
^IBA(364.6,58,0)="8^N^^50^1^^0^18^8^DATE OF ONSET^^1"
^IBA(364.6,59,0)="8^N^^50^1^^0^19^8^FIRST DATE SIMILAR ILLNESS^^1"
^IBA(364.6,60,0)="8^N^^50^1^^0^20^8^DATE UNABLE TO WORK FROM^^1"
^IBA(364.6,61,0)="8^N^^50^1^^0^21^8^DATE UNABLE TO WORK TO^^1"
^IBA(364.6,62,0)="8^N^^50^1^^0^22^1^SOURCE OF ADMISSION^^1"
^IBA(364.6,63,0)="8^N^^50^1^^0^23^1^TYPE OF ADMISSION^^1"
^IBA(364.6,64,0)="8^N^^50^1^^0^24^2^PATIENT STATUS^^1"
^IBA(364.6,65,0)="8^N^^30^1^^0^14^30^INSURED STREET ADDRESS 2^^1"
^IBA(364.6,66,0)="8^N^^50^1^^0^26^3^COVERED DAYS^^1"
^IBA(364.6,67,0)="8^N^^50^1^^0^27^3^NON-COVERED DAYS^^1"
^IBA(364.6,70,0)="8^N^^50^1^^0^28^2^CONDITION REL TO AUTO ACC^^1"
^IBA(364.6,71,0)="8^N^^50^1^^0^29^2^CONDITION REL TO EMPLOYMENT^^1"
^IBA(364.6,72,0)="8^N^^50^1^^0^30^2^CONDITION REL TO OTH ACC^^1"
^IBA(364.6,73,0)="8^N^^50^1^^0^31^2^STATE CODE FOR AUTO ACCIDENT^^1"
^IBA(364.6,74,0)="8^N^^50^1^^0^32^1^PROVIDER SIGNATURE ON FILE^^1"
^IBA(364.6,75,0)="8^N^^60^1^^0^3^2^SPECIAL PROGRAM^^1"
^IBA(364.6,76,0)="8^N^^60^1^^0^4^8^DATE LAST SEEN^^1"
^IBA(364.6,81,0)="8^N^^65^1^^0^2^8^OCCURRENCE DATE^^1"
^IBA(364.6,82,0)="8^N^^65^1^^0^3^3^OCCURRENCE CODE^^1"
^IBA(364.6,83,0)="8^N^^70^1^^0^2^8^OCCURRENCE SPAN FROM DATE^^1"
^IBA(364.6,84,0)="8^N^^70^1^^0^4^3^OCCURRENCE SPAN CODE^^1"
^IBA(364.6,85,0)="8^N^^75^1^^0^2^8^PROCEDURE DATE^^1"
^IBA(364.6,86,0)="8^N^^75^1^^0^3^10^PROCEDURE CODE^^1"
^IBA(364.6,87,0)="8^N^^75^1^^0^4^2^PROCEDURE QUALIFIER^^1"
^IBA(364.6,88,0)="8^N^^80^1^^0^2^2^VALUE CODE^^1"
^IBA(364.6,89,0)="8^N^^80^1^^0^3^9^VALUE CODE DOLLARS^^1"
^IBA(364.6,90,0)="8^N^^80^1^^0^4^7^VALUE CODE QUANTITY^^1"
^IBA(364.6,91,0)="8^N^^85^1^^0^2^2^CONDITION CODE^^1"
^IBA(364.6,92,0)="8^N^^90^1^^0^2^10^DIAGNOSIS CODE 1^^1"
^IBA(364.6,93,0)="8^N^^90^1^^0^3^1^PRIMARY DX CODE FLAG^^1"
^IBA(364.6,94,0)="8^N^^95^1^^0^2^60^DIAGNOSIS CODE 1^^1"
^IBA(364.6,95,0)="8^N^^105^1^^0^2^1^OTHER INSURANCE SEQUENCE^^1"
^IBA(364.6,96,0)="8^N^^105^1^^0^11^35^OTHER INSURANCE CO NAME^^1"
^IBA(364.6,97,0)="8^N^^105^1^^0^3^2^OTHER INSURANCE PT RELATION^^1"
^IBA(364.6,98,0)="8^N^^105^1^^0^4^20^OTHER INSURANCE GRP NUMBER^^1"
^IBA(364.6,99,0)="8^N^^110^1^^0^3^35^OTHER INSURANCE ID NUMBER^^1"
^IBA(364.6,100,0)="8^N^^105^1^^0^5^35^OTHER INSURANCE GROUP NAME^^1"
^IBA(364.6,101,0)="8^N^^110^1^^0^4^30^OTHER INSURED LAST NAME^^1"
^IBA(364.6,102,0)="8^N^^110^1^^0^5^20^OTHER INSURED FIRST NAME^^1"
^IBA(364.6,103,0)="8^N^^110^1^^0^6^25^OTHER INSURED MIDDLE NAME^^1"
^IBA(364.6,104,0)="8^N^^105^1^^0^6^8^OTHER INSURED BIRTH DATE^^1"
^IBA(364.6,105,0)="8^N^^105^1^^0^7^1^OTHER INSURED SEX^^1"
^IBA(364.6,106,0)="8^N^^105^1^^0^8^8^OTHER INSURANCE PRIOR PAYMENT^^1"
^IBA(364.6,107,0)="8^N^^105^1^^0^9^2^OTHER INSURED EMPLOY STAT^^1"
^IBA(364.6,108,0)="8^N^^110^1^^0^7^35^OTHER INSURED EMPLOYER NAME^^1"
^IBA(364.6,109,0)="8^N^^110^1^^0^8^30^OTHER INSURED EMPLOYER CITY^^1"
^IBA(364.6,110,0)="8^N^^110^1^^0^9^2^OTHER INSURED EMPLOYER STATE^^1"
^IBA(364.6,111,0)="8^N^^105^1^^0^10^23^OTHER INSURED FORM LOCATOR 64^^1"
^IBA(364.6,112,0)="8^N^^180^1^^0^2^6^OUTPT LINE NUMBER FOR CLAIM^^1^0"
^IBA(364.6,113,0)="8^N^^180^1^^0^3^2^OUTPT CODE TYPE^^1"
^IBA(364.6,114,0)="8^N^^180^1^^0^5^8^OUTPT LINE CHARGE^^1^0"
^IBA(364.6,115,0)="8^N^^180^1^^0^6^6^OUTPT UNITS^^1^0"
^IBA(364.6,116,0)="8^N^^180^1^^0^7^2^PLACE OF SERVICE^^1^0"
^IBA(364.6,117,0)="8^N^^180^1^^0^8^2^TYPE OF SERVICE^^1^0"
^IBA(364.6,118,0)="8^N^^180^1^^0^9^8^DATE OF SERVICE (FROM)^^1^0"
^IBA(364.6,119,0)="8^N^^180^1^^0^11^1^DIAGNOSIS CODE POINTER 1^^1"
^IBA(364.6,120,0)="8^N^^180^1^^0^12^1^DIAGNOSIS CODE POINTER 2^^1"
^IBA(364.6,121,0)="8^N^^180^1^^0^13^1^DIAGNOSIS CODE POINTER 3^^1"
^IBA(364.6,122,0)="8^N^^180^1^^0^14^1^DIAGNOSIS CODE POINTER 4^^1"
^IBA(364.6,123,0)="8^N^^185^1^^0^2^6^INPT LINE # FOR CLAIM^^1"
^IBA(364.6,124,0)="8^N^^185^1^^0^3^10^INPT REVENUE CODE^^1"
^IBA(364.6,125,0)="8^N^^185^1^^0^4^10^INPT PROC ASSOC W/REV CODE^^1"
^IBA(364.6,126,0)="8^N^^185^1^^0^5^6^INPT UNITS^^1^0"
^IBA(364.6,127,0)="8^N^^185^1^^0^6^8^INPT RATE^^1"
^IBA(364.6,128,0)="8^N^^185^1^^0^7^2^PROC MODIFIER 1^^1"
^IBA(364.6,129,0)="8^N^^185^1^^0^8^2^PROC MODIFIER 2^^1"
^IBA(364.6,130,0)="8^N^^185^1^^0^9^8^INPT LINE CHARGE^^1"
^IBA(364.6,131,0)="8^N^^185^1^^0^10^8^SERVICE FROM DATE^^1^0"
^IBA(364.6,132,0)="8^N^^185^1^^0^11^8^SERVICE TO DATE^^1"
^IBA(364.6,133,0)="8^N^^190^1^^0^2^6^PRESCRIPTION LINE # FOR CLAIM^^1"
^IBA(364.6,134,0)="8^N^^190^1^^0^3^15^PRESCRIPTION NUMBER^^1"
^IBA(364.6,135,0)="8^N^^190^1^^0^4^11^NDC CODE #^^1"
^IBA(364.6,136,0)="8^N^^190^1^^0^5^3^REFILL #^^1"
^IBA(364.6,137,0)="8^N^^190^1^^0^6^55^DRUG NAME (INCL DAYS & QTY)^^1"
^IBA(364.6,138,0)="8^N^^190^1^^0^7^8^REFILL DATE^^1"
^IBA(364.6,139,0)="8^N^^75^1^^0^1.9^99^PROCEDURE CODES/DATES^1^1"
^IBA(364.6,140,0)="8^N^^40^1^^0^3.9^70^PATIENT FULL NAME^1^1"
^IBA(364.6,141,0)="8^N^^65^1^^0^1.9^50^OCCURRENCE CODE EXTRACT^1^1"
^IBA(364.6,142,0)="8^N^^50^1^^0^13.9^13^ADMISSION DATE/TIME^1^1"
^IBA(364.6,143,0)="8^N^^50^1^^0^15.9^13^DISCHARGE DATE/TIME^1^1"
^IBA(364.6,144,0)="8^N^^5^1^^0^99.9^^KILL IBXSAVE ARRAY^1^1"
^IBA(364.6,145,0)="8^N^^25.99^1^^0^1.9^^KILL IBXSAVE ARRAY^1^1"
^IBA(364.6,146,0)="8^N^^35^1^^0^99.9^^KILL IBXSAVE ARRAY^1^1"
^IBA(364.6,147,0)="8^N^^45^1^^0^99.9^^KILL IBXSAVE ARRAY^1^1"
^IBA(364.6,150,0)="8^N^^75^1^^0^99.9^^KILL IBXSAVE ARRAY^1^1"
^IBA(364.6,151,0)="8^N^^80^1^^0^99.9^^KILL IBXSAVE ARRAY^1^1"
^IBA(364.6,152,0)="8^N^^85^1^^0^99.9^^KILL IBXSAVE ARRAY^1^1"
^IBA(364.6,153,0)="8^N^^90^1^^0^99.9^^KILL IBXSAVE ARRAY^1^1"
^IBA(364.6,154,0)="8^N^^95^1^^0^99.9^^KILL IBXSAVE ARRAY^1^1"
^IBA(364.6,155,0)="8^N^^105^1^^0^99.9^^KILL IBXSAVE ARRAY^1^1"
^IBA(364.6,156,0)="8^N^^200^1^^0^99.9^^KILL IBXSAVE ARRAY^1^1"
^IBA(364.6,159,0)="8^N^^70^1^^0^99.9^^KILL IBXSAVE ARRAY^1^1"
^IBA(364.6,161,0)="8^N^^80^1^^0^1.9^30^VALUE CODE GROUP^1^1"
^IBA(364.6,162,0)="8^N^^110^1^^0^3.9^60^OTHER INSURED FULL NAME^1^1"
^IBA(364.6,163,0)="8^N^^105^1^^0^5.9^30^OTHER INSURED DEMOGRAPHICS^1^1"
^IBA(364.6,164,0)="8^N^^110^1^^0^6.9^100^OTHER INSURED EMPLOYER GROUP^1^1"
^IBA(364.6,165,0)="8^N^^60^1^^0^2^1^HOMEBOUND INDICATOR^^1"
^IBA(364.6,166,0)="8^N^^50^1^^0^33^10^ADMITTING DIAGNOSIS^^1"
^IBA(364.6,167,0)="8^N^^5^1^^0^2^10^BATCH #^0^1"
^IBA(364.6,168,0)="8^N^^5^1^^0^3^8^BATCH DATE^^1^0"
^IBA(364.6,169,0)="8^N^^5^1^^0^4^10^BATCH REFERENCE #^^1^0"
^IBA(364.6,170,0)="8^N^^55^1^^0^2^30^OTHER FACILITY NAME^^1"
^IBA(364.6,171,0)="8^N^^55^1^^0^3^35^OTHER FACILITY ADDRESS^^1"
^IBA(364.6,172,0)="8^N^^55^1^^0^4^30^OTHER FACILITY CITY^^1"
^IBA(364.6,173,0)="8^N^^55^1^^0^5^2^OTHER FACILITY STATE^^1"
^IBA(364.6,174,0)="8^N^^55^1^^0^6^5^OTHER FACILITY ZIP^^1"
^IBA(364.6,175,0)="8^N^^5^1^^0^6^30^RECEIVER ID NUMBER^^1^0"
^IBA(364.6,177,0)="8^N^^15^1^^0^3^25^FACILITY BILLING NAME^^1^0"
^IBA(364.6,178,0)="8^N^^15^1^^0^4^35^AGENT CASHIER STREET ADDRESS^^1^0"
^IBA(364.6,179,0)="8^N^^15^1^^0^6^2^AGENT CASHIER STATE^^1^0"
^IBA(364.6,180,0)="8^N^^15^1^^0^7^5^AGENT CASHIER ZIP CODE^^1^0"
^IBA(364.6,181,0)="8^N^^15^1^^0^5^30^AGENT CASHIER CITY^^1^0"
^IBA(364.6,182,0)="8^N^^15^1^^0^9^17^FEDERAL TAX ID NUMBER^^1^0"
^IBA(364.6,183,0)="8^N^^15^1^^0^8^20^EDI SITE CONTACT PHONE^^1"
^IBA(364.6,185,0)="8^N^^20^1^^0^3^35^CURRENT INSURANCE STREET^^1^0"
^IBA(364.6,186,0)="8^N^^20^1^^0^4^30^CURRENT INSURANCE CITY^^1^0"
^IBA(364.6,187,0)="8^N^^20^1^^0^5^2^CURRENT INSURANCE STATE^^1^0"
^IBA(364.6,188,0)="8^N^^20^1^^0^6^5^CURRENT INSURANCE ZIP CODE^^1^0"
^IBA(364.6,189,0)="8^N^^35^1^^0^2^20^CURRENT INSURED GROUP NUMBER^^1"
^IBA(364.6,190,0)="8^N^^35^1^^0^3^30^CURRENT INSURED GROUP NAME^^1"
^IBA(364.6,191,0)="8^N^^35^1^^0^4^2^INSURED EMPLOYMENT STATUS^^1"
^IBA(364.6,192,0)="8^N^^20^1^^0^2^30^CURRENT INSURANCE CO NAME^^1^0"
^IBA(364.6,193,0)="8^N^^19.99^1^^0^.9^^SET BATCH HDR NODE^1^1"
^IBA(364.6,194,0)="8^N^^180^1^^0^4^10^OUTPT PROCEDURE/REVENUE CODE^^1^0"
^IBA(364.6,195,0)="8^N^^105^1^^0^12^20^OTH INSURANCE PROVIDER #^^1"
^IBA(364.6,196,0)="8^N^^20^1^^0^8^30^CURR INS CO 837 ID NUMBER^^1"
^IBA(364.6,197,0)="8^N^^60^1^^0^99.9^^KILL IBXSAVE ARRAY^1^1"
^IBA(364.6,198,0)="8^N^^110^1^^0^99.9^^KILL IBXSAVE ARRAY^1^1"
^IBA(364.6,206,0)="8^N^^5^1^^0^1^4^RECORD ID 'GEN '^^1^1"
^IBA(364.6,207,0)="8^N^^55^1^^0^1^4^RECORD ID 'SUB '^^1^1"
^IBA(364.6,208,0)="8^N^^10^1^^0^1^4^RECORD ID 'REC '^^1^1"
^IBA(364.6,209,0)="8^N^^15^1^^0^1^4^RECORD ID 'PRV '^^1^1"
^IBA(364.6,210,0)="8^N^^20^1^^0^1^4^RECORD ID 'CI1 '^^1^1"
^IBA(364.6,212,0)="8^N^^30^1^^0^1^4^RECORD ID 'CI2 '^^1^1"
^IBA(364.6,213,0)="8^N^^35^1^^0^1^4^RECORD ID 'CI3 '^^1^1"
^IBA(364.6,214,0)="8^N^^40^1^^0^1^4^RECORD ID 'PT1 '^^1^1"
^IBA(364.6,215,0)="8^N^^45^1^^0^1^4^RECORD ID 'PT2 '^^1^1"
^IBA(364.6,216,0)="8^N^^50^1^^0^1^4^RECORD ID 'CL1 '^^1^1"
^IBA(364.6,217,0)="8^N^^60^1^^0^1^4^RECORD ID 'UB1 '^^1^1"
^IBA(364.6,226,0)="8^N^^28^1^^0^2^2^BILLING PROV SECONDARY ID Q(1)^0^1^0"
^IBA(364.6,227,0)="8^N^^28^1^^0^3^20^BILLING PROV SECONDARY ID #(1)^0^1^0"
^IBA(364.6,230,0)="8^N^^110^1^^0^2^1^OTHER INSURANCE SEQUENCE^^1"
^IBA(364.6,240,0)="8^N^^65^1^^0^1^4^RECORD ID 'OC1 '^^1^1"
^IBA(364.6,242,0)="8^N^^70^1^^0^1^4^RECORD ID 'OCS '^^1^1"
^IBA(364.6,243,0)="8^N^^75^1^^0^1^4^RECORD ID 'PC1 '^^1^1"
^IBA(364.6,244,0)="8^N^^80^1^^0^1^4^RECORD ID 'VC1 '^^1^1"
^IBA(364.6,245,0)="8^N^^85^1^^0^1^4^RECORD ID 'CC1 '^^1^1"
^IBA(364.6,246,0)="8^N^^90^1^^0^1^4^RECORD ID 'DC1 '^^1^1"
^IBA(364.6,247,0)="8^N^^95^1^^0^1^4^RECORD ID 'COM '^^1^1"
^IBA(364.6,249,0)="8^N^^105^1^^0^1^4^RECORD ID 'OI1 '^^1^1"
^IBA(364.6,250,0)="8^N^^110^1^^0^1^4^RECORD ID 'OI2 '^^1^1"
^IBA(364.6,251,0)="8^N^^180^1^^0^1^4^RECORD ID 'PRF '^^1^1"
^IBA(364.6,252,0)="8^N^^185^1^^0^1^4^RECORD ID 'INS '^^1^1"
^IBA(364.6,253,0)="8^N^^190^1^^0^1^4^RECORD ID 'RX1 '^^1^1"
^IBA(364.6,479,0)="8^N^^50^1^^0^11^8^STATEMENT COVERS TO DATE^^1^0"
^IBA(364.6,481,0)="8^N^^70^1^^0^3^8^OCCURRENCE SPAN TO DATE^^1"
^IBA(364.6,483,0)="8^N^^180^1^^0^10^8^DATE OF SERVICE (TO)^^1"
^IBA(364.6,488,0)="8^N^^5^1^^0^5^3^SITE NUMBER^^1^0"
^IBA(364.6,489,0)="12^N^^1^1^^1^1^80^PRINT STAT (HCFA-1500 TOP LN)^0"
^IBA(364.6,490,0)="12^N^^1^2^^1^1^80^MAILING ADDRESS NM (FORM LN 2)^0"
^IBA(364.6,495,0)="12^N^^1^9^^1^50^28^INSURED ID # (BX-1A)"
^IBA(364.6,496,0)="12^N^^1^11^^1^1^28^PATIENT NAME (BX-2)"
^IBA(364.6,497,0)="12^N^^1^11^^1^31^10^PATIENT DOB (BX-3/1)"
^IBA(364.6,498,0)="12^N^^1^11^^1^42^1^PATIENT SEX=MALE (BX-3/2A)"
^IBA(364.6,499,0)="12^N^^1^11^^1^47^1^PATIENT SEX=FEMALE (BX-3/2B)"
^IBA(364.6,500,0)="12^N^^1^11^^1^50^28^INSURED'S NAME (BX-4)"
^IBA(364.6,501,0)="12^N^^1^13^^1^1^28^PATIENT STR ADDRESS (BX-5/1)"
^IBA(364.6,502,0)="12^N^^1^13^^1^33^1^PT REL TO INSURED=SELF (BX-6)"
^IBA(364.6,503,0)="12^N^^1^13^^1^38^1^PT REL TO INSRD=SPOUSE (BX-6)"
^IBA(364.6,504,0)="12^N^^1^13^^1^42^1^PT REL TO INSRD=CHILD (BX-6)"
^IBA(364.6,505,0)="12^N^^1^13^^1^47^1^PT REL TO INSRD=OTHER (BX-6)"
^IBA(364.6,506,0)="12^N^^1^13^^1^50^28^INSURED STR ADDRESS (BX-7/1)"
^IBA(364.6,507,0)="12^N^^1^15^^1^1^28^PATIENT CITY ADDRESS (BX-5/2A)"
^IBA(364.6,508,0)="12^N^^1^15^^1^26^2^PATIENT STATE (BX-5/2B)"
^IBA(364.6,509,0)="12^N^^1^15^^1^35^1^PT MARITAL STAT=SINGL (BX-8/A)"
^IBA(364.6,510,0)="12^N^^1^15^^1^41^1^PT MARITAL STAT=MARRD (BX-8/B)"
^IBA(364.6,511,0)="12^N^^1^15^^1^47^1^PT MARITAL STAT=OTHER (BX-8/C)"
^IBA(364.6,512,0)="12^N^^1^17^^1^1^12^PATIENT ZIP CODE (BX-5/3A)"
^IBA(364.6,513,0)="12^N^^1^17^^1^15^16^PATIENT TELEPHONE (BX-5/3B)"
^IBA(364.6,514,0)="12^N^^1^17^^1^35^1^PT EMPL STAT=EMPLOYD (BX-8/2A)"
^IBA(364.6,515,0)="12^N^^1^19^^1^1^28^OTH INSURED NAME (BX-9/1)"
^IBA(364.6,516,0)="12^N^^1^19^^1^50^28^INSURED POLICY GROUP (BX-11)"
^IBA(364.6,517,0)="12^N^^1^21^^1^1^28^OTH INSURED POLICY # (BX-9A)"
^IBA(364.6,518,0)="12^N^^1^21^^1^35^1^COND REL TO EMP=YES (BX-10A/A)"
^IBA(364.6,519,0)="12^N^^1^21^^1^41^1^COND REL TO EMP=NO (BX-10A/B)"
^IBA(364.6,520,0)="12^N^^1^21^^1^54^10^INSUREDS DOB (BX-11A/1)"
^IBA(364.6,521,0)="12^N^^1^21^^1^68^1^INSUREDS SEX=MALE (BX-11A/2A)"
^IBA(364.6,522,0)="12^N^^1^21^^1^75^1^INSURED SEX=FEMALE (BX-11A/2B)"
^IBA(364.6,523,0)="12^N^^1^23^^1^2^10^OTH INSURED DOB (BX-9B/1)"
^IBA(364.6,524,0)="12^N^^1^23^^1^18^1^OTH INS SEX=MALE (BX-9B/2A)"
^IBA(364.6,525,0)="12^N^^1^23^^1^24^1^OTH INS SEX=FEMALE (BX-9B/2B)"
^IBA(364.6,526,0)="12^N^^1^23^^1^35^1^COND REL AUTO=YES (BX-10B/A)"
^IBA(364.6,527,0)="12^N^^1^23^^1^41^1^COND REL AUTO=NO (BX-10B/B)"
^IBA(364.6,528,0)="12^N^^1^23^^1^45^2^AUTO ACCIDENT STATE (BX-10B/C)"
^IBA(364.6,529,0)="12^N^^1^23^^1^50^28^INSURED EMPLOYR NAME (BX-11B)"
^IBA(364.6,530,0)="12^N^^1^25^^1^1^28^OTH INS EMPLR (BX-9C)"
^IBA(364.6,531,0)="12^N^^1^25^^1^35^1^COND REL TO OTH=YES (BX-10C/A)"
^IBA(364.6,532,0)="12^N^^1^25^^1^41^1^COND REL TO OTH=NO (BX-10C/B)"
^IBA(364.6,533,0)="12^N^^1^25^^1^50^28^INSUREDS PLAN NAME (BX-11C)"
^IBA(364.6,534,0)="12^N^^1^27^^1^1^28^OTH INS PLAN NAME (BX-9D)"
^IBA(364.6,535,0)="12^N^^1^27^^1^52^1^ANOTHER PLAN=YES (BX-11D/A)"
^IBA(364.6,536,0)="12^N^^1^27^^1^57^1^ANOTHER PLAN=NO (BX-11D/B)"
^IBA(364.6,537,0)="12^N^^1^31^^1^6^25^PATIENT SIGNATURE (BX-12)"
^IBA(364.6,538,0)="12^N^^1^31^^1^57^22^INSUREDS SIGNATURE (BX-13)"
^IBA(364.6,539,0)="12^N^^1^33^^1^2^10^DATE OF CURR ILLNESS (BX-14)"
^IBA(364.6,540,0)="12^N^^1^33^^1^37^10^DATE OF SIMLAR ILLNESS (BX-15)"
^IBA(364.6,541,0)="12^N^^1^33^^1^54^10^DT UNABLE TO WRK FR (BX-16/1)"
^IBA(364.6,542,0)="12^N^^1^33^^1^68^10^DT UNABLE TO WRK TO (BX-16/2)"
^IBA(364.6,543,0)="12^N^^1^35^^1^54^10^HOSP FROM DATE (BX-18/1)"
^IBA(364.6,544,0)="12^N^^1^35^^1^68^10^HOSP TO DATE (BX-18/2)"
^IBA(364.6,545,0)="12^N^^1^36^^1^1^48^UPPER LINE HCFA (BX-19)"
^IBA(364.6,546,0)="12^N^^1^37^^1^1^48^LOWER LINE - HCFA (BX-19)"
^IBA(364.6,547,0)="12^N^^1^37^^1^52^11^OUTSIDE LAB (BX-20/1B)"
^IBA(364.6,548,0)="12^N^^1^39^^1^3^7^DIAGNOSIS CODE 1 (BX-21.1)"
^IBA(364.6,549,0)="12^N^^1^39^^1^31^7^DIAGNOSIS CODE 3 (BX-21.3)"
^IBA(364.6,550,0)="12^N^^1^41^^1^3^7^DIAGNOSIS CODE 2 (BX-21.2)"
^IBA(364.6,551,0)="12^N^^1^41^^1^31^7^DIAGNOSIS CODE 4 (BX-21.4)"
^IBA(364.6,552,0)="12^N^^1^41^^1^50^30^PRIOR AUTH NUMBER (BX-23)"
^IBA(364.6,554,0)="12^N^^1^44^^1^1^9^DATE OF SERV FR (BX-24A/A)"
^IBA(364.6,555,0)="12^N^^1^44^^1^10^9^DATE OF SERV TO (BX-24A/B)"
^IBA(364.6,556,0)="12^N^^1^44^^1^19^3^PLACE OF SERVICE (BX-24B)"
^IBA(364.6,557,0)="12^N^^1^44^^1^22^3^TYPE OF SERVICE (BX-24C)"
^IBA(364.6,558,0)="12^N^^1^44^^1^25^17^PROCEDURE (BX-24D/1)"
^IBA(364.6,559,0)="12^N^^1^44^^1^42^7^DIAGNOSIS CODE REFS (BX-24E)"
^IBA(364.6,560,0)="12^N^^1^44^^1^49^10^CHARGES (BX-24F)"
^IBA(364.6,561,0)="12^N^^1^44^^1^59^3^UNITS (BX-24G)"
^IBA(364.6,562,0)="12^N^^1^57^^1^1^16^FED TAX ID # (BX-25/1)"
^IBA(364.6,563,0)="12^N^^1^57^^1^19^1^ID NUMBER=EIN (BX-25/2B)"
^IBA(364.6,564,0)="12^N^^1^57^^1^23^14^PATIENT ACCT NUMBER (BX-26)"
^IBA(364.6,565,0)="12^N^^1^57^^1^50^10^TOTAL CHARGE (BX-28)"
^IBA(364.6,566,0)="12^N^^1^59^^1^23^26^FACILITY NAME (BX-32/LINE 1)"
^IBA(364.6,567,0)="12^N^^1^59^^1^50^30^AGENT CASHIER NM (BX-33/LN 1)"
^IBA(364.6,568,0)="12^N^^1^60^^1^1^21^BLOCK 31 CHR 1-21 (BX-31/LN1)"
^IBA(364.6,569,0)="12^N^^1^60^^1^23^26^FAC ADR LINE 1 (BX-32/LN 2)"
^IBA(364.6,570,0)="12^N^^1^60^^1^50^30^AGENT CASH ADR LN1 (BX-33/LN2)"
^IBA(364.6,571,0)="12^N^^1^61^^1^1^21^BLOCK 31 CHR 22-42 (BX-31/LN2)"
^IBA(364.6,572,0)="12^N^^1^61^^1^23^27^FAC CITY/ST/ZIP (BX-32/LN 3)"
^IBA(364.6,573,0)="12^N^^1^61^^1^50^30^AG CA CITY/ST/ZIP (BX-33/LN 3)"
^IBA(364.6,574,0)="12^N^^1^62^^1^1^21^BLOCK 31 CHR 43-63 (BX-31/LN3)"
^IBA(364.6,576,0)="12^N^^1^3^4^1^1^80^MAILING ADDR FULL (FORM LN 3)"
^IBA(364.6,577,0)="8^N^^25^1^^0^1^4^RECORD ID 'CCOM'^^1^1"
^IBA(364.6,578,0)="8^N^^25^1^^0^2^60^COMMON COMMENTS^^1"
^IBA(364.6,579,0)="8^N^^185^1^^0^12^8^NON-COVERED CHARGE^^1"
^IBA(364.6,580,0)="8^N^^190^1^^0^8^10^DRUG QUANTITY^^1"
^IBA(364.6,581,0)="8^N^^190^1^^0^9^3^DAYS SUPPLY^^1"
^IBA(364.6,582,0)="8^N^^1^1^^0^1^4^BGN SEGMENT^^1^1"
^IBA(364.6,583,0)="8^N^^1^1^^0^2^1^SEGMENT DELIMITER^^1^1"
^IBA(364.6,584,0)="12^N^^1^60^^1^22.8^^FACILITY STR ADDR 1 EXTRACT^1"
^IBA(364.6,585,0)="12^N^^1^60^^1^22.9^^FACILITY STR ADDR 2 EXTRACT^1"
^IBA(364.6,589,0)="12^N^^1^61^^1^49.7^^AGENT CASHIER CITY EXTRACT^1"
^IBA(364.6,590,0)="12^N^^1^61^^1^49.8^^AGENT CASHIER STATE EXTRACT^1"
^IBA(364.6,591,0)="12^N^^1^61^^1^49.9^^AGENT CASHIER ZIP EXTRACT^1"
^IBA(364.6,592,0)="12^N^^1^44^^1^.5^^SERVICE LN EXTRACT - HCFA 1500^1"
^IBA(364.6,593,0)="12^N^^1^63^^0^1.9^^MULTIPLE PAGE CHECK/POPULATE^1"
^IBA(364.6,594,0)="12^N^^1^57^^1^63^7^TOTAL PRIOR PAYMENTS (BX-29)"
^IBA(364.6,595,0)="12^N^^1^57^^1^72^7^TOT CHRG-PRIOR PYMNTS (BX-30)"
^IBA(364.6,596,0)="12^N^^1^55^^1^80.1^^CLEAN UP IBXSAVE^1"
^IBA(364.6,597,0)="12^N^^1^9^^1^1^46^CHECK BOX FOR BILL TYPE"
^IBA(364.6,598,0)="12^N^^1^27^^1^30^20^BOX 10D HCFA 1500"
^IBA(364.6,599,0)="12^N^^1^35^^1^1^26^BOX 17 HCFA 1500"
^IBA(364.6,600,0)="12^N^^1^35^^1^28^21^BOX 17a HCFA 1500"
^IBA(364.6,601,0)="12^N^^1^37^^1^60^10^LAB CHARGES (BX-20/B)"
^IBA(364.6,602,0)="12^N^^1^39^^1^50^11^MEDICAID RESUB CODE (BX-22/A)"
^IBA(364.6,603,0)="12^N^^1^39^^1^62^18^ORIGINAL REF NO (BX-22/B)"
^IBA(364.6,604,0)="12^N^^1^57^^1^38^6^ACCEPT ASSIGNMENT (BX-27)"
^IBA(364.6,605,0)="12^N^^1^44^^1^62^3^EPSDT FAMILY PLAN (BX-24H)"
^IBA(364.6,606,0)="12^N^^1^44^^1^65^3^EMG (BX-24I)"
^IBA(364.6,607,0)="12^N^^1^44^^1^68^3^COB (BX-24J)"
^IBA(364.6,608,0)="12^N^^1^44^^1^71^10^LOCAL USE (BX-24K)"
^IBA(364.6,610,0)="8^N^^180^1^^0^15^2^PROF PROC MODIFIER 1^^1"
^IBA(364.6,611,0)="13^N^^1^1^^1^1^4^SIGNATURE REQ FLAG - TOP LINE"
^IBA(364.6,612,0)="13^N^^1^1^^1^35^35^PRINT STAT (UB92 TOP LINE)"
^IBA(364.6,613,0)="13^N^^1^2^^1^1^25^AGENT CASH MAIL SYMB (FL-1/1)"
^IBA(364.6,614,0)="13^N^^1^2^^1^27^30^UB92 FORM LOCATOR 2 (FL-2/1)"
^IBA(364.6,615,0)="13^N^^1^3^^1^1^25^AGENT CASHIER ADDRESS (FL-1/2)"
^IBA(364.6,616,0)="13^N^^1^3^^1^27^31^UB92 FORM LOCATOR 2 (FL-2/2)"
^IBA(364.6,617,0)="13^N^^1^3^^1^58^20^PATIENT CONTROL NUMBER (FL-3)"
^IBA(364.6,618,0)="13^N^^1^3^^1^78^4^UB92 TYPE OF BILL (FL-4)"
^IBA(364.6,619,0)="13^N^^1^4^^1^1^25^AGENT CASH CIT/ST/ZIP (FL-1/3)"
^IBA(364.6,620,0)="13^N^^1^4^^1^69^13^FORM LOCATOR 11 (FL-11/1)"
^IBA(364.6,621,0)="13^N^^1^5^^1^1^25^AGENT CASH PHONE (FL-1/4)"
^IBA(364.6,622,0)="13^N^^1^5^^1^27^10^FED TAX ID # (FL-5)"
^IBA(364.6,623,0)="13^N^^1^5^^1^38^6^STATEMENT FROM DATE (FL-6A)"
^IBA(364.6,624,0)="13^N^^1^5^^1^45^6^STATEMENT THRU DATE (FL-6B)"
^IBA(364.6,625,0)="13^N^^1^5^^1^52^4^COVERED DAYS (FL-7)"
^IBA(364.6,626,0)="13^N^^1^5^^1^56^5^NON-COVERED DAYS (FL-8)"
^IBA(364.6,627,0)="13^N^^1^5^^1^61^4^FORM LOCATOR 9 (FL-9)"
^IBA(364.6,628,0)="13^N^^1^5^^1^65^4^FORM LOCATOR 10 (FL-10)"
^IBA(364.6,629,0)="13^N^^1^5^^1^68^14^FORM LOCATOR 11 (FL-11/2)"
^IBA(364.6,630,0)="13^N^^1^7^^1^1^30^PATIENT NAME (FL-12)"
^IBA(364.6,631,0)="13^N^^1^7^^1^32^49^PATIENT SHORT ADDRESS (FL-13)"
^IBA(364.6,632,0)="13^N^^1^8^^1^76^6^FORM LOCATOR 31 (FL-31/1)"
^IBA(364.6,633,0)="13^N^^1^9^^1^1^8^PATIENT DOB (FL-14)"
^IBA(364.6,634,0)="13^N^^1^9^^1^10^1^PATIENT SEX (FL-15)"
^IBA(364.6,635,0)="13^N^^1^9^^1^13^1^PATIENT MARITAL STATUS (FL-16)"
^IBA(364.6,636,0)="13^N^^1^9^^1^15^6^ADMISSION DATE (FL-17)"
^IBA(364.6,637,0)="13^N^^1^9^^1^22^2^ADMISSION HR (FL-18)"
^IBA(364.6,638,0)="13^N^^1^9^^1^26^1^ADMISSION TYPE (FL-19)"
^IBA(364.6,639,0)="13^N^^1^9^^1^29^1^ADMISSION SOURCE (FL-20)"
^IBA(364.6,640,0)="13^N^^1^9^^1^31^2^DISCHARGE HR (FL-21)"
^IBA(364.6,641,0)="13^N^^1^9^^1^34^3^PATIENT STATUS (FL-22)"
^IBA(364.6,642,0)="13^N^^1^9^^1^37^18^MEDICAL RECORD NUMBER (FL-23)"
^IBA(364.6,643,0)="13^N^^1^9^^1^54.9^^EXTRACT CONDITION CODES^1"
^IBA(364.6,644,0)="13^N^^1^9^^1^55^3^CONDITION CODE 1 (FL-24)"
^IBA(364.6,645,0)="13^N^^1^9^^1^58^3^CONDITION CODE 2 (FL-25)"
^IBA(364.6,646,0)="13^N^^1^9^^1^61^3^CONDITION CODE 3 (FL-26)"
^IBA(364.6,647,0)="13^N^^1^9^^1^64^3^CONDITION CODE 4 (FL-27)"
^IBA(364.6,648,0)="13^N^^1^9^^1^67^3^CONDITION CODE 5 (FL-28)"
^IBA(364.6,649,0)="13^N^^1^9^^1^70^3^CONDITION CODE 6 (FL-29)"
^IBA(364.6,650,0)="13^N^^1^9^^1^73^3^CONDITION CODE 7 (FL-30)"
^IBA(364.6,651,0)="13^N^^1^9^^1^75^7^FORM LOCATOR 31 (FL-31/2)"
^IBA(364.6,652,0)="13^N^^1^10^^1^58^24^FORM LOCATOR 37A"
^IBA(364.6,655,0)="13^N^^1^11^^1^1^3^OCCURRENCE CODE (FL-32/1)"
^IBA(364.6,656,0)="13^N^^1^11^^1^4^7^OCCURRENCE DATE (FL-32/2)"
^IBA(364.6,658,0)="13^N^^1^11^^1^14^7^OCCURRENCE DATE (FL-33/2)"
^IBA(364.6,661,0)="13^N^^1^11^^1^24^7^OCCURRENCE DATE (FL-34/2)"
^IBA(364.6,663,0)="13^N^^1^11^^1^34^7^OCCURRENCE DATE (FL-35/2)"
^IBA(364.6,664,0)="13^N^^1^11^^1^41^3^OCCURRENCE SPAN CODE (FL-36/1)"
^IBA(364.6,665,0)="13^N^^1^11^^1^44^7^OCC SPAN DATE FROM (FL-36/2)"
^IBA(364.6,666,0)="13^N^^1^11^^1^51^7^OCC SPAN DATE TO (FL-36/3)"
^IBA(364.6,678,0)="13^N^^1^13^^1^1^42^RESPONSIBLE PARTY NM (FL-38/1)"
^IBA(364.6,679,0)="13^N^^1^14^^1^1^42^RESP PARTY ADDR LN 1 (FL-38/2)"
^IBA(364.6,680,0)="13^N^^1^14^^1^43.9^^VALUE CODE EXTRACT (FL-39:41)^1"
^IBA(364.6,681,0)="13^N^^1^14^^1^44^3^VALUE CODES CD 1 (FL-39a:d/1)"
^IBA(364.6,682,0)="13^N^^1^14^^1^46^10^VALUE CODES AMT 1 (FL-39a:d/2)"
^IBA(364.6,683,0)="13^N^^1^14^^1^57^3^VALUE CODES CD 2 (FL-40a:d/1)"
^IBA(364.6,684,0)="13^N^^1^14^^1^59^10^VALUE CODES AMT 2 (FL-40a:d/2)"
^IBA(364.6,685,0)="13^N^^1^14^^1^70^3^VALUE CODES CD 3 (FL-41a:d/1)"
^IBA(364.6,686,0)="13^N^^1^14^^1^72^10^VALUE CODES AMT 3 (FL-41a:d/2)"
^IBA(364.6,687,0)="13^N^^1^15^^1^1^42^RESP PARTY ADDR LN 2 (FL-38/3)"
^IBA(364.6,688,0)="13^N^^1^16^^1^1^42^RESP PARTY ADDR LN 3 (FL-38/4)"
^IBA(364.6,689,0)="13^N^^1^17^^1^1^42^RESP PARTY ADDR LN 4 (FL-38/5)"
^IBA(364.6,690,0)="13^N^^1^19^^1^.9^^REV CODE EXTRACT (FL-42:49)^1"
^IBA(364.6,691,0)="13^N^^1^19^^1^1^5^REVENUE CODE (FL-42)"
^IBA(364.6,692,0)="13^N^^1^19^^1^6^25^REV CODE DESCRIPTION (FL-43)"
^IBA(364.6,693,0)="13^N^^1^19^^1^31^10^HCPCS/RATES (FL-44)"
^IBA(364.6,694,0)="13^N^^1^19^^1^41^7^SERVICE DATE (FL-45)"
^IBA(364.6,695,0)="13^N^^1^19^^1^48^6^SERVICE UNITS (FL-46)"
^IBA(364.6,696,0)="13^N^^1^19^^1^54^13^TOTAL CHARGES (FL-47)"
^IBA(364.6,697,0)="13^N^^1^19^^1^67^11^NON-COVERED CHARGES (FL-48)"
^IBA(364.6,698,0)="13^N^^1^19^^1^78^4^FORM LOCATOR 49 (FL-49)"
^IBA(364.6,699,0)="13^N^^1^42^^1^68^14^FORM LOCATOR 56 LN 1 (FL-56/1)"
^IBA(364.6,700,0)="13^N^^1^43^^1^67^15^FORM LOCATOR 56 LN 2 (FL-56/2)"
^IBA(364.6,701,0)="13^N^^1^44^^1^67^15^FORM LOCATOR 56 LN 3 (FL-56/3)"
^IBA(364.6,702,0)="13^N^^1^45^^1^67^15^FORM LOCATOR 56 LN 4 (FL-56/4)"
^IBA(364.6,703,0)="13^N^^1^46^^1^67^15^FORM LOCATOR 56 LN 5 (FL-56/5)"
^IBA(364.6,704,0)="13^N^^1^43^^1^1^25^PAYER NAME (FL-50A:C)"
^IBA(364.6,705,0)="13^N^^1^43^^1^27^13^PROVIDER NUMBER (FL-51A:C)"
^IBA(364.6,706,0)="13^N^^1^43^^1^41^1^RELEASE OF INFO (FL-52A:C)"
^IBA(364.6,707,0)="13^N^^1^43^^1^44^1^ASSIGN OF BENEFITS (FL-53A:C)"
^IBA(364.6,708,0)="13^N^^1^43^^1^46^10^PRIOR PAYMENTS (FL-54A:C)"
^IBA(364.6,709,0)="13^N^^1^43^^1^57^10^EST AMOUNT DUE (FL-55A:C)"
^IBA(364.6,710,0)="13^N^^1^46^^1^2^28^FORM LOCATOR 57 (FL-57)"
^IBA(364.6,711,0)="13^N^^1^46^^1^46^11^PT PRIOR PAYMENTS (FL-54/4)"
^IBA(364.6,712,0)="13^N^^1^46^^1^57^11^DUE FRM PATIENT FL55 (FL-55/4)"
^IBA(364.6,713,0)="13^N^^1^48^^1^1^25^INSUREDS NAME (FL-58A:C)"
^IBA(364.6,714,0)="13^N^^1^48^^1^27^3^PATIENT RELATION (FL-59A:C)"
^IBA(364.6,715,0)="13^N^^1^48^^1^30^19^CERT-SSN-HIC-ID NO (FL-60A:C)"
^IBA(364.6,716,0)="13^N^^1^48^^1^50^14^GROUP NAME (FL-61A:C)"
^IBA(364.6,717,0)="13^N^^1^48^^1^65^17^INSURANCE GROUP NO (FL-62A:C)"
^IBA(364.6,718,0)="13^N^^1^52^^1^1^18^TREATMNT AUTH CODES (FL-63A:C)"
^IBA(364.6,719,0)="13^N^^1^52^^1^20^2^EMPL STATUS CODE (FL-64A:C)"
^IBA(364.6,720,0)="13^N^^1^52^^1^22^24^EMPLOYER NAME (FL-65A:C)"
^IBA(364.6,721,0)="13^N^^1^52^^1^47^34^EMPLOYER LOCATION (FL-66)"
^IBA(364.6,722,0)="13^N^^1^55^^1^79^3^FORM LOCATOR 78 (FL-78/1)"
^IBA(364.6,724,0)="13^N^^1^56^^1^1^7^PRIN DIAG CODE (FL-67)"
^IBA(364.6,725,0)="13^N^^1^56^^1^8^7^OTHER DIAG CODE 1 (FL-68)"
^IBA(364.6,726,0)="13^N^^1^56^^1^15^7^OTHER DIAG CODE 2 (FL-69)"
^IBA(364.6,727,0)="13^N^^1^56^^1^22^7^OTHER DIAG CODE 3 (FL-70)"
^IBA(364.6,728,0)="13^N^^1^56^^1^29^7^OTHER DIAG CODE 4 (FL-71)"
^IBA(364.6,729,0)="13^N^^1^56^^1^36^7^OTHER DIAG CODE 5 (FL-72)"
^IBA(364.6,730,0)="13^N^^1^56^^1^43^7^OTHER DIAG CODE 6 (FL-73)"
^IBA(364.6,731,0)="13^N^^1^56^^1^50^7^OTHER DIAG CODE 7 (FL-74)"
^IBA(364.6,732,0)="13^N^^1^56^^1^57^7^OTHER DIAG CODE 8 (FL-75)"
^IBA(364.6,733,0)="13^N^^1^56^^1^65^7^ADM DIAG CODE (FL-76)"
^IBA(364.6,734,0)="13^N^^1^56^^1^72^7^E-CODE (FL-77)"
^IBA(364.6,735,0)="13^N^^1^56^^1^78^4^FORM LOCATOR 78 (FL-78/2)"
^IBA(364.6,736,0)="13^N^^1^57^^1^59^23^ATTENDING PHYS ID (FL-82/1)"
^IBA(364.6,737,0)="13^N^^1^58^^1^1^1^PROC CODING METHOD (FL-79)"
^IBA(364.6,738,0)="13^N^^1^19^^1^.8^^PROCEDURE EXTRACT^1"
^IBA(364.6,739,0)="13^N^^1^58^^1^4^8^PRIN PROCEDURE CODE (FL-80/1)"
^IBA(364.6,740,0)="13^N^^1^58^^1^12^7^PRIN PROCEDURE DATE (FL-80/2)"
^IBA(364.6,741,0)="13^N^^1^58^^1^19^8^OTHER PROC CODE 1 (FL-81/1.1)"
^IBA(364.6,742,0)="13^N^^1^58^^1^27^7^OTHER PROC DATE 1 (FL-81/1.2)"
^IBA(364.6,743,0)="13^N^^1^58^^1^34^8^OTHER PROC CODE 2 (FL-81/1.3)"
^IBA(364.6,744,0)="13^N^^1^58^^1^42^7^OTHER PROC DATE 2 (FL-81/1.4)"
^IBA(364.6,745,0)="13^N^^1^58^^1^51^31^ATTENDING PHYS ID (FL-82/2)"
^IBA(364.6,746,0)="13^N^^1^60^^1^4^8^OTHER PROC CODE 3 (FL-81/2.1)"
^IBA(364.6,747,0)="13^N^^1^60^^1^12^7^OTHER PROC DATE 3 (FL-81/2.2)"
^IBA(364.6,748,0)="13^N^^1^60^^1^19^8^OTHER PROC CODE 4 (FL-81/2.3)"
^IBA(364.6,749,0)="13^N^^1^60^^1^27^7^OTHER PROC DATE 4 (FL-81/2.4)"
^IBA(364.6,750,0)="13^N^^1^60^^1^34^8^OTHER PROC CODE 5 (FL-81/2.5)"
^IBA(364.6,751,0)="13^N^^1^60^^1^42^7^OTHER PROC DATE 5 (FL-81/2.6)"
^IBA(364.6,752,0)="13^N^^1^60^^1^51^31^OTHER PHYS ID (FL-83/2)"
^IBA(364.6,753,0)="13^N^^1^59^^1^57^25^OTHER PHYS ID (FL-83/1)"
^IBA(364.6,754,0)="13^N^^1^61^^1^8^27^REMARKS LINE 1 (FL-84a)"
^IBA(364.6,755,0)="13^N^^1^61^^1^57^24^OTHER PHYS ID (FL-83/3)"
^IBA(364.6,756,0)="13^N^^1^62^^1^1^48^REMARKS LINE 2 (FL-84b)"
^IBA(364.6,757,0)="13^N^^1^62^^1^50^30^OTH PHYS ID (FL-83/4)"
^IBA(364.6,758,0)="13^N^^1^63^^1^1^48^REMARKS LINE 3 (FL-84c)"
^IBA(364.6,759,0)="13^N^^1^64^^1^1^48^REMARKS LINE 4 (FL-84d)"
^IBA(364.6,760,0)="13^N^^1^64^^1^51^22^PROVIDER REP LINE 1 (FL-85/1A)"
^IBA(364.6,761,0)="13^N^^1^64^^1^73^8^PROVIDER REP DATE (FL-85/1B)"
^IBA(364.6,765,0)="13^N^^1^1^^1^.9^^UB92 PRE-FORM HOUSEKEEPING^1"
^IBA(364.6,766,0)="13^N^^1^11^^^11^3^OCCURRENCE CODE (FL-33/1)"
^IBA(364.6,767,0)="13^N^^1^11^^^21^3^OCCURRENCE CODE (FL-34/1)"
^IBA(364.6,768,0)="13^N^^1^11^^^31^3^OCCURRENCE CODE (FL-35/1)"
^IBA(364.6,769,0)="13^N^^1^4^^1^.91^^AGENT CASHIER CITY EXTRACT^1"
^IBA(364.6,770,0)="13^N^^1^4^^1^.92^^AGENT CASHIER STATE EXTRACT^1"
^IBA(364.6,771,0)="13^N^^1^4^^1^.93^^AGENT CASHIER ZIP CODE EXTRACT^1"
^IBA(364.6,772,0)="13^N^^1^14^^1^.9^^RESP PARTY ADDRESS EXTRACT^1"
^IBA(364.6,774,0)="13^N^^1^65^^1^80.1^^CHECK FOR MULTIPLE PAGES^1"
^IBA(364.6,775,0)="8^N^^50^1^^0^4^1^TYPE OF BILL CLASSIFICATION^^1"
^IBA(364.6,777,0)="12^N^^1^15^^1^50^24^INSURED'S CITY (BX-7/2A)^0"
^IBA(364.6,778,0)="12^N^^1^15^^1^74^2^INSURED'S STATE (BX-7/2B)^0"
^IBA(364.6,779,0)="12^N^^1^17^^1^50^13^INSURED'S ZIP CODE (BX-7/3A)^0"
^IBA(364.6,780,0)="12^N^^1^17^^1^65^15^INSURED'S PHONE (BX-7/3B)^0"
^IBA(364.6,781,0)="12^N^^1^13^^1^49.9^72^CURR INSURED'S FULL ADDR EXTR^1"
^IBA(364.6,782,0)="12^N^^1^11^^1^49.9^80^CURR INSURED DEMOG EXTRACT^1"
^IBA(364.6,783,0)="8^N^^55^1^^0^7^15^TOTAL OUTSIDE LAB CHARGES^0^1"
^IBA(364.6,784,0)="8^N^^50^1^^0^34^3^CO-INSURANCE DAYS^^1"
^IBA(364.6,785,0)="8^N^^50^1^^0^35^3^LIFETIME RESERVED DAYS^^1"
^IBA(364.6,788,0)="12^N^^1^62^^1^67^13^VA GRP # (BX-33/LN5B)"
^IBA(364.6,789,0)="8^N^^30^1^^0^9^2^INSURED STATE^^1"
^IBA(364.6,790,0)="8^N^^45^1^^0^3^20^PATIENT PHONE^^1"
^IBA(364.6,791,0)="8^N^^25.99^1^^0^.9^^SET INSURANCE CO HDR NODE^1^1"
^IBA(364.6,793,0)="8^N^^20^1^^0^10^35^CURRENT INSURANCE STREET-2^^1"
^IBA(364.6,794,0)="8^N^^35^1^^0^8^2^CURRENT INSURED POLICY TYPE^^1^0"
^IBA(364.6,795,0)="8^N^^45^1^^0^4^8^PATIENT DATE OF DEATH^^1"
^IBA(364.6,796,0)="8^N^^50^1^^0^25^8^LAST MENSTRUAL DT^^1"
^IBA(364.6,804,0)="8^N^^105^1^^0^13^2^OTHER INS TYPE OF INSURANCE^^1"
^IBA(364.6,805,0)="8^N^^105^1^^0^14^2^OTHER INS POLICY TYPE^^1"
^IBA(364.6,806,0)="8^N^^105^1^^0^15^20^ENVOY PAYER ID^^1"
^IBA(364.6,807,0)="8^N^^115^1^^0^1^4^RECORD ID 'COB1'^^1^1"
^IBA(364.6,808,0)="8^N^^115^1^^0^2^1^OTHER INSURANCE SEQUENCE^^1"
^IBA(364.6,809,0)="8^N^^115^1^^0^3^15^COB PT RESP AMT^^1"
^IBA(364.6,810,0)="8^N^^115^1^^0^4^15^COB COVERED AMT^^1"
^IBA(364.6,811,0)="8^N^^115^1^^0^5^15^COB DISCOUNT AMT^^1"
^IBA(364.6,812,0)="8^N^^115^1^^0^6^15^COB DAY LIMIT AMT^^1"
^IBA(364.6,813,0)="8^N^^115^1^^0^7^15^COB INTEREST AMT^^1"
^IBA(364.6,814,0)="8^N^^115^1^^0^8^15^COB TAX AMT^^1"
^IBA(364.6,815,0)="8^N^^115^1^^0^9^15^COB TOTAL BEFORE TAXES^^1"
^IBA(364.6,816,0)="8^N^^120^1^^0^1^4^RECORD ID 'MOA1'^^1^1"
^IBA(364.6,817,0)="8^N^^120^1^^0^2^1^OTHER INSURANCE SEQUENCE^^1"
^IBA(364.6,818,0)="8^N^^120^1^^0^3^3^OUTPT REIMBURSEMENT %^^1"
^IBA(364.6,819,0)="8^N^^120^1^^0^4^15^HCPCS PAYABLE AMT^^1"
^IBA(364.6,820,0)="8^N^^120^1^^0^5^15^REMARKS CODE 1^^1"
^IBA(364.6,821,0)="8^N^^120^1^^0^6^15^REMARKS CODE 2^^1"
^IBA(364.6,822,0)="8^N^^120^1^^0^7^15^REMARKS CODE 3^^1"
^IBA(364.6,823,0)="8^N^^120^1^^0^8^15^REMARKS CODE 4^^1"
^IBA(364.6,825,0)="8^N^^120^1^^0^10^15^ESRD AMT PAID^^1"
^IBA(364.6,826,0)="8^N^^120^1^^0^11^15^NON-PAYABLE PROF COMPONENT^^1"
^IBA(364.6,827,0)="8^N^^125^1^^0^1^4^RECORD ID 'MIA1'^^1^1"
^IBA(364.6,828,0)="8^N^^125^1^^0^2^1^OTHER INSURANCE SEQUENCE^^1"
^IBA(364.6,829,0)="8^N^^125^1^^0^3^4^COB COVERED DAYS/VISITS^^1"
^IBA(364.6,830,0)="8^N^^125^1^^0^4^15^CLAIM DRG AMT^^1"
^IBA(364.6,831,0)="8^N^^125^1^^0^5^10^DRG CODE USED^^1"
^IBA(364.6,832,0)="8^N^^125^1^^0^6^15^CLAIM DISPROP SHARE AMT^^1"
^IBA(364.6,833,0)="8^N^^125^1^^0^7^15^CLAIM MSP PASS THRU AMT^^1"
^IBA(364.6,834,0)="8^N^^125^1^^0^8^15^CLAIM PPS CAPITAL AMT^^1"
^IBA(364.6,835,0)="8^N^^125^1^^0^9^15^PPS CAPITAL FSP DRG AMT^^1"
^IBA(364.6,836,0)="8^N^^125^1^^0^10^15^PPS CAPITAL HSP DRG AMT^^1"
^IBA(364.6,837,0)="8^N^^125^1^^0^11^15^PPS CAPITAL DSH DRG AMT^^1"
^IBA(364.6,838,0)="8^N^^125^1^^0^12^15^OLD CAPITAL AMT^^1"
^IBA(364.6,839,0)="8^N^^130^1^^0^1^4^RECORD ID 'MIA2'^^1^1"
^IBA(364.6,840,0)="8^N^^130^1^^0^2^1^OTHER INSURANCE SEQUENCE^^1"
^IBA(364.6,841,0)="8^N^^130^1^^0^3^4^PPS CAPITAL IME AMT^^1"
^IBA(364.6,842,0)="8^N^^130^1^^0^4^15^PPS OPER HOSP SPEC DRG AMT^^1"
^IBA(364.6,843,0)="8^N^^130^1^^0^5^4^COST REPORT DAY COUNT^^1"
^IBA(364.6,844,0)="8^N^^130^1^^0^6^15^PPS OPER FED SPEC DRG AMT^^1"
^IBA(364.6,845,0)="8^N^^130^1^^0^7^15^CLAIM PPS CAPITAL OUTLIER AMT^^1"
^IBA(364.6,846,0)="8^N^^130^1^^0^8^15^CLAIM INDIRECT TEACHING AMT^^1"
^IBA(364.6,847,0)="8^N^^130^1^^0^9^15^NON-PAYABLE PROF COMPONENT AMT^^1"
^IBA(364.6,848,0)="8^N^^130^1^^0^10^10^CLAIM PAYMENT REMARK CODE 1^^1"
^IBA(364.6,849,0)="8^N^^130^1^^0^11^10^CLAIM PAYMENT REMARK CODE 2^^1"
^IBA(364.6,850,0)="8^N^^130^1^^0^12^10^CLAIM PAYMENT REMARK CODE 3^^1"
^IBA(364.6,851,0)="8^N^^130^1^^0^13^10^CLAIM PAYMENT REMARK CODE 4^^1"
^IBA(364.6,852,0)="8^N^^130^1^^0^15^15^PPS CAPITAL EXCEPTION AMT^^1"
^IBA(364.6,853,0)="8^N^^135^1^^0^1^4^RECORD ID 'CCAS'^^1^1"
^IBA(364.6,854,0)="8^N^^135^1^^0^2^1^OTHER INSURANCE SEQUENCE^^1"
^IBA(364.6,855,0)="8^N^^135^1^^0^3^2^ADJUSTMENT GROUP CODE^^1"
^IBA(364.6,856,0)="8^N^^135^1^^0^4^5^ADJUSTMENT REASON CODE-1^^1"
^IBA(364.6,857,0)="8^N^^135^1^^0^5^15^ADJUSTMENT AMT-1^^1"
^IBA(364.6,858,0)="8^N^^135^1^^0^6^6^ADJUSTMENT QUANTITY-1^^1"
^IBA(364.6,859,0)="8^N^^180^1^^0^16^2^PROF PROC MODIFIER 2^^1"
^IBA(364.6,860,0)="8^N^^180^1^^0^17^2^PROF PROC MODIFIER 3^^1"
^IBA(364.6,861,0)="8^N^^180^1^^0^18^2^PROF PROC MODIFIER 4^^1"
^IBA(364.6,862,0)="8^N^^180^1^^0^19^1^EMERGENCY INDICATOR^^1"
^IBA(364.6,863,0)="8^N^^180^1^^0^20^2^PROF TYPE OF UNITS^^1"
^IBA(364.6,864,0)="8^N^^185^1^^0^13^2^INST TYPE OF UNITS^^1"
^IBA(364.6,865,0)="8^N^^195^1^^0^1^4^RECORD ID 'LCOB'^^1^1"
^IBA(364.6,866,0)="8^N^^195^1^^0^2^6^COB REFERENCE CLAIM LINE #^^1^1"
^IBA(364.6,867,0)="8^N^^195^1^^0^3^20^COB INS CO PAYER ID^^1"
^IBA(364.6,868,0)="8^N^^195^1^^0^4^15^LINE COB AMT PAID^^1"
^IBA(364.6,869,0)="8^N^^195^1^^0^5^20^COB LINE PAID PROCEDURE^^1"
^IBA(364.6,870,0)="8^N^^195^1^^0^6^10^COB LINE REVENUE CODE^^1"
^IBA(364.6,871,0)="8^N^^195^1^^0^7^2^COB LINE MODIFIER 1^^1"
^IBA(364.6,872,0)="8^N^^195^1^^0^8^2^COB LINE MODIFIER 2^^1"
^IBA(364.6,873,0)="8^N^^195^1^^0^9^2^COB LINE MODIFIER 3^^1"
^IBA(364.6,874,0)="8^N^^195^1^^0^10^2^COB LINE MODIFIER 4^^1"
^IBA(364.6,875,0)="8^N^^195^1^^0^11^80^COB LINE DESCRIPTION^^1"
^IBA(364.6,876,0)="8^N^^195^1^^0^12^15^COB LINE PAID UNITS^^1"
^IBA(364.6,877,0)="8^N^^195^1^^0^13^6^COB ASSIGNED LINE #^^1"
^IBA(364.6,878,0)="8^N^^200^1^^0^1^4^RECORD ID 'LCAS'^^1^1"
^IBA(364.6,879,0)="8^N^^200^1^^0^2^6^COB REFERENCE CLAIM LINE #^^1"
^IBA(364.6,880,0)="8^N^^200^1^^0^3^2^COB LINE ADJUSTMENT GROUP CODE^^1"
^IBA(364.6,881,0)="8^N^^200^1^^0^4^5^COB LINE ADJ REASON CODE-1^^1"
^IBA(364.6,882,0)="8^N^^200^1^^0^5^15^COB LINE ADJUSTMENT AMT-1^^1"
^IBA(364.6,883,0)="8^N^^200^1^^0^6^6^COB LINE ADJUSTMENT QUANTITY-1^^1"
^IBA(364.6,884,0)="8^N^^135^1^^0^99.9^^KILL IBXSAVE ARRAY^1^1"
^IBA(364.6,885,0)="8^N^^20^1^^0^2.9^^CURRENT INSURANCE FULL ADDRESS^1^1"
^IBA(364.6,886,0)="8^N^^115^1^^0^1.9^^OTHER INS DATA^1^1"
^IBA(364.6,887,0)="8^N^^120^1^^0^1.9^^OTHER INS COB MOA DATA^1^1"
^IBA(364.6,888,0)="8^N^^125^1^^0^1.9^^OTHER INS COB MIA(1) DATA^1^1"
^IBA(364.6,890,0)="8^N^^135^1^^0^1.9^^OTHER INS COB ADJ DATA^1^1"
^IBA(364.6,891,0)="8^N^^115^1^^0^10^8^DATE CLAIM PAID^^1"
^IBA(364.6,892,0)="8^N^^135^1^^0^7^5^ADJUSTMENT REASON CODE-2^^1"
^IBA(364.6,893,0)="8^N^^135^1^^0^10^5^ADJUSTMENT REASON CODE-3^^1"
^IBA(364.6,894,0)="8^N^^135^1^^0^13^5^ADJUSTMENT REASON CODE-4^^1"
^IBA(364.6,895,0)="8^N^^135^1^^0^16^5^ADJUSTMENT REASON CODE-5^^1"
^IBA(364.6,896,0)="8^N^^135^1^^0^19^5^ADJUSTMENT REASON CODE-6^^1"
^IBA(364.6,897,0)="8^N^^135^1^^0^8^15^ADJUSTMENT AMT-2^^1"
^IBA(364.6,898,0)="8^N^^135^1^^0^11^15^ADJUSTMENT AMT-3^^1"
^IBA(364.6,899,0)="8^N^^135^1^^0^14^15^ADJUSTMENT AMT-4^^1"
^IBA(364.6,900,0)="8^N^^135^1^^0^17^15^ADJUSTMENT AMT-5^^1"
^IBA(364.6,901,0)="8^N^^135^1^^0^20^15^ADJUSTMENT AMT-6^^1"
^IBA(364.6,902,0)="8^N^^135^1^^0^9^6^ADJUSTMENT QUANTITY-2^^1"
^IBA(364.6,903,0)="8^N^^135^1^^0^12^6^ADJUSTMENT QUANTITY-3^^1"
^IBA(364.6,904,0)="8^N^^135^1^^0^15^6^ADJUSTMENT QUANTITY-4^^1"
^IBA(364.6,905,0)="8^N^^135^1^^0^18^6^ADJUSTMENT QUANTITY-5^^1"
^IBA(364.6,906,0)="8^N^^135^1^^0^21^6^ADJUSTMENT QUANTITY-6^^1"
^IBA(364.6,907,0)="8^N^^200^1^^0^7^5^COB LINE ADJ REASON CODE-2^^1"
^IBA(364.6,908,0)="8^N^^200^1^^0^10^5^COB LINE ADJ REASON CODE-3^^1"
^IBA(364.6,909,0)="8^N^^200^1^^0^13^5^COB LINE ADJ REASON CODE-4^^1"
^IBA(364.6,910,0)="8^N^^200^1^^0^16^5^COB LINE ADJ REASON CODE-5^^1"
^IBA(364.6,911,0)="8^N^^200^1^^0^19^5^COB LINE ADJ REASON CODE-6^^1"
^IBA(364.6,912,0)="8^N^^200^1^^0^8^15^COB LINE ADJUSTMENT AMT-2^^1"
^IBA(364.6,913,0)="8^N^^200^1^^0^11^15^COB LINE ADJUSTMENT AMT-3^^1"
^IBA(364.6,914,0)="8^N^^200^1^^0^14^15^COB LINE ADJUSTMENT AMT-4^^1"
^IBA(364.6,915,0)="8^N^^200^1^^0^17^15^COB LINE ADJUSTMENT AMT-5^^1"
^IBA(364.6,916,0)="8^N^^200^1^^0^20^15^COB LINE ADJUSTMENT AMT-6^^1"
^IBA(364.6,917,0)="8^N^^200^1^^0^9^6^COB LINE ADJUSTMENT QUANTITY-2^^1"
^IBA(364.6,918,0)="8^N^^200^1^^0^12^6^COB LINE ADJUSTMENT QUANTITY-3^^1"
^IBA(364.6,919,0)="8^N^^200^1^^0^15^6^COB LINE ADJUSTMENT QUANTITY-4^^1"
^IBA(364.6,920,0)="8^N^^200^1^^0^18^6^COB LINE ADJUSTMENT QUANTITY-5^^1"
^IBA(364.6,921,0)="8^N^^200^1^^0^21^6^COB LINE ADJUSTMENT QUANTITY-6^^1"
^IBA(364.6,923,0)="8^N^^120^1^^0^9^15^REMARKS CODE 5^^1"
^IBA(364.6,924,0)="8^N^^130^1^^0^14^10^CLAIM PAYMENT REMARK CODE 5^^1"
^IBA(364.6,935,0)="8^N^^96^1^^0^16^2^REFERRING PROVIDER STATE^0^1"
^IBA(364.6,936,0)="8^N^^96^1^^0^15^10^REFERRING PHY NAME SUFFIX^0^1"
^IBA(364.6,937,0)="8^N^^96^1^^0^14^20^REFERRING PROVIDER FIRST NAME^0^1"
^IBA(364.6,938,0)="8^N^^96^1^^0^13^20^REFERRING PROVIDER LAST NAME^0^1"
^IBA(364.6,939,0)="8^N^^96^1^^0^12^5^OPERATING PHYS SPECIALTY^0^1"
^IBA(364.6,941,0)="8^N^^96^1^^0^2^20^ATT/REND PROV LAST NAME^0^1^0"
^IBA(364.6,942,0)="8^N^^96^1^^0^3^20^ATT/REND PROV FIRST NAME^0^1"
^IBA(364.6,943,0)="8^N^^96^1^^0^4^10^ATT/REND NAME SUFFIX^0^1^0"
^IBA(364.6,944,0)="8^N^^96^1^^0^5^5^ATT/REND PROV SPECIALTY^0^1"
^IBA(364.6,945,0)="8^N^^96^1^^0^6^20^OTHER PROV LAST NAME^0^1"
^IBA(364.6,946,0)="8^N^^96^1^^0^7^20^OTHER PROV FIRST NAME^0^1"
^IBA(364.6,947,0)="8^N^^96^1^^0^8^10^OTHER PROV NAME SUFFIX^0^1"
^IBA(364.6,948,0)="8^N^^96^1^^0^9^20^OPERATING PHYS LAST NAME^0^1"
^IBA(364.6,949,0)="8^N^^96^1^^0^10^20^OPERATING PHYS FIRST NAME^0^1"
^IBA(364.6,950,0)="8^N^^96^1^^0^11^10^OPERATING PHY NAME SUFFIX^0^1"
^IBA(364.6,951,0)="8^N^^96^1^^0^17^5^REFERRING PROV SPECIALTY^0^1"
^IBA(364.6,952,0)="8^N^^50^1^^0^36^10^E-CODE DIAGNOSIS^0^1"
^IBA(364.6,953,0)="13^N^^1^4^^1^33^5^UPPER FORM LOCATOR 5^0"
^IBA(364.6,954,0)="13^N^^1^11^^1^58^24^FORM LOCATOR 37B"
^IBA(364.6,955,0)="13^N^^1^12^^1^58^24^FORM LOCATOR 37C"
^IBA(364.6,956,0)="8^N^^105^1^^0^16^18^OTH INS TREATMENT AUTH CODE^^1"
^IBA(364.6,957,0)="8^N^^35^1^^0^9^35^TREATMENT AUTH CODE^^1"
^IBA(364.6,958,0)="8^N^^185^1^^0^14^4^FORM LOCATOR 49^0^1"
^IBA(364.6,959,0)="12^N^^1^62^^1^52^12^VA PIN # (BX-33/LN5A)^0"
^IBA(364.6,960,0)="8^N^^50^1^^0^37^1^EXPLANATION OF BENEFITS IND^0^1"
^IBA(364.6,961,0)="8^N^^115^1^^0^11^15^ALLOWED AMOUNT^0^1"
^IBA(364.6,962,0)="8^N^^115^1^^0^12^2^CLAIM STATUS^0^1"
^IBA(364.6,964,0)="8^N^^115^1^^0^13^3^COB COVERED DAYS^0^1"
^IBA(364.6,965,0)="8^N^^50^1^^0^38^8^ACCIDENT DATE^0^1"
^IBA(364.6,966,0)="12^N^^1^9^^1^2^49^INS TYPE CHECK BOX (BX-1)^0"
^IBA(364.6,967,0)="12^N^^1^31^^1^36^13^PATIENT SIGNATURE DT (BX-12/2)"
^IBA(364.6,968,0)="8^N^^15^1^^0^10^15^MOVED TO CI1A-3^0^1^0"
^IBA(364.6,969,0)="8^N^^15^1^^0^2^^FILLER^^1"
^IBA(364.6,970,0)="8^N^^55^1^^0^8^10^CLIA #^0^1"
^IBA(364.6,971,0)="8^N^^55^1^^0^9^10^LAB OR FACILITY PRIMARY ID^0^1"
^IBA(364.6,972,0)="8^N^^55^1^^0^10^1^PURCH/REMOTE SVC FLAG^0^1"
^IBA(364.6,973,0)="8^N^^97^1^^0^4^1^ATT/REND PERSON/NON-PERSON^0^1^1"
^IBA(364.6,974,0)="8^N^^180^1^^0^21^8^PURCH SERVICE CHARGE^0^1"
^IBA(364.6,975,0)="8^N^^180^1^^0^22^15^BOX 24K DATA - NO LONGER USED^0^1"
^IBA(364.6,976,0)="8^N^^195^1^^0^14^8^LINE ITEM DATE PAID^0^1"
^IBA(364.6,977,0)="8^N^^180^1^^0^23^8^LAST X-RAY DATE^0^1"
^IBA(364.6,978,0)="8^N^^180^1^^0^24^1^ATTENDING NOT HOSPICE^0^1"
^IBA(364.6,979,0)="8^N^^180^1^^0^25^3^BEGIN LEVEL OF SUBLUXATION^0^1"
^IBA(364.6,980,0)="8^N^^180^1^^0^27^15^CHIRO - QUANTITY^0^1"
^IBA(364.6,981,0)="8^N^^180^1^^0^28^9^CHIRO - SERIES #^0^1"
^IBA(364.6,982,0)="8^N^^180^1^^0^29^1^EPSDT FLAG^0^1"
^IBA(364.6,983,0)="8^N^^195^1^^0^1.9^^EXTRACT LINE LEVEL ADJUSTMENTS^1^1"
^IBA(364.6,984,0)="8^N^^96^1^^0^18^10^PRIMARY INS ATT/REND PROV ID^0^1"
^IBA(364.6,985,0)="8^N^^97^1^^0^2^10^ATT/REND PROV PRIMARY ID QUAL^0^1"
^IBA(364.6,986,0)="8^N^^97^1^^0^3^10^ATT/REND PROV PRIMARY ID CODE^0^1"
^IBA(364.6,987,0)="8^N^^35^1^^0^12^20^INSURED EMPLOYER STREET^0^1"
^IBA(364.6,988,0)="8^N^^110^1^^0^10^20^OTHER INSURED EMPLOYER STREET^0^1"
^IBA(364.6,990,0)="8^N^^97^1^^0^7^1^OTHER PROV PERSON/NON-PERSON^0^1"
^IBA(364.6,991,0)="8^N^^97^1^^0^5^10^OTHER PROV PRIMARY ID QUAL^0^1"
^IBA(364.6,992,0)="8^N^^97^1^^0^6^10^OTHER PROV PRIMARY ID CODE^0^1"
^IBA(364.6,993,0)="8^N^^97^1^^0^8^10^OPERATING PHY PRIMARY ID QUAL^0^1"
^IBA(364.6,994,0)="8^N^^97^1^^0^9^10^OPERATING PHY PRIMARY ID CODE^0^1"
^IBA(364.6,995,0)="12^N^^1^30^^1^3^45^RELEASE OF INFO SIG (12A)"
^IBA(364.6,996,0)="12^N^^1^30^^1^51^28^ASSIGN OF BENEFITS SIG (13A)"
^IBA(364.6,999,0)="8^N^^35^1^^0^11^20^CURR INSURANCE ICN/DCN^^1"
^IBA(364.6,1000,0)="8^N^^35^1^^0^10^15^CURR INS CO ATTENDING PROV ID^^1"
^IBA(364.6,1001,0)="12^N^^1^37^^1^70^10^PURCH SVC CHARGES (BX-20/C)"
^IBA(364.6,1002,0)="8^N^^60^1^^0^19^32^CMS-1500 BOX 19 RAW DATA^^1"
^IBA(364.6,1004,0)="8^N^^20^1^^0^11^15^CURR INS EMC #^0^1"
^IBA(364.6,1005,0)="8^N^^105^1^^0^17^2^PROF TYPE OF POLICY^^1"
^IBA(364.6,1006,0)="8^N^^180^1^^0^30^61^SERVICE LINE COMMENT^0^1"
^IBA(364.6,1007,0)="8^N^^97^1^^0^10^3^RENDERING PROVIDER CREDENTIALS^0^1"
^IBA(364.6,1008,0)="12^N^^1^62^^1^23^27^NON-VA FACILITY ID"
^IBA(364.6,1009,0)="8^N^^20^1^^0^12^2^CURRENT INSURANCE TYPE CODE^0^1^0"
^IBA(364.6,1010,0)="8^N^^180^1^^0^26^3^END LEVEL OF SUBLUXATION^0^1"
^IBA(364.6,1011,0)="8^N^^190^1^^0^10^2^NDC FORMAT^0^1"
^IBA(364.6,1012,0)="8^N^^195^1^^0^15^2^PROCEDURE TYPE^^1"
^IBA(364.6,1014,0)="8^N^^5^1^^0^7^13^X12 Version Number for HIPAA^0^1"
^IBA(364.6,1015,0)="8^N^^28^1^^0^6^2^BILLING PROV SECONDARY ID Q(3)^0^1"
^IBA(364.6,1016,0)="8^N^^30^1^^0^15^10^INSURED NAME SUFFIX^0^1^0"
^IBA(364.6,1017,0)="8^N^^36^1^^0^1^4^RECORD ID 'CI4 '^0^1^1"
^IBA(364.6,1018,0)="8^N^^36^1^^0^2^2^ENTITY INDENTIFIER CODE QD^0^1^0"
^IBA(364.6,1019,0)="8^N^^36^1^^0^3^1^ENTITY TYPE QUALIFIER^0^1^0"
^IBA(364.6,1020,0)="8^N^^36^1^^0^4^35^RESPONSIBLE NAME LAST/ORG^0^1^0"
^IBA(364.6,1021,0)="8^N^^36^1^^0^5^25^RESPONSIBLE PARTY FIRST NAME^0^1^0"
^IBA(364.6,1022,0)="8^N^^36^1^^0^6^25^RESPONSIBLE PARTY MIDDLE NAME^0^1^0"
^IBA(364.6,1023,0)="8^N^^36^1^^0^7^10^RESPONSIBLE PARTY SUFFIX^0^1^0"
^IBA(364.6,1024,0)="8^N^^36^1^^0^8^50^RESP PARTY ADDRESS LINE1^0^1^0"
^IBA(364.6,1025,0)="8^N^^36^1^^0^9^50^RESP PARTY ADDRESS LINE2^0^1^0"
^IBA(364.6,1026,0)="8^N^^36^1^^0^10^30^RESPONSIBLE PARTY CITY^0^1^0"
^IBA(364.6,1027,0)="8^N^^36^1^^0^11^2^RESPONSIBLE PARTY STATE^0^1^0"
^IBA(364.6,1028,0)="8^N^^36^1^^0^12^15^RESPONSIBLE PARTY ZIP CODE^0^1^0"
^IBA(364.6,1029,0)="8^N^^40^1^^0^17^2^UNIT OR BASIS FOR MEASUREMENT^0^1^0"
^IBA(364.6,1030,0)="8^N^^40^1^^0^18^10^PATIENT WEIGHT^0^1^0"
^IBA(364.6,1031,0)="8^N^^40^1^^0^19^1^PREGNANCY INDICATOR^0^1^0"
^IBA(364.6,1032,0)="8^N^^51^1^^0^2^8^INITIAL TREATMENT DATE-SPINAL^0^1^0"
^IBA(364.6,1033,0)="8^N^^51^1^^0^3^8^LAST XRAY DATE-SPINAL^0^1^0"
^IBA(364.6,1034,0)="8^N^^51^1^^0^4^8^HEARING/VISION PRESCRIPT. DATE^0^1^0"
^IBA(364.6,1035,0)="8^N^^51^1^^0^5^1^MEDICARE ASSIGNNMENT CODE^0^1^0"
^IBA(364.6,1036,0)="8^N^^51^1^^0^6^30^MAMMOGRAPHY CERT NUMBER^0^1^0"
^IBA(364.6,1037,0)="8^N^^51^1^^0^7^1^SPINAL MANIP. CONDITION CODE^0^1^0"
^IBA(364.6,1038,0)="8^N^^51^1^^0^8^8^ACUTE MANIFEST. DATE-SPINAL^0^1^0"
^IBA(364.6,1039,0)="8^N^^55^1^^0^12^50^SERVICE FAC. ADDRESS LINE2^0^1^0"
^IBA(364.6,1040,0)="8^N^^56^1^^0^2^2^PURCH SERV SECOND QUALIF 1^0^1^0"
^IBA(364.6,1041,0)="8^N^^57^1^^0^2^2^SERVICE/LAB FACILITY PROV CODE^0^1^0"
^IBA(364.6,1042,0)="8^N^^57^1^^0^3^1^SERV FAC ENTITY TYPE QUALIFIER^0^1^0"
^IBA(364.6,1043,0)="8^N^^57^1^^0^4^35^SERV FAC PROV ORGANIZ NAME^0^1^0"
^IBA(364.6,1044,0)="8^N^^57^1^^0^7^2^SERV FAC SECONDARY QUALIF 1^0^1^0"
^IBA(364.6,1045,0)="8^N^^57^1^^0^5^2^SERV FAC ID CODE QUALIF^0^1^0"
^IBA(364.6,1046,0)="8^N^^57^1^^0^6^20^SERVICE FACILITY ID NUMBER^0^1^0"
^IBA(364.6,1047,0)="8^N^^97^1^^0^11^10^REFERRING PHY PRIMARY ID QUAL^0^1^0"
^IBA(364.6,1048,0)="8^N^^97^1^^0^12^10^REFERRING PHY PRIMARY ID CODE^0^1^0"
^IBA(364.6,1051,0)="8^N^^51^1^^0^9^2^MAMMOGRAPHY CERT# QUALIFIER^0^1^0"
^IBA(364.6,1056,0)="8^N^^103^1^^0^1^4^RECORD ID 'OPR7'^0^1^1"
^IBA(364.6,1057,0)="8^N^^103^1^^0^1.9^^SPRVSING PROV FULL NAME^1^1"
^IBA(364.6,1058,0)="8^N^^103^1^^0^2^35^SPRVSING PROV LAST NAME^0^1^0"
^IBA(364.6,1059,0)="8^N^^103^1^^0^3^25^SPRVSING PROV FIRST NAME^0^1^0"
^IBA(364.6,1060,0)="8^N^^103^1^^0^4^25^SPRVSING PROV MIDDLE NAME^0^1^0"
^IBA(364.6,1061,0)="8^N^^103^1^^0^5^10^SPRVSING PROV NAME SUFFIX^0^1^0"
^IBA(364.6,1062,0)="8^N^^103^1^^0^6^2^SPRVSING PHY PRIMARY ID QUAL^0^1^0"
^IBA(364.6,1063,0)="8^N^^103^1^^0^7^30^SPRVSING PHY PRIMARY ID CODE^0^1^0"
^IBA(364.6,1065,0)="8^N^^105^1^0^0^18^1^OTHER INS PAT SIG SOURCE CODE^0^1^0"
^IBA(364.6,1072,0)="8^N^^112^1^^0^2.9^157^OTHER INSURANCE FULL ADDRESS^1^1^0"
^IBA(364.6,1073,0)="8^N^^112^1^^0^3^55^OTHER INSURANCE ADDRESS LINE 1^0^1^0"
^IBA(364.6,1074,0)="8^N^^112^1^^0^4^55^OTHER INSURANCE ADDRESS LINE2^0^1^0"
^IBA(364.6,1075,0)="8^N^^112^1^^0^5^30^OTHER INSURANCE CITY^0^1^0"
^IBA(364.6,1076,0)="8^N^^112^1^^0^6^2^OTHER INSURANCE STATE^0^1^0"
^IBA(364.6,1077,0)="8^N^^112^1^^0^7^15^OTHER INSURANCE ZIP^0^1^0"
^IBA(364.6,1078,0)="8^N^^110^1^^0^17.1^116^OTHER INSURED QUALIFIER/ID#^1^1^0"
^IBA(364.6,1080,0)="8^N^^110^1^^0^16.9^136^N-OTHER INSURED QUALIF/ID ALL^1^1^0"
^IBA(364.6,1081,0)="8^N^^113^1^^0^3^10^OTHER INSURED NAME SUFFIX^0^1^0"
^IBA(364.6,1082,0)="8^N^^111^1^^0^1^4^RECORD ID 'OI3 '^0^1^1"
^IBA(364.6,1083,0)="8^N^^111^1^0^0^4^1^OTH PAYER PAT ENTITY TYPE^0^1^0"
^IBA(364.6,1084,0)="8^N^^111^1^0^0^5^2^OTH PAYER PAT ID NUMBER QUAL^0^1^0"
^IBA(364.6,1085,0)="8^N^^111^1^0^0^6^30^OTH PAYER PAT ID NUMBER^0^1^0"
^IBA(364.6,1086,0)="8^N^^111^1^0^0^7^2^OTH PAYER PAT ID QUAL (1)^0^1^0"
^IBA(364.6,1087,0)="8^N^^111^1^0^0^8^30^OTH PAYER PAT ID (1)^0^1^0"
^IBA(364.6,1088,0)="8^N^^111^1^0^0^9^2^OTH PAYER PAT ID QUAL (2)^0^1^0"
^IBA(364.6,1089,0)="8^N^^111^1^0^0^10^30^OTH PAYER PAT ID (2)^0^1^0"
^IBA(364.6,1090,0)="8^N^^111^1^0^0^11^2^OTH PAYER PAT ID QUAL (3)^0^1^0"
^IBA(364.6,1091,0)="8^N^^111^1^0^0^12^30^OTH PAYER PAT ID (3)^0^1^0"
^IBA(364.6,1092,0)="8^N^^111^1^0^0^13^30^OTH PAYER PAT ID# 3^0^1"
^IBA(364.6,1094,0)="8^N^^28^1^^0^7^20^BILLING PROV SECONDARY ID #(3)^0^1"
^IBA(364.6,1095,0)="8^N^^28^1^^0^8^2^BILLING PROV SECONDARY ID Q(4)^0^1"
^IBA(364.6,1096,0)="8^N^^28^1^^0^9^20^BILLING PROV SECONDARY ID #(4)^0^1"
^IBA(364.6,1097,0)="8^N^^28^1^^0^10^2^BILLING PROV SECONDARY ID Q(5)^0^1"
^IBA(364.6,1098,0)="8^N^^28^1^^0^11^20^BILLING PROV SECONDARY ID #(5)^0^1"
^IBA(364.6,1099,0)="8^N^^28^1^^0^12^2^BILLING PROV SECONDARY ID Q(6)^0^1"
^IBA(364.6,1100,0)="8^N^^28^1^^0^13^20^BILLING PROV SECONDARY ID #(6)^0^1"
^IBA(364.6,1101,0)="8^N^^28^1^^0^14^2^BILLING PROV SECONDARY ID Q(7)^0^1"
^IBA(364.6,1102,0)="8^N^^28^1^^0^15^20^BILLING PROV SECONDARY ID #(7)^^1"
^IBA(364.6,1103,0)="8^N^^28^1^^0^16^2^BILLING PROV SECONDARY ID Q(8)^0^1"
^IBA(364.6,1104,0)="8^N^^28^1^^0^17^20^BILLING PROV SECONDARY ID #(8)^0^1"
^IBA(364.6,1106,0)="8^N^^170^1^0^0^1^4^RECORD ID 'OP1 '^0^1^1"
^IBA(364.6,1107,0)="8^N^^170^1^0^0^3^2^OTHER PAYER ATT NAME QUAL^0^1^0"
^IBA(364.6,1108,0)="8^N^^170^1^0^0^4^1^OTHER PAYER ATT PROV QUAL^0^1^0"
^IBA(364.6,1110,0)="8^N^^170^1^0^0^5^2^OTH PAYER ATT ID QUAL^0^1^0"
^IBA(364.6,1111,0)="8^N^^170^1^0^0^6^30^OTHER PAYER ATTENDING PROV ID^0^1^0"
^IBA(364.6,1112,0)="8^N^^170^1^0^0^7^2^OTH PAYER ATT ID QUAL(2)^0^1^0"
^IBA(364.6,1113,0)="8^N^^170^1^0^0^8^30^OTHER PAYER ATT PROV ID(2)^0^1^0"
^IBA(364.6,1114,0)="8^N^^170^1^0^0^9^2^OTH PAYER ATT ID QUAL(3)^0^1^0"
^IBA(364.6,1115,0)="8^N^^170^1^0^0^10^30^OTHER PAYER ATT PROV ID(3)^0^1^0"
^IBA(364.6,1116,0)="8^N^^171^1^^0^1^4^RECORD ID 'OP2 '^0^1^1"
^IBA(364.6,1117,0)="8^N^^171^1^0^0^3^2^OTH PAYER OPER PROV NAME QUAL^0^1^0"
^IBA(364.6,1118,0)="8^N^^171^1^0^0^4^1^OTH PAYER OPER ENTITY QUAL^0^1^0"
^IBA(364.6,1119,0)="8^N^^171^1^0^0^5^2^OTH PAYER OPER PROV ID QUAL^0^1^0"
^IBA(364.6,1120,0)="8^N^^171^1^0^0^6^30^OTH PAYER OPER PROV ID(1)^0^1^0"
^IBA(364.6,1121,0)="8^N^^171^1^0^0^7^2^OTH PAYER OPER PROV ID QUAL(2)^0^1^0"
^IBA(364.6,1122,0)="8^N^^171^1^0^0^8^30^OTH PAER OPER PROV ID(2)^0^1^0"
^IBA(364.6,1123,0)="8^N^^171^1^0^0^9^2^OTH PAYER OPER PROV ID QUAL(3)^0^1^0"
^IBA(364.6,1124,0)="8^N^^171^1^0^0^10^30^OTH PAYER OPER PROV ID(3)^0^1^0"
^IBA(364.6,1126,0)="8^N^^172^1^^0^1^4^RECORD ID 'OP3 '^0^1^1"
^IBA(364.6,1127,0)="8^N^^172^1^0^0^3^2^OTH PAYER FAC PROV NAM QUAL^0^1^0"
^IBA(364.6,1128,0)="8^N^^172^1^0^0^4^1^OTH PAYER FAC PROV ENTY QUAL^0^1^0"
^IBA(364.6,1129,0)="8^N^^172^1^0^0^5^2^OTH PAYER FAC PROV ID QUAL(1)^0^1^0"
^IBA(364.6,1130,0)="8^N^^172^1^0^0^6^30^OTH PAYER FAC PROV ID(1)^0^1^0"
^IBA(364.6,1131,0)="8^N^^172^1^0^0^7^2^OTH PAYER FAC PROV ID QUAL(2)^0^1^0"
^IBA(364.6,1132,0)="8^N^^172^1^0^0^8^30^OTH PAYER FAC PROV ID(2)^0^1^0"
^IBA(364.6,1133,0)="8^N^^172^1^0^0^9^2^OTH PAYER FAC PROV ID QUAL(3)^0^1^0"
^IBA(364.6,1134,0)="8^N^^172^1^0^0^10^30^OTH PAYER FAC PROV ID(3)^0^1^0"
^IBA(364.6,1135,0)="8^N^^173^1^^0^1^4^RECORD ID 'OP4 '^0^1^1"
^IBA(364.6,1136,0)="8^N^^173^1^0^0^3^2^OTH PAYER REF PROV ID QUAL^0^1^0"
^IBA(364.6,1137,0)="8^N^^173^1^0^0^4^1^OTH PAYER REF PROV ENT TYPE^0^1^0"
^IBA(364.6,1138,0)="8^N^^173^1^0^0^5^2^OTH PAYER REF PROV ID QUAL(1)^0^1^0"
^IBA(364.6,1139,0)="8^N^^173^1^^0^6^30^OTH PAYER REF PROV ID(1)^0^1^0"
^IBA(364.6,1140,0)="8^N^^173^1^0^0^7^2^OTH PAYER REF PROV ID QUAL(2)^0^1^0"
^IBA(364.6,1141,0)="8^N^^173^1^0^0^8^30^OTH PAYER REF PROV ID(2)^0^1^0"
^IBA(364.6,1142,0)="8^N^^173^1^0^0^9^2^OTH PAYER REF PROV ID QUAL(3)^0^1^0"
^IBA(364.6,1143,0)="8^N^^173^1^0^0^10^30^OTH PAYER REF PROV ID(3)^0^1^0"
^IBA(364.6,1153,0)="8^N^^175^1^^0^1^4^RECORD ID 'OP6 '^0^1^1"
^IBA(364.6,1154,0)="8^N^^175^1^0^0^3^2^OTH PAY PUR PROV ID QUAL^0^1^0"
^IBA(364.6,1155,0)="8^N^^175^1^0^0^4^1^OTH PAY PUR PROV ENTITY TYPE^0^1^0"
^IBA(364.6,1156,0)="8^N^^175^1^0^0^5^2^OTH PAY PUR PROV ID QUAL(1)^0^1^0"
^IBA(364.6,1157,0)="8^N^^175^1^0^0^6^30^OTH PAY PUR PROV ID(1)^0^1^0"
^IBA(364.6,1158,0)="8^N^^175^1^0^0^7^2^OTH PAY PUR PROV ID QUAL(2)^0^1^0"
^IBA(364.6,1159,0)="8^N^^175^1^0^0^8^30^OTH PAY PUR PROV ID(2)^0^1^0"
^IBA(364.6,1160,0)="8^N^^175^1^0^0^9^2^OTH PAY PUR PROV ID QUAL(3)^0^1^0"
^IBA(364.6,1161,0)="8^N^^175^1^0^0^10^30^OTH PAY PUR PROV ID(3)^0^1^0"
^IBA(364.6,1162,0)="8^N^^176^1^^0^1^4^RECORD ID 'OP7 '^0^1^1"
^IBA(364.6,1163,0)="8^N^^176^1^0^0^3^2^OTH PAY SERV FAC LOC ID QUAL^0^1^0"
^IBA(364.6,1164,0)="8^N^^176^1^0^0^4^1^OTH PAY SERV FAC LOC ENT TYPE^0^1^0"
^IBA(364.6,1165,0)="8^N^^176^1^0^0^5^2^OTH PAY SERV FAC ID QUAL(1)^0^1^0"
^IBA(364.6,1166,0)="8^N^^176^1^0^0^6^30^OTH PAY SERV FAC ID(1)^0^1^0"
^IBA(364.6,1167,0)="8^N^^176^1^0^0^7^2^OTH PAY SERV FAC ID QUAL(2)^0^1^0"
^IBA(364.6,1168,0)="8^N^^176^1^0^0^8^30^OTH PAY SERV FAC ID(2)^0^1^0"
^IBA(364.6,1169,0)="8^N^^176^1^0^0^9^2^OTH PAY SERV FAC ID QUAL(3)^0^1^0"
^IBA(364.6,1170,0)="8^N^^176^1^0^0^10^30^OTH PAY SERV FAC ID(3)^0^1^0"
^IBA(364.6,1171,0)="8^N^^177^1^^0^1^4^RECORD ID 'OP8 '^0^1^1"
^IBA(364.6,1172,0)="8^N^^177^1^0^0^3^2^OTH PAY SUPER PROV NAM QUAL^0^1^0"
^IBA(364.6,1173,0)="8^N^^177^1^0^0^4^1^OTH PAY SUPER PROV ENTITY^0^1^0"
^IBA(364.6,1174,0)="8^N^^177^1^0^0^5^2^OTH PAY SUPER PROV ID QUAL(1)^0^1^0"
^IBA(364.6,1175,0)="8^N^^177^1^0^0^6^30^OTH PAY SUPER PROV ID(1)^0^1^0"
^IBA(364.6,1176,0)="8^N^^177^1^0^0^7^2^OTH PAY SUPER PROV ID QUAL(2)^0^1^0"
^IBA(364.6,1177,0)="8^N^^177^1^0^0^8^30^OTH PAY SUPER PROV ID(2)^0^1^0"
^IBA(364.6,1178,0)="8^N^^177^1^0^0^9^2^OTH PAY SUPER PROV ID QUAL(3)^0^1^0"
^IBA(364.6,1179,0)="8^N^^177^1^0^0^10^30^OTH PAY SUPER PROV ID(3)^0^1^0"
^IBA(364.6,1180,0)="8^N^^178^1^^0^1^4^RECORD ID 'OP9 '^0^1^1"
^IBA(364.6,1181,0)="8^N^^178^1^0^0^3^2^OTH PAY OTH PROV NAME QUAL^0^1^0"
^IBA(364.6,1182,0)="8^N^^178^1^0^0^4^1^OTH PAY OTH PROV ENTITY TYPE^0^1^0"
^IBA(364.6,1183,0)="8^N^^178^1^0^0^5^2^OTH PAY OTH PROV ID QUAL(1)^0^1^0"
^IBA(364.6,1184,0)="8^N^^178^1^0^0^6^30^OTH PAY OTH PROV ID(1)^0^1^0"
^IBA(364.6,1185,0)="8^N^^178^1^0^0^7^2^OTH PAY OTH PROV ID QUAL(2)^0^1^0"
^IBA(364.6,1186,0)="8^N^^178^1^0^0^8^30^OTH PAY OTH PROV ID(2)^0^1^0"
^IBA(364.6,1187,0)="8^N^^178^1^0^0^9^2^OTH PAY OTH PROV ID QUAL(3)^0^1^0"
^IBA(364.6,1188,0)="8^N^^178^1^0^0^10^30^OTH PAY OTH PROV ID(3)^0^1^0"
^IBA(364.6,1189,0)="8^N^^51^1^^0^1^4^RECORD ID 'CL1A'^^1^1"
^IBA(364.6,1190,0)="8^N^^28^1^^0^1^4^RECORD ID 'CI1A'^0^1^1"
^IBA(364.6,1191,0)="8^N^^28^1^^0^4^2^BILLING PROV SECONDARY ID Q(2)^0^1"
^IBA(364.6,1192,0)="8^N^^28^1^^0^5^20^BILLING PROV SECONDARY ID #(2)^0^1^0"
^IBA(364.6,1194,0)="8^N^^55^1^^0^11^11^PURCHASED NON-LAB CHARGES^0^1"
^IBA(364.6,1195,0)="8^N^^55^1^^0^13^2^PURCH SERV PRIM QUALIF^0^1"
^IBA(364.6,1196,0)="8^N^^55^1^^0^14^1^PURCH SERV ENTITY TYP QUALIF^0^1"
^IBA(364.6,1197,0)="8^N^^56^1^^0^1^4^RECORD ID 'SUB1'^0^1^1"
^IBA(364.6,1198,0)="8^N^^56^1^^0^3^20^PURCH SERV SECOND ID 1^0^1"
^IBA(364.6,1199,0)="8^N^^56^1^^0^4^2^PURCH SERV SECOND QUALIF 2^0^1"
^IBA(364.6,1200,0)="8^N^^56^1^^0^5^20^PURCH SERV SECOND ID 2^0^1"
^IBA(364.6,1201,0)="8^N^^56^1^^0^6^2^PURCH SERV SECOND QUALIF 3^0^1"
^IBA(364.6,1202,0)="8^N^^56^1^^0^7^20^PURCH SERV SECOND ID 3^0^1"
^IBA(364.6,1203,0)="8^N^^56^1^^0^8^2^PURCH SERV SECOND QUALIF 4^0^1"
^IBA(364.6,1204,0)="8^N^^56^1^^0^9^20^PURCH SERV SECOND ID 4^0^1"
^IBA(364.6,1205,0)="8^N^^56^1^^0^10^2^PURCH SERV SECOND QUALIF 5^0^1"
^IBA(364.6,1206,0)="8^N^^56^1^^0^11^20^PURCH SERV SECOND ID 5^0^1"
^IBA(364.6,1207,0)="8^N^^57^1^^0^1^4^RECORD ID 'SUB2'^0^1^1"
^IBA(364.6,1209,0)="8^N^^57^1^^0^8^20^SERV FAC SECONDARY ID 1^0^1"
^IBA(364.6,1210,0)="8^N^^57^1^^0^9^2^SERV FAC SECONDARY QUALIF 2^0^1"
^IBA(364.6,1211,0)="8^N^^57^1^^0^10^20^SERV FAC SECONDARY ID 2^0^1"
^IBA(364.6,1212,0)="8^N^^57^1^^0^11^2^SERV FAC SECONDARY QUALIF 3^0^1"
^IBA(364.6,1213,0)="8^N^^57^1^^0^12^20^SERV FAC SECONDARY ID 3^0^1"
^IBA(364.6,1214,0)="8^N^^57^1^^0^13^2^SERV FAC SECONDARY QUALIF 4^0^1"
^IBA(364.6,1215,0)="8^N^^57^1^^0^14^20^SERV FAC SECONDARY ID 4^0^1"
^IBA(364.6,1216,0)="8^N^^57^1^^0^15^2^SERV FAC SECONDARY QUALIF 5^0^1"
^IBA(364.6,1217,0)="8^N^^57^1^^0^16^20^SERV FAC SECONDARY ID 5^0^1"
^IBA(364.6,1218,0)="8^N^^101^1^^0^1^4^RECORD ID 'OPR5'^0^1^1"
^IBA(364.6,1219,0)="8^N^^104^1^^0^1^4^RECORD ID 'OPR8'^0^1^1"
^IBA(364.6,1220,0)="8^N^^99^1^^0^1^4^RECORD ID 'OPR3'^0^1^1"
^IBA(364.6,1221,0)="8^N^^98^1^^0^1^4^RECORD ID 'OPR2'^0^1^1"
^IBA(364.6,1222,0)="8^N^^97^1^^0^1^4^RECORD ID 'OPR1'^0^1^1"
^IBA(364.6,1223,0)="8^N^^96^1^0^0^1^4^RECORD ID 'OPR '^0^1^1"
^IBA(364.6,1224,0)="8^N^^98^1^^0^2^2^ATT/REND PROV SECOND QUALIF 1^0^1"
^IBA(364.6,1225,0)="8^N^^98^1^^0^3^30^ATT/REND PROV SECOND ID 1^0^1"
^IBA(364.6,1226,0)="8^N^^98^1^^0^4^2^ATT/REND PROV SECOND QUALIF 2^0^1"
^IBA(364.6,1227,0)="8^N^^98^1^^0^5^30^ATT/REND PROV SECOND ID 2^0^1"
^IBA(364.6,1228,0)="8^N^^98^1^^0^6^2^ATT/REND PROV SECOND QUALIF 3^0^1"
^IBA(364.6,1229,0)="8^N^^98^1^^0^7^30^ATT/REND PROV SECOND ID 3^0^1"
^IBA(364.6,1230,0)="8^N^^98^1^^0^8^2^ATT/REND PROV SECOND QUALIF 4^0^1"
^IBA(364.6,1231,0)="8^N^^98^1^^0^9^30^ATT/REND PROV SECOND ID 4^0^1"
^IBA(364.6,1232,0)="8^N^^98^1^^0^10^2^ATT/REND PROV SECOND QUALIF 5^0^1"
^IBA(364.6,1233,0)="8^N^^98^1^^0^11^30^ATT/REND PROV SECOND ID 5^0^1"
^IBA(364.6,1234,0)="8^N^^99^1^^0^2^2^OPER PHY SECONDARY QUALIF 1^0^1"
^IBA(364.6,1235,0)="8^N^^99^1^^0^3^30^OPER PHY SECONDARY ID 1^0^1"
^IBA(364.6,1236,0)="8^N^^99^1^^0^4^2^OPER PHY SECONDARY QUALIF 2^0^1"
^IBA(364.6,1237,0)="8^N^^99^1^^0^5^30^OPER PHY SECONDARY ID 2^0^1"
^IBA(364.6,1238,0)="8^N^^99^1^^0^6^2^OPER PHY SECONDARY QUALIF 3^0^1"
^IBA(364.6,1239,0)="8^N^^99^1^^0^7^30^OPER PHY SECONDARY ID 3^0^1"
^IBA(364.6,1240,0)="8^N^^99^1^^0^8^2^OPER PHY SECONDARY QUALIF 4^0^1"
^IBA(364.6,1241,0)="8^N^^99^1^^0^9^30^OPER PHY SECONDARY ID 4^0^1"
^IBA(364.6,1242,0)="8^N^^99^1^^0^10^2^OPER PHY SECONDARY QUALIF 5^0^1"
^IBA(364.6,1243,0)="8^N^^99^1^^0^11^30^OPER PHY SECONDARY ID 5^0^1"
^IBA(364.6,1244,0)="8^N^^100^1^^0^2^2^OTHER PROV SECOND QUALIF 1^^1"
^IBA(364.6,1245,0)="8^N^^100^1^^0^3^30^OTHER PROV SECOND ID 1^^1"
^IBA(364.6,1246,0)="8^N^^100^1^^0^4^2^OTHER PROV SECOND QUALIF 2^^1"
^IBA(364.6,1247,0)="8^N^^100^1^^0^5^30^OTHER PROV SECOND ID 2^^1"
^IBA(364.6,1248,0)="8^N^^100^1^^0^6^2^OTHER PROV SECOND QUALIF 3^^1"
^IBA(364.6,1249,0)="8^N^^100^1^^0^7^30^OTHER PROV SECOND ID 3^^1"
^IBA(364.6,1250,0)="8^N^^100^1^^0^8^2^OTHER PROV SECOND QUALIF 4^^1"
^IBA(364.6,1251,0)="8^N^^100^1^^0^9^30^OTHER PROV SECOND ID 4^^1"
^IBA(364.6,1252,0)="8^N^^100^1^^0^10^2^OTHER PROV SECOND QUALIF 5^^1"
^IBA(364.6,1253,0)="8^N^^100^1^^0^11^30^OTHER PROV SECOND ID 5^^1"
^IBA(364.6,1254,0)="8^N^^101^1^^0^2^2^REFERING PROV SECOND QUALIF 1^0^1^0"
^IBA(364.6,1255,0)="8^N^^101^1^^0^3^30^REFERING PROV SECOND ID 1^0^1"
^IBA(364.6,1256,0)="8^N^^101^1^^0^4^2^REFERING PROV SECOND QUALIF 2^0^1"
^IBA(364.6,1257,0)="8^N^^101^1^^0^5^30^REFERING PROV SECOND ID 2^0^1"
^IBA(364.6,1258,0)="8^N^^101^1^^0^6^2^REFERING PROV SECOND QUALIF 3^0^1"
^IBA(364.6,1259,0)="8^N^^101^1^^0^7^30^REFERING PROV SECOND ID 3^0^1"
^IBA(364.6,1260,0)="8^N^^101^1^^0^8^2^REFERING PROV SECOND QUALIF 4^0^1"
^IBA(364.6,1261,0)="8^N^^101^1^^0^9^30^REFERING PROV SECOND ID 4^0^1"
^IBA(364.6,1262,0)="8^N^^101^1^^0^10^2^REFERING PROV SECOND QUALIF 5^0^1"
^IBA(364.6,1263,0)="8^N^^101^1^^0^11^30^REFERING PROV SECOND ID 5^0^1"
^IBA(364.6,1277,0)="8^N^^104^1^^0^2^2^SUPERV PROV SECOND QUALIF 1^0^1"
^IBA(364.6,1278,0)="8^N^^104^1^^0^3^30^SUPERV PROV SECOND ID 1^0^1"
^IBA(364.6,1279,0)="8^N^^104^1^^0^4^2^SUPERV PROV SECOND QUALIF 2^0^1"
^IBA(364.6,1280,0)="8^N^^104^1^^0^5^30^SUPERV PROV SECOND ID 2^0^1"
^IBA(364.6,1281,0)="8^N^^104^1^^0^6^2^SUPERV PROV SECOND QUALIF 3^0^1"
^IBA(364.6,1282,0)="8^N^^104^1^^0^7^30^SUPERV PROV SECOND ID 3^0^1"
^IBA(364.6,1283,0)="8^N^^104^1^^0^8^2^SUPERV PROV SECOND QUALIF 4^0^1"
^IBA(364.6,1284,0)="8^N^^104^1^^0^9^30^SUPERV PROV SECOND ID 4^0^1"
^IBA(364.6,1285,0)="8^N^^104^1^^0^10^2^SUPERV PROV SECOND QUALIF 5^0^1"
^IBA(364.6,1286,0)="8^N^^104^1^^0^11^30^SUPERV PROV SECOND ID 5^0^1"
^IBA(364.6,1287,0)="8^N^^112^1^^0^1^4^RECORD ID 'OI4 '^0^1^1"
^IBA(364.6,1288,0)="8^N^^113^1^^0^1^4^RECORD ID 'OI5 '^0^1^1"
^IBA(364.6,1289,0)="8^N^^113^1^^0^4^45^OTH INS SUBSCR ADDRESS LINE 1^0^1"
^IBA(364.6,1290,0)="8^N^^113^1^^0^5^40^OTH INS SUBSCR ADDRESS LINE 2^0^1"
^IBA(364.6,1291,0)="8^N^^113^1^^0^6^30^OTH INS SUBSCR CITY^0^1"
^IBA(364.6,1292,0)="8^N^^113^1^^0^7^2^OTH INS SUBSCR STATE^0^1"
^IBA(364.6,1293,0)="8^N^^113^1^^0^8^10^OTH INS SUBSCR ZIP^0^1"
^IBA(364.6,1294,0)="8^N^^113^1^^0^9^2^OTH INS SUBSCR QUALIF 1^0^1"
^IBA(364.6,1295,0)="8^N^^113^1^^0^10^30^OTH INS SUBSCR ID 1^0^1"
^IBA(364.6,1296,0)="8^N^^113^1^^0^11^2^OTH INS SUBSCR QUALIF 2^0^1"
^IBA(364.6,1297,0)="8^N^^113^1^^0^12^30^OTH INS SUBSCR ID 2^0^1"
^IBA(364.6,1298,0)="8^N^^113^1^^0^13^2^OTH INS SUBSCR QUALIF 3^0^1"
^IBA(364.6,1299,0)="8^N^^113^1^^0^14^30^OTH INS SUBSCR ID 3^0^1"
^IBA(364.6,1300,0)="8^N^^100^1^0^0^1^4^RECORD ID 'OPR4'^^1^1"
^IBA(364.6,1301,0)="8^N^^177^1^^0^2^1^SUPERV PROV COB SEQUENCE^0^1"
^IBA(364.6,1303,0)="8^N^^170^1^^0^2^1^ATT/REND PROV COB SEQUENCE^0^1"
^IBA(364.6,1304,0)="8^N^^171^1^^0^2^1^OPERATING PROV COB SEQUENCE^0^1^0"
^IBA(364.6,1305,0)="8^N^^172^1^^0^2^1^FACILITY PROV COB SEQUENCE^0^1"
^IBA(364.6,1306,0)="8^N^^173^1^^0^2^1^REFERRING PROV COB SEQUENCE^0^1"
^IBA(364.6,1308,0)="8^N^^175^1^^0^2^1^PURCHASE PROV COB SEQUENCE^0^1"
^IBA(364.6,1309,0)="8^N^^176^1^^0^2^1^SERV FAC COB SEQUENCE^0^1"
^IBA(364.6,1310,0)="8^N^^178^1^^0^2^1^OTHER PROV COB SEQUENCE^0^1"
^IBA(364.6,1311,0)="8^N^^111^1^^0^2^1^OTH PAYER INSURANCE SEQUENCE^0^1^0"
^IBA(364.6,1312,0)="8^N^^112^1^^0^2^1^OTHER INSURANCE SEQUENCE^^1"
^IBA(364.6,1313,0)="8^N^^113^1^^0^2^1^OTHER INSURANCE SEQUENCE^^1"
^IBA(364.6,1314,0)="8^N^^111^1^3^0^3^2^OTH PAYER PAT NAME QUAL^0^1^0"
^IBA(364.6,1315,0)="8^N^^20^1^1^0^9^2^CURRENT INSURANCE CO INS TYPE^0^1"
^IBA(364.6,1316,0)="8^N^^20^1^^0^7^20^CURRENT INS CO PROVIDER NUMBER^0^1"
^IBA(364.6,1317,0)="8^N^^20^1^1^^13^2^FILLER^0^1"
^IBA(364.6,1318,0)="8^N^^97^1^^0^14^1^REFERRING PERSON/NON-PERSON^0^1"
^IBA(364.6,1319,0)="8^N^^97^1^^0^15^1^OPERATING PERSON/NON-PERSON^0^1^0"
^IBA(364.6,1320,0)="8^N^^113^1^^0^99.9^1^CLEAN UP OI5^1^1"
^IBA(364.6,1321,0)="8^N^^20^1^1^0^14^1^PAYER SEQUENCE^0^1^0"
^IBA(364.6,1322,0)="8^N^^20^1^1^0^15^1^MRA SECONDARY INDICATOR^0^1^0"
^IBA(364.6,1323,0)="8^N^^104.5^1^^0^1^4^RECORD ID 'NPI '^0^1^1"
^IBA(364.6,1324,0)="8^N^^104.5^1^^0^2^10^ATTEND/RENDER PHY NPI CODE^0^1^0"
^IBA(364.6,1325,0)="8^N^^104.5^1^^0^3^10^ATTEND/RENDER PHY TAXONOMY^0^1^0"
^IBA(364.6,1326,0)="8^N^^104.5^1^^0^4^10^OTHER PROV NPI CODE^0^1^0"
^IBA(364.6,1327,0)="8^N^^104.5^1^^0^5^10^OTHER PROV TAXONOMY^0^1^0"
^IBA(364.6,1328,0)="8^N^^104.5^1^^0^6^10^OPERATING PHY NPI CODE^0^1^0"
^IBA(364.6,1329,0)="8^N^^104.5^1^^0^7^10^OPERATING PHY TAXONOMY^0^1^0"
^IBA(364.6,1330,0)="8^N^^104.5^1^^0^8^10^SUPERVISING PROV NPI CODE^0^1^0"
^IBA(364.6,1331,0)="8^N^^104.5^1^^0^9^10^SUPERVISING PROV TAXONOMY^0^1^0"
^IBA(364.6,1332,0)="8^N^^104.5^1^^0^10^10^REFERRING PROV NPI CODE^0^1^0"
^IBA(364.6,1333,0)="8^N^^104.5^1^^0^11^10^REFERRING PROV TAXONOMY^0^1^0"
^IBA(364.6,1334,0)="8^N^^104.5^1^^0^12^10^BILLING PROV NPI CODE^0^1^0"
^IBA(364.6,1335,0)="8^N^^104.5^1^^0^13^10^BILLING PROV TAXONOMY^0^1^0"
^IBA(364.6,1336,0)="8^N^^104.5^1^^0^14^10^PURCHASED SVC PROV NPI CODE^0^1^0"
^IBA(364.6,1337,0)="8^N^^104.5^1^^0^15^10^PURCHASED SVC PROV TAXONOMY^0^1^0"
^IBA(364.6,1338,0)="8^N^^104.5^1^^0^16^10^SVC FACILITY PROV NPI CODE^0^1^0"
^IBA(364.6,1339,0)="8^N^^104.5^1^^0^17^10^SVC FACILITY PROV TAXONOMY^0^1^0"
^IBA(364.6,1400,0)="2^N^^1^1^^1^1^78^PRINT STATUS (1500 TOP LINE)^0"
^IBA(364.6,1401,0)="2^N^^1^2^^1^1^78^MAILING ADDRESS NM (FORM LN 2)^0"
^IBA(364.6,1402,0)="2^N^^1^3^4^1^1^78^MAILING ADDR FULL (FORM LN 3)"
^IBA(364.6,1403,0)="2^N^^1^9^^1^1^45^CHECK BOX FOR BILL TYPE (BX-1)"
^IBA(364.6,1404,0)="2^N^^1^9^^1^50^29^INSURED ID # (BX-1A)"
^IBA(364.6,1405,0)="2^N^^1^11^^1^1^28^PATIENT NAME (BX-2)"
^IBA(364.6,1406,0)="2^N^^1^11^^1^31^10^PATIENT DOB (BX-3/1)"
^IBA(364.6,1407,0)="2^N^^1^11^^1^42^1^PATIENT SEX=MALE (BX-3/2A)"
^IBA(364.6,1408,0)="2^N^^1^11^^1^47^1^PATIENT SEX=FEMALE (BX-3/2B)"
^IBA(364.6,1409,0)="2^N^^1^11^^1^49.9^80^CURR INSURED DEMOG EXTRACT^1"
^IBA(364.6,1410,0)="2^N^^1^11^^1^50^29^INSURED'S NAME (BX-4)"
^IBA(364.6,1411,0)="2^N^^1^13^^1^1^28^PATIENT STR ADDRESS (BX-5/1)"
^IBA(364.6,1412,0)="2^N^^1^13^^1^33^1^PT REL TO INSURED=SELF (BX-6)"
^IBA(364.6,1413,0)="2^N^^1^13^^1^38^1^PT REL TO INSRD=SPOUSE (BX-6)"
^IBA(364.6,1414,0)="2^N^^1^13^^1^42^1^PT REL TO INSRD=CHILD (BX-6)"
^IBA(364.6,1415,0)="2^N^^1^13^^1^47^1^PT REL TO INSRD=OTHER (BX-6)"
^IBA(364.6,1416,0)="2^N^^1^13^^1^49.9^72^CURR INSURED'S FULL ADDR EXTR^1"
^IBA(364.6,1417,0)="2^N^^1^13^^1^50^29^INSURED STR ADDRESS (BX-7/1)"
^IBA(364.6,1418,0)="2^N^^1^15^^1^1^24^PATIENT CITY ADDRESS (BX-5/2A)"
^IBA(364.6,1419,0)="2^N^^1^15^^1^26^2^PATIENT STATE (BX-5/2B)"
^IBA(364.6,1420,0)="2^N^^1^15^^1^35^1^PT MARITAL STAT=SINGL (BX-8/A)"
^IBA(364.6,1421,0)="2^N^^1^15^^1^41^1^PT MARITAL STAT=MARRD (BX-8/B)"
^IBA(364.6,1422,0)="2^N^^1^15^^1^47^1^PT MARITAL STAT=OTHER (BX-8/C)"
^IBA(364.6,1423,0)="2^N^^1^15^^1^50^23^INSURED'S CITY (BX-7/2A)^0"
^IBA(364.6,1424,0)="2^N^^1^15^^1^74^2^INSURED'S STATE (BX-7/2B)^0"
^IBA(364.6,1425,0)="2^N^^1^17^^1^1^12^PATIENT ZIP CODE (BX-5/3A)"
^IBA(364.6,1426,0)="2^N^^1^17^^1^15^14^PATIENT TELEPHONE (BX-5/3B)"
^IBA(364.6,1427,0)="2^N^^1^17^^1^35^1^PT EMPL STAT=EMPLOYD (BX-8/2A)"
^IBA(364.6,1428,0)="2^N^^1^17^^1^50^12^INSURED'S ZIP CODE (BX-7/3A)^0"
^IBA(364.6,1429,0)="2^N^^1^17^^1^65^14^INSURED'S PHONE (BX-7/3B)^0"
^IBA(364.6,1430,0)="2^N^^1^19^^1^1^28^OTH INSURED NAME (BX-9/1)"
^IBA(364.6,1431,0)="2^N^^1^19^^1^50^29^INSURED POLICY GROUP (BX-11)"
^IBA(364.6,1432,0)="2^N^^1^21^^1^1^28^OTH INSURED POLICY # (BX-9A)"
^IBA(364.6,1433,0)="2^N^^1^21^^1^35^1^COND REL TO EMP=YES (BX-10A/A)"
^IBA(364.6,1434,0)="2^N^^1^21^^1^41^1^COND REL TO EMP=NO (BX-10A/B)"
^IBA(364.6,1435,0)="2^N^^1^21^^1^53^10^INSUREDS DOB (BX-11A/1)"
^IBA(364.6,1436,0)="2^N^^1^21^^1^68^1^INSUREDS SEX=MALE (BX-11A/2A)"
^IBA(364.6,1437,0)="2^N^^1^21^^1^75^1^INSURED SEX=FEMALE (BX-11A/2B)"
^IBA(364.6,1438,0)="2^N^^1^23^^1^2^10^OTH INSURED DOB (BX-9B/1)"
^IBA(364.6,1439,0)="2^N^^1^23^^1^18^1^OTH INS SEX=MALE (BX-9B/2A)"
^IBA(364.6,1440,0)="2^N^^1^23^^1^24^1^OTH INS SEX=FEMALE (BX-9B/2B)"
^IBA(364.6,1441,0)="2^N^^1^23^^1^35^1^COND REL AUTO=YES (BX-10B/A)"
^IBA(364.6,1442,0)="2^N^^1^23^^1^41^1^COND REL AUTO=NO (BX-10B/B)"
^IBA(364.6,1443,0)="2^N^^1^23^^1^45^2^AUTO ACCIDENT STATE (BX-10B/C)"
^IBA(364.6,1444,0)="2^N^^1^23^^1^50^29^INSURED EMPLOYR NAME (BX-11B)"
^IBA(364.6,1445,0)="2^N^^1^25^^1^1^28^OTH INS EMPLR (BX-9C)"
^IBA(364.6,1446,0)="2^N^^1^25^^1^35^1^COND REL TO OTH=YES (BX-10C/A)"
^IBA(364.6,1447,0)="2^N^^1^25^^1^41^1^COND REL TO OTH=NO (BX-10C/B)"
^IBA(364.6,1448,0)="2^N^^1^25^^1^50^29^INSUREDS PLAN NAME (BX-11C)"
^IBA(364.6,1449,0)="2^N^^1^27^^1^1^28^OTH INS PLAN NAME (BX-9D)"
^IBA(364.6,1450,0)="2^N^^1^27^^1^30^19^BOX 10D CMS-1500"
^IBA(364.6,1451,0)="2^N^^1^27^^1^52^1^ANOTHER PLAN=YES (BX-11D/A)"
^IBA(364.6,1452,0)="2^N^^1^27^^1^57^1^ANOTHER PLAN=NO (BX-11D/B)"
^IBA(364.6,1453,0)="2^N^^1^30^^1^4^45^RELEASE OF INFO SIG (12A)"
^IBA(364.6,1454,0)="2^N^^1^30^^1^53^26^ASSIGN OF BENEFITS SIG (13A)"
^IBA(364.6,1455,0)="2^N^^1^31^^1^6^25^PATIENT SIGNATURE (BX-12)"
^IBA(364.6,1456,0)="2^N^^1^31^^1^36^13^PATIENT SIGNATURE DT (BX-12/2)"
^IBA(364.6,1457,0)="2^N^^1^31^^1^56^23^INSUREDS SIGNATURE (BX-13)"
^IBA(364.6,1458,0)="2^N^^1^33^^1^2^10^DATE OF CURR ILLNESS (BX-14)"
^IBA(364.6,1459,0)="2^N^^1^33^^1^37^10^DATE OF SIMLAR ILLNESS (BX-15)"
^IBA(364.6,1460,0)="2^N^^1^33^^1^54^10^DT UNABLE TO WRK FR (BX-16/1)"
^IBA(364.6,1461,0)="2^N^^1^33^^1^68^10^DT UNABLE TO WRK TO (BX-16/2)"
^IBA(364.6,1462,0)="2^N^^1^34^^1^30^2^REF PROV OTH ID QUAL (17A/1)^0"
^IBA(364.6,1463,0)="2^N^^1^34^^1^33^16^REF PROV OTH ID# (BX 17A/2)^0"
^IBA(364.6,1464,0)="2^N^^1^35^^1^1^26^REFERRING PROV NAME (BX 17)"
^IBA(364.6,1465,0)="2^N^^1^35^^1^33^16^REFERRING PROV NPI# (BX 17B)"
^IBA(364.6,1466,0)="2^N^^1^35^^1^54^10^HOSP FROM DATE (BX-18/1)"
^IBA(364.6,1467,0)="2^N^^1^35^^1^68^10^HOSP TO DATE (BX-18/2)"
^IBA(364.6,1468,0)="2^N^^1^36^^1^1^48^UPPER LINE 1500 (BX-19)"
^IBA(364.6,1469,0)="2^N^^1^37^^1^1^48^LOWER LINE - 1500 (BX-19)"
^IBA(364.6,1470,0)="2^N^^1^37^^1^52^1^OUTSIDE LAB? YES (BX-20)"
^IBA(364.6,1471,0)="2^N^^1^37^^1^61^9^LAB CHARGES (BX-20/B)"
^IBA(364.6,1472,0)="2^N^^1^37^^1^70^9^PURCH SVC CHARGES (BX-20/C)"
^IBA(364.6,1473,0)="2^N^^1^39^^1^3^8^DIAGNOSIS CODE 1 (BX-21.1)"
^IBA(364.6,1474,0)="2^N^^1^39^^1^30^8^DIAGNOSIS CODE 3 (BX-21.3)"
^IBA(364.6,1475,0)="2^N^^1^39^^1^50^11^MEDICAID RESUB CODE (BX-22/A)"
^IBA(364.6,1476,0)="2^N^^1^39^^1^62^17^ORIGINAL REF NO (BX-22/B)"
^IBA(364.6,1477,0)="2^N^^1^41^^1^3^8^DIAGNOSIS CODE 2 (BX-21.2)"
^IBA(364.6,1478,0)="2^N^^1^41^^1^30^8^DIAGNOSIS CODE 4 (BX-21.4)"
^IBA(364.6,1479,0)="2^N^^1^41^^1^50^29^PRIOR AUTH NUMBER (BX-23)"
^IBA(364.6,1480,0)="2^N^^1^44^^1^.5^^SERVICE LN EXTRACT - CMS 1500^1"
^IBA(364.6,1481,0)="2^N^^1^44^^1^1^9^DATE OF SERV FR (BX-24A/A)"
^IBA(364.6,1482,0)="2^N^^1^44^^1^10^9^DATE OF SERV TO (BX-24A/B)"
^IBA(364.6,1483,0)="2^N^^1^44^^1^19^3^PLACE OF SERVICE (BX-24B)"
^IBA(364.6,1484,0)="2^N^^1^44^^1^22^3^EMG (BX-24C)"
^IBA(364.6,1485,0)="2^N^^1^44^^1^25^20^PROCEDURE (BX-24D/1)"
^IBA(364.6,1486,0)="2^N^^1^44^^1^45^4^DIAGNOSIS POINTER (BX-24E)"
^IBA(364.6,1487,0)="2^N^^1^44^^1^49^9^CHARGES (BX-24F)"
^IBA(364.6,1488,0)="2^N^^1^44^^1^58^4^UNITS (BX-24G)"
^IBA(364.6,1489,0)="2^N^^1^44^^1^63^1^EPSDT FAMILY PLAN (BX-24H)"
^IBA(364.6,1490,0)="2^N^^1^44^^1^65^2^ID QUALIFER (BX-24I)"
^IBA(364.6,1491,0)="2^N^^1^44^^1^68^11^RENDERING PROVIDER ID (BX-24J)"
^IBA(364.6,1492,0)="2^N^^1^56^^1^1^^CLEAN UP IBXSAVE^1"
^IBA(364.6,1493,0)="2^N^^1^57^^1^1^15^FED TAX ID # (BX-25/1)"
^IBA(364.6,1494,0)="2^N^^1^57^^1^19^1^ID NUMBER=EIN (BX-25/2B)"
^IBA(364.6,1495,0)="2^N^^1^57^^1^23^14^PATIENT ACCT NUMBER (BX-26)"
^IBA(364.6,1496,0)="2^N^^1^57^^1^38^6^ACCEPT ASSIGNMENT (BX-27)"
^IBA(364.6,1497,0)="2^N^^1^57^^1^51^9^TOTAL CHARGE (BX-28)"
^IBA(364.6,1498,0)="2^N^^1^57^^1^62^8^TOTAL PRIOR PAYMENTS (BX-29)"
^IBA(364.6,1499,0)="2^N^^1^57^^1^71^8^TOT CHRG-PRIOR PYMNTS (BX-30)"
^IBA(364.6,1500,0)="2^N^^1^58^^1^66^13^BILL PROV PHONE# (BX-33/LN 1)"
^IBA(364.6,1501,0)="2^N^^1^59^^1^23^26^FACILITY NAME (BX-32/LINE 1)"
^IBA(364.6,1502,0)="2^N^^1^59^^1^50^29^AGENT CASHIER NM (BX-33/LN 1)"
^IBA(364.6,1503,0)="2^N^^1^60^^1^1^21^BLOCK 31 CHR 1-21 (BX-31/LN1)"
^IBA(364.6,1506,0)="2^N^^1^60^^1^23^26^FAC ADR LINE 1 (BX-32/LN 2)"
^IBA(364.6,1507,0)="2^N^^1^60^^1^50^29^BILL PROV ADDR LN1 (BX-33/LN3)"
^IBA(364.6,1508,0)="2^N^^1^61^^1^1^21^BLOCK 31 CHR 22-42 (BX-31/LN2)"
^IBA(364.6,1509,0)="2^N^^1^61^^1^23^26^FAC CITY/ST/ZIP (BX-32/LN 3)"
^IBA(364.6,1510,0)="2^N^^1^61^^1^49.7^^AGENT CASHIER CITY EXTRACT^1"
^IBA(364.6,1511,0)="2^N^^1^61^^1^49.8^^AGENT CASHIER STATE EXTRACT^1"
^IBA(364.6,1512,0)="2^N^^1^61^^1^49.9^^AGENT CASHIER ZIP EXTRACT^1"
^IBA(364.6,1513,0)="2^N^^1^61^^1^50^29^AG CA CITY/ST/ZIP (BX-33/LN 3)"
^IBA(364.6,1514,0)="2^N^^1^62^^1^1^21^BLOCK 31 CHR 43-63 (BX-31/LN3)"
^IBA(364.6,1515,0)="2^N^^1^62^^1^24^10^SERVICE FAC NPI (BX-32A)"
^IBA(364.6,1516,0)="2^N^^1^62^^1^35^14^SERV FAC OTH ID# (BX-32B)"
^IBA(364.6,1517,0)="2^N^^1^62^^1^51^10^BILLING PROVIDER NPI (BX-33A)"
^IBA(364.6,1518,0)="2^N^^1^62^^1^62^17^BILLING PROV OTH ID# (BX-33B)"
^IBA(364.6,1519,0)="2^N^^1^63^^0^1.9^^MULTIPLE PAGE CHECK/POPULATE^1"
^IBA(364.6,1520,0)="2^N^^1^37^^1^57^1^OUTSIDE LAB? NO (BX-20)"
^IBA(364.6,1550,0)="3^N^^1^1^^1^.9^^UB-04 PRE-FORM HOUSEKEEPING^1"
^IBA(364.6,1551,0)="3^N^^1^1^^1^35^35^PRINT STAT (UB-04 TOP LINE)"
^IBA(364.6,1552,0)="3^N^^1^2^^1^2^24^BILLING PROVIDER NAME (FL-1/1)"
^IBA(364.6,1553,0)="3^N^^1^3^^1^1^25^BILLING PROVIDER ADDR (FL-1/2)"
^IBA(364.6,1554,0)="3^N^^1^4^^1^1^12^BILL PROVIDER CITY (FL-1/3/1)"
^IBA(364.6,1555,0)="3^N^^1^4^^1^14^2^BILL PROVIDER STATE (FL-1/3/2)"
^IBA(364.6,1556,0)="3^N^^1^4^^1^17^9^BILL PROVIDER ZIP (FL-1/3/3)"
^IBA(364.6,1557,0)="3^N^^1^5^^1^1^10^BILL PROVIDER PHONE (FL-1/4/1)"
^IBA(364.6,1558,0)="3^N^^1^5^^1^13^10^BILL PROVIDER FAX (FL-1/4/2)"
^IBA(364.6,1559,0)="3^N^^1^5^^1^24^2^BILL PROV COUNTRY (FL-1/4/3)"
^IBA(364.6,1560,0)="3^N^^1^2^^1^27^24^PAY-TO FACILITY NAME (FL-2/1)"
^IBA(364.6,1561,0)="3^N^^1^3^^1^26^25^AGENT CASHIER ADDRESS (FL-2/2)"
^IBA(364.6,1562,0)="3^N^^1^4^^1^26^16^AGENT CASHIER CITY (FL-2/3/1)"
^IBA(364.6,1563,0)="3^N^^1^4^^1^43^2^AGENT CASHIER STATE (FL-2/3/2)"
^IBA(364.6,1564,0)="3^N^^1^4^^1^46^5^AGENT CASHIER ZIP (FL-2/3/3)"
^IBA(364.6,1565,0)="3^N^^1^58^^1^1^7^PRIN PROCEDURE CODE (FL-74/1)"
^IBA(364.6,1566,0)="3^N^^1^5^^1^26^25^NOT USED (FL-2/4)"
^IBA(364.6,1567,0)="3^N^^1^2^^1^54^20^PATIENT CONTROL NUMBER (FL-3A)"
^IBA(364.6,1568,0)="3^N^^1^3^^1^54^24^MEDICAL RECORD NUMBER (FL-3B)"
^IBA(364.6,1569,0)="3^N^^1^3^^1^78^4^TYPE OF BILL (FL-4)"
^IBA(364.6,1570,0)="3^N^^1^4^^1^57^4^UPPER FORM LOCATOR 5"
^IBA(364.6,1571,0)="3^N^^1^5^^1^51^10^FED TAX ID # (FL-5/2)"
^IBA(364.6,1572,0)="3^N^^1^5^^1^62^6^STATEMENT FROM DATE (FL-6A)"
^IBA(364.6,1573,0)="3^N^^1^5^^1^69^6^STATEMENT THRU DATE (FL-6B)"
^IBA(364.6,1574,0)="3^N^^1^4^^1^76^7^NOT USED (FL-7/1)"
^IBA(364.6,1575,0)="3^N^^1^5^^1^75^8^NOT USED (FL-7/2)"
^IBA(364.6,1576,0)="3^N^^1^6^^1^12^19^PATIENT ID (FL-8A)^0"
^IBA(364.6,1577,0)="3^N^^1^7^^1^2^29^PATIENT NAME (FL-8B)^0"
^IBA(364.6,1578,0)="3^N^^1^6^^1^42^40^PATIENT ADDR. - STREET (FL-9A)^0"
^IBA(364.6,1579,0)="3^N^^1^7^^1^32^30^PATIENT ADDR. - CITY (FL-9B)^0"
^IBA(364.6,1580,0)="3^N^^1^7^^1^65^2^PATIENT ADDR. - STATE (FL-9C)^0"
^IBA(364.6,1581,0)="3^N^^1^7^^1^69^10^PATIENT ADDR. - ZIP (FL-9D)^0"
^IBA(364.6,1582,0)="3^N^^1^11^^1^1^3^OCCURRENCE CODE (FL-31/1)"
^IBA(364.6,1583,0)="3^N^^1^11^^1^5^6^OCCURRENCE DATE (FL-31/2)"
^IBA(364.6,1584,0)="3^N^^1^11^^1^11^3^OCCURRENCE CODE (FL-32/1)"
^IBA(364.6,1585,0)="3^N^^1^11^^1^15^6^OCCURRENCE DATE (FL-32/2)"
^IBA(364.6,1586,0)="3^N^^1^11^^1^21^3^OCCURRENCE CODE (FL-33/1)"
^IBA(364.6,1587,0)="3^N^^1^11^^1^25^6^OCCURRENCE DATE (FL-33/2)"
^IBA(364.6,1588,0)="3^N^^1^11^^1^31^3^OCCURRENCE CODE (FL-34/1)"
^IBA(364.6,1589,0)="3^N^^1^11^^1^35^6^OCCURRENCE DATE (FL-34/2)"
^IBA(364.6,1590,0)="3^N^^1^11^^1^41^3^OCCURRENCE SPAN CODE (FL-35/1)"
^IBA(364.6,1591,0)="3^N^^1^11^^1^45^6^OCC SPAN DATE FROM (FL-35/2)"
^IBA(364.6,1592,0)="3^N^^1^11^^1^52^6^OCC SPAN DATE TO (FL-35/3)"
^IBA(364.6,1593,0)="3^N^^1^7^^1^80^3^PATIENT ADDR. - CNTRY (FL-9E)^0"
^IBA(364.6,1594,0)="3^N^^1^11^^1^58^3^OCCURRENCE SPAN CODE (FL-36/1)"
^IBA(364.6,1595,0)="3^N^^1^11^^1^62^6^OCC SPAN DATE FROM (FL-36/2)"
^IBA(364.6,1596,0)="3^N^^1^11^^1^69^6^OCC SPAN DATE TO (FL-36/3)"
^IBA(364.6,1597,0)="3^N^^1^55^^1^1^1^ICD VERSION INDICATOR (FL-66)"
^IBA(364.6,1598,0)="3^N^^1^54^^1^2^7^PRIN DIAG CODE (FL-67/1/1)"
^IBA(364.6,1599,0)="3^N^^1^65^^1^1^^CHECK FOR MULTIPLE PAGES^1"
^IBA(364.6,1600,0)="3^N^^1^11^^1^75^8^NOT USED (FL-37/1)"
^IBA(364.6,1601,0)="3^N^^1^12^^1^75^8^NOT USED (FL-37/2)"
^IBA(364.6,1602,0)="3^N^^1^55^^1^10^7^OTHER DIAG CODE 10(FL-67J/1/1)"
^IBA(364.6,1603,0)="3^N^^1^9^^1^1^8^PATIENT DOB (FL-10)^0"
^IBA(364.6,1604,0)="3^N^^1^9^^1^10^1^PATIENT SEX (FL-11)^0"
^IBA(364.6,1605,0)="3^N^^1^9^^1^13^6^ADMISSION DATE (FL-12)^0"
^IBA(364.6,1606,0)="3^N^^1^9^^1^19^2^ADMISSION HR (FL-13)^0"
^IBA(364.6,1607,0)="3^N^^1^9^^1^22^1^ADMISSION TYPE (FL-14)"
^IBA(364.6,1608,0)="3^N^^1^9^^1^25^1^ADMISSION SOURCE (FL-15)^0"
^IBA(364.6,1609,0)="3^N^^1^9^^1^28^2^DISCHARGE HR (FL-16)^0"
^IBA(364.6,1610,0)="3^N^^1^9^^1^31^3^PATIENT STATUS (FL-17)"
^IBA(364.6,1611,0)="3^N^^1^13^^1^.5^^CURRENT PAYER NAME EXTRACT^1"
^IBA(364.6,1612,0)="3^N^^1^13^^1^.7^^CURRENT PAYER ADDRESS EXTRACT^1"
^IBA(364.6,1613,0)="3^N^^1^13^5^1^1^42^CURR PAYER NAME/ADDR (FL-38)"
^IBA(364.6,1614,0)="3^N^^1^55^^1^18^7^OTHER DIAG CODE 11(FL-67K/1/1)"
^IBA(364.6,1615,0)="3^N^^1^55^^1^26^7^OTHER DIAG CODE 12(FL-67L/1/1)"
^IBA(364.6,1616,0)="3^N^^1^14^^1^40^^VALUE CODE EXTRACT (FL-39:41)^1"
^IBA(364.6,1617,0)="3^N^^1^14^^1^41^^VALUE CODE SORT (FL-39:41)^1"
^IBA(364.6,1618,0)="3^N^^1^14^^1^42^^VALUE CODE REBUILD (FL-39:41)^1"
^IBA(364.6,1619,0)="3^N^^1^14^^1^44^3^VALUE CODES CD 1 (FL-39a:d/1)"
^IBA(364.6,1620,0)="3^N^^1^14^^1^47^10^VALUE CODES AMT 1 (FL-39a:d/2)"
^IBA(364.6,1621,0)="3^N^^1^14^^1^57^3^VALUE CODES CD 2 (FL-40a:d/1)"
^IBA(364.6,1622,0)="3^N^^1^14^^1^60^10^VALUE CODES AMT 2 (FL-40a:d/2)"
^IBA(364.6,1623,0)="3^N^^1^14^^1^70^3^VALUE CODES CD 3 (FL-41a:d/1)"
^IBA(364.6,1624,0)="3^N^^1^14^^1^73^10^VALUE CODES AMT 3 (FL-41a:d/2)"
^IBA(364.6,1625,0)="3^N^^1^9^^1^34^3^CONDITION CODE 1 (FL-18)^0"
^IBA(364.6,1626,0)="3^N^^1^9^^1^33.8^^EXTRACT CONDITION CODES^1"
^IBA(364.6,1627,0)="3^N^^1^9^^1^37^3^CONDITION CODE 2 (FL-19)^0"
^IBA(364.6,1628,0)="3^N^^1^9^^1^40^3^CONDITION CODE 3 (FL-20)^0"
^IBA(364.6,1629,0)="3^N^^1^9^^1^43^3^CONDITION CODE 4 (FL-21)^0"
^IBA(364.6,1630,0)="3^N^^1^9^^1^46^3^CONDITION CODE 5 (FL-22)^0"
^IBA(364.6,1631,0)="3^N^^1^9^^1^49^3^CONDITION CODE 6 (FL-23)^0"
^IBA(364.6,1632,0)="3^N^^1^9^^1^52^3^CONDITION CODE 7 (FL-24)^0"
^IBA(364.6,1633,0)="3^N^^1^9^^1^55^3^CONDITION CODE 8 (FL-25)^0"
^IBA(364.6,1634,0)="3^N^^1^9^^1^58^3^CONDITION CODE 9 (FL-26)^0"
^IBA(364.6,1635,0)="3^N^^1^9^^1^61^3^CONDITION CODE 10 (FL-27)^0"
^IBA(364.6,1636,0)="3^N^^1^9^^1^64^3^CONDITION CODE 11 (FL-28)^0"
^IBA(364.6,1637,0)="3^N^^1^9^^1^67^3^ACCIDENT STATE (FL-29)^0"
^IBA(364.6,1638,0)="3^N^^1^9^^1^70^13^RESERVED (FL-30/2)^0"
^IBA(364.6,1639,0)="3^N^^1^42^^1^68^15^BILLING PROVIDER NPI (FL-56)^0"
^IBA(364.6,1640,0)="3^N^^1^43^^1^1^23^PAYER NAME (FL-50A:C)^0"
^IBA(364.6,1641,0)="3^N^^1^43^^1^24^15^HEALTH PLAN ID (FL-51A:C)^0"
^IBA(364.6,1642,0)="3^N^^1^43^^1^39^2^RELEASE OF INFO (FL-52A:C)^0"
^IBA(364.6,1643,0)="3^N^^1^43^^1^42^2^ASSIGN OF BENEFITS (FL-53A:C)^0"
^IBA(364.6,1644,0)="3^N^^1^43^^1^44^10^PRIOR PAYMENTS (FL-54A:C)^0"
^IBA(364.6,1645,0)="3^N^^1^43^^1^54^11^EST AMOUNT DUE (FL-55A:C)^0"
^IBA(364.6,1646,0)="3^N^^1^54^^1^10^7^OTHER DIAG CODE 1 (FL-67A/1/1)"
^IBA(364.6,1647,0)="3^N^^1^54^^1^18^7^OTHER DIAG CODE 2 (FL-67B/1/1)"
^IBA(364.6,1648,0)="3^N^^1^54^^1^26^7^OTHER DIAG CODE 3 (FL-67C/1/1)"
^IBA(364.6,1649,0)="3^N^^1^54^^1^34^7^OTHER DIAG CODE 4 (FL-67D/1/1)"
^IBA(364.6,1650,0)="3^N^^1^54^^1^42^7^OTHER DIAG CODE 5 (FL-67E/1/1)"
^IBA(364.6,1651,0)="3^N^^1^54^^1^50^7^OTHER DIAG CODE 6 (FL-67F/1/1)"
^IBA(364.6,1652,0)="3^N^^1^54^^1^58^7^OTHER DIAG CODE 7 (FL-67G/1/1)"
^IBA(364.6,1653,0)="3^N^^1^54^^1^66^7^OTHER DIAG CODE 8 (FL-67H/1/1)"
^IBA(364.6,1654,0)="3^N^^1^55^^1^2^7^OTHER DIAG CODE 9 (FL-67I/1/1)"
^IBA(364.6,1655,0)="3^N^^1^55^^1^34^7^OTHER DIAG CODE 13(FL-67M/1/1)"
^IBA(364.6,1656,0)="3^N^^1^55^^1^42^7^OTHER DIAG CODE 14(FL-67N/1/1)"
^IBA(364.6,1657,0)="3^N^^1^55^^1^50^7^OTHER DIAG CODE 15(FL-67O/1/1)"
^IBA(364.6,1658,0)="3^N^^1^55^^1^58^7^OTHER DIAG CODE 16(FL-67P/1/1)"
^IBA(364.6,1659,0)="3^N^^1^55^^1^66^7^OTHER DIAG CODE 17(FL-67Q/1/1)"
^IBA(364.6,1660,0)="3^N^^1^43^^1^68^15^OTHER PRV ID (FL-57A:C)^0"
^IBA(364.6,1661,0)="3^N^^1^47^^1^1^26^INSUREDS NAME (FL-58A:C)^0"
^IBA(364.6,1662,0)="3^N^^1^47^^1^27^3^PATIENT RELATION (FL-59A:C)"
^IBA(364.6,1663,0)="3^N^^1^47^^1^30^20^INSUREDS UNIQUE ID (FL-60A:C)^0"
^IBA(364.6,1664,0)="3^N^^1^47^^1^50^15^GROUP NAME (FL-61A:C)^0"
^IBA(364.6,1665,0)="3^N^^1^47^^1^65^18^INSURANCE GROUP NO (FL-62A:C)^0"
^IBA(364.6,1666,0)="3^N^^1^51^^1^1^31^TREATMNT AUTH CODES (FL-63A:C)^0"
^IBA(364.6,1667,0)="3^N^^1^51^^1^32^26^DOCUMENT CNTRL NUM (FL-64A:C)^0"
^IBA(364.6,1668,0)="3^N^^1^51^^1^58^25^EMPLOYER NAME (FL-65A:C)^0"
^IBA(364.6,1669,0)="3^N^^1^8^^1^72^11^NOT USED (FL-30/1)"
^IBA(364.6,1670,0)="3^N^^1^56^^1^5^7^ADM DIAG CODE (FL-69)"
^IBA(364.6,1671,0)="3^N^^1^56^^1^49^7^ECI (FL-72A/1/1)"
^IBA(364.6,1672,0)="3^N^^1^58^^1^10^6^PRIN PROCEDURE DATE (FL-74/2)"
^IBA(364.6,1673,0)="3^N^^1^58^^1^16^7^OTHER PROC CODE 1 (FL-74A/1)"
^IBA(364.6,1674,0)="3^N^^1^58^^1^25^6^OTHER PROC DATE 1 (FL-74A/1)"
^IBA(364.6,1675,0)="3^N^^1^58^^1^31^7^OTHER PROC CODE 2 (FL-74B/1)"
^IBA(364.6,1676,0)="3^N^^1^58^^1^40^6^OTHER PROC DATE 2 (FL-74B/2)"
^IBA(364.6,1677,0)="3^N^^1^60^^1^1^7^OTHER PROC CODE 3 (FL-74C/1)"
^IBA(364.6,1678,0)="3^N^^1^60^^1^10^6^OTHER PROC DATE 3 (FL-74C/2)"
^IBA(364.6,1679,0)="3^N^^1^60^^1^16^7^OTHER PROC CODE 4 (FL-74D/1)"
^IBA(364.6,1680,0)="3^N^^1^60^^1^25^6^OTHER PROC DATE 4 (FL-74D/2)"
^IBA(364.6,1681,0)="3^N^^1^60^^1^31^7^OTHER PROC CODE 5 (FL-74E/1)"
^IBA(364.6,1682,0)="3^N^^1^60^^1^40^6^OTHER PROC DATE 5 (FL-74E/2)"
^IBA(364.6,1683,0)="3^N^^1^54^^1^9^1^PRIN DIAG POA (FL-67/1/2)"
^IBA(364.6,1684,0)="3^N^^1^54^^1^17^1^OTHER DIAG 1 POA (FL-67A/1/2)"
^IBA(364.6,1685,0)="3^N^^1^54^^1^25^1^OTHER DIAG 2 POA (FL-67B/1/2)"
^IBA(364.6,1686,0)="3^N^^1^54^^1^33^1^OTHER DIAG 3 POA (FL-67C/1/2)"
^IBA(364.6,1687,0)="3^N^^1^54^^1^41^1^OTHER DIAG 4 POA (FL-67D/1/2)"
^IBA(364.6,1688,0)="3^N^^1^54^^1^49^1^OTHER DIAG 5 POA (FL-67E/1/2)"
^IBA(364.6,1689,0)="3^N^^1^54^^1^57^1^OTHER DIAG 6 POA (FL-67F/1/2)"
^IBA(364.6,1690,0)="3^N^^1^54^^1^65^1^OTHER DIAG 7 POA (FL-67G/1/2)"
^IBA(364.6,1691,0)="3^N^^1^54^^1^73^1^OTHER DIAG 8 POA (FL-67H/1/2)"
^IBA(364.6,1692,0)="3^N^^1^55^^1^9^1^OTHER DIAG 9 POA (FL-67I/1/2)"
^IBA(364.6,1693,0)="3^N^^1^55^^1^17^1^OTHER DIAG 10 POA (FL-67J/1/2)"
^IBA(364.6,1694,0)="3^N^^1^55^^1^25^1^OTHER DIAG 11 POA (FL-67K/1/2)"
^IBA(364.6,1695,0)="3^N^^1^55^^1^33^1^OTHER DIAG 12 POA (FL-67L/1/2)"
^IBA(364.6,1696,0)="3^N^^1^55^^1^41^1^OTHER DIAG 13 POA (FL-67M/1/2)"
^IBA(364.6,1697,0)="3^N^^1^55^^1^49^1^OTHER DIAG 14 POA (FL-67N/1/2)"
^IBA(364.6,1698,0)="3^N^^1^55^^1^57^1^OTHER DIAG 15 POA (FL-67O/1/2)"
^IBA(364.6,1699,0)="3^N^^1^55^^1^65^1^OTHER DIAG 16 POA (FL-67P/1/2)"
^IBA(364.6,1700,0)="3^N^^1^55^^1^73^1^OTHER DIAG 17 POA (FL-67Q/1/2)"
^IBA(364.6,1701,0)="3^N^^1^54^^1^75^8^RESERVED BY NUBC (FL-68/1)"
^IBA(364.6,1702,0)="3^N^^1^55^^1^74^9^RESERVED BY NUBC (FL-68/2)"
^IBA(364.6,1703,0)="3^N^^1^19^^1^.8^^PROCEDURE EXTRACT^1"
^IBA(364.6,1704,0)="3^N^^1^19^^1^.9^^REV CODE EXTRACT (FL-42:49)^1"
^IBA(364.6,1705,0)="3^N^^1^19^^1^1^5^REVENUE CODE (FL-42)"
^IBA(364.6,1706,0)="3^N^^1^19^^1^6^25^REV CODE DESCRIPTION (FL-43)"
^IBA(364.6,1707,0)="3^N^^1^56^^1^17^7^PATIENT REASON DX (FL-70/1/1)"
^IBA(364.6,1708,0)="3^N^^1^56^^1^24^7^PATIENT REASON DX (FL-70/1/2)"
^IBA(364.6,1709,0)="3^N^^1^56^^1^31^7^PATIENT REASON DX (FL-70/1/3)"
^IBA(364.6,1710,0)="3^N^^1^56^^1^42^5^PPS CODE (FL-71)"
^IBA(364.6,1711,0)="3^N^^1^56^^1^56^1^ECI POA (FL-72A/1/2)"
^IBA(364.6,1712,0)="3^N^^1^56^^1^57^7^ECI (FL-72B/1/1)"
^IBA(364.6,1713,0)="3^N^^1^56^^1^64^1^ECI POA (FL-72B/1/2)"
^IBA(364.6,1714,0)="3^N^^1^56^^1^65^7^ECI (FL-72C/1/1)"
^IBA(364.6,1715,0)="3^N^^1^56^^1^72^1^ECI POA (FL-72C/1/2)"
^IBA(364.6,1716,0)="3^N^^1^56^^1^74^9^RESERVED BY NUBC (FL-73)"
^IBA(364.6,1717,0)="3^N^^1^19^^1^31^15^HCPCS/RATES (FL-44)"
^IBA(364.6,1718,0)="3^N^^1^19^^1^46^7^SERVICE DATE (FL-45)"
^IBA(364.6,1719,0)="3^N^^1^57^^1^46^4^RESERVED BY NUBC (FL-75/1)"
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^IBA(364.6,1721,0)="3^N^^1^59^^1^46^4^RESERVED BY NUBC (FL-75/3)"
^IBA(364.6,1722,0)="3^N^^1^60^^1^46^4^RESERVED BY NUBC (FL-75/4)"
^IBA(364.6,1723,0)="3^N^^1^61^4^1^1^24^REMARKS (FL-80)"
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^IBA(364.6,1728,0)="3^N^^1^61^^1^29^10^CODE CODE MIDDLE (FL-81/1/2)"
^IBA(364.6,1729,0)="3^N^^1^61^^1^39^12^CODE CODE RIGHT (FL-81/1/3)"
^IBA(364.6,1730,0)="3^N^^1^58^^1^53^16^ATTENDING NAME (FL-76/2/1)"
^IBA(364.6,1731,0)="3^N^^1^58^^1^71^12^ATTENDING NAME (FL-76/2/2)"
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^IBA(364.6,1733,0)="3^N^^1^60^^1^71^12^OPERATING NAME (FL-77/2/2)"
^IBA(364.6,1734,0)="3^N^^1^19^^1^53^7^SERVICE UNITS (FL-46)"
^IBA(364.6,1735,0)="3^N^^1^19^^1^60^10^TOTAL CHARGES (FL-47)"
^IBA(364.6,1736,0)="3^N^^1^62^^1^53^16^OTHER NAME (FL-78/2/1)"
^IBA(364.6,1737,0)="3^N^^1^62^^1^71^12^OTHER NAME (FL-78/2/2)"
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^IBA(364.6,1740,0)="3^N^^1^57^^1^59^11^ATTENDING NPI (FL-76/1/1)"
^IBA(364.6,1741,0)="3^N^^1^57^^1^72^2^ATTENDING ID QUAL (FL-76/1/2)"
^IBA(364.6,1742,0)="3^N^^1^57^^1^74^9^ATTENDING OTHER ID (FL-76/1/3)"
^IBA(364.6,1743,0)="3^N^^1^59^^1^59^11^OPERATING NPI (FL-77/1/1)"
^IBA(364.6,1744,0)="3^N^^1^59^^1^72^2^OPERATING ID QUAL (FL-77/1/2)"
^IBA(364.6,1745,0)="3^N^^1^59^^1^74^9^OPERATING OTHER ID (FL-77/1/3)"
^IBA(364.6,1746,0)="3^N^^1^61^^1^59^11^OTHER PROVIDER NPI (FL-78/1/2)"
^IBA(364.6,1747,0)="3^N^^1^61^^1^72^2^OTHER PROV ID QUAL (FL-78/1/3)"
^IBA(364.6,1748,0)="3^N^^1^61^^1^74^9^OTHER PROV ID (FL-78/1/4)"
^IBA(364.6,1749,0)="3^N^^1^19^^1^70^10^NON-COVERED CHARGES (FL-48)"
^IBA(364.6,1750,0)="3^N^^1^19^^1^80^3^RESERVED (FL-49)"
^IBA(364.6,1751,0)="3^N^^1^63^^1^59^11^OTHER NPI (FL-79/1/2)"
^IBA(364.6,1752,0)="3^N^^1^63^^1^72^2^OTHER PROV ID QUAL (FL-79/1/3)"
^IBA(364.6,1753,0)="3^N^^1^63^^1^74^9^OTHER PROV ID (FL-79/1/4)"
^IBA(364.6,1754,0)="3^N^^1^63^^1^56^2^PROV TYPE QUAL (FL-79/1/1)"
^IBA(364.6,1755,0)="3^N^^1^61^^1^56^2^PROV TYPE QUAL (FL-78/1/1)"
^IBA(364.6,1756,0)="3^N^^1^41^^1^1^4^RESERVED (FL-41/23)^0"
^IBA(364.6,1757,0)="3^N^^1^41^^1^46^6^CREATION DATE (FL-45/23)"
^IBA(364.6,1758,0)="3^N^^1^11^^1^74.9^^CLEAN UP IBXSAVE OCCS^1"
^IBA(364.6,1759,0)="3^N^^1^9^^1^33.9^^SORT CONDITION CODES^1"
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^IBA(364.6,"C","AGENT CASHIER NM (BX-33/LN 1)",1502)=""
^IBA(364.6,"C","AGENT CASHIER STATE",179)=""
^IBA(364.6,"C","AGENT CASHIER STATE (FL-2/3/2)",1563)=""
^IBA(364.6,"C","AGENT CASHIER STATE EXTRACT",590)=""
^IBA(364.6,"C","AGENT CASHIER STATE EXTRACT",770)=""
^IBA(364.6,"C","AGENT CASHIER STATE EXTRACT",1511)=""
^IBA(364.6,"C","AGENT CASHIER STREET ADDRESS",178)=""
^IBA(364.6,"C","AGENT CASHIER ZIP (FL-2/3/3)",1564)=""
^IBA(364.6,"C","AGENT CASHIER ZIP CODE",180)=""
^IBA(364.6,"C","AGENT CASHIER ZIP CODE EXTRACT",771)=""
^IBA(364.6,"C","AGENT CASHIER ZIP EXTRACT",591)=""
^IBA(364.6,"C","AGENT CASHIER ZIP EXTRACT",1512)=""
^IBA(364.6,"C","ALLOWED AMOUNT",961)=""
^IBA(364.6,"C","ANOTHER PLAN=NO (BX-11D/B)",536)=""
^IBA(364.6,"C","ANOTHER PLAN=NO (BX-11D/B)",1452)=""
^IBA(364.6,"C","ANOTHER PLAN=YES (BX-11D/A)",535)=""
^IBA(364.6,"C","ANOTHER PLAN=YES (BX-11D/A)",1451)=""
^IBA(364.6,"C","ASSIGN OF BENEFITS (FL-53A:C)",707)=""
^IBA(364.6,"C","ASSIGN OF BENEFITS (FL-53A:C)",1643)=""
^IBA(364.6,"C","ASSIGN OF BENEFITS SIG (13A)",996)=""
^IBA(364.6,"C","ASSIGN OF BENEFITS SIG (13A)",1454)=""
^IBA(364.6,"C","ASSIGNMENT OF BENEFITS",49)=""
^IBA(364.6,"C","ATT/REND NAME SUFFIX",943)=""
^IBA(364.6,"C","ATT/REND PERSON/NON-PERSON",973)=""
^IBA(364.6,"C","ATT/REND PROV COB SEQUENCE",1303)=""
^IBA(364.6,"C","ATT/REND PROV FIRST NAME",942)=""
^IBA(364.6,"C","ATT/REND PROV LAST NAME",941)=""
^IBA(364.6,"C","ATT/REND PROV PRIMARY ID CODE",986)=""
^IBA(364.6,"C","ATT/REND PROV PRIMARY ID QUAL",985)=""
^IBA(364.6,"C","ATT/REND PROV SECOND ID 1",1225)=""
^IBA(364.6,"C","ATT/REND PROV SECOND ID 2",1227)=""
^IBA(364.6,"C","ATT/REND PROV SECOND ID 3",1229)=""
^IBA(364.6,"C","ATT/REND PROV SECOND ID 4",1231)=""
^IBA(364.6,"C","ATT/REND PROV SECOND ID 5",1233)=""
^IBA(364.6,"C","ATT/REND PROV SECOND QUALIF 1",1224)=""
^IBA(364.6,"C","ATT/REND PROV SECOND QUALIF 2",1226)=""
^IBA(364.6,"C","ATT/REND PROV SECOND QUALIF 3",1228)=""
^IBA(364.6,"C","ATT/REND PROV SECOND QUALIF 4",1230)=""
^IBA(364.6,"C","ATT/REND PROV SECOND QUALIF 5",1232)=""
^IBA(364.6,"C","ATT/REND PROV SPECIALTY",944)=""
^IBA(364.6,"C","ATTEND/RENDER PHY NPI CODE",1324)=""
^IBA(364.6,"C","ATTEND/RENDER PHY TAXONOMY",1325)=""
^IBA(364.6,"C","ATTENDING ID QUAL (FL-76/1/2)",1741)=""
^IBA(364.6,"C","ATTENDING NAME (FL-76/2/1)",1730)=""
^IBA(364.6,"C","ATTENDING NAME (FL-76/2/2)",1731)=""
^IBA(364.6,"C","ATTENDING NOT HOSPICE",978)=""
^IBA(364.6,"C","ATTENDING NPI (FL-76/1/1)",1740)=""
^IBA(364.6,"C","ATTENDING OTHER ID (FL-76/1/3)",1742)=""
^IBA(364.6,"C","ATTENDING PHYS ID (FL-82/1)",736)=""
^IBA(364.6,"C","ATTENDING PHYS ID (FL-82/2)",745)=""
^IBA(364.6,"C","AUTO ACCIDENT STATE (BX-10B/C)",528)=""
^IBA(364.6,"C","AUTO ACCIDENT STATE (BX-10B/C)",1443)=""
^IBA(364.6,"C","BALANCE DUE",52)=""
^IBA(364.6,"C","BATCH #",167)=""
^IBA(364.6,"C","BATCH DATE",168)=""
^IBA(364.6,"C","BATCH REFERENCE #",169)=""
^IBA(364.6,"C","BEGIN LEVEL OF SUBLUXATION",979)=""
^IBA(364.6,"C","BGN SEGMENT",582)=""
^IBA(364.6,"C","BILL DESIGNATION",1)=""
^IBA(364.6,"C","BILL PROV ADDR LN1 (BX-33/LN3)",1507)=""
^IBA(364.6,"C","BILL PROV COUNTRY (FL-1/4/3)",1559)=""
^IBA(364.6,"C","BILL PROV PHONE# (BX-33/LN 1)",1500)=""
^IBA(364.6,"C","BILL PROVIDER CITY (FL-1/3/1)",1554)=""
^IBA(364.6,"C","BILL PROVIDER FAX (FL-1/4/2)",1558)=""
^IBA(364.6,"C","BILL PROVIDER PHONE (FL-1/4/1)",1557)=""
^IBA(364.6,"C","BILL PROVIDER STATE (FL-1/3/2)",1555)=""
^IBA(364.6,"C","BILL PROVIDER ZIP (FL-1/3/3)",1556)=""
^IBA(364.6,"C","BILL STATUS",50)=""
^IBA(364.6,"C","BILLING PROV NPI CODE",1334)=""
^IBA(364.6,"C","BILLING PROV OTH ID# (BX-33B)",1518)=""
^IBA(364.6,"C","BILLING PROV SECONDARY ID #(1)",227)=""
^IBA(364.6,"C","BILLING PROV SECONDARY ID #(2)",1192)=""
^IBA(364.6,"C","BILLING PROV SECONDARY ID #(3)",1094)=""
^IBA(364.6,"C","BILLING PROV SECONDARY ID #(4)",1096)=""
^IBA(364.6,"C","BILLING PROV SECONDARY ID #(5)",1098)=""
^IBA(364.6,"C","BILLING PROV SECONDARY ID #(6)",1100)=""
^IBA(364.6,"C","BILLING PROV SECONDARY ID #(7)",1102)=""
^IBA(364.6,"C","BILLING PROV SECONDARY ID #(8)",1104)=""
^IBA(364.6,"C","BILLING PROV SECONDARY ID Q(1)",226)=""
^IBA(364.6,"C","BILLING PROV SECONDARY ID Q(2)",1191)=""
^IBA(364.6,"C","BILLING PROV SECONDARY ID Q(3)",1015)=""
^IBA(364.6,"C","BILLING PROV SECONDARY ID Q(4)",1095)=""
^IBA(364.6,"C","BILLING PROV SECONDARY ID Q(5)",1097)=""
^IBA(364.6,"C","BILLING PROV SECONDARY ID Q(6)",1099)=""
^IBA(364.6,"C","BILLING PROV SECONDARY ID Q(7)",1101)=""
^IBA(364.6,"C","BILLING PROV SECONDARY ID Q(8)",1103)=""
^IBA(364.6,"C","BILLING PROV TAXONOMY",1335)=""
^IBA(364.6,"C","BILLING PROVIDER ADDR (FL-1/2)",1553)=""
^IBA(364.6,"C","BILLING PROVIDER ADDRESS L2",3)=""
^IBA(364.6,"C","BILLING PROVIDER NAME (FL-1/1)",1552)=""
^IBA(364.6,"C","BILLING PROVIDER NPI (BX-33A)",1517)=""
^IBA(364.6,"C","BILLING PROVIDER NPI (FL-56)",1639)=""
^IBA(364.6,"C","BLOCK 31 CHR 1-21 (BX-31/LN1)",568)=""
^IBA(364.6,"C","BLOCK 31 CHR 1-21 (BX-31/LN1)",1503)=""
^IBA(364.6,"C","BLOCK 31 CHR 22-42 (BX-31/LN2)",571)=""
^IBA(364.6,"C","BLOCK 31 CHR 22-42 (BX-31/LN2)",1508)=""
^IBA(364.6,"C","BLOCK 31 CHR 43-63 (BX-31/LN3)",574)=""
^IBA(364.6,"C","BLOCK 31 CHR 43-63 (BX-31/LN3)",1514)=""
^IBA(364.6,"C","BOX 10D CMS-1500",1450)=""
^IBA(364.6,"C","BOX 10D HCFA 1500",598)=""
^IBA(364.6,"C","BOX 17 HCFA 1500",599)=""
^IBA(364.6,"C","BOX 17a HCFA 1500",600)=""
^IBA(364.6,"C","BOX 24K DATA - NO LONGER USED",975)=""
^IBA(364.6,"C","CERT-SSN-HIC-ID NO (FL-60A:C)",715)=""
^IBA(364.6,"C","CHARGES (BX-24F)",560)=""
^IBA(364.6,"C","CHARGES (BX-24F)",1487)=""
^IBA(364.6,"C","CHECK BOX FOR BILL TYPE",597)=""
^IBA(364.6,"C","CHECK BOX FOR BILL TYPE (BX-1)",1403)=""
^IBA(364.6,"C","CHECK FOR MULTIPLE PAGES",774)=""
^IBA(364.6,"C","CHECK FOR MULTIPLE PAGES",1599)=""
^IBA(364.6,"C","CHIRO - QUANTITY",980)=""
^IBA(364.6,"C","CHIRO - SERIES #",981)=""
^IBA(364.6,"C","CLAIM DISPROP SHARE AMT",832)=""
^IBA(364.6,"C","CLAIM DRG AMT",830)=""
^IBA(364.6,"C","CLAIM INDIRECT TEACHING AMT",846)=""
^IBA(364.6,"C","CLAIM MSP PASS THRU AMT",833)=""
^IBA(364.6,"C","CLAIM PAYMENT REMARK CODE 1",848)=""
^IBA(364.6,"C","CLAIM PAYMENT REMARK CODE 2",849)=""
^IBA(364.6,"C","CLAIM PAYMENT REMARK CODE 3",850)=""
^IBA(364.6,"C","CLAIM PAYMENT REMARK CODE 4",851)=""
^IBA(364.6,"C","CLAIM PAYMENT REMARK CODE 5",924)=""
^IBA(364.6,"C","CLAIM PPS CAPITAL AMT",834)=""
^IBA(364.6,"C","CLAIM PPS CAPITAL OUTLIER AMT",845)=""
^IBA(364.6,"C","CLAIM STATUS",962)=""
^IBA(364.6,"C","CLAIM TYPE",47)=""
^IBA(364.6,"C","CLEAN UP IBXSAVE",596)=""
^IBA(364.6,"C","CLEAN UP IBXSAVE",1492)=""
^IBA(364.6,"C","CLEAN UP IBXSAVE OCCS",1758)=""
^IBA(364.6,"C","CLEAN UP OI5",1320)=""
^IBA(364.6,"C","CLIA #",970)=""
^IBA(364.6,"C","CMS-1500 BOX 19 RAW DATA",1002)=""
^IBA(364.6,"C","CO-INSURANCE DAYS",784)=""
^IBA(364.6,"C","COB (BX-24J)",607)=""
^IBA(364.6,"C","COB ASSIGNED LINE #",877)=""
^IBA(364.6,"C","COB COVERED AMT",810)=""
^IBA(364.6,"C","COB COVERED DAYS",964)=""
^IBA(364.6,"C","COB COVERED DAYS/VISITS",829)=""
^IBA(364.6,"C","COB DAY LIMIT AMT",812)=""
^IBA(364.6,"C","COB DISCOUNT AMT",811)=""
^IBA(364.6,"C","COB INS CO PAYER ID",867)=""
^IBA(364.6,"C","COB INTEREST AMT",813)=""
^IBA(364.6,"C","COB LINE ADJ REASON CODE-1",881)=""
^IBA(364.6,"C","COB LINE ADJ REASON CODE-2",907)=""
^IBA(364.6,"C","COB LINE ADJ REASON CODE-3",908)=""
^IBA(364.6,"C","COB LINE ADJ REASON CODE-4",909)=""
^IBA(364.6,"C","COB LINE ADJ REASON CODE-5",910)=""
^IBA(364.6,"C","COB LINE ADJ REASON CODE-6",911)=""
^IBA(364.6,"C","COB LINE ADJUSTMENT AMT-1",882)=""
^IBA(364.6,"C","COB LINE ADJUSTMENT AMT-2",912)=""
^IBA(364.6,"C","COB LINE ADJUSTMENT AMT-3",913)=""
^IBA(364.6,"C","COB LINE ADJUSTMENT AMT-4",914)=""
^IBA(364.6,"C","COB LINE ADJUSTMENT AMT-5",915)=""
^IBA(364.6,"C","COB LINE ADJUSTMENT AMT-6",916)=""
^IBA(364.6,"C","COB LINE ADJUSTMENT GROUP CODE",880)=""
^IBA(364.6,"C","COB LINE ADJUSTMENT QUANTITY-1",883)=""
^IBA(364.6,"C","COB LINE ADJUSTMENT QUANTITY-2",917)=""
^IBA(364.6,"C","COB LINE ADJUSTMENT QUANTITY-3",918)=""
^IBA(364.6,"C","COB LINE ADJUSTMENT QUANTITY-4",919)=""
^IBA(364.6,"C","COB LINE ADJUSTMENT QUANTITY-5",920)=""
^IBA(364.6,"C","COB LINE ADJUSTMENT QUANTITY-6",921)=""
^IBA(364.6,"C","COB LINE DESCRIPTION",875)=""
^IBA(364.6,"C","COB LINE MODIFIER 1",871)=""
^IBA(364.6,"C","COB LINE MODIFIER 2",872)=""
^IBA(364.6,"C","COB LINE MODIFIER 3",873)=""
^IBA(364.6,"C","COB LINE MODIFIER 4",874)=""
^IBA(364.6,"C","COB LINE PAID PROCEDURE",869)=""
^IBA(364.6,"C","COB LINE PAID UNITS",876)=""
^IBA(364.6,"C","COB LINE REVENUE CODE",870)=""
^IBA(364.6,"C","COB PT RESP AMT",809)=""
^IBA(364.6,"C","COB REFERENCE CLAIM LINE #",866)=""
^IBA(364.6,"C","COB REFERENCE CLAIM LINE #",879)=""
^IBA(364.6,"C","COB TAX AMT",814)=""
^IBA(364.6,"C","COB TOTAL BEFORE TAXES",815)=""
^IBA(364.6,"C","CODE CODE LEFT (FL-81/1/1)",1727)=""
^IBA(364.6,"C","CODE CODE MIDDLE (FL-81/1/2)",1728)=""
^IBA(364.6,"C","CODE CODE RIGHT (FL-81/1/3)",1729)=""
^IBA(364.6,"C","COMMON COMMENTS",578)=""
^IBA(364.6,"C","COND REL AUTO=NO (BX-10B/B)",527)=""
^IBA(364.6,"C","COND REL AUTO=NO (BX-10B/B)",1442)=""
^IBA(364.6,"C","COND REL AUTO=YES (BX-10B/A)",526)=""
^IBA(364.6,"C","COND REL AUTO=YES (BX-10B/A)",1441)=""
^IBA(364.6,"C","COND REL TO EMP=NO (BX-10A/B)",519)=""
^IBA(364.6,"C","COND REL TO EMP=NO (BX-10A/B)",1434)=""
^IBA(364.6,"C","COND REL TO EMP=YES (BX-10A/A)",518)=""
^IBA(364.6,"C","COND REL TO EMP=YES (BX-10A/A)",1433)=""
^IBA(364.6,"C","COND REL TO OTH=NO (BX-10C/B)",532)=""
^IBA(364.6,"C","COND REL TO OTH=NO (BX-10C/B)",1447)=""
^IBA(364.6,"C","COND REL TO OTH=YES (BX-10C/A)",531)=""
^IBA(364.6,"C","COND REL TO OTH=YES (BX-10C/A)",1446)=""
^IBA(364.6,"C","CONDITION CODE",91)=""
^IBA(364.6,"C","CONDITION CODE 1 (FL-18)",1625)=""
^IBA(364.6,"C","CONDITION CODE 1 (FL-24)",644)=""
^IBA(364.6,"C","CONDITION CODE 10 (FL-27)",1635)=""
^IBA(364.6,"C","CONDITION CODE 11 (FL-28)",1636)=""
^IBA(364.6,"C","CONDITION CODE 2 (FL-19)",1627)=""
^IBA(364.6,"C","CONDITION CODE 2 (FL-25)",645)=""
^IBA(364.6,"C","CONDITION CODE 3 (FL-20)",1628)=""
^IBA(364.6,"C","CONDITION CODE 3 (FL-26)",646)=""
^IBA(364.6,"C","CONDITION CODE 4 (FL-21)",1629)=""
^IBA(364.6,"C","CONDITION CODE 4 (FL-27)",647)=""
^IBA(364.6,"C","CONDITION CODE 5 (FL-22)",1630)=""
^IBA(364.6,"C","CONDITION CODE 5 (FL-28)",648)=""
^IBA(364.6,"C","CONDITION CODE 6 (FL-23)",1631)=""
^IBA(364.6,"C","CONDITION CODE 6 (FL-29)",649)=""
^IBA(364.6,"C","CONDITION CODE 7 (FL-24)",1632)=""
^IBA(364.6,"C","CONDITION CODE 7 (FL-30)",650)=""
^IBA(364.6,"C","CONDITION CODE 8 (FL-25)",1633)=""
^IBA(364.6,"C","CONDITION CODE 9 (FL-26)",1634)=""
^IBA(364.6,"C","CONDITION REL TO AUTO ACC",70)=""
^IBA(364.6,"C","CONDITION REL TO EMPLOYMENT",71)=""
^IBA(364.6,"C","CONDITION REL TO OTH ACC",72)=""
^IBA(364.6,"C","COST REPORT DAY COUNT",843)=""
^IBA(364.6,"C","COVERED DAYS",66)=""
^IBA(364.6,"C","COVERED DAYS (FL-7)",625)=""
^IBA(364.6,"C","CREATION DATE (FL-45/23)",1757)=""
^IBA(364.6,"C","CURR INS CO 837 ID NUMBER",196)=""
^IBA(364.6,"C","CURR INS CO ATTENDING PROV ID",1000)=""
^IBA(364.6,"C","CURR INS EMC #",1004)=""
^IBA(364.6,"C","CURR INSURANCE ICN/DCN",999)=""
^IBA(364.6,"C","CURR INSURED DEMOG EXTRACT",782)=""
^IBA(364.6,"C","CURR INSURED DEMOG EXTRACT",1409)=""
^IBA(364.6,"C","CURR INSURED'S FULL ADDR EXTR",781)=""
^IBA(364.6,"C","CURR INSURED'S FULL ADDR EXTR",1416)=""
^IBA(364.6,"C","CURR PAYER NAME/ADDR (FL-38)",1613)=""
^IBA(364.6,"C","CURRENT INS CO PROVIDER NUMBER",1316)=""
^IBA(364.6,"C","CURRENT INSURANCE CITY",186)=""
^IBA(364.6,"C","CURRENT INSURANCE CO INS TYPE",1315)=""
^IBA(364.6,"C","CURRENT INSURANCE CO NAME",192)=""
^IBA(364.6,"C","CURRENT INSURANCE FULL ADDRESS",885)=""
^IBA(364.6,"C","CURRENT INSURANCE STATE",187)=""
^IBA(364.6,"C","CURRENT INSURANCE STREET",185)=""
^IBA(364.6,"C","CURRENT INSURANCE STREET-2",793)=""
^IBA(364.6,"C","CURRENT INSURANCE TYPE CODE",1009)=""
^IBA(364.6,"C","CURRENT INSURANCE ZIP CODE",188)=""
^IBA(364.6,"C","CURRENT INSURED GROUP NAME",190)=""
^IBA(364.6,"C","CURRENT INSURED GROUP NUMBER",189)=""
^IBA(364.6,"C","CURRENT INSURED POLICY TYPE",794)=""
^IBA(364.6,"C","CURRENT PAYER ADDRESS EXTRACT",1612)=""
^IBA(364.6,"C","CURRENT PAYER NAME EXTRACT",1611)=""
^IBA(364.6,"C","DATE CLAIM PAID",891)=""
^IBA(364.6,"C","DATE LAST SEEN",76)=""
^IBA(364.6,"C","DATE OF CURR ILLNESS (BX-14)",539)=""
^IBA(364.6,"C","DATE OF CURR ILLNESS (BX-14)",1458)=""
^IBA(364.6,"C","DATE OF ONSET",58)=""
^IBA(364.6,"C","DATE OF SERV FR (BX-24A/A)",554)=""
^IBA(364.6,"C","DATE OF SERV FR (BX-24A/A)",1481)=""
^IBA(364.6,"C","DATE OF SERV TO (BX-24A/B)",555)=""
^IBA(364.6,"C","DATE OF SERV TO (BX-24A/B)",1482)=""
^IBA(364.6,"C","DATE OF SERVICE (FROM)",118)=""
^IBA(364.6,"C","DATE OF SERVICE (TO)",483)=""
^IBA(364.6,"C","DATE OF SIMLAR ILLNESS (BX-15)",540)=""
^IBA(364.6,"C","DATE OF SIMLAR ILLNESS (BX-15)",1459)=""
^IBA(364.6,"C","DATE UNABLE TO WORK FROM",60)=""
^IBA(364.6,"C","DATE UNABLE TO WORK TO",61)=""
^IBA(364.6,"C","DAYS SUPPLY",581)=""
^IBA(364.6,"C","DIAGNOSIS CODE 1",92)=""
^IBA(364.6,"C","DIAGNOSIS CODE 1",94)=""
^IBA(364.6,"C","DIAGNOSIS CODE 1 (BX-21.1)",548)=""
^IBA(364.6,"C","DIAGNOSIS CODE 1 (BX-21.1)",1473)=""
^IBA(364.6,"C","DIAGNOSIS CODE 2 (BX-21.2)",550)=""
^IBA(364.6,"C","DIAGNOSIS CODE 2 (BX-21.2)",1477)=""
^IBA(364.6,"C","DIAGNOSIS CODE 3 (BX-21.3)",549)=""
^IBA(364.6,"C","DIAGNOSIS CODE 3 (BX-21.3)",1474)=""
^IBA(364.6,"C","DIAGNOSIS CODE 4 (BX-21.4)",551)=""
^IBA(364.6,"C","DIAGNOSIS CODE 4 (BX-21.4)",1478)=""
^IBA(364.6,"C","DIAGNOSIS CODE POINTER 1",119)=""
^IBA(364.6,"C","DIAGNOSIS CODE POINTER 2",120)=""
^IBA(364.6,"C","DIAGNOSIS CODE POINTER 3",121)=""
^IBA(364.6,"C","DIAGNOSIS CODE POINTER 4",122)=""
^IBA(364.6,"C","DIAGNOSIS CODE REFS (BX-24E)",559)=""
^IBA(364.6,"C","DIAGNOSIS POINTER (BX-24E)",1486)=""
^IBA(364.6,"C","DISCHARGE DATE",56)=""
^IBA(364.6,"C","DISCHARGE DATE/TIME",143)=""
^IBA(364.6,"C","DISCHARGE HOUR",57)=""
^IBA(364.6,"C","DISCHARGE HR (FL-16)",1609)=""
^IBA(364.6,"C","DISCHARGE HR (FL-21)",640)=""
^IBA(364.6,"C","DOCUMENT CNTRL NUM (FL-64A:C)",1667)=""
^IBA(364.6,"C","DRG CODE USED",831)=""
^IBA(364.6,"C","DRUG NAME (INCL DAYS & QTY)",137)=""
^IBA(364.6,"C","DRUG QUANTITY",580)=""
^IBA(364.6,"C","DT UNABLE TO WRK FR (BX-16/1)",541)=""
^IBA(364.6,"C","DT UNABLE TO WRK FR (BX-16/1)",1460)=""
^IBA(364.6,"C","DT UNABLE TO WRK TO (BX-16/2)",542)=""
^IBA(364.6,"C","DT UNABLE TO WRK TO (BX-16/2)",1461)=""
^IBA(364.6,"C","DUE FRM PATIENT FL55 (FL-55/4)",712)=""
^IBA(364.6,"C","E-CODE (FL-77)",734)=""
^IBA(364.6,"C","E-CODE DIAGNOSIS",952)=""
^IBA(364.6,"C","ECI (FL-72A/1/1)",1671)=""
^IBA(364.6,"C","ECI (FL-72B/1/1)",1712)=""
^IBA(364.6,"C","ECI (FL-72C/1/1)",1714)=""
^IBA(364.6,"C","ECI POA (FL-72A/1/2)",1711)=""
^IBA(364.6,"C","ECI POA (FL-72B/1/2)",1713)=""
^IBA(364.6,"C","ECI POA (FL-72C/1/2)",1715)=""
^IBA(364.6,"C","EDI SITE CONTACT PHONE",183)=""
^IBA(364.6,"C","EMERGENCY INDICATOR",862)=""
^IBA(364.6,"C","EMG (BX-24C)",1484)=""
^IBA(364.6,"C","EMG (BX-24I)",606)=""
^IBA(364.6,"C","EMPL STATUS CODE (FL-64A:C)",719)=""
^IBA(364.6,"C","EMPLOYER LOCATION (FL-66)",721)=""
^IBA(364.6,"C","EMPLOYER NAME (FL-65A:C)",720)=""
^IBA(364.6,"C","EMPLOYER NAME (FL-65A:C)",1668)=""
^IBA(364.6,"C","END LEVEL OF SUBLUXATION",1010)=""
^IBA(364.6,"C","ENTITY INDENTIFIER CODE QD",1018)=""
^IBA(364.6,"C","ENTITY TYPE QUALIFIER",1019)=""
^IBA(364.6,"C","ENVOY PAYER ID",806)=""
^IBA(364.6,"C","EPSDT FAMILY PLAN (BX-24H)",605)=""
^IBA(364.6,"C","EPSDT FAMILY PLAN (BX-24H)",1489)=""
^IBA(364.6,"C","EPSDT FLAG",982)=""
^IBA(364.6,"C","ESRD AMT PAID",825)=""
^IBA(364.6,"C","EST AMOUNT DUE (FL-55A:C)",709)=""
^IBA(364.6,"C","EST AMOUNT DUE (FL-55A:C)",1645)=""
^IBA(364.6,"C","EXPLANATION OF BENEFITS IND",960)=""
^IBA(364.6,"C","EXTRACT CONDITION CODES",643)=""
^IBA(364.6,"C","EXTRACT CONDITION CODES",1626)=""
^IBA(364.6,"C","EXTRACT LINE LEVEL ADJUSTMENTS",983)=""
^IBA(364.6,"C","FAC ADR LINE 1 (BX-32/LN 2)",569)=""
^IBA(364.6,"C","FAC ADR LINE 1 (BX-32/LN 2)",1506)=""
^IBA(364.6,"C","FAC CITY/ST/ZIP (BX-32/LN 3)",572)=""
^IBA(364.6,"C","FAC CITY/ST/ZIP (BX-32/LN 3)",1509)=""
^IBA(364.6,"C","FACILITY BILLING NAME",177)=""
^IBA(364.6,"C","FACILITY NAME (BX-32/LINE 1)",566)=""
^IBA(364.6,"C","FACILITY NAME (BX-32/LINE 1)",1501)=""
^IBA(364.6,"C","FACILITY PROV COB SEQUENCE",1305)=""
^IBA(364.6,"C","FACILITY STR ADDR 1 EXTRACT",584)=""
^IBA(364.6,"C","FACILITY STR ADDR 2 EXTRACT",585)=""
^IBA(364.6,"C","FED TAX ID # (BX-25/1)",562)=""
^IBA(364.6,"C","FED TAX ID # (BX-25/1)",1493)=""
^IBA(364.6,"C","FED TAX ID # (FL-5)",622)=""
^IBA(364.6,"C","FED TAX ID # (FL-5/2)",1571)=""
^IBA(364.6,"C","FEDERAL TAX ID NUMBER",182)=""
^IBA(364.6,"C","FILLER",969)=""
^IBA(364.6,"C","FILLER",1317)=""
^IBA(364.6,"C","FIRST DATE SIMILAR ILLNESS",59)=""
^IBA(364.6,"C","FORM LOCATOR 10 (FL-10)",628)=""
^IBA(364.6,"C","FORM LOCATOR 11 (FL-11/1)",620)=""
^IBA(364.6,"C","FORM LOCATOR 11 (FL-11/2)",629)=""
^IBA(364.6,"C","FORM LOCATOR 31 (FL-31/1)",632)=""
^IBA(364.6,"C","FORM LOCATOR 31 (FL-31/2)",651)=""
^IBA(364.6,"C","FORM LOCATOR 37A",652)=""
^IBA(364.6,"C","FORM LOCATOR 37B",954)=""
^IBA(364.6,"C","FORM LOCATOR 37C",955)=""
^IBA(364.6,"C","FORM LOCATOR 49",958)=""
^IBA(364.6,"C","FORM LOCATOR 49 (FL-49)",698)=""
^IBA(364.6,"C","FORM LOCATOR 56 LN 1 (FL-56/1)",699)=""
^IBA(364.6,"C","FORM LOCATOR 56 LN 2 (FL-56/2)",700)=""
^IBA(364.6,"C","FORM LOCATOR 56 LN 3 (FL-56/3)",701)=""
^IBA(364.6,"C","FORM LOCATOR 56 LN 4 (FL-56/4)",702)=""
^IBA(364.6,"C","FORM LOCATOR 56 LN 5 (FL-56/5)",703)=""
^IBA(364.6,"C","FORM LOCATOR 57 (FL-57)",710)=""
^IBA(364.6,"C","FORM LOCATOR 78 (FL-78/1)",722)=""
^IBA(364.6,"C","FORM LOCATOR 78 (FL-78/2)",735)=""
^IBA(364.6,"C","FORM LOCATOR 9 (FL-9)",627)=""
^IBA(364.6,"C","FREQUENCY",46)=""
^IBA(364.6,"C","GROUP NAME (FL-61A:C)",716)=""
^IBA(364.6,"C","GROUP NAME (FL-61A:C)",1664)=""
^IBA(364.6,"C","HCPCS PAYABLE AMT",819)=""
^IBA(364.6,"C","HCPCS/RATES (FL-44)",693)=""
^IBA(364.6,"C","HCPCS/RATES (FL-44)",1717)=""
^IBA(364.6,"C","HEALTH PLAN ID (FL-51A:C)",1641)=""
^IBA(364.6,"C","HEALTH RECORD NUMBER",42)=""
^IBA(364.6,"C","HEARING/VISION PRESCRIPT. DATE",1034)=""
^IBA(364.6,"C","HOMEBOUND INDICATOR",165)=""
^IBA(364.6,"C","HOSP FROM DATE (BX-18/1)",543)=""
^IBA(364.6,"C","HOSP FROM DATE (BX-18/1)",1466)=""
^IBA(364.6,"C","HOSP TO DATE (BX-18/2)",544)=""
^IBA(364.6,"C","HOSP TO DATE (BX-18/2)",1467)=""
^IBA(364.6,"C","ICD VERSION INDICATOR (FL-66)",1597)=""
^IBA(364.6,"C","ID NUMBER=EIN (BX-25/2B)",563)=""
^IBA(364.6,"C","ID NUMBER=EIN (BX-25/2B)",1494)=""
^IBA(364.6,"C","ID QUALIFER (BX-24I)",1490)=""
^IBA(364.6,"C","INITIAL TREATMENT DATE-SPINAL",1032)=""
^IBA(364.6,"C","INPT LINE # FOR CLAIM",123)=""
^IBA(364.6,"C","INPT LINE CHARGE",130)=""
^IBA(364.6,"C","INPT PROC ASSOC W/REV CODE",125)=""
^IBA(364.6,"C","INPT RATE",127)=""
^IBA(364.6,"C","INPT REVENUE CODE",124)=""
^IBA(364.6,"C","INPT UNITS",126)=""
^IBA(364.6,"C","INS TYPE CHECK BOX (BX-1)",966)=""
^IBA(364.6,"C","INST TYPE OF UNITS",864)=""
^IBA(364.6,"C","INSURANCE GROUP NO (FL-62A:C)",717)=""
^IBA(364.6,"C","INSURANCE GROUP NO (FL-62A:C)",1665)=""
^IBA(364.6,"C","INSURED ADDR (STR/CITY/ST/ZIP)",6)=""
^IBA(364.6,"C","INSURED BIRTH DATE",16)=""
^IBA(364.6,"C","INSURED CITY",7)=""
^IBA(364.6,"C","INSURED DEMO (BDT/SEX/PHONE)",10)=""
^IBA(364.6,"C","INSURED EMPLOYER CITY",15)=""
^IBA(364.6,"C","INSURED EMPLOYER NAME",18)=""
^IBA(364.6,"C","INSURED EMPLOYER STATE",14)=""
^IBA(364.6,"C","INSURED EMPLOYER STREET",987)=""
^IBA(364.6,"C","INSURED EMPLOYMENT STATUS",191)=""
^IBA(364.6,"C","INSURED EMPLOYR NAME (BX-11B)",529)=""
^IBA(364.6,"C","INSURED EMPLOYR NAME (BX-11B)",1444)=""
^IBA(364.6,"C","INSURED EMPLR GRP (NM/CITY/ST)",13)=""
^IBA(364.6,"C","INSURED FIRST NAME",22)=""
^IBA(364.6,"C","INSURED FULL NAME",4)=""
^IBA(364.6,"C","INSURED ID # (BX-1A)",495)=""
^IBA(364.6,"C","INSURED ID # (BX-1A)",1404)=""
^IBA(364.6,"C","INSURED ID NUMBER",5)=""
^IBA(364.6,"C","INSURED LAST NAME",26)=""
^IBA(364.6,"C","INSURED MIDDLE NAME",27)=""
^IBA(364.6,"C","INSURED NAME SUFFIX",1016)=""
^IBA(364.6,"C","INSURED PHONE",12)=""
^IBA(364.6,"C","INSURED POLICY GROUP (BX-11)",516)=""
^IBA(364.6,"C","INSURED POLICY GROUP (BX-11)",1431)=""
^IBA(364.6,"C","INSURED RELATIONSHIP TO PT",28)=""
^IBA(364.6,"C","INSURED SEX",11)=""
^IBA(364.6,"C","INSURED SEX=FEMALE (BX-11A/2B)",522)=""
^IBA(364.6,"C","INSURED SEX=FEMALE (BX-11A/2B)",1437)=""
^IBA(364.6,"C","INSURED STATE",789)=""
^IBA(364.6,"C","INSURED STR ADDRESS (BX-7/1)",506)=""
^IBA(364.6,"C","INSURED STR ADDRESS (BX-7/1)",1417)=""
^IBA(364.6,"C","INSURED STREET ADDRESS",17)=""
^IBA(364.6,"C","INSURED STREET ADDRESS 2",65)=""
^IBA(364.6,"C","INSURED ZIP CODE",9)=""
^IBA(364.6,"C","INSURED'S CITY (BX-7/2A)",777)=""
^IBA(364.6,"C","INSURED'S CITY (BX-7/2A)",1423)=""
^IBA(364.6,"C","INSURED'S NAME (BX-4)",500)=""
^IBA(364.6,"C","INSURED'S NAME (BX-4)",1410)=""
^IBA(364.6,"C","INSURED'S PHONE (BX-7/3B)",780)=""
^IBA(364.6,"C","INSURED'S PHONE (BX-7/3B)",1429)=""
^IBA(364.6,"C","INSURED'S STATE (BX-7/2B)",778)=""
^IBA(364.6,"C","INSURED'S STATE (BX-7/2B)",1424)=""
^IBA(364.6,"C","INSURED'S ZIP CODE (BX-7/3A)",779)=""
^IBA(364.6,"C","INSURED'S ZIP CODE (BX-7/3A)",1428)=""
^IBA(364.6,"C","INSUREDS DOB (BX-11A/1)",520)=""
^IBA(364.6,"C","INSUREDS DOB (BX-11A/1)",1435)=""
^IBA(364.6,"C","INSUREDS NAME (FL-58A:C)",713)=""
^IBA(364.6,"C","INSUREDS NAME (FL-58A:C)",1661)=""
^IBA(364.6,"C","INSUREDS PLAN NAME (BX-11C)",533)=""
^IBA(364.6,"C","INSUREDS PLAN NAME (BX-11C)",1448)=""
^IBA(364.6,"C","INSUREDS SEX=MALE (BX-11A/2A)",521)=""
^IBA(364.6,"C","INSUREDS SEX=MALE (BX-11A/2A)",1436)=""
^IBA(364.6,"C","INSUREDS SIGNATURE (BX-13)",538)=""
^IBA(364.6,"C","INSUREDS SIGNATURE (BX-13)",1457)=""
^IBA(364.6,"C","INSUREDS UNIQUE ID (FL-60A:C)",1663)=""
^IBA(364.6,"C","KILL IBXSAVE ARRAY",144)=""
^IBA(364.6,"C","KILL IBXSAVE ARRAY",145)=""
^IBA(364.6,"C","KILL IBXSAVE ARRAY",146)=""
^IBA(364.6,"C","KILL IBXSAVE ARRAY",147)=""
^IBA(364.6,"C","KILL IBXSAVE ARRAY",150)=""
^IBA(364.6,"C","KILL IBXSAVE ARRAY",151)=""
^IBA(364.6,"C","KILL IBXSAVE ARRAY",152)=""
^IBA(364.6,"C","KILL IBXSAVE ARRAY",153)=""
^IBA(364.6,"C","KILL IBXSAVE ARRAY",154)=""
^IBA(364.6,"C","KILL IBXSAVE ARRAY",155)=""
^IBA(364.6,"C","KILL IBXSAVE ARRAY",156)=""
^IBA(364.6,"C","KILL IBXSAVE ARRAY",159)=""
^IBA(364.6,"C","KILL IBXSAVE ARRAY",197)=""
^IBA(364.6,"C","KILL IBXSAVE ARRAY",198)=""
^IBA(364.6,"C","KILL IBXSAVE ARRAY",884)=""
^IBA(364.6,"C","LAB CHARGES (BX-20/B)",601)=""
^IBA(364.6,"C","LAB CHARGES (BX-20/B)",1471)=""
^IBA(364.6,"C","LAB OR FACILITY PRIMARY ID",971)=""
^IBA(364.6,"C","LAST MENSTRUAL DT",796)=""
^IBA(364.6,"C","LAST X-RAY DATE",977)=""
^IBA(364.6,"C","LAST XRAY DATE-SPINAL",1033)=""
^IBA(364.6,"C","LIFETIME RESERVED DAYS",785)=""
^IBA(364.6,"C","LINE COB AMT PAID",868)=""
^IBA(364.6,"C","LINE ITEM DATE PAID",976)=""
^IBA(364.6,"C","LOCAL USE (BX-24K)",608)=""
^IBA(364.6,"C","LOWER LINE - 1500 (BX-19)",1469)=""
^IBA(364.6,"C","LOWER LINE - HCFA (BX-19)",546)=""
^IBA(364.6,"C","MAILING ADDR FULL (FORM LN 3)",576)=""
^IBA(364.6,"C","MAILING ADDR FULL (FORM LN 3)",1402)=""
^IBA(364.6,"C","MAILING ADDRESS NM (FORM LN 2)",490)=""
^IBA(364.6,"C","MAILING ADDRESS NM (FORM LN 2)",1401)=""
^IBA(364.6,"C","MAMMOGRAPHY CERT NUMBER",1036)=""
^IBA(364.6,"C","MAMMOGRAPHY CERT# QUALIFIER",1051)=""
^IBA(364.6,"C","MEDICAID RESUB CODE (BX-22/A)",602)=""
^IBA(364.6,"C","MEDICAID RESUB CODE (BX-22/A)",1475)=""
^IBA(364.6,"C","MEDICAL RECORD NUMBER (FL-23)",642)=""
^IBA(364.6,"C","MEDICAL RECORD NUMBER (FL-3B)",1568)=""
^IBA(364.6,"C","MEDICARE ASSIGNNMENT CODE",1035)=""
^IBA(364.6,"C","MOVED TO CI1A-3",968)=""
^IBA(364.6,"C","MRA SECONDARY INDICATOR",1322)=""
^IBA(364.6,"C","MULTIPLE PAGE CHECK/POPULATE",593)=""
^IBA(364.6,"C","MULTIPLE PAGE CHECK/POPULATE",1519)=""
^IBA(364.6,"C","N-OTHER INSURED QUALIF/ID ALL",1080)=""
^IBA(364.6,"C","NDC CODE #",135)=""
^IBA(364.6,"C","NDC FORMAT",1011)=""
^IBA(364.6,"C","NON-COVERED CHARGE",579)=""
^IBA(364.6,"C","NON-COVERED CHARGES (FL-48)",697)=""
^IBA(364.6,"C","NON-COVERED CHARGES (FL-48)",1749)=""
^IBA(364.6,"C","NON-COVERED DAYS",67)=""
^IBA(364.6,"C","NON-COVERED DAYS (FL-8)",626)=""
^IBA(364.6,"C","NON-PAYABLE PROF COMPONENT",826)=""
^IBA(364.6,"C","NON-PAYABLE PROF COMPONENT AMT",847)=""
^IBA(364.6,"C","NON-VA FACILITY ID",1008)=""
^IBA(364.6,"C","NOT USED (FL-2/4)",1566)=""
^IBA(364.6,"C","NOT USED (FL-30/1)",1669)=""
^IBA(364.6,"C","NOT USED (FL-37/1)",1600)=""
^IBA(364.6,"C","NOT USED (FL-37/2)",1601)=""
^IBA(364.6,"C","NOT USED (FL-7/1)",1574)=""
^IBA(364.6,"C","NOT USED (FL-7/2)",1575)=""
^IBA(364.6,"C","OCC SPAN DATE FROM (FL-35/2)",1591)=""
^IBA(364.6,"C","OCC SPAN DATE FROM (FL-36/2)",665)=""
^IBA(364.6,"C","OCC SPAN DATE FROM (FL-36/2)",1595)=""
^IBA(364.6,"C","OCC SPAN DATE TO (FL-35/3)",1592)=""
^IBA(364.6,"C","OCC SPAN DATE TO (FL-36/3)",666)=""
^IBA(364.6,"C","OCC SPAN DATE TO (FL-36/3)",1596)=""
^IBA(364.6,"C","OCCURRENCE CODE",82)=""
^IBA(364.6,"C","OCCURRENCE CODE (FL-31/1)",1582)=""
^IBA(364.6,"C","OCCURRENCE CODE (FL-32/1)",655)=""
^IBA(364.6,"C","OCCURRENCE CODE (FL-32/1)",1584)=""
^IBA(364.6,"C","OCCURRENCE CODE (FL-33/1)",766)=""
^IBA(364.6,"C","OCCURRENCE CODE (FL-33/1)",1586)=""
^IBA(364.6,"C","OCCURRENCE CODE (FL-34/1)",767)=""
^IBA(364.6,"C","OCCURRENCE CODE (FL-34/1)",1588)=""
^IBA(364.6,"C","OCCURRENCE CODE (FL-35/1)",768)=""
^IBA(364.6,"C","OCCURRENCE CODE EXTRACT",141)=""
^IBA(364.6,"C","OCCURRENCE DATE",81)=""
^IBA(364.6,"C","OCCURRENCE DATE (FL-31/2)",1583)=""
^IBA(364.6,"C","OCCURRENCE DATE (FL-32/2)",656)=""
^IBA(364.6,"C","OCCURRENCE DATE (FL-32/2)",1585)=""
^IBA(364.6,"C","OCCURRENCE DATE (FL-33/2)",658)=""
^IBA(364.6,"C","OCCURRENCE DATE (FL-33/2)",1587)=""
^IBA(364.6,"C","OCCURRENCE DATE (FL-34/2)",661)=""
^IBA(364.6,"C","OCCURRENCE DATE (FL-34/2)",1589)=""
^IBA(364.6,"C","OCCURRENCE DATE (FL-35/2)",663)=""
^IBA(364.6,"C","OCCURRENCE SPAN CODE",84)=""
^IBA(364.6,"C","OCCURRENCE SPAN CODE (FL-35/1)",1590)=""
^IBA(364.6,"C","OCCURRENCE SPAN CODE (FL-36/1)",664)=""
^IBA(364.6,"C","OCCURRENCE SPAN CODE (FL-36/1)",1594)=""
^IBA(364.6,"C","OCCURRENCE SPAN FROM DATE",83)=""
^IBA(364.6,"C","OCCURRENCE SPAN TO DATE",481)=""
^IBA(364.6,"C","OLD CAPITAL AMT",838)=""
^IBA(364.6,"C","OPER PHY SECONDARY ID 1",1235)=""
^IBA(364.6,"C","OPER PHY SECONDARY ID 2",1237)=""
^IBA(364.6,"C","OPER PHY SECONDARY ID 3",1239)=""
^IBA(364.6,"C","OPER PHY SECONDARY ID 4",1241)=""
^IBA(364.6,"C","OPER PHY SECONDARY ID 5",1243)=""
^IBA(364.6,"C","OPER PHY SECONDARY QUALIF 1",1234)=""
^IBA(364.6,"C","OPER PHY SECONDARY QUALIF 2",1236)=""
^IBA(364.6,"C","OPER PHY SECONDARY QUALIF 3",1238)=""
^IBA(364.6,"C","OPER PHY SECONDARY QUALIF 4",1240)=""
^IBA(364.6,"C","OPER PHY SECONDARY QUALIF 5",1242)=""
^IBA(364.6,"C","OPERATING ID QUAL (FL-77/1/2)",1744)=""
^IBA(364.6,"C","OPERATING NAME (FL-77/2/1)",1732)=""
^IBA(364.6,"C","OPERATING NAME (FL-77/2/2)",1733)=""
^IBA(364.6,"C","OPERATING NPI (FL-77/1/1)",1743)=""
^IBA(364.6,"C","OPERATING OTHER ID (FL-77/1/3)",1745)=""
^IBA(364.6,"C","OPERATING PERSON/NON-PERSON",1319)=""
^IBA(364.6,"C","OPERATING PHY NAME SUFFIX",950)=""
^IBA(364.6,"C","OPERATING PHY NPI CODE",1328)=""
^IBA(364.6,"C","OPERATING PHY PRIMARY ID CODE",994)=""
^IBA(364.6,"C","OPERATING PHY PRIMARY ID QUAL",993)=""
^IBA(364.6,"C","OPERATING PHY TAXONOMY",1329)=""
^IBA(364.6,"C","OPERATING PHYS FIRST NAME",949)=""
^IBA(364.6,"C","OPERATING PHYS LAST NAME",948)=""
^IBA(364.6,"C","OPERATING PHYS SPECIALTY",939)=""
^IBA(364.6,"C","OPERATING PROV COB SEQUENCE",1304)=""
^IBA(364.6,"C","ORIGINAL REF NO (BX-22/B)",603)=""
^IBA(364.6,"C","ORIGINAL REF NO (BX-22/B)",1476)=""
^IBA(364.6,"C","OTH INS EMPLR (BX-9C)",530)=""
^IBA(364.6,"C","OTH INS EMPLR (BX-9C)",1445)=""
^IBA(364.6,"C","OTH INS PLAN NAME (BX-9D)",534)=""
^IBA(364.6,"C","OTH INS PLAN NAME (BX-9D)",1449)=""
^IBA(364.6,"C","OTH INS SEX=FEMALE (BX-9B/2B)",525)=""
^IBA(364.6,"C","OTH INS SEX=FEMALE (BX-9B/2B)",1440)=""
^IBA(364.6,"C","OTH INS SEX=MALE (BX-9B/2A)",524)=""
^IBA(364.6,"C","OTH INS SEX=MALE (BX-9B/2A)",1439)=""
^IBA(364.6,"C","OTH INS SUBSCR ADDRESS LINE 1",1289)=""
^IBA(364.6,"C","OTH INS SUBSCR ADDRESS LINE 2",1290)=""
^IBA(364.6,"C","OTH INS SUBSCR CITY",1291)=""
^IBA(364.6,"C","OTH INS SUBSCR ID 1",1295)=""
^IBA(364.6,"C","OTH INS SUBSCR ID 2",1297)=""
^IBA(364.6,"C","OTH INS SUBSCR ID 3",1299)=""
^IBA(364.6,"C","OTH INS SUBSCR QUALIF 1",1294)=""
^IBA(364.6,"C","OTH INS SUBSCR QUALIF 2",1296)=""
^IBA(364.6,"C","OTH INS SUBSCR QUALIF 3",1298)=""
^IBA(364.6,"C","OTH INS SUBSCR STATE",1292)=""
^IBA(364.6,"C","OTH INS SUBSCR ZIP",1293)=""
^IBA(364.6,"C","OTH INS TREATMENT AUTH CODE",956)=""
^IBA(364.6,"C","OTH INSURANCE PROVIDER #",195)=""
^IBA(364.6,"C","OTH INSURED DOB (BX-9B/1)",523)=""
^IBA(364.6,"C","OTH INSURED DOB (BX-9B/1)",1438)=""
^IBA(364.6,"C","OTH INSURED NAME (BX-9/1)",515)=""
^IBA(364.6,"C","OTH INSURED NAME (BX-9/1)",1430)=""
^IBA(364.6,"C","OTH INSURED POLICY # (BX-9A)",517)=""
^IBA(364.6,"C","OTH INSURED POLICY # (BX-9A)",1432)=""
^IBA(364.6,"C","OTH PAER OPER PROV ID(2)",1122)=""
^IBA(364.6,"C","OTH PAY OTH PROV ENTITY TYPE",1182)=""
^IBA(364.6,"C","OTH PAY OTH PROV ID QUAL(1)",1183)=""
^IBA(364.6,"C","OTH PAY OTH PROV ID QUAL(2)",1185)=""
^IBA(364.6,"C","OTH PAY OTH PROV ID QUAL(3)",1187)=""
^IBA(364.6,"C","OTH PAY OTH PROV ID(1)",1184)=""
^IBA(364.6,"C","OTH PAY OTH PROV ID(2)",1186)=""
^IBA(364.6,"C","OTH PAY OTH PROV ID(3)",1188)=""
^IBA(364.6,"C","OTH PAY OTH PROV NAME QUAL",1181)=""
^IBA(364.6,"C","OTH PAY PUR PROV ENTITY TYPE",1155)=""
^IBA(364.6,"C","OTH PAY PUR PROV ID QUAL",1154)=""
^IBA(364.6,"C","OTH PAY PUR PROV ID QUAL(1)",1156)=""
^IBA(364.6,"C","OTH PAY PUR PROV ID QUAL(2)",1158)=""
^IBA(364.6,"C","OTH PAY PUR PROV ID QUAL(3)",1160)=""
^IBA(364.6,"C","OTH PAY PUR PROV ID(1)",1157)=""
^IBA(364.6,"C","OTH PAY PUR PROV ID(2)",1159)=""
^IBA(364.6,"C","OTH PAY PUR PROV ID(3)",1161)=""
^IBA(364.6,"C","OTH PAY SERV FAC ID QUAL(1)",1165)=""
^IBA(364.6,"C","OTH PAY SERV FAC ID QUAL(2)",1167)=""
^IBA(364.6,"C","OTH PAY SERV FAC ID QUAL(3)",1169)=""
^IBA(364.6,"C","OTH PAY SERV FAC ID(1)",1166)=""
^IBA(364.6,"C","OTH PAY SERV FAC ID(2)",1168)=""
^IBA(364.6,"C","OTH PAY SERV FAC ID(3)",1170)=""
^IBA(364.6,"C","OTH PAY SERV FAC LOC ENT TYPE",1164)=""
^IBA(364.6,"C","OTH PAY SERV FAC LOC ID QUAL",1163)=""
^IBA(364.6,"C","OTH PAY SUPER PROV ENTITY",1173)=""
^IBA(364.6,"C","OTH PAY SUPER PROV ID QUAL(1)",1174)=""
^IBA(364.6,"C","OTH PAY SUPER PROV ID QUAL(2)",1176)=""
^IBA(364.6,"C","OTH PAY SUPER PROV ID QUAL(3)",1178)=""
^IBA(364.6,"C","OTH PAY SUPER PROV ID(1)",1175)=""
^IBA(364.6,"C","OTH PAY SUPER PROV ID(2)",1177)=""
^IBA(364.6,"C","OTH PAY SUPER PROV ID(3)",1179)=""
^IBA(364.6,"C","OTH PAY SUPER PROV NAM QUAL",1172)=""
^IBA(364.6,"C","OTH PAYER ATT ID QUAL",1110)=""
^IBA(364.6,"C","OTH PAYER ATT ID QUAL(2)",1112)=""
^IBA(364.6,"C","OTH PAYER ATT ID QUAL(3)",1114)=""
^IBA(364.6,"C","OTH PAYER FAC PROV ENTY QUAL",1128)=""
^IBA(364.6,"C","OTH PAYER FAC PROV ID QUAL(1)",1129)=""
^IBA(364.6,"C","OTH PAYER FAC PROV ID QUAL(2)",1131)=""
^IBA(364.6,"C","OTH PAYER FAC PROV ID QUAL(3)",1133)=""
^IBA(364.6,"C","OTH PAYER FAC PROV ID(1)",1130)=""
^IBA(364.6,"C","OTH PAYER FAC PROV ID(2)",1132)=""
^IBA(364.6,"C","OTH PAYER FAC PROV ID(3)",1134)=""
^IBA(364.6,"C","OTH PAYER FAC PROV NAM QUAL",1127)=""
^IBA(364.6,"C","OTH PAYER INSURANCE SEQUENCE",1311)=""
^IBA(364.6,"C","OTH PAYER OPER ENTITY QUAL",1118)=""
^IBA(364.6,"C","OTH PAYER OPER PROV ID QUAL",1119)=""
^IBA(364.6,"C","OTH PAYER OPER PROV ID QUAL(2)",1121)=""
^IBA(364.6,"C","OTH PAYER OPER PROV ID QUAL(3)",1123)=""
^IBA(364.6,"C","OTH PAYER OPER PROV ID(1)",1120)=""
^IBA(364.6,"C","OTH PAYER OPER PROV ID(3)",1124)=""
^IBA(364.6,"C","OTH PAYER OPER PROV NAME QUAL",1117)=""
^IBA(364.6,"C","OTH PAYER PAT ENTITY TYPE",1083)=""
^IBA(364.6,"C","OTH PAYER PAT ID (1)",1087)=""
^IBA(364.6,"C","OTH PAYER PAT ID (2)",1089)=""
^IBA(364.6,"C","OTH PAYER PAT ID (3)",1091)=""
^IBA(364.6,"C","OTH PAYER PAT ID NUMBER",1085)=""
^IBA(364.6,"C","OTH PAYER PAT ID NUMBER QUAL",1084)=""
^IBA(364.6,"C","OTH PAYER PAT ID QUAL (1)",1086)=""
^IBA(364.6,"C","OTH PAYER PAT ID QUAL (2)",1088)=""
^IBA(364.6,"C","OTH PAYER PAT ID QUAL (3)",1090)=""
^IBA(364.6,"C","OTH PAYER PAT ID# 3",1092)=""
^IBA(364.6,"C","OTH PAYER PAT NAME QUAL",1314)=""
^IBA(364.6,"C","OTH PAYER REF PROV ENT TYPE",1137)=""
^IBA(364.6,"C","OTH PAYER REF PROV ID QUAL",1136)=""
^IBA(364.6,"C","OTH PAYER REF PROV ID QUAL(1)",1138)=""
^IBA(364.6,"C","OTH PAYER REF PROV ID QUAL(2)",1140)=""
^IBA(364.6,"C","OTH PAYER REF PROV ID QUAL(3)",1142)=""
^IBA(364.6,"C","OTH PAYER REF PROV ID(1)",1139)=""
^IBA(364.6,"C","OTH PAYER REF PROV ID(2)",1141)=""
^IBA(364.6,"C","OTH PAYER REF PROV ID(3)",1143)=""
^IBA(364.6,"C","OTH PHYS ID (FL-83/4)",757)=""
^IBA(364.6,"C","OTHER DIAG 1 POA (FL-67A/1/2)",1684)=""
^IBA(364.6,"C","OTHER DIAG 10 POA (FL-67J/1/2)",1693)=""
^IBA(364.6,"C","OTHER DIAG 11 POA (FL-67K/1/2)",1694)=""
^IBA(364.6,"C","OTHER DIAG 12 POA (FL-67L/1/2)",1695)=""
^IBA(364.6,"C","OTHER DIAG 13 POA (FL-67M/1/2)",1696)=""
^IBA(364.6,"C","OTHER DIAG 14 POA (FL-67N/1/2)",1697)=""
^IBA(364.6,"C","OTHER DIAG 15 POA (FL-67O/1/2)",1698)=""
^IBA(364.6,"C","OTHER DIAG 16 POA (FL-67P/1/2)",1699)=""
^IBA(364.6,"C","OTHER DIAG 17 POA (FL-67Q/1/2)",1700)=""
^IBA(364.6,"C","OTHER DIAG 2 POA (FL-67B/1/2)",1685)=""
^IBA(364.6,"C","OTHER DIAG 3 POA (FL-67C/1/2)",1686)=""
^IBA(364.6,"C","OTHER DIAG 4 POA (FL-67D/1/2)",1687)=""
^IBA(364.6,"C","OTHER DIAG 5 POA (FL-67E/1/2)",1688)=""
^IBA(364.6,"C","OTHER DIAG 6 POA (FL-67F/1/2)",1689)=""
^IBA(364.6,"C","OTHER DIAG 7 POA (FL-67G/1/2)",1690)=""
^IBA(364.6,"C","OTHER DIAG 8 POA (FL-67H/1/2)",1691)=""
^IBA(364.6,"C","OTHER DIAG 9 POA (FL-67I/1/2)",1692)=""
^IBA(364.6,"C","OTHER DIAG CODE 1 (FL-67A/1/1)",1646)=""
^IBA(364.6,"C","OTHER DIAG CODE 1 (FL-68)",725)=""
^IBA(364.6,"C","OTHER DIAG CODE 10(FL-67J/1/1)",1602)=""
^IBA(364.6,"C","OTHER DIAG CODE 11(FL-67K/1/1)",1614)=""
^IBA(364.6,"C","OTHER DIAG CODE 12(FL-67L/1/1)",1615)=""
^IBA(364.6,"C","OTHER DIAG CODE 13(FL-67M/1/1)",1655)=""
^IBA(364.6,"C","OTHER DIAG CODE 14(FL-67N/1/1)",1656)=""
^IBA(364.6,"C","OTHER DIAG CODE 15(FL-67O/1/1)",1657)=""
^IBA(364.6,"C","OTHER DIAG CODE 16(FL-67P/1/1)",1658)=""
^IBA(364.6,"C","OTHER DIAG CODE 17(FL-67Q/1/1)",1659)=""
^IBA(364.6,"C","OTHER DIAG CODE 2 (FL-67B/1/1)",1647)=""
^IBA(364.6,"C","OTHER DIAG CODE 2 (FL-69)",726)=""
^IBA(364.6,"C","OTHER DIAG CODE 3 (FL-67C/1/1)",1648)=""
^IBA(364.6,"C","OTHER DIAG CODE 3 (FL-70)",727)=""
^IBA(364.6,"C","OTHER DIAG CODE 4 (FL-67D/1/1)",1649)=""
^IBA(364.6,"C","OTHER DIAG CODE 4 (FL-71)",728)=""
^IBA(364.6,"C","OTHER DIAG CODE 5 (FL-67E/1/1)",1650)=""
^IBA(364.6,"C","OTHER DIAG CODE 5 (FL-72)",729)=""
^IBA(364.6,"C","OTHER DIAG CODE 6 (FL-67F/1/1)",1651)=""
^IBA(364.6,"C","OTHER DIAG CODE 6 (FL-73)",730)=""
^IBA(364.6,"C","OTHER DIAG CODE 7 (FL-67G/1/1)",1652)=""
^IBA(364.6,"C","OTHER DIAG CODE 7 (FL-74)",731)=""
^IBA(364.6,"C","OTHER DIAG CODE 8 (FL-67H/1/1)",1653)=""
^IBA(364.6,"C","OTHER DIAG CODE 8 (FL-75)",732)=""
^IBA(364.6,"C","OTHER DIAG CODE 9 (FL-67I/1/1)",1654)=""
^IBA(364.6,"C","OTHER FACILITY ADDRESS",171)=""
^IBA(364.6,"C","OTHER FACILITY CITY",172)=""
^IBA(364.6,"C","OTHER FACILITY NAME",170)=""
^IBA(364.6,"C","OTHER FACILITY STATE",173)=""
^IBA(364.6,"C","OTHER FACILITY ZIP",174)=""
^IBA(364.6,"C","OTHER INS COB ADJ DATA",890)=""
^IBA(364.6,"C","OTHER INS COB MIA(1) DATA",888)=""
^IBA(364.6,"C","OTHER INS COB MOA DATA",887)=""
^IBA(364.6,"C","OTHER INS DATA",886)=""
^IBA(364.6,"C","OTHER INS PAT SIG SOURCE CODE",1065)=""
^IBA(364.6,"C","OTHER INS POLICY TYPE",805)=""
^IBA(364.6,"C","OTHER INS TYPE OF INSURANCE",804)=""
^IBA(364.6,"C","OTHER INSURANCE ADDRESS LINE 1",1073)=""
^IBA(364.6,"C","OTHER INSURANCE ADDRESS LINE2",1074)=""
^IBA(364.6,"C","OTHER INSURANCE CITY",1075)=""
^IBA(364.6,"C","OTHER INSURANCE CO NAME",96)=""
^IBA(364.6,"C","OTHER INSURANCE FULL ADDRESS",1072)=""
^IBA(364.6,"C","OTHER INSURANCE GROUP NAME",100)=""
^IBA(364.6,"C","OTHER INSURANCE GRP NUMBER",98)=""
^IBA(364.6,"C","OTHER INSURANCE ID NUMBER",99)=""
^IBA(364.6,"C","OTHER INSURANCE PRIOR PAYMENT",106)=""
^IBA(364.6,"C","OTHER INSURANCE PT RELATION",97)=""
^IBA(364.6,"C","OTHER INSURANCE SEQUENCE",95)=""
^IBA(364.6,"C","OTHER INSURANCE SEQUENCE",230)=""
^IBA(364.6,"C","OTHER INSURANCE SEQUENCE",808)=""
^IBA(364.6,"C","OTHER INSURANCE SEQUENCE",817)=""
^IBA(364.6,"C","OTHER INSURANCE SEQUENCE",828)=""
^IBA(364.6,"C","OTHER INSURANCE SEQUENCE",840)=""
^IBA(364.6,"C","OTHER INSURANCE SEQUENCE",854)=""
^IBA(364.6,"C","OTHER INSURANCE SEQUENCE",1312)=""
^IBA(364.6,"C","OTHER INSURANCE SEQUENCE",1313)=""
^IBA(364.6,"C","OTHER INSURANCE STATE",1076)=""
^IBA(364.6,"C","OTHER INSURANCE ZIP",1077)=""
^IBA(364.6,"C","OTHER INSURED BIRTH DATE",104)=""
^IBA(364.6,"C","OTHER INSURED DEMOGRAPHICS",163)=""
^IBA(364.6,"C","OTHER INSURED EMPLOY STAT",107)=""
^IBA(364.6,"C","OTHER INSURED EMPLOYER CITY",109)=""
^IBA(364.6,"C","OTHER INSURED EMPLOYER GROUP",164)=""
^IBA(364.6,"C","OTHER INSURED EMPLOYER NAME",108)=""
^IBA(364.6,"C","OTHER INSURED EMPLOYER STATE",110)=""
^IBA(364.6,"C","OTHER INSURED EMPLOYER STREET",988)=""
^IBA(364.6,"C","OTHER INSURED FIRST NAME",102)=""
^IBA(364.6,"C","OTHER INSURED FORM LOCATOR 64",111)=""
^IBA(364.6,"C","OTHER INSURED FULL NAME",162)=""
^IBA(364.6,"C","OTHER INSURED LAST NAME",101)=""
^IBA(364.6,"C","OTHER INSURED MIDDLE NAME",103)=""
^IBA(364.6,"C","OTHER INSURED NAME SUFFIX",1081)=""
^IBA(364.6,"C","OTHER INSURED QUALIFIER/ID#",1078)=""
^IBA(364.6,"C","OTHER INSURED SEX",105)=""
^IBA(364.6,"C","OTHER NAME (FL-78/2/1)",1736)=""
^IBA(364.6,"C","OTHER NAME (FL-78/2/2)",1737)=""
^IBA(364.6,"C","OTHER NAME (FL-79/2/1)",1738)=""
^IBA(364.6,"C","OTHER NAME (FL-79/2/2)",1739)=""
^IBA(364.6,"C","OTHER NPI (FL-79/1/2)",1751)=""
^IBA(364.6,"C","OTHER PAYER ATT NAME QUAL",1107)=""
^IBA(364.6,"C","OTHER PAYER ATT PROV ID(2)",1113)=""
^IBA(364.6,"C","OTHER PAYER ATT PROV ID(3)",1115)=""
^IBA(364.6,"C","OTHER PAYER ATT PROV QUAL",1108)=""
^IBA(364.6,"C","OTHER PAYER ATTENDING PROV ID",1111)=""
^IBA(364.6,"C","OTHER PHYS ID (FL-83/1)",753)=""
^IBA(364.6,"C","OTHER PHYS ID (FL-83/2)",752)=""
^IBA(364.6,"C","OTHER PHYS ID (FL-83/3)",755)=""
^IBA(364.6,"C","OTHER PROC CODE 1 (FL-74A/1)",1673)=""
^IBA(364.6,"C","OTHER PROC CODE 1 (FL-81/1.1)",741)=""
^IBA(364.6,"C","OTHER PROC CODE 2 (FL-74B/1)",1675)=""
^IBA(364.6,"C","OTHER PROC CODE 2 (FL-81/1.3)",743)=""
^IBA(364.6,"C","OTHER PROC CODE 3 (FL-74C/1)",1677)=""
^IBA(364.6,"C","OTHER PROC CODE 3 (FL-81/2.1)",746)=""
^IBA(364.6,"C","OTHER PROC CODE 4 (FL-74D/1)",1679)=""
^IBA(364.6,"C","OTHER PROC CODE 4 (FL-81/2.3)",748)=""
^IBA(364.6,"C","OTHER PROC CODE 5 (FL-74E/1)",1681)=""
^IBA(364.6,"C","OTHER PROC CODE 5 (FL-81/2.5)",750)=""
^IBA(364.6,"C","OTHER PROC DATE 1 (FL-74A/1)",1674)=""
^IBA(364.6,"C","OTHER PROC DATE 1 (FL-81/1.2)",742)=""
^IBA(364.6,"C","OTHER PROC DATE 2 (FL-74B/2)",1676)=""
^IBA(364.6,"C","OTHER PROC DATE 2 (FL-81/1.4)",744)=""
^IBA(364.6,"C","OTHER PROC DATE 3 (FL-74C/2)",1678)=""
^IBA(364.6,"C","OTHER PROC DATE 3 (FL-81/2.2)",747)=""
^IBA(364.6,"C","OTHER PROC DATE 4 (FL-74D/2)",1680)=""
^IBA(364.6,"C","OTHER PROC DATE 4 (FL-81/2.4)",749)=""
^IBA(364.6,"C","OTHER PROC DATE 5 (FL-74E/2)",1682)=""
^IBA(364.6,"C","OTHER PROC DATE 5 (FL-81/2.6)",751)=""
^IBA(364.6,"C","OTHER PROV COB SEQUENCE",1310)=""
^IBA(364.6,"C","OTHER PROV FIRST NAME",946)=""
^IBA(364.6,"C","OTHER PROV ID (FL-78/1/4)",1748)=""
^IBA(364.6,"C","OTHER PROV ID (FL-79/1/4)",1753)=""
^IBA(364.6,"C","OTHER PROV ID QUAL (FL-78/1/3)",1747)=""
^IBA(364.6,"C","OTHER PROV ID QUAL (FL-79/1/3)",1752)=""
^IBA(364.6,"C","OTHER PROV LAST NAME",945)=""
^IBA(364.6,"C","OTHER PROV NAME SUFFIX",947)=""
^IBA(364.6,"C","OTHER PROV NPI CODE",1326)=""
^IBA(364.6,"C","OTHER PROV PERSON/NON-PERSON",990)=""
^IBA(364.6,"C","OTHER PROV PRIMARY ID CODE",992)=""
^IBA(364.6,"C","OTHER PROV PRIMARY ID QUAL",991)=""
^IBA(364.6,"C","OTHER PROV SECOND ID 1",1245)=""
^IBA(364.6,"C","OTHER PROV SECOND ID 2",1247)=""
^IBA(364.6,"C","OTHER PROV SECOND ID 3",1249)=""
^IBA(364.6,"C","OTHER PROV SECOND ID 4",1251)=""
^IBA(364.6,"C","OTHER PROV SECOND ID 5",1253)=""
^IBA(364.6,"C","OTHER PROV SECOND QUALIF 1",1244)=""
^IBA(364.6,"C","OTHER PROV SECOND QUALIF 2",1246)=""
^IBA(364.6,"C","OTHER PROV SECOND QUALIF 3",1248)=""
^IBA(364.6,"C","OTHER PROV SECOND QUALIF 4",1250)=""
^IBA(364.6,"C","OTHER PROV SECOND QUALIF 5",1252)=""
^IBA(364.6,"C","OTHER PROV TAXONOMY",1327)=""
^IBA(364.6,"C","OTHER PROVIDER NPI (FL-78/1/2)",1746)=""
^IBA(364.6,"C","OTHER PRV ID (FL-57A:C)",1660)=""
^IBA(364.6,"C","OUTPT CODE TYPE",113)=""
^IBA(364.6,"C","OUTPT LINE CHARGE",114)=""
^IBA(364.6,"C","OUTPT LINE NUMBER FOR CLAIM",112)=""
^IBA(364.6,"C","OUTPT PROCEDURE/REVENUE CODE",194)=""
^IBA(364.6,"C","OUTPT REIMBURSEMENT %",818)=""
^IBA(364.6,"C","OUTPT UNITS",115)=""
^IBA(364.6,"C","OUTSIDE LAB (BX-20/1B)",547)=""
^IBA(364.6,"C","OUTSIDE LAB? NO (BX-20)",1520)=""
^IBA(364.6,"C","OUTSIDE LAB? YES (BX-20)",1470)=""
^IBA(364.6,"C","PATIENT ACCT NUMBER (BX-26)",564)=""
^IBA(364.6,"C","PATIENT ACCT NUMBER (BX-26)",1495)=""
^IBA(364.6,"C","PATIENT ADDR. - CITY (FL-9B)",1579)=""
^IBA(364.6,"C","PATIENT ADDR. - CNTRY (FL-9E)",1593)=""
^IBA(364.6,"C","PATIENT ADDR. - STATE (FL-9C)",1580)=""
^IBA(364.6,"C","PATIENT ADDR. - STREET (FL-9A)",1578)=""
^IBA(364.6,"C","PATIENT ADDR. - ZIP (FL-9D)",1581)=""
^IBA(364.6,"C","PATIENT ADDRESS LINE 1",33)=""
^IBA(364.6,"C","PATIENT ADDRESS LINE 2",34)=""
^IBA(364.6,"C","PATIENT BIRTHDATE",38)=""
^IBA(364.6,"C","PATIENT CITY",35)=""
^IBA(364.6,"C","PATIENT CITY ADDRESS (BX-5/2A)",507)=""
^IBA(364.6,"C","PATIENT CITY ADDRESS (BX-5/2A)",1418)=""
^IBA(364.6,"C","PATIENT CONTROL #",44)=""
^IBA(364.6,"C","PATIENT CONTROL NUMBER (FL-3)",617)=""
^IBA(364.6,"C","PATIENT CONTROL NUMBER (FL-3A)",1567)=""
^IBA(364.6,"C","PATIENT DATE OF DEATH",795)=""
^IBA(364.6,"C","PATIENT DOB (BX-3/1)",497)=""
^IBA(364.6,"C","PATIENT DOB (BX-3/1)",1406)=""
^IBA(364.6,"C","PATIENT DOB (FL-10)",1603)=""
^IBA(364.6,"C","PATIENT DOB (FL-14)",633)=""
^IBA(364.6,"C","PATIENT EMPLOYER NAME",43)=""
^IBA(364.6,"C","PATIENT FIRST NAME",31)=""
^IBA(364.6,"C","PATIENT FULL NAME",140)=""
^IBA(364.6,"C","PATIENT ID (FL-8A)",1576)=""
^IBA(364.6,"C","PATIENT LAST NAME",30)=""
^IBA(364.6,"C","PATIENT MARITAL STATUS",40)=""
^IBA(364.6,"C","PATIENT MARITAL STATUS (FL-16)",635)=""
^IBA(364.6,"C","PATIENT MIDDLE NAME",32)=""
^IBA(364.6,"C","PATIENT NAME (BX-2)",496)=""
^IBA(364.6,"C","PATIENT NAME (BX-2)",1405)=""
^IBA(364.6,"C","PATIENT NAME (FL-12)",630)=""
^IBA(364.6,"C","PATIENT NAME (FL-8B)",1577)=""
^IBA(364.6,"C","PATIENT PHONE",790)=""
^IBA(364.6,"C","PATIENT REASON DX (FL-70/1/1)",1707)=""
^IBA(364.6,"C","PATIENT REASON DX (FL-70/1/2)",1708)=""
^IBA(364.6,"C","PATIENT REASON DX (FL-70/1/3)",1709)=""
^IBA(364.6,"C","PATIENT RELATION (FL-59A:C)",714)=""
^IBA(364.6,"C","PATIENT RELATION (FL-59A:C)",1662)=""
^IBA(364.6,"C","PATIENT SEX",39)=""
^IBA(364.6,"C","PATIENT SEX (FL-11)",1604)=""
^IBA(364.6,"C","PATIENT SEX (FL-15)",634)=""
^IBA(364.6,"C","PATIENT SEX=FEMALE (BX-3/2B)",499)=""
^IBA(364.6,"C","PATIENT SEX=FEMALE (BX-3/2B)",1408)=""
^IBA(364.6,"C","PATIENT SEX=MALE (BX-3/2A)",498)=""
^IBA(364.6,"C","PATIENT SEX=MALE (BX-3/2A)",1407)=""
^IBA(364.6,"C","PATIENT SHORT ADDRESS (FL-13)",631)=""
^IBA(364.6,"C","PATIENT SIGNATURE (BX-12)",537)=""
^IBA(364.6,"C","PATIENT SIGNATURE (BX-12)",1455)=""
^IBA(364.6,"C","PATIENT SIGNATURE DT (BX-12/2)",967)=""
^IBA(364.6,"C","PATIENT SIGNATURE DT (BX-12/2)",1456)=""
^IBA(364.6,"C","PATIENT SSN",41)=""
^IBA(364.6,"C","PATIENT STATE",36)=""
^IBA(364.6,"C","PATIENT STATE (BX-5/2B)",508)=""
^IBA(364.6,"C","PATIENT STATE (BX-5/2B)",1419)=""
^IBA(364.6,"C","PATIENT STATUS",64)=""
^IBA(364.6,"C","PATIENT STATUS (FL-17)",1610)=""
^IBA(364.6,"C","PATIENT STATUS (FL-22)",641)=""
^IBA(364.6,"C","PATIENT STR ADDRESS (BX-5/1)",501)=""
^IBA(364.6,"C","PATIENT STR ADDRESS (BX-5/1)",1411)=""
^IBA(364.6,"C","PATIENT TELEPHONE (BX-5/3B)",513)=""
^IBA(364.6,"C","PATIENT TELEPHONE (BX-5/3B)",1426)=""
^IBA(364.6,"C","PATIENT WEIGHT",1030)=""
^IBA(364.6,"C","PATIENT ZIP CODE",37)=""
^IBA(364.6,"C","PATIENT ZIP CODE (BX-5/3A)",512)=""
^IBA(364.6,"C","PATIENT ZIP CODE (BX-5/3A)",1425)=""
^IBA(364.6,"C","PAY-TO FACILITY NAME (FL-2/1)",1560)=""
^IBA(364.6,"C","PAYER NAME (FL-50A:C)",704)=""
^IBA(364.6,"C","PAYER NAME (FL-50A:C)",1640)=""
^IBA(364.6,"C","PAYER SEQUENCE",1321)=""
^IBA(364.6,"C","PLACE OF SERVICE",116)=""
^IBA(364.6,"C","PLACE OF SERVICE (BX-24B)",556)=""
^IBA(364.6,"C","PLACE OF SERVICE (BX-24B)",1483)=""
^IBA(364.6,"C","PPS CAPITAL DSH DRG AMT",837)=""
^IBA(364.6,"C","PPS CAPITAL EXCEPTION AMT",852)=""
^IBA(364.6,"C","PPS CAPITAL FSP DRG AMT",835)=""
^IBA(364.6,"C","PPS CAPITAL HSP DRG AMT",836)=""
^IBA(364.6,"C","PPS CAPITAL IME AMT",841)=""
^IBA(364.6,"C","PPS CODE (FL-71)",1710)=""
^IBA(364.6,"C","PPS OPER FED SPEC DRG AMT",844)=""
^IBA(364.6,"C","PPS OPER HOSP SPEC DRG AMT",842)=""
^IBA(364.6,"C","PREGNANCY INDICATOR",1031)=""
^IBA(364.6,"C","PRESCRIPTION LINE # FOR CLAIM",133)=""
^IBA(364.6,"C","PRESCRIPTION NUMBER",134)=""
^IBA(364.6,"C","PRIMARY DX CODE FLAG",93)=""
^IBA(364.6,"C","PRIMARY INS ATT/REND PROV ID",984)=""
^IBA(364.6,"C","PRIN DIAG CODE (FL-67)",724)=""
^IBA(364.6,"C","PRIN DIAG CODE (FL-67/1/1)",1598)=""
^IBA(364.6,"C","PRIN DIAG POA (FL-67/1/2)",1683)=""
^IBA(364.6,"C","PRIN PROCEDURE CODE (FL-74/1)",1565)=""
^IBA(364.6,"C","PRIN PROCEDURE CODE (FL-80/1)",739)=""
^IBA(364.6,"C","PRIN PROCEDURE DATE (FL-74/2)",1672)=""
^IBA(364.6,"C","PRIN PROCEDURE DATE (FL-80/2)",740)=""
^IBA(364.6,"C","PRINT STAT (HCFA-1500 TOP LN)",489)=""
^IBA(364.6,"C","PRINT STAT (UB-04 TOP LINE)",1551)=""
^IBA(364.6,"C","PRINT STAT (UB92 TOP LINE)",612)=""
^IBA(364.6,"C","PRINT STATUS (1500 TOP LINE)",1400)=""
^IBA(364.6,"C","PRIOR AUTH NUMBER (BX-23)",552)=""
^IBA(364.6,"C","PRIOR AUTH NUMBER (BX-23)",1479)=""
^IBA(364.6,"C","PRIOR PAYMENTS (FL-54A:C)",708)=""
^IBA(364.6,"C","PRIOR PAYMENTS (FL-54A:C)",1644)=""
^IBA(364.6,"C","PROC CODING METHOD (FL-79)",737)=""
^IBA(364.6,"C","PROC MODIFIER 1",128)=""
^IBA(364.6,"C","PROC MODIFIER 2",129)=""
^IBA(364.6,"C","PROCEDURE (BX-24D/1)",558)=""
^IBA(364.6,"C","PROCEDURE (BX-24D/1)",1485)=""
^IBA(364.6,"C","PROCEDURE CODE",86)=""
^IBA(364.6,"C","PROCEDURE CODES/DATES",139)=""
^IBA(364.6,"C","PROCEDURE DATE",85)=""
^IBA(364.6,"C","PROCEDURE EXTRACT",738)=""
^IBA(364.6,"C","PROCEDURE EXTRACT",1703)=""
^IBA(364.6,"C","PROCEDURE QUALIFIER",87)=""
^IBA(364.6,"C","PROCEDURE TYPE",1012)=""
^IBA(364.6,"C","PROF PROC MODIFIER 1",610)=""
^IBA(364.6,"C","PROF PROC MODIFIER 2",859)=""
^IBA(364.6,"C","PROF PROC MODIFIER 3",860)=""
^IBA(364.6,"C","PROF PROC MODIFIER 4",861)=""
^IBA(364.6,"C","PROF TYPE OF POLICY",1005)=""
^IBA(364.6,"C","PROF TYPE OF UNITS",863)=""
^IBA(364.6,"C","PROV TYPE QUAL (FL-78/1/1)",1755)=""
^IBA(364.6,"C","PROV TYPE QUAL (FL-79/1/1)",1754)=""
^IBA(364.6,"C","PROVIDER NUMBER (FL-51A:C)",705)=""
^IBA(364.6,"C","PROVIDER REP DATE (FL-85/1B)",761)=""
^IBA(364.6,"C","PROVIDER REP LINE 1 (FL-85/1A)",760)=""
^IBA(364.6,"C","PROVIDER SIGNATURE ON FILE",74)=""
^IBA(364.6,"C","PT EMPL STAT=EMPLOYD (BX-8/2A)",514)=""
^IBA(364.6,"C","PT EMPL STAT=EMPLOYD (BX-8/2A)",1427)=""
^IBA(364.6,"C","PT EMPLOYMENT STATUS",29)=""
^IBA(364.6,"C","PT MARITAL STAT=MARRD (BX-8/B)",510)=""
^IBA(364.6,"C","PT MARITAL STAT=MARRD (BX-8/B)",1421)=""
^IBA(364.6,"C","PT MARITAL STAT=OTHER (BX-8/C)",511)=""
^IBA(364.6,"C","PT MARITAL STAT=OTHER (BX-8/C)",1422)=""
^IBA(364.6,"C","PT MARITAL STAT=SINGL (BX-8/A)",509)=""
^IBA(364.6,"C","PT MARITAL STAT=SINGL (BX-8/A)",1420)=""
^IBA(364.6,"C","PT PRIOR PAYMENTS (FL-54/4)",711)=""
^IBA(364.6,"C","PT REL TO INSRD=CHILD (BX-6)",504)=""
^IBA(364.6,"C","PT REL TO INSRD=CHILD (BX-6)",1414)=""
^IBA(364.6,"C","PT REL TO INSRD=OTHER (BX-6)",505)=""
^IBA(364.6,"C","PT REL TO INSRD=OTHER (BX-6)",1415)=""
^IBA(364.6,"C","PT REL TO INSRD=SPOUSE (BX-6)",503)=""
^IBA(364.6,"C","PT REL TO INSRD=SPOUSE (BX-6)",1413)=""
^IBA(364.6,"C","PT REL TO INSURED=SELF (BX-6)",502)=""
^IBA(364.6,"C","PT REL TO INSURED=SELF (BX-6)",1412)=""
^IBA(364.6,"C","PURCH SERV ENTITY TYP QUALIF",1196)=""
^IBA(364.6,"C","PURCH SERV PRIM QUALIF",1195)=""
^IBA(364.6,"C","PURCH SERV SECOND ID 1",1198)=""
^IBA(364.6,"C","PURCH SERV SECOND ID 2",1200)=""
^IBA(364.6,"C","PURCH SERV SECOND ID 3",1202)=""
^IBA(364.6,"C","PURCH SERV SECOND ID 4",1204)=""
^IBA(364.6,"C","PURCH SERV SECOND ID 5",1206)=""
^IBA(364.6,"C","PURCH SERV SECOND QUALIF 1",1040)=""
^IBA(364.6,"C","PURCH SERV SECOND QUALIF 2",1199)=""
^IBA(364.6,"C","PURCH SERV SECOND QUALIF 3",1201)=""
^IBA(364.6,"C","PURCH SERV SECOND QUALIF 4",1203)=""
^IBA(364.6,"C","PURCH SERV SECOND QUALIF 5",1205)=""
^IBA(364.6,"C","PURCH SERVICE CHARGE",974)=""
^IBA(364.6,"C","PURCH SVC CHARGES (BX-20/C)",1001)=""
^IBA(364.6,"C","PURCH SVC CHARGES (BX-20/C)",1472)=""
^IBA(364.6,"C","PURCH/REMOTE SVC FLAG",972)=""
^IBA(364.6,"C","PURCHASE PROV COB SEQUENCE",1308)=""
^IBA(364.6,"C","PURCHASED NON-LAB CHARGES",1194)=""
^IBA(364.6,"C","PURCHASED SVC PROV NPI CODE",1336)=""
^IBA(364.6,"C","PURCHASED SVC PROV TAXONOMY",1337)=""
^IBA(364.6,"C","RECEIVER ID NUMBER",175)=""
^IBA(364.6,"C","RECORD ID 'CC1 '",245)=""
^IBA(364.6,"C","RECORD ID 'CCAS'",853)=""
^IBA(364.6,"C","RECORD ID 'CCOM'",577)=""
^IBA(364.6,"C","RECORD ID 'CI1 '",210)=""
^IBA(364.6,"C","RECORD ID 'CI1A'",1190)=""
^IBA(364.6,"C","RECORD ID 'CI2 '",212)=""
^IBA(364.6,"C","RECORD ID 'CI3 '",213)=""
^IBA(364.6,"C","RECORD ID 'CI4 '",1017)=""
^IBA(364.6,"C","RECORD ID 'CL1 '",216)=""
^IBA(364.6,"C","RECORD ID 'CL1A'",1189)=""
^IBA(364.6,"C","RECORD ID 'COB1'",807)=""
^IBA(364.6,"C","RECORD ID 'COM '",247)=""
^IBA(364.6,"C","RECORD ID 'DC1 '",246)=""
^IBA(364.6,"C","RECORD ID 'GEN '",206)=""
^IBA(364.6,"C","RECORD ID 'INS '",252)=""
^IBA(364.6,"C","RECORD ID 'LCAS'",878)=""
^IBA(364.6,"C","RECORD ID 'LCOB'",865)=""
^IBA(364.6,"C","RECORD ID 'MIA1'",827)=""
^IBA(364.6,"C","RECORD ID 'MIA2'",839)=""
^IBA(364.6,"C","RECORD ID 'MOA1'",816)=""
^IBA(364.6,"C","RECORD ID 'NPI '",1323)=""
^IBA(364.6,"C","RECORD ID 'OC1 '",240)=""
^IBA(364.6,"C","RECORD ID 'OCS '",242)=""
^IBA(364.6,"C","RECORD ID 'OI1 '",249)=""
^IBA(364.6,"C","RECORD ID 'OI2 '",250)=""
^IBA(364.6,"C","RECORD ID 'OI3 '",1082)=""
^IBA(364.6,"C","RECORD ID 'OI4 '",1287)=""
^IBA(364.6,"C","RECORD ID 'OI5 '",1288)=""
^IBA(364.6,"C","RECORD ID 'OP1 '",1106)=""
^IBA(364.6,"C","RECORD ID 'OP2 '",1116)=""
^IBA(364.6,"C","RECORD ID 'OP3 '",1126)=""
^IBA(364.6,"C","RECORD ID 'OP4 '",1135)=""
^IBA(364.6,"C","RECORD ID 'OP6 '",1153)=""
^IBA(364.6,"C","RECORD ID 'OP7 '",1162)=""
^IBA(364.6,"C","RECORD ID 'OP8 '",1171)=""
^IBA(364.6,"C","RECORD ID 'OP9 '",1180)=""
^IBA(364.6,"C","RECORD ID 'OPR '",1223)=""
^IBA(364.6,"C","RECORD ID 'OPR1'",1222)=""
^IBA(364.6,"C","RECORD ID 'OPR2'",1221)=""
^IBA(364.6,"C","RECORD ID 'OPR3'",1220)=""
^IBA(364.6,"C","RECORD ID 'OPR4'",1300)=""
^IBA(364.6,"C","RECORD ID 'OPR5'",1218)=""
^IBA(364.6,"C","RECORD ID 'OPR7'",1056)=""
^IBA(364.6,"C","RECORD ID 'OPR8'",1219)=""
^IBA(364.6,"C","RECORD ID 'PC1 '",243)=""
^IBA(364.6,"C","RECORD ID 'PRF '",251)=""
^IBA(364.6,"C","RECORD ID 'PRV '",209)=""
^IBA(364.6,"C","RECORD ID 'PT1 '",214)=""
^IBA(364.6,"C","RECORD ID 'PT2 '",215)=""
^IBA(364.6,"C","RECORD ID 'REC '",208)=""
^IBA(364.6,"C","RECORD ID 'RX1 '",253)=""
^IBA(364.6,"C","RECORD ID 'SUB '",207)=""
^IBA(364.6,"C","RECORD ID 'SUB1'",1197)=""
^IBA(364.6,"C","RECORD ID 'SUB2'",1207)=""
^IBA(364.6,"C","RECORD ID 'UB1 '",217)=""
^IBA(364.6,"C","RECORD ID 'VC1 '",244)=""
^IBA(364.6,"C","REF PROV OTH ID QUAL (17A/1)",1462)=""
^IBA(364.6,"C","REF PROV OTH ID# (BX 17A/2)",1463)=""
^IBA(364.6,"C","REFERING PROV SECOND ID 1",1255)=""
^IBA(364.6,"C","REFERING PROV SECOND ID 2",1257)=""
^IBA(364.6,"C","REFERING PROV SECOND ID 3",1259)=""
^IBA(364.6,"C","REFERING PROV SECOND ID 4",1261)=""
^IBA(364.6,"C","REFERING PROV SECOND ID 5",1263)=""
^IBA(364.6,"C","REFERING PROV SECOND QUALIF 1",1254)=""
^IBA(364.6,"C","REFERING PROV SECOND QUALIF 2",1256)=""
^IBA(364.6,"C","REFERING PROV SECOND QUALIF 3",1258)=""
^IBA(364.6,"C","REFERING PROV SECOND QUALIF 4",1260)=""
^IBA(364.6,"C","REFERING PROV SECOND QUALIF 5",1262)=""
^IBA(364.6,"C","REFERRING PERSON/NON-PERSON",1318)=""
^IBA(364.6,"C","REFERRING PHY NAME SUFFIX",936)=""
^IBA(364.6,"C","REFERRING PHY PRIMARY ID CODE",1048)=""
^IBA(364.6,"C","REFERRING PHY PRIMARY ID QUAL",1047)=""
^IBA(364.6,"C","REFERRING PROV COB SEQUENCE",1306)=""
^IBA(364.6,"C","REFERRING PROV NAME (BX 17)",1464)=""
^IBA(364.6,"C","REFERRING PROV NPI CODE",1332)=""
^IBA(364.6,"C","REFERRING PROV NPI# (BX 17B)",1465)=""
^IBA(364.6,"C","REFERRING PROV SPECIALTY",951)=""
^IBA(364.6,"C","REFERRING PROV TAXONOMY",1333)=""
^IBA(364.6,"C","REFERRING PROVIDER FIRST NAME",937)=""
^IBA(364.6,"C","REFERRING PROVIDER LAST NAME",938)=""
^IBA(364.6,"C","REFERRING PROVIDER STATE",935)=""
^IBA(364.6,"C","REFILL #",136)=""
^IBA(364.6,"C","REFILL DATE",138)=""
^IBA(364.6,"C","RELEASE OF INFO (FL-52A:C)",706)=""
^IBA(364.6,"C","RELEASE OF INFO (FL-52A:C)",1642)=""
^IBA(364.6,"C","RELEASE OF INFO SIG (12A)",995)=""
^IBA(364.6,"C","RELEASE OF INFO SIG (12A)",1453)=""
^IBA(364.6,"C","RELEASE OF INFORMATION",48)=""
^IBA(364.6,"C","REMARKS (FL-80)",1723)=""
^IBA(364.6,"C","REMARKS CODE 1",820)=""
^IBA(364.6,"C","REMARKS CODE 2",821)=""
^IBA(364.6,"C","REMARKS CODE 3",822)=""
^IBA(364.6,"C","REMARKS CODE 4",823)=""
^IBA(364.6,"C","REMARKS CODE 5",923)=""
^IBA(364.6,"C","REMARKS LINE 1 (FL-84a)",754)=""
^IBA(364.6,"C","REMARKS LINE 2 (FL-84b)",756)=""
^IBA(364.6,"C","REMARKS LINE 3 (FL-84c)",758)=""
^IBA(364.6,"C","REMARKS LINE 4 (FL-84d)",759)=""
^IBA(364.6,"C","RENDERING PROVIDER CREDENTIALS",1007)=""
^IBA(364.6,"C","RENDERING PROVIDER ID (BX-24J)",1491)=""
^IBA(364.6,"C","RESERVED (FL-30/2)",1638)=""
^IBA(364.6,"C","RESERVED (FL-41/23)",1756)=""
^IBA(364.6,"C","RESERVED (FL-49)",1750)=""
^IBA(364.6,"C","RESERVED BY NUBC (FL-68/1)",1701)=""
^IBA(364.6,"C","RESERVED BY NUBC (FL-68/2)",1702)=""
^IBA(364.6,"C","RESERVED BY NUBC (FL-73)",1716)=""
^IBA(364.6,"C","RESERVED BY NUBC (FL-75/1)",1719)=""
^IBA(364.6,"C","RESERVED BY NUBC (FL-75/2)",1720)=""
^IBA(364.6,"C","RESERVED BY NUBC (FL-75/3)",1721)=""
^IBA(364.6,"C","RESERVED BY NUBC (FL-75/4)",1722)=""
^IBA(364.6,"C","RESP PARTY ADDR LN 1 (FL-38/2)",679)=""
^IBA(364.6,"C","RESP PARTY ADDR LN 2 (FL-38/3)",687)=""
^IBA(364.6,"C","RESP PARTY ADDR LN 3 (FL-38/4)",688)=""
^IBA(364.6,"C","RESP PARTY ADDR LN 4 (FL-38/5)",689)=""
^IBA(364.6,"C","RESP PARTY ADDRESS EXTRACT",772)=""
^IBA(364.6,"C","RESP PARTY ADDRESS LINE1",1024)=""
^IBA(364.6,"C","RESP PARTY ADDRESS LINE2",1025)=""
^IBA(364.6,"C","RESPONSIBLE NAME LAST/ORG",1020)=""
^IBA(364.6,"C","RESPONSIBLE PARTY CITY",1026)=""
^IBA(364.6,"C","RESPONSIBLE PARTY FIRST NAME",1021)=""
^IBA(364.6,"C","RESPONSIBLE PARTY MIDDLE NAME",1022)=""
^IBA(364.6,"C","RESPONSIBLE PARTY NM (FL-38/1)",678)=""
^IBA(364.6,"C","RESPONSIBLE PARTY STATE",1027)=""
^IBA(364.6,"C","RESPONSIBLE PARTY SUFFIX",1023)=""
^IBA(364.6,"C","RESPONSIBLE PARTY ZIP CODE",1028)=""
^IBA(364.6,"C","REV CODE DESCRIPTION (FL-43)",692)=""
^IBA(364.6,"C","REV CODE DESCRIPTION (FL-43)",1706)=""
^IBA(364.6,"C","REV CODE EXTRACT (FL-42:49)",690)=""
^IBA(364.6,"C","REV CODE EXTRACT (FL-42:49)",1704)=""
^IBA(364.6,"C","REVENUE CODE (FL-42)",691)=""
^IBA(364.6,"C","REVENUE CODE (FL-42)",1705)=""
^IBA(364.6,"C","SEGMENT DELIMITER",583)=""
^IBA(364.6,"C","SERV FAC COB SEQUENCE",1309)=""
^IBA(364.6,"C","SERV FAC ENTITY TYPE QUALIFIER",1042)=""
^IBA(364.6,"C","SERV FAC ID CODE QUALIF",1045)=""
^IBA(364.6,"C","SERV FAC OTH ID# (BX-32B)",1516)=""
^IBA(364.6,"C","SERV FAC PROV ORGANIZ NAME",1043)=""
^IBA(364.6,"C","SERV FAC SECONDARY ID 1",1209)=""
^IBA(364.6,"C","SERV FAC SECONDARY ID 2",1211)=""
^IBA(364.6,"C","SERV FAC SECONDARY ID 3",1213)=""
^IBA(364.6,"C","SERV FAC SECONDARY ID 4",1215)=""
^IBA(364.6,"C","SERV FAC SECONDARY ID 5",1217)=""
^IBA(364.6,"C","SERV FAC SECONDARY QUALIF 1",1044)=""
^IBA(364.6,"C","SERV FAC SECONDARY QUALIF 2",1210)=""
^IBA(364.6,"C","SERV FAC SECONDARY QUALIF 3",1212)=""
^IBA(364.6,"C","SERV FAC SECONDARY QUALIF 4",1214)=""
^IBA(364.6,"C","SERV FAC SECONDARY QUALIF 5",1216)=""
^IBA(364.6,"C","SERVICE DATE (FL-45)",694)=""
^IBA(364.6,"C","SERVICE DATE (FL-45)",1718)=""
^IBA(364.6,"C","SERVICE FAC NPI (BX-32A)",1515)=""
^IBA(364.6,"C","SERVICE FAC. ADDRESS LINE2",1039)=""
^IBA(364.6,"C","SERVICE FACILITY ID NUMBER",1046)=""
^IBA(364.6,"C","SERVICE FROM DATE",131)=""
^IBA(364.6,"C","SERVICE LINE COMMENT",1006)=""
^IBA(364.6,"C","SERVICE LN EXTRACT - CMS 1500",1480)=""
^IBA(364.6,"C","SERVICE LN EXTRACT - HCFA 1500",592)=""
^IBA(364.6,"C","SERVICE TO DATE",132)=""
^IBA(364.6,"C","SERVICE UNITS (FL-46)",695)=""
^IBA(364.6,"C","SERVICE UNITS (FL-46)",1734)=""
^IBA(364.6,"C","SERVICE/LAB FACILITY PROV CODE",1041)=""
^IBA(364.6,"C","SET BATCH HDR NODE",193)=""
^IBA(364.6,"C","SET INSURANCE CO HDR NODE",791)=""
^IBA(364.6,"C","SIGNATURE REQ FLAG - TOP LINE",611)=""
^IBA(364.6,"C","SITE NUMBER",488)=""
^IBA(364.6,"C","SORT CONDITION CODES",1759)=""
^IBA(364.6,"C","SOURCE OF ADMISSION",62)=""
^IBA(364.6,"C","SPECIAL PROGRAM",75)=""
^IBA(364.6,"C","SPINAL MANIP. CONDITION CODE",1037)=""
^IBA(364.6,"C","SPRVSING PHY PRIMARY ID CODE",1063)=""
^IBA(364.6,"C","SPRVSING PHY PRIMARY ID QUAL",1062)=""
^IBA(364.6,"C","SPRVSING PROV FIRST NAME",1059)=""
^IBA(364.6,"C","SPRVSING PROV FULL NAME",1057)=""
^IBA(364.6,"C","SPRVSING PROV LAST NAME",1058)=""
^IBA(364.6,"C","SPRVSING PROV MIDDLE NAME",1060)=""
^IBA(364.6,"C","SPRVSING PROV NAME SUFFIX",1061)=""
^IBA(364.6,"C","STATE CODE FOR AUTO ACCIDENT",73)=""
^IBA(364.6,"C","STATEMENT COVERS FROM DATE",51)=""
^IBA(364.6,"C","STATEMENT COVERS TO DATE",479)=""
^IBA(364.6,"C","STATEMENT FROM DATE (FL-6A)",623)=""
^IBA(364.6,"C","STATEMENT FROM DATE (FL-6A)",1572)=""
^IBA(364.6,"C","STATEMENT THRU DATE (FL-6B)",624)=""
^IBA(364.6,"C","STATEMENT THRU DATE (FL-6B)",1573)=""
^IBA(364.6,"C","SUPERV PROV COB SEQUENCE",1301)=""
^IBA(364.6,"C","SUPERV PROV SECOND ID 1",1278)=""
^IBA(364.6,"C","SUPERV PROV SECOND ID 2",1280)=""
^IBA(364.6,"C","SUPERV PROV SECOND ID 3",1282)=""
^IBA(364.6,"C","SUPERV PROV SECOND ID 4",1284)=""
^IBA(364.6,"C","SUPERV PROV SECOND ID 5",1286)=""
^IBA(364.6,"C","SUPERV PROV SECOND QUALIF 1",1277)=""
^IBA(364.6,"C","SUPERV PROV SECOND QUALIF 2",1279)=""
^IBA(364.6,"C","SUPERV PROV SECOND QUALIF 3",1281)=""
^IBA(364.6,"C","SUPERV PROV SECOND QUALIF 4",1283)=""
^IBA(364.6,"C","SUPERV PROV SECOND QUALIF 5",1285)=""
^IBA(364.6,"C","SUPERVISING PROV NPI CODE",1330)=""
^IBA(364.6,"C","SUPERVISING PROV TAXONOMY",1331)=""
^IBA(364.6,"C","SVC FACILITY PROV NPI CODE",1338)=""
^IBA(364.6,"C","SVC FACILITY PROV TAXONOMY",1339)=""
^IBA(364.6,"C","TOT CHRG-PRIOR PYMNTS (BX-30)",595)=""
^IBA(364.6,"C","TOT CHRG-PRIOR PYMNTS (BX-30)",1499)=""
^IBA(364.6,"C","TOTAL CHARGE (BX-28)",565)=""
^IBA(364.6,"C","TOTAL CHARGE (BX-28)",1497)=""
^IBA(364.6,"C","TOTAL CHARGES",53)=""
^IBA(364.6,"C","TOTAL CHARGES (FL-47)",696)=""
^IBA(364.6,"C","TOTAL CHARGES (FL-47)",1735)=""
^IBA(364.6,"C","TOTAL OUTSIDE LAB CHARGES",783)=""
^IBA(364.6,"C","TOTAL PRIOR PAYMENTS (BX-29)",594)=""
^IBA(364.6,"C","TOTAL PRIOR PAYMENTS (BX-29)",1498)=""
^IBA(364.6,"C","TREATMENT AUTH CODE",957)=""
^IBA(364.6,"C","TREATMNT AUTH CODES (FL-63A:C)",718)=""
^IBA(364.6,"C","TREATMNT AUTH CODES (FL-63A:C)",1666)=""
^IBA(364.6,"C","TYPE OF ADMISSION",63)=""
^IBA(364.6,"C","TYPE OF BILL (FL-4)",1569)=""
^IBA(364.6,"C","TYPE OF BILL CLASSIFICATION",775)=""
^IBA(364.6,"C","TYPE OF FACILITY",45)=""
^IBA(364.6,"C","TYPE OF SERVICE",117)=""
^IBA(364.6,"C","TYPE OF SERVICE (BX-24C)",557)=""
^IBA(364.6,"C","UB-04 PRE-FORM HOUSEKEEPING",1550)=""
^IBA(364.6,"C","UB92 FORM LOCATOR 2 (FL-2/1)",614)=""
^IBA(364.6,"C","UB92 FORM LOCATOR 2 (FL-2/2)",616)=""
^IBA(364.6,"C","UB92 PRE-FORM HOUSEKEEPING",765)=""
^IBA(364.6,"C","UB92 TYPE OF BILL (FL-4)",618)=""
^IBA(364.6,"C","UNIT OR BASIS FOR MEASUREMENT",1029)=""
^IBA(364.6,"C","UNITS (BX-24G)",561)=""
^IBA(364.6,"C","UNITS (BX-24G)",1488)=""
^IBA(364.6,"C","UPPER FORM LOCATOR 5",953)=""
^IBA(364.6,"C","UPPER FORM LOCATOR 5",1570)=""
^IBA(364.6,"C","UPPER LINE 1500 (BX-19)",1468)=""
^IBA(364.6,"C","UPPER LINE HCFA (BX-19)",545)=""
^IBA(364.6,"C","VA GRP # (BX-33/LN5B)",788)=""
^IBA(364.6,"C","VA PIN # (BX-33/LN5A)",959)=""
^IBA(364.6,"C","VALUE CODE",88)=""
^IBA(364.6,"C","VALUE CODE DOLLARS",89)=""
^IBA(364.6,"C","VALUE CODE EXTRACT (FL-39:41)",680)=""
^IBA(364.6,"C","VALUE CODE EXTRACT (FL-39:41)",1616)=""
^IBA(364.6,"C","VALUE CODE GROUP",161)=""
^IBA(364.6,"C","VALUE CODE QUANTITY",90)=""
^IBA(364.6,"C","VALUE CODE REBUILD (FL-39:41)",1618)=""
^IBA(364.6,"C","VALUE CODE SORT (FL-39:41)",1617)=""
^IBA(364.6,"C","VALUE CODES AMT 1 (FL-39a:d/2)",682)=""
^IBA(364.6,"C","VALUE CODES AMT 1 (FL-39a:d/2)",1620)=""
^IBA(364.6,"C","VALUE CODES AMT 2 (FL-40a:d/2)",684)=""
^IBA(364.6,"C","VALUE CODES AMT 2 (FL-40a:d/2)",1622)=""
^IBA(364.6,"C","VALUE CODES AMT 3 (FL-41a:d/2)",686)=""
^IBA(364.6,"C","VALUE CODES AMT 3 (FL-41a:d/2)",1624)=""
^IBA(364.6,"C","VALUE CODES CD 1 (FL-39a:d/1)",681)=""
^IBA(364.6,"C","VALUE CODES CD 1 (FL-39a:d/1)",1619)=""
^IBA(364.6,"C","VALUE CODES CD 2 (FL-40a:d/1)",683)=""
^IBA(364.6,"C","VALUE CODES CD 2 (FL-40a:d/1)",1621)=""
^IBA(364.6,"C","VALUE CODES CD 3 (FL-41a:d/1)",685)=""
^IBA(364.6,"C","VALUE CODES CD 3 (FL-41a:d/1)",1623)=""
^IBA(364.6,"C","X12 Version Number for HIPAA",1014)=""
^IBA(364.6,"D","12,1,1,1",489)=""
^IBA(364.6,"D","12,1,11,1",496)=""
^IBA(364.6,"D","12,1,11,31",497)=""
^IBA(364.6,"D","12,1,11,42",498)=""
^IBA(364.6,"D","12,1,11,47",499)=""
^IBA(364.6,"D","12,1,11,49.9",782)=""
^IBA(364.6,"D","12,1,11,50",500)=""
^IBA(364.6,"D","12,1,13,1",501)=""
^IBA(364.6,"D","12,1,13,33",502)=""
^IBA(364.6,"D","12,1,13,38",503)=""
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^IBA(364.6,"D","8,35,1,11",999)=""
^IBA(364.6,"D","8,35,1,12",987)=""
^IBA(364.6,"D","8,35,1,2",189)=""
^IBA(364.6,"D","8,35,1,3",190)=""
^IBA(364.6,"D","8,35,1,4",191)=""
^IBA(364.6,"D","8,35,1,4.9",13)=""
^IBA(364.6,"D","8,35,1,5",18)=""
^IBA(364.6,"D","8,35,1,6",15)=""
^IBA(364.6,"D","8,35,1,7",14)=""
^IBA(364.6,"D","8,35,1,8",794)=""
^IBA(364.6,"D","8,35,1,9",957)=""
^IBA(364.6,"D","8,35,1,99.9",146)=""
^IBA(364.6,"D","8,36,1,1",1017)=""
^IBA(364.6,"D","8,36,1,10",1026)=""
^IBA(364.6,"D","8,36,1,11",1027)=""
^IBA(364.6,"D","8,36,1,12",1028)=""
^IBA(364.6,"D","8,36,1,2",1018)=""
^IBA(364.6,"D","8,36,1,3",1019)=""
^IBA(364.6,"D","8,36,1,4",1020)=""
^IBA(364.6,"D","8,36,1,5",1021)=""
^IBA(364.6,"D","8,36,1,6",1022)=""
^IBA(364.6,"D","8,36,1,7",1023)=""
^IBA(364.6,"D","8,36,1,8",1024)=""
^IBA(364.6,"D","8,36,1,9",1025)=""
^IBA(364.6,"D","8,40,1,1",214)=""
^IBA(364.6,"D","8,40,1,10",36)=""
^IBA(364.6,"D","8,40,1,11",37)=""
^IBA(364.6,"D","8,40,1,12",38)=""
^IBA(364.6,"D","8,40,1,13",39)=""
^IBA(364.6,"D","8,40,1,14",40)=""
^IBA(364.6,"D","8,40,1,15",41)=""
^IBA(364.6,"D","8,40,1,16",42)=""
^IBA(364.6,"D","8,40,1,17",1029)=""
^IBA(364.6,"D","8,40,1,18",1030)=""
^IBA(364.6,"D","8,40,1,19",1031)=""
^IBA(364.6,"D","8,40,1,2",28)=""
^IBA(364.6,"D","8,40,1,3",29)=""
^IBA(364.6,"D","8,40,1,3.9",140)=""
^IBA(364.6,"D","8,40,1,4",30)=""
^IBA(364.6,"D","8,40,1,5",31)=""
^IBA(364.6,"D","8,40,1,6",32)=""
^IBA(364.6,"D","8,40,1,7",33)=""
^IBA(364.6,"D","8,40,1,8",34)=""
^IBA(364.6,"D","8,40,1,9",35)=""
^IBA(364.6,"D","8,45,1,1",215)=""
^IBA(364.6,"D","8,45,1,2",43)=""
^IBA(364.6,"D","8,45,1,3",790)=""
^IBA(364.6,"D","8,45,1,4",795)=""
^IBA(364.6,"D","8,45,1,99.9",147)=""
^IBA(364.6,"D","8,5,1,1",206)=""
^IBA(364.6,"D","8,5,1,2",167)=""
^IBA(364.6,"D","8,5,1,3",168)=""
^IBA(364.6,"D","8,5,1,4",169)=""
^IBA(364.6,"D","8,5,1,5",488)=""
^IBA(364.6,"D","8,5,1,6",175)=""
^IBA(364.6,"D","8,5,1,7",1014)=""
^IBA(364.6,"D","8,5,1,99.9",144)=""
^IBA(364.6,"D","8,50,1,1",216)=""
^IBA(364.6,"D","8,50,1,10",51)=""
^IBA(364.6,"D","8,50,1,11",479)=""
^IBA(364.6,"D","8,50,1,12",52)=""
^IBA(364.6,"D","8,50,1,13",53)=""
^IBA(364.6,"D","8,50,1,13.9",142)=""
^IBA(364.6,"D","8,50,1,14",54)=""
^IBA(364.6,"D","8,50,1,15",55)=""
^IBA(364.6,"D","8,50,1,15.9",143)=""
^IBA(364.6,"D","8,50,1,16",56)=""
^IBA(364.6,"D","8,50,1,17",57)=""
^IBA(364.6,"D","8,50,1,18",58)=""
^IBA(364.6,"D","8,50,1,19",59)=""
^IBA(364.6,"D","8,50,1,2",44)=""
^IBA(364.6,"D","8,50,1,20",60)=""
^IBA(364.6,"D","8,50,1,21",61)=""
^IBA(364.6,"D","8,50,1,22",62)=""
^IBA(364.6,"D","8,50,1,23",63)=""
^IBA(364.6,"D","8,50,1,24",64)=""
^IBA(364.6,"D","8,50,1,25",796)=""
^IBA(364.6,"D","8,50,1,26",66)=""
^IBA(364.6,"D","8,50,1,27",67)=""
^IBA(364.6,"D","8,50,1,28",70)=""
^IBA(364.6,"D","8,50,1,29",71)=""
^IBA(364.6,"D","8,50,1,3",45)=""
^IBA(364.6,"D","8,50,1,30",72)=""
^IBA(364.6,"D","8,50,1,31",73)=""
^IBA(364.6,"D","8,50,1,32",74)=""
^IBA(364.6,"D","8,50,1,33",166)=""
^IBA(364.6,"D","8,50,1,34",784)=""
^IBA(364.6,"D","8,50,1,35",785)=""
^IBA(364.6,"D","8,50,1,36",952)=""
^IBA(364.6,"D","8,50,1,37",960)=""
^IBA(364.6,"D","8,50,1,38",965)=""
^IBA(364.6,"D","8,50,1,4",775)=""
^IBA(364.6,"D","8,50,1,5",46)=""
^IBA(364.6,"D","8,50,1,6",47)=""
^IBA(364.6,"D","8,50,1,7",48)=""
^IBA(364.6,"D","8,50,1,8",49)=""
^IBA(364.6,"D","8,50,1,9",50)=""
^IBA(364.6,"D","8,51,1,1",1189)=""
^IBA(364.6,"D","8,51,1,2",1032)=""
^IBA(364.6,"D","8,51,1,3",1033)=""
^IBA(364.6,"D","8,51,1,4",1034)=""
^IBA(364.6,"D","8,51,1,5",1035)=""
^IBA(364.6,"D","8,51,1,6",1036)=""
^IBA(364.6,"D","8,51,1,7",1037)=""
^IBA(364.6,"D","8,51,1,8",1038)=""
^IBA(364.6,"D","8,51,1,9",1051)=""
^IBA(364.6,"D","8,55,1,1",207)=""
^IBA(364.6,"D","8,55,1,10",972)=""
^IBA(364.6,"D","8,55,1,11",1194)=""
^IBA(364.6,"D","8,55,1,12",1039)=""
^IBA(364.6,"D","8,55,1,13",1195)=""
^IBA(364.6,"D","8,55,1,14",1196)=""
^IBA(364.6,"D","8,55,1,2",170)=""
^IBA(364.6,"D","8,55,1,3",171)=""
^IBA(364.6,"D","8,55,1,4",172)=""
^IBA(364.6,"D","8,55,1,5",173)=""
^IBA(364.6,"D","8,55,1,6",174)=""
^IBA(364.6,"D","8,55,1,7",783)=""
^IBA(364.6,"D","8,55,1,8",970)=""
^IBA(364.6,"D","8,55,1,9",971)=""
^IBA(364.6,"D","8,56,1,1",1197)=""
^IBA(364.6,"D","8,56,1,10",1205)=""
^IBA(364.6,"D","8,56,1,11",1206)=""
^IBA(364.6,"D","8,56,1,2",1040)=""
^IBA(364.6,"D","8,56,1,3",1198)=""
^IBA(364.6,"D","8,56,1,4",1199)=""
^IBA(364.6,"D","8,56,1,5",1200)=""
^IBA(364.6,"D","8,56,1,6",1201)=""
^IBA(364.6,"D","8,56,1,7",1202)=""
^IBA(364.6,"D","8,56,1,8",1203)=""
^IBA(364.6,"D","8,56,1,9",1204)=""
^IBA(364.6,"D","8,57,1,1",1207)=""
^IBA(364.6,"D","8,57,1,10",1211)=""
^IBA(364.6,"D","8,57,1,11",1212)=""
^IBA(364.6,"D","8,57,1,12",1213)=""
^IBA(364.6,"D","8,57,1,13",1214)=""
^IBA(364.6,"D","8,57,1,14",1215)=""
^IBA(364.6,"D","8,57,1,15",1216)=""
^IBA(364.6,"D","8,57,1,16",1217)=""
^IBA(364.6,"D","8,57,1,2",1041)=""
^IBA(364.6,"D","8,57,1,3",1042)=""
^IBA(364.6,"D","8,57,1,4",1043)=""
^IBA(364.6,"D","8,57,1,5",1045)=""
^IBA(364.6,"D","8,57,1,6",1046)=""
^IBA(364.6,"D","8,57,1,7",1044)=""
^IBA(364.6,"D","8,57,1,8",1209)=""
^IBA(364.6,"D","8,57,1,9",1210)=""
^IBA(364.6,"D","8,60,1,1",217)=""
^IBA(364.6,"D","8,60,1,19",1002)=""
^IBA(364.6,"D","8,60,1,2",165)=""
^IBA(364.6,"D","8,60,1,3",75)=""
^IBA(364.6,"D","8,60,1,4",76)=""
^IBA(364.6,"D","8,60,1,99.9",197)=""
^IBA(364.6,"D","8,65,1,1",240)=""
^IBA(364.6,"D","8,65,1,1.9",141)=""
^IBA(364.6,"D","8,65,1,2",81)=""
^IBA(364.6,"D","8,65,1,3",82)=""
^IBA(364.6,"D","8,70,1,1",242)=""
^IBA(364.6,"D","8,70,1,2",83)=""
^IBA(364.6,"D","8,70,1,3",481)=""
^IBA(364.6,"D","8,70,1,4",84)=""
^IBA(364.6,"D","8,70,1,99.9",159)=""
^IBA(364.6,"D","8,75,1,1",243)=""
^IBA(364.6,"D","8,75,1,1.9",139)=""
^IBA(364.6,"D","8,75,1,2",85)=""
^IBA(364.6,"D","8,75,1,3",86)=""
^IBA(364.6,"D","8,75,1,4",87)=""
^IBA(364.6,"D","8,75,1,99.9",150)=""
^IBA(364.6,"D","8,80,1,1",244)=""
^IBA(364.6,"D","8,80,1,1.9",161)=""
^IBA(364.6,"D","8,80,1,2",88)=""
^IBA(364.6,"D","8,80,1,3",89)=""
^IBA(364.6,"D","8,80,1,4",90)=""
^IBA(364.6,"D","8,80,1,99.9",151)=""
^IBA(364.6,"D","8,85,1,1",245)=""
^IBA(364.6,"D","8,85,1,2",91)=""
^IBA(364.6,"D","8,85,1,99.9",152)=""
^IBA(364.6,"D","8,90,1,1",246)=""
^IBA(364.6,"D","8,90,1,2",92)=""
^IBA(364.6,"D","8,90,1,3",93)=""
^IBA(364.6,"D","8,90,1,99.9",153)=""
^IBA(364.6,"D","8,95,1,1",247)=""
^IBA(364.6,"D","8,95,1,2",94)=""
^IBA(364.6,"D","8,95,1,99.9",154)=""
^IBA(364.6,"D","8,96,1,1",1223)=""
^IBA(364.6,"D","8,96,1,10",949)=""
^IBA(364.6,"D","8,96,1,11",950)=""
^IBA(364.6,"D","8,96,1,12",939)=""
^IBA(364.6,"D","8,96,1,13",938)=""
^IBA(364.6,"D","8,96,1,14",937)=""
^IBA(364.6,"D","8,96,1,15",936)=""
^IBA(364.6,"D","8,96,1,16",935)=""
^IBA(364.6,"D","8,96,1,17",951)=""
^IBA(364.6,"D","8,96,1,18",984)=""
^IBA(364.6,"D","8,96,1,2",941)=""
^IBA(364.6,"D","8,96,1,3",942)=""
^IBA(364.6,"D","8,96,1,4",943)=""
^IBA(364.6,"D","8,96,1,5",944)=""
^IBA(364.6,"D","8,96,1,6",945)=""
^IBA(364.6,"D","8,96,1,7",946)=""
^IBA(364.6,"D","8,96,1,8",947)=""
^IBA(364.6,"D","8,96,1,9",948)=""
^IBA(364.6,"D","8,97,1,1",1222)=""
^IBA(364.6,"D","8,97,1,10",1007)=""
^IBA(364.6,"D","8,97,1,11",1047)=""
^IBA(364.6,"D","8,97,1,12",1048)=""
^IBA(364.6,"D","8,97,1,14",1318)=""
^IBA(364.6,"D","8,97,1,15",1319)=""
^IBA(364.6,"D","8,97,1,2",985)=""
^IBA(364.6,"D","8,97,1,3",986)=""
^IBA(364.6,"D","8,97,1,4",973)=""
^IBA(364.6,"D","8,97,1,5",991)=""
^IBA(364.6,"D","8,97,1,6",992)=""
^IBA(364.6,"D","8,97,1,7",990)=""
^IBA(364.6,"D","8,97,1,8",993)=""
^IBA(364.6,"D","8,97,1,9",994)=""
^IBA(364.6,"D","8,98,1,1",1221)=""
^IBA(364.6,"D","8,98,1,10",1232)=""
^IBA(364.6,"D","8,98,1,11",1233)=""
^IBA(364.6,"D","8,98,1,2",1224)=""
^IBA(364.6,"D","8,98,1,3",1225)=""
^IBA(364.6,"D","8,98,1,4",1226)=""
^IBA(364.6,"D","8,98,1,5",1227)=""
^IBA(364.6,"D","8,98,1,6",1228)=""
^IBA(364.6,"D","8,98,1,7",1229)=""
^IBA(364.6,"D","8,98,1,8",1230)=""
^IBA(364.6,"D","8,98,1,9",1231)=""
^IBA(364.6,"D","8,99,1,1",1220)=""
^IBA(364.6,"D","8,99,1,10",1242)=""
^IBA(364.6,"D","8,99,1,11",1243)=""
^IBA(364.6,"D","8,99,1,2",1234)=""
^IBA(364.6,"D","8,99,1,3",1235)=""
^IBA(364.6,"D","8,99,1,4",1236)=""
^IBA(364.6,"D","8,99,1,5",1237)=""
^IBA(364.6,"D","8,99,1,6",1238)=""
^IBA(364.6,"D","8,99,1,7",1239)=""
^IBA(364.6,"D","8,99,1,8",1240)=""
^IBA(364.6,"D","8,99,1,9",1241)=""
^IBA(364.7,0)="IB FORM FIELD CONTENT^364.7IP^1459^1265"
^IBA(364.7,1,0)="1^N^54^^^^N"
^IBA(364.7,1,3,0)="^^1^1^2991007^^^^"
^IBA(364.7,1,3,1,0)="If data element's value is null, don't output it."
^IBA(364.7,2,0)="4^N^2^^^^N"
^IBA(364.7,2,1)="S IBXSAVE(""INM"")=$$NAME^IBCEFG1(IBXDATA) K IBXDATA"
^IBA(364.7,2,3,0)="^^2^2^2991007^^^^"
^IBA(364.7,2,3,1,0)="Changes data element (name) into LAST^FIRST^MIDDLE format.  Saves data in"
^IBA(364.7,2,3,2,0)="IBXSAVE array for use by later fields.  No output."
^IBA(364.7,3,0)="5^N^3^^^^N"
^IBA(364.7,3,1)="I $$WNRBILL^IBEFUNC(IBXIEN) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA)"
^IBA(364.7,3,3,0)="^^2^2^2991007^^^^"
^IBA(364.7,3,3,1,0)="If data element's value is null, don't output it."
^IBA(364.7,3,3,2,0)="If this is the HIC # for MEDICARE, strip the dashes, if any."
^IBA(364.7,4,0)="6^N^4^^^^N"
^IBA(364.7,4,1)="N IBZA S IBXSAVE(""IADR"")=IBXDATA D F^IBCEF(""N-CURRENT INSURED RELATIONSHIP"",""IBZA"") I +IBZA=1!(+IBZA=2),$$FT^IBCEF(IBXIEN)=2 S IBXSAVE(""IADR"")=""SAME"""
^IBA(364.7,4,3,0)="^^1^1^2991007^^^^"
^IBA(364.7,4,3,1,0)="Saves off data element in IBXSAVE array.  No output."
^IBA(364.7,5,0)="7^N^5^^^^N"
^IBA(364.7,5,1)="S IBXDATA=$TR($P($G(IBXSAVE(""IADR"")),U,2),""-/.,()'"",""  "") I IBXDATA="""" D PTSELF^IBCEF73 I $G(IBXDATA)=""18"" S IBXDATA=$TR($$PTADDR^IBCEF(IBXIEN,4),""-/.,()'"",""  "")"
^IBA(364.7,5,3,0)="2^364.73^2^2^3030911^^^^"
^IBA(364.7,5,3,1,0)="Retrieves insured city data from IBXSAVE array previously extracted.  If"
^IBA(364.7,5,3,2,0)="data element's value is null, do not output."
^IBA(364.7,6,0)="3^N^103^^^^N"
^IBA(364.7,6,1)="K:$D(^TMP(""IBHDR"",$J)) IBXDATA S:'$D(IBXDATA) IBXNOREQ=1"
^IBA(364.7,6,3,0)="^364.73^1^1^3031105^^^^"
^IBA(364.7,6,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR"",$J) will already exist.  Don't want to extract this field again, so kill data element so there is no output."
^IBA(364.7,7,0)="9^N^5^^^^N"
^IBA(364.7,7,1)="S IBXDATA=$P($G(IBXSAVE(""IADR"")),U,4) I IBXDATA="""" D PTSELF^IBCEF73 I $G(IBXDATA)=""18"" S IBXDATA=$$PTADDR^IBCEF(IBXIEN,11)"
^IBA(364.7,7,3,0)="^364.73^2^2^3030911^^^^"
^IBA(364.7,7,3,1,0)="Retrieves insured zip code address data from IBXSAVE array previously"
^IBA(364.7,7,3,2,0)="extracted.  If data element's value is null, do not output."
^IBA(364.7,8,0)="10^N^6^^^^N"
^IBA(364.7,8,1)="S IBXSAVE(""IDEM"")=$$DT^IBCEFG1($P(IBXDATA,U),"""",""D8"")_U_$P(IBXDATA,U,2)_U_$$NOPUNCT^IBCEF($P(IBXDATA,U,3),1) K IBXDATA"
^IBA(364.7,8,3,0)="^^3^3^2991115^^^^"
^IBA(364.7,8,3,1,0)="Saves off data element in IBXSAVE array with the first '^' piece of the"
^IBA(364.7,8,3,2,0)="data reformatted to a date format of CCYYMMDD and phone # stripped of"
^IBA(364.7,8,3,3,0)="punctuation.  No output."
^IBA(364.7,9,0)="11^N^5^^^^N"
^IBA(364.7,9,1)="S IBXDATA=$P($G(IBXSAVE(""IDEM"")),U,2)"
^IBA(364.7,9,3,0)="^^2^2^2960815^^^^"
^IBA(364.7,9,3,1,0)="Retrieves insured demographics from IBXSAVE array previously extracted.  If"
^IBA(364.7,9,3,2,0)="data element's value is null, do not output."
^IBA(364.7,10,0)="12^N^5^^^^N"
^IBA(364.7,10,1)="S IBXDATA=$P($G(IBXSAVE(""IDEM"")),U,3)"
^IBA(364.7,10,3,0)="^^2^2^2991007^^^^"
^IBA(364.7,10,3,1,0)="Retrieves insured demographics from IBXSAVE array previously extracted.  If"
^IBA(364.7,10,3,2,0)="data element's value is null, do not output."
^IBA(364.7,11,0)="13^N^7^^^^N"
^IBA(364.7,11,1)="S IBXSAVE(""EMP"")=IBXDATA K IBXDATA"
^IBA(364.7,11,3,0)="^^1^1^3000107^^^^"
^IBA(364.7,11,3,1,0)="Saves off data element in IBXSAVE array.  Do not output."
^IBA(364.7,12,0)="1015^N^5^^^^N"
^IBA(364.7,12,1)="S IBXDATA=$P($G(IBXSAVE(""BILLING PRV"",IBXIEN,""C"",1,3)),U,1)"
^IBA(364.7,12,3,0)="^364.73^7^7^3041202^^^^"
^IBA(364.7,12,3,1,0)="EI=Employer ID;SY=Social Security Number;0B=State License Number;"
^IBA(364.7,12,3,2,0)="1A = Blue Cross Number;1B=Blue Shield Number;1C=Medicare Number;"
^IBA(364.7,12,3,3,0)="1D = Medicaid Number;1G=UPIN Number;1H=TRICARE ID Number;"
^IBA(364.7,12,3,4,0)="B3 = PPO Number;BQ=HMO Code Number;U3=USIN Number;G2=Commercial Number;"
^IBA(364.7,12,3,5,0)="FH = Clinic Number;X5=State Industrial Accident Provider Number;"
^IBA(364.7,12,3,6,0)="LU=Location Number"
^IBA(364.7,12,3,7,0)="This is the X12 interpretation of the type of billing provider id for this insurance co.  It is calculated from the electronic type of plan. Refer to the 837 V4010 (professional) fields 2010BB/REF(2)/01 and 2000B/SBR/09 for details."
^IBA(364.7,13,0)="1016^N^5^^^^N^0"
^IBA(364.7,13,1)="S IBXDATA=$P($G(IBXSAVE(""INM"")),U,5)"
^IBA(364.7,13,3,0)="^364.73^3^3^3030910^^^^"
^IBA(364.7,13,3,1,0)="INSURED NAME SUFFIX also known as SUBSCRIBER NAME SUFFIX. It is extracted "
^IBA(364.7,13,3,2,0)="using a function call, $$SETSTR^VALM1 to get the full name then an IB"
^IBA(364.7,13,3,3,0)="function to format it, $$NAME^IBCEFG1."
^IBA(364.7,14,0)="17^N^5^^^^N"
^IBA(364.7,14,1)="S IBXDATA=$P($G(IBXSAVE(""IADR"")),U,5) I IBXDATA="""" D PTSELF^IBCEF73 I $G(IBXDATA)=""18"" S IBXDATA=$G(^UTILITY(""VAPA"",$J,1))"
^IBA(364.7,14,3,0)="^364.73^2^2^3030911^^^^"
^IBA(364.7,14,3,1,0)="Retrieves insured address data from IBXSAVE array previously extracted.  If"
^IBA(364.7,14,3,2,0)="data element's value is null, do not output."
^IBA(364.7,15,0)="16^N^5^^^^N"
^IBA(364.7,15,1)="S IBXDATA=$P($G(IBXSAVE(""IDEM"")),U)"
^IBA(364.7,15,3,0)="^^2^2^3000217^^^^"
^IBA(364.7,15,3,1,0)="Retrieves insured demographics data from IBXSAVE array previously extracted."
^IBA(364.7,15,3,2,0)=" "
^IBA(364.7,16,0)="18^N^5^^^^N"
^IBA(364.7,16,1)="S IBXDATA=$P($G(IBXSAVE(""EMP"")),U)"
^IBA(364.7,16,3,0)="^^2^2^2991006^^^^"
^IBA(364.7,16,3,1,0)="Retrieves insured employment info from IBXSAVE array previously extracted."
^IBA(364.7,16,3,2,0)="If data element's value is null, do not output."
^IBA(364.7,17,0)="1017^N^131^^^^N"
^IBA(364.7,17,1)="S IBXDATA=""CI4 """
^IBA(364.7,17,3,0)="^^2^2^3030811^^^^"
^IBA(364.7,17,3,1,0)="Loop 2110, Piece 1 of Sequence 36, Current Insured Group - Responsible"
^IBA(364.7,17,3,2,0)="Party Information. RECORD ID = CI4"
^IBA(364.7,18,0)="1018^N^5^^^^N^1"
^IBA(364.7,18,1)="K IBXDATA"
^IBA(364.7,18,3,0)="^^1^1^3030821^^^^"
^IBA(364.7,18,3,1,0)="ENTITY INDENTIFIER CODE set to QD, Professional and Institution."
^IBA(364.7,19,0)="22^N^5^^^^N"
^IBA(364.7,19,1)="S IBXDATA=$P($G(IBXSAVE(""INM"")),U,2)"
^IBA(364.7,19,3,0)="^^2^2^2960815^^^^"
^IBA(364.7,19,3,1,0)="Pull off first name of insured from IBXSAVE array previously extracted."
^IBA(364.7,19,3,2,0)="Don't output data element if its value is null."
^IBA(364.7,20,0)="26^N^5^^^^N"
^IBA(364.7,20,1)="S IBXDATA=$P($G(IBXSAVE(""INM"")),U)"
^IBA(364.7,20,3,0)="^^2^2^2960815^^^^"
^IBA(364.7,20,3,1,0)="Pull off last name of insured from IBXSAVE array previously extracted."
^IBA(364.7,20,3,2,0)="Don't output data element if its value is null."
^IBA(364.7,21,0)="27^N^5^^^^N"
^IBA(364.7,21,1)="S IBXDATA=$P($G(IBXSAVE(""INM"")),U,3)"
^IBA(364.7,21,3,0)="^^2^2^2960815^^^^"
^IBA(364.7,21,3,1,0)="Pull off middle name of insured from IBXSAVE array previously extracted."
^IBA(364.7,21,3,2,0)="Don't output data element if its value is null."
^IBA(364.7,22,0)="15^N^5^^^^N"
^IBA(364.7,22,1)="S IBXDATA=$P($G(IBXSAVE(""EMP"")),U,2),IBXDATA=$TR(IBXDATA,""-/.,()'"",""  "")"
^IBA(364.7,22,3,0)="^^2^2^3000107^^^^"
^IBA(364.7,22,3,1,0)="Retrieves insured employment info from IBXSAVE array previously extracted."
^IBA(364.7,22,3,2,0)="If data element's value is null, do not output."
^IBA(364.7,23,0)="14^N^5^^^^N"
^IBA(364.7,23,1)="S IBXDATA=$P($G(IBXSAVE(""EMP"")),U,3)"
^IBA(364.7,23,3,0)="^^2^2^2991006^^^^"
^IBA(364.7,23,3,1,0)="Retrieves insured employment info from IBXSAVE array previously extracted."
^IBA(364.7,23,3,2,0)="If data element's value is null, do not output."
^IBA(364.7,24,0)="28^N^25^^^^N"
^IBA(364.7,24,1)="S IBXDATA=$$RELATION^IBCEFG1(IBXDATA)"
^IBA(364.7,24,3,0)="^^2^2^2960815^^^^"
^IBA(364.7,24,3,1,0)="Calculates the X12 code for relationship from the DHCP code extracted."
^IBA(364.7,24,3,2,0)="If data element's value is null, do not output."
^IBA(364.7,25,0)="60^N^93^^^^N"
^IBA(364.7,25,1)="S IBXDATA=$$DT^IBCEFG1(IBXDATA,"""",""D8"")"
^IBA(364.7,25,3,0)="^^2^2^2991115^^^^"
^IBA(364.7,25,3,1,0)="Format data element in CCYYMMDD date format.  If data element's value is"
^IBA(364.7,25,3,2,0)="null, do not output."
^IBA(364.7,26,0)="61^N^94^^^^N"
^IBA(364.7,26,1)="S IBXDATA=$$DT^IBCEFG1(IBXDATA,"""",""D8"")"
^IBA(364.7,26,3,0)="^^2^2^2991115^^^^"
^IBA(364.7,26,3,1,0)="Format data element in CCYYMMDD date format.  If data element's value is"
^IBA(364.7,26,3,2,0)="null, do not output."
^IBA(364.7,27,0)="92^N^86^^^^N"
^IBA(364.7,27,1)="N A,C,R,Z M A=IBXDATA S (Z,R)=0,C=1 K IBXDATA,IBXSAVE(""DX-E"") F  S Z=$O(A(Z)) Q:'Z  S A=$TR($P($G(^ICD9(+A(Z),0)),U),""."") I A'="""" D ID1^IBCEF2(.R,.A,.C) Q:C=""""  I A'="""" S IBXDATA(R)=A"
^IBA(364.7,27,3,0)="^364.73^9^9^3040303^^^^"
^IBA(364.7,27,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,27,3,2,0)="possible for the data element in the IBXDATA array.  Each diagnosis code"
^IBA(364.7,27,3,3,0)="name is stripped of its decimal point and is output on its own DCn entry"
^IBA(364.7,27,3,4,0)="where n is a record count that will allow it to be mapped into one of the"
^IBA(364.7,27,3,5,0)="12 available pieces of the 837 diagnosis code record correctly.  This is"
^IBA(364.7,27,3,6,0)="done to accommodate Austin's translator and one of its shortcomings.  Save"
^IBA(364.7,27,3,7,0)="off the extract sequence # of each diagnosis output in the global array"
^IBA(364.7,27,3,8,0)="^TMP(""IBXSAVE"",$J,""DX"") for later use."
^IBA(364.7,27,3,9,0)="Z>4 ADDED TO PREVENT SENDING MORE THAN 4 DIAG CODES (BL)"
^IBA(364.7,28,0)="56^N^5^^^^N"
^IBA(364.7,28,1)="S IBXDATA=$G(IBXSAVE(""DISDT"")) D:$S('IBXDATA:'$$INPAT^IBCEF(IBXIEN,1),1:0) F^IBCEF(""N-STATEMENT COVERS TO DATE"",,,IBXIEN) I IBXDATA S IBXDATA=$$DT^IBCEFG1(IBXDATA\1,"""",""D8"")"
^IBA(364.7,28,3,0)="^364.73^4^4^3040227^"
^IBA(364.7,28,3,1,0)="Extract only date from date/time retrieved from IBXSAVE array previously"
^IBA(364.7,28,3,2,0)="extracted.  For an outpatient claim not related to an inpatient episode,"
^IBA(364.7,28,3,3,0)="output the statement 'To Date'.  Format date in CCYYMMDD format."
^IBA(364.7,28,3,4,0)="If data element's value is null, do not output."
^IBA(364.7,29,0)="59^N^90^^^^N"
^IBA(364.7,29,1)="S IBXDATA=$$DT^IBCEFG1(IBXDATA,"""",""D8"")"
^IBA(364.7,29,3,0)="^^2^2^2991115^^^^"
^IBA(364.7,29,3,1,0)="Format data element in CCYYMMDD date format.  If data element's value is"
^IBA(364.7,29,3,2,0)="null, do not output."
^IBA(364.7,30,0)="76^N^285^^^^N"
^IBA(364.7,30,1)="I IBXDATA'="""" S IBXDATA=$$DT^IBCEFG1(IBXDATA,,""D8"")"
^IBA(364.7,30,3,0)="^^1^1^2991130^^^^"
^IBA(364.7,30,3,1,0)="Format the date in X12 8-digit format if data not null."
^IBA(364.7,31,0)="75^N^284^^^^N"
^IBA(364.7,31,1)="I IBXDATA="""",$$WNRBILL^IBEFUNC(IBXIEN),$$FT^IBCEF(IBXIEN)=2 S IBXDATA=""31"""
^IBA(364.7,36,0)="42^N^10^^^^N"
^IBA(364.7,36,1)="S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA)"
^IBA(364.7,36,3,0)="^^1^1^2980922^^^^"
^IBA(364.7,36,3,1,0)="If data element's value is null, do not output.  Remove any punctuation."
^IBA(364.7,37,0)="139^N^16^^^^N"
^IBA(364.7,37,1)="K:$$FT^IBCEF(IBXIEN)=2 IBXDATA N Z S Z=0 F  S Z=$O(IBXDATA(Z)) K:'Z IBXDATA Q:'Z  I '$D(IBXDATA(Z,""M"")) S IBXSAVE(""PROC"",Z)=IBXDATA(Z) I Z'<6 K IBXDATA Q"
^IBA(364.7,37,3,0)="^^6^6^2991013^^^^"
^IBA(364.7,37,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,37,3,2,0)="possible for the data element in the IBXDATA array.  If an institutional"
^IBA(364.7,37,3,3,0)="bill or if the bill is professional and the procedure being extracted was"
^IBA(364.7,37,3,4,0)="not added as a result of being a modifier with a 5-digit code starting with"
^IBA(364.7,37,3,5,0)="0 (""M"" node does not exist), save in an IBXSAVE array for later use.  No"
^IBA(364.7,37,3,6,0)="output."
^IBA(364.7,38,0)="86^N^5^^^^N"
^IBA(364.7,38,1)="K IBXDATA N Q,R,S,Z,IBZ S (Z,R)=0 D F^IBCEF(""N-PROCEDURE CODING METHD"",""IBZ"",,IBXIEN) F  S Z=$O(IBXSAVE(""PROC"",Z)) Q:'Z  S Q=$$PROC^IBCEF1($P(IBXSAVE(""PROC"",Z),U),$S(IBZ=9:""ICD"",1:"""")) S:Q'="""" R=R+1,IBXDATA(R)=Q"
^IBA(364.7,38,3,0)="^^3^3^2991013^^^^"
^IBA(364.7,38,3,1,0)="Each procedure code found in the IBXSAVE array previously extracted is"
^IBA(364.7,38,3,2,0)="formatted into the name of the CPT or ICD procedure or the code from the"
^IBA(364.7,38,3,3,0)="procedure modifier."
^IBA(364.7,39,0)="85^N^5^^^^N"
^IBA(364.7,39,1)="K IBXDATA N Z,Z0,Z1,R S (Z,Z1,R)=0 F  S Z=$O(IBXSAVE(""PROC"",Z)) Q:'Z  S Z0=$$DT^IBCEFG1($P(IBXSAVE(""PROC"",Z),U,2),"""",""D8"") I Z0'="""" S Z1=Z1+1,IBXDATA(Z1)=Z0 D ID^IBCEF2(Z1,""PC""_$$M^IBCEF2(.R))"
^IBA(364.7,39,3,0)="^^5^5^2991115^^^^"
^IBA(364.7,39,3,1,0)="Each procedure date found in the IBXSAVE array previously extracted is"
^IBA(364.7,39,3,2,0)="formatted into CCYYMMDD date format and is output on its own PCn entry where"
^IBA(364.7,39,3,3,0)="n is a record count that will allow it to be mapped into one of the 12"
^IBA(364.7,39,3,4,0)="available pieces of the 837 procedure code record correctly.  This is done"
^IBA(364.7,39,3,5,0)="to accommodate Austin's translator and one of its shortcomings."
^IBA(364.7,40,0)="87^N^5^^^^N"
^IBA(364.7,40,1)="K IBXDATA N Z S Z=0 F  S Z=$O(IBXSAVE(""PROC"",Z)) Q:'Z  S IBXDATA(Z)=$S($O(IBXSAVE(""PROC"",Z),-1)="""":$S($P(IBXSAVE(""PROC"",Z),U)[""CPT"":""BP"",1:""BR""),$P(IBXSAVE(""PROC"",Z),U)[""CPT"":""BO"",1:""BQ"")"
^IBA(364.7,40,3,0)="^^7^7^2991013^^^^"
^IBA(364.7,40,3,1,0)="If there are any procedures (not relating to charges) on the bill, output"
^IBA(364.7,40,3,2,0)="the type of procedure here:"
^IBA(364.7,40,3,3,0)=" "
^IBA(364.7,40,3,4,0)="BP = principal procedure and is a CPT/HCPCS code"
^IBA(364.7,40,3,5,0)="BR = principal procedure and is an ICD code"
^IBA(364.7,40,3,6,0)="BO = not principal procedure, but is a CPT/HCPCS code"
^IBA(364.7,40,3,7,0)="BQ = not principal procedure, but is an ICD code"
^IBA(364.7,41,0)="93^N^5^^^^N"
^IBA(364.7,41,1)="K IBXDATA I $O(^TMP(""IBXSAVE"",$J,""DX"",IBXIEN,""""))'="""" S IBXDATA(1)=1"
^IBA(364.7,41,3,0)="^^2^2^2960815^^^^"
^IBA(364.7,41,3,1,0)="If any diagnoses were output, flag the first one as the primary diagnosis."
^IBA(364.7,41,3,2,0)="If there were no diagnoses on the bill, there is no output."
^IBA(364.7,42,0)="29^N^99^^^^N"
^IBA(364.7,42,1)="S IBXDATA=$$EMPLST^IBCEFG1(IBXDATA)"
^IBA(364.7,42,3,0)="^^2^2^2991006^^^^"
^IBA(364.7,42,3,1,0)="Calculates the X12 code for employment status from the DHCP code extracted."
^IBA(364.7,42,3,2,0)="If data element's value is null, do not output."
^IBA(364.7,43,0)="31^N^5^^^^N"
^IBA(364.7,43,1)="S IBXDATA=$P($G(IBXSAVE(""PTNM"")),U,2)"
^IBA(364.7,43,3,0)="^^2^2^2960815^^^^"
^IBA(364.7,43,3,1,0)="Retrieves patient's first name from IBXSAVE array previously extracted."
^IBA(364.7,43,3,2,0)="If data element's value is null, do not output."
^IBA(364.7,44,0)="30^N^5^^^^N"
^IBA(364.7,44,1)="S IBXDATA=$P($G(IBXSAVE(""PTNM"")),U)"
^IBA(364.7,44,3,0)="^^2^2^2960815^^^^"
^IBA(364.7,44,3,1,0)="Retrieves patient's last name from IBXSAVE array previously extracted."
^IBA(364.7,44,3,2,0)="If data element's value is null, do not output."
^IBA(364.7,45,0)="32^N^5^^^^N"
^IBA(364.7,45,1)="S IBXDATA=$P($G(IBXSAVE(""PTNM"")),U,3)"
^IBA(364.7,45,3,0)="^^2^2^2960815^^^^"
^IBA(364.7,45,3,1,0)="Retrieves patient's middle name from IBXSAVE array previously extracted."
^IBA(364.7,45,3,2,0)="If data element's value is null, do not output."
^IBA(364.7,46,0)="140^N^65^^^^N"
^IBA(364.7,46,1)="S IBXSAVE(""PTNM"")=$$NAME^IBCEFG1(IBXDATA) K IBXDATA"
^IBA(364.7,46,3,0)="^^2^2^2960815^^^^"
^IBA(364.7,46,3,1,0)="Changes data element (name) into LAST^FIRST^MIDDLE format.  Saves data in"
^IBA(364.7,46,3,2,0)="IBXSAVE array.  No output."
^IBA(364.7,47,0)="67^N^76^^^^N"
^IBA(364.7,47,3,0)="^^1^1^2960815^^^^"
^IBA(364.7,47,3,1,0)="If data element's value is null, do not output."
^IBA(364.7,48,0)="47^N^97^^^^N"
^IBA(364.7,48,1)="I $$FT^IBCEF(IBXIEN)=3 K IBXDATA"
^IBA(364.7,48,3,0)="^^1^1^2991001^^^^"
^IBA(364.7,48,3,1,0)="If an institutional bill or data element's value is null, no output."
^IBA(364.7,49,0)="141^N^190^^^^N"
^IBA(364.7,49,1)="K IBXDATA"
^IBA(364.7,49,3,0)="^^1^1^2991014^^^^"
^IBA(364.7,49,3,1,0)="No output."
^IBA(364.7,50,0)="81^N^5^^^^N"
^IBA(364.7,50,1)="K IBXDATA N Z,Z0,R S (Z,R)=0 F  S Z=$O(IBXSAVE(""OCC"",Z)) Q:'Z  S Z0=$$DT^IBCEFG1($P(IBXSAVE(""OCC"",Z),U,2),"""",""D8"") I Z0'="""" D ID^IBCEF2(Z,""OC""_$$M^IBCEF2(.R)) S IBXDATA(Z)=Z0"
^IBA(364.7,50,3,0)="^^5^5^2991115^^^^"
^IBA(364.7,50,3,1,0)="Each occurrence code date found in the IBXSAVE array previously extracted"
^IBA(364.7,50,3,2,0)="is formatted into CCYYMMDD date format and is output on its own OCn entry"
^IBA(364.7,50,3,3,0)="where n is a record count that will allow it to be mapped into one of the"
^IBA(364.7,50,3,4,0)="12 available pieces of the 837 occurrence code record correctly.  This is"
^IBA(364.7,50,3,5,0)="done to accommodate Austin's translator and one of its shortcomings."
^IBA(364.7,51,0)="82^N^5^^^^N"
^IBA(364.7,51,1)="K IBXDATA N Z,Z0 S Z=0 F  S Z=$O(IBXSAVE(""OCC"",Z)) Q:'Z  S Z0=$P(IBXSAVE(""OCC"",Z),U) S:Z0'="""" IBXDATA(Z)=Z0"
^IBA(364.7,51,3,0)="^^2^2^2991014^^^^"
^IBA(364.7,51,3,1,0)="Each occurrence code found in the IBXSAVE array previously extracted is"
^IBA(364.7,51,3,2,0)="output."
^IBA(364.7,52,0)="58^N^232^^^^N"
^IBA(364.7,52,1)="S IBXDATA=$$DT^IBCEFG1(IBXDATA,"""",""D8"")"
^IBA(364.7,52,3,0)="^^2^2^3000302^^^^"
^IBA(364.7,52,3,1,0)="Format data element in CCYYMMDD date format.  If data element's value is"
^IBA(364.7,52,3,2,0)="null, do not output."
^IBA(364.7,53,0)="945^N^5^^^^N"
^IBA(364.7,53,1)="N IBZ D GETPRV^IBCEU(IBXIEN,9,.IBZ) N IBZZ S IBZZ=$P($G(IBZ(9,1)),U),IBXDATA=$$GETNMEL^IBCEF7(IBZZ,""FAMILY"")"
^IBA(364.7,53,3,0)="^364.73^2^2^3030917^^^^"
^IBA(364.7,53,3,1,0)=" "
^IBA(364.7,53,3,2,0)="Operating provider last name"
^IBA(364.7,54,0)="38^N^66^^^^N"
^IBA(364.7,54,1)="S IBXDATA=$$DT^IBCEFG1(IBXDATA,"""",""D8"")"
^IBA(364.7,54,3,0)="^^2^2^2991115^^^^"
^IBA(364.7,54,3,1,0)="Format date returned as CCYYMMDD.  If data element's value is null, do not"
^IBA(364.7,54,3,2,0)="output."
^IBA(364.7,55,0)="35^N^61^^^^N"
^IBA(364.7,55,1)="I $G(IBXDATA)'="""" S IBXDATA=$TR(IBXDATA,""-/.,()'"",""  "")"
^IBA(364.7,55,3,0)="^^1^1^2960815^^^^"
^IBA(364.7,55,3,1,0)="If data element's value is null, do not output."
^IBA(364.7,56,0)="36^N^62^^^^N"
^IBA(364.7,56,1)="S IBXDATA=$$STATE^IBCEFG1(IBXDATA)"
^IBA(364.7,56,3,0)="^^2^2^2960815^^^^"
^IBA(364.7,56,3,1,0)="Format data as state's 2-character abbreviation.  If data element's value"
^IBA(364.7,56,3,2,0)="is null, do not output."
^IBA(364.7,57,0)="37^N^63^^^^N"
^IBA(364.7,57,3,0)="^^1^1^2960815^^^^"
^IBA(364.7,57,3,1,0)="If data element's value is null, do not output."
^IBA(364.7,58,0)="33^N^59^^^^N"
^IBA(364.7,58,3,0)="^^1^1^2960815^^^^"
^IBA(364.7,58,3,1,0)="If data element's value is null, do not output."
^IBA(364.7,59,0)="34^N^60^^^^N"
^IBA(364.7,59,3,0)="^^1^1^2960815^^^"
^IBA(364.7,59,3,1,0)="If data element's value is null, do not output."
^IBA(364.7,60,0)="39^N^67^^^^N"
^IBA(364.7,60,1)="S IBXDATA=$$SEX^IBCEFG1(IBXDATA)"
^IBA(364.7,60,3,0)="^^2^2^2960815^^^^"
^IBA(364.7,60,3,1,0)="Calculates the X12 code for sex from the DHCP code extracted. If data"
^IBA(364.7,60,3,2,0)="element's value is null, do not output."
^IBA(364.7,61,0)="40^N^68^^^^N"
^IBA(364.7,61,1)="S IBXDATA=$$MARITAL^IBCEFG1(IBXDATA)"
^IBA(364.7,61,3,0)="^364.73^1^1^3010514^^^^"
^IBA(364.7,61,3,1,0)="Calculates the X12 code for marital status from the DHCP code extracted."
^IBA(364.7,62,0)="41^N^143^^^^N"
^IBA(364.7,62,3,0)="^^1^1^2960815^^^^"
^IBA(364.7,62,3,1,0)="If data element's value is null, do not output."
^IBA(364.7,63,0)="43^N^70^^^^N"
^IBA(364.7,63,3,0)="^^1^1^2991006^^^^"
^IBA(364.7,63,3,1,0)="If data element's value is null, do not output."
^IBA(364.7,64,0)="64^N^9^^^^N"
^IBA(364.7,65,0)="44^N^210^^^^N"
^IBA(364.7,65,3,0)="^^3^3^2990722^^^^"
^IBA(364.7,65,3,1,0)="If data element's value is null, do not output."
^IBA(364.7,65,3,2,0)="If this is a request for an MRA, append the batch number as the 3rd '-'"
^IBA(364.7,65,3,3,0)="piece of the patient control number."
^IBA(364.7,66,0)="45^N^222^^^^N"
^IBA(364.7,66,3,0)="^^1^1^2981008^^^^"
^IBA(364.7,66,3,1,0)="If data element's value is null, do not output."
^IBA(364.7,67,0)="46^N^74^^^^N"
^IBA(364.7,67,3,0)="^^1^1^2960815^^^^"
^IBA(364.7,67,3,1,0)="If data element's value is null, do not output."
^IBA(364.7,68,0)="48^N^23^^^^N"
^IBA(364.7,68,1)="S IBXDATA=$S(IBXDATA:""M"",1:""Y"")"
^IBA(364.7,68,3,0)="^^1^1^2960815^^^^"
^IBA(364.7,68,3,1,0)="Converts release of information indicator from DHCP to X12 format."
^IBA(364.7,69,0)="66^N^75^^^^N"
^IBA(364.7,69,3,0)="^^1^1^2960815^^^^"
^IBA(364.7,69,3,1,0)="If data element's value is null, do not output."
^IBA(364.7,70,0)="83^N^5^^^^N"
^IBA(364.7,70,1)="K IBXDATA N Z,Z0,R S (Z,R)=0 F  S Z=$O(IBXSAVE(""OCCS"",Z)) Q:'Z  S Z0=$$DT^IBCEFG1($P(IBXSAVE(""OCCS"",Z),U,2),"""",""D8"") I Z0'="""" S IBXDATA(Z)=Z0 D ID^IBCEF2(Z,""OS""_$$M^IBCEF2(.R))"
^IBA(364.7,70,3,0)="^^6^6^2991115^^^^"
^IBA(364.7,70,3,1,0)="Each occurrence span code from date found in the IBXSAVE array previously"
^IBA(364.7,70,3,2,0)="extracted is formatted into CCYYMMDD date format and is output on its own"
^IBA(364.7,70,3,3,0)="OCSn entry where n is a record count that will allow it to be mapped into"
^IBA(364.7,70,3,4,0)="one of the 12 available pieces of the 837 occurrence span code records"
^IBA(364.7,70,3,5,0)="correctly.  This is done to accommodate Austin's translator and one of its"
^IBA(364.7,70,3,6,0)="shortcomings."
^IBA(364.7,71,0)="84^N^5^^^^N"
^IBA(364.7,71,1)="K IBXDATA N Z,Z0 S Z=0 F  S Z=$O(IBXSAVE(""OCCS"",Z)) Q:'Z  S Z0=$P(IBXSAVE(""OCCS"",Z),U) S:Z0'="""" IBXDATA(Z)=Z0"
^IBA(364.7,71,3,0)="^^2^2^2991014^^^^"
^IBA(364.7,71,3,1,0)="Each occurrence span code found in the IBXSAVE array previously extracted is"
^IBA(364.7,71,3,2,0)="output."
^IBA(364.7,72,0)="49^N^24^^^^N"
^IBA(364.7,72,1)="S IBXDATA=$S(""Nn0""[IBXDATA&(IBXDATA'=""""):""N"",1:""Y"")"
^IBA(364.7,72,3,0)="^^1^1^2960815^^^^"
^IBA(364.7,72,3,1,0)="Converts assignment of benefits indicator from DHCP to X12 format."
^IBA(364.7,73,0)="50^N^98^^^^N"
^IBA(364.7,73,1)="S IBXDATA=$S(1[IBXDATA:""00"",1:""15"")"
^IBA(364.7,73,3,0)="^^2^2^2960815^^^^"
^IBA(364.7,73,3,1,0)="Converts bill submission status from DHCP to X12 format.  '00' is original"
^IBA(364.7,73,3,2,0)="submission, '15' is any subsequent submission of this bill."
^IBA(364.7,74,0)="51^N^71^^^^N"
^IBA(364.7,74,1)="S IBXDATA=$$DT^IBCEFG1(IBXDATA,"""",""D8"")"
^IBA(364.7,74,3,0)="^^2^2^2991115^^^^"
^IBA(364.7,74,3,1,0)="Format date in CCYYMMDD format.  If data element's value is null, do not"
^IBA(364.7,74,3,2,0)="output."
^IBA(364.7,75,0)="52^N^173^^^^N"
^IBA(364.7,75,1)="S IBXNOREQ='$$REQ^IBCEF1(2,"""",IBXIEN) S IBXDATA=$$DOLLAR^IBCEFG1(IBXDATA)"
^IBA(364.7,75,3,0)="^^2^2^2991115^^^^"
^IBA(364.7,75,3,1,0)="Format data element so it is numeric including cents, without the decimal."
^IBA(364.7,75,3,2,0)="If data element's value is null, do not output."
^IBA(364.7,76,0)="53^N^95^^^^N"
^IBA(364.7,76,1)="S IBXDATA=$$DOLLAR^IBCEFG1(IBXDATA)"
^IBA(364.7,76,3,0)="^^2^2^2991115^^^^"
^IBA(364.7,76,3,1,0)="Format data element so it is numeric including cents, without the decimal."
^IBA(364.7,76,3,2,0)="If data element's value is null, do not output."
^IBA(364.7,77,0)="54^N^5^^^^N"
^IBA(364.7,77,1)="S IBXDATA=$G(IBXSAVE(""ADMDT"")) S:$L(IBXDATA)=6 IBXDATA=$$DATE^IBCEU($E(IBXDATA,5,6)_$E(IBXDATA,1,4)) D:$S(IBXDATA="""":'$$INPAT^IBCEF(IBXIEN,1),1:0) F^IBCEF(""N-STATEMENT COVERS FROM DATE"",,,IBXIEN) I IBXDATA S IBXDATA=$$DT^IBCEFG1(IBXDATA,"""",""D8"")"
^IBA(364.7,77,3,0)="^^3^3^3000208^^^^"
^IBA(364.7,77,3,1,0)="If data exists from the previous extract of IBXSAVE(""ADMDT""), output it."
^IBA(364.7,77,3,2,0)="If no data here and outpatient bill, use statement from date.  Format date"
^IBA(364.7,77,3,3,0)="in CCYYMMDD format."
^IBA(364.7,78,0)="159^N^100^^^^N"
^IBA(364.7,78,1)="K IBXSAVE"
^IBA(364.7,78,3,0)="^^1^1^2990218^^^^"
^IBA(364.7,78,3,1,0)="Cleans up IBXSAVE array.  No output."
^IBA(364.7,79,0)="1019^N^5^^^^N^0"
^IBA(364.7,79,1)="K IBXDATA"
^IBA(364.7,79,3,0)="^^1^1^3030821^^^^"
^IBA(364.7,79,3,1,0)="ENTITY TYPE QUALIFIER. PERSON =1, NON-PERSON=2. Calculated or Extracted."
^IBA(364.7,80,0)="1020^N^5^^^^N^0"
^IBA(364.7,80,1)="K IBXDATA"
^IBA(364.7,80,3,0)="^^1^1^3030821^^^^"
^IBA(364.7,80,3,1,0)="Last Name or organization Name for the Responsible Party."
^IBA(364.7,81,0)="156^N^100^^^^N"
^IBA(364.7,81,1)="K IBXSAVE,^TMP(""IBTX"",$J,IBXIEN)"
^IBA(364.7,81,3,0)="^^1^1^2990902^^^^"
^IBA(364.7,81,3,1,0)="Cleans up the IBXSAVE array.  No output."
^IBA(364.7,82,0)="155^N^100^^^^N"
^IBA(364.7,82,1)="K IBXSAVE"
^IBA(364.7,82,3,0)="^^1^1^2990218^^^^"
^IBA(364.7,82,3,1,0)="Cleans up the IBXSAVE array.  No output."
^IBA(364.7,83,0)="154^N^100^^^^N"
^IBA(364.7,83,1)="K IBXSAVE"
^IBA(364.7,83,3,0)="^^1^1^2990218^^^^"
^IBA(364.7,83,3,1,0)="Cleans up the IBXSAVE array.  No output."
^IBA(364.7,84,0)="153^N^100^^^^N"
^IBA(364.7,84,1)="K IBXSAVE"
^IBA(364.7,84,3,0)="^^1^1^2990218^^^^"
^IBA(364.7,84,3,1,0)="Cleans up the IBXSAVE array.  No output."
^IBA(364.7,85,0)="152^N^100^^^^N"
^IBA(364.7,85,1)="K IBXSAVE"
^IBA(364.7,85,3,0)="^^1^1^2990218^^^^"
^IBA(364.7,85,3,1,0)="Cleans up IBXSAVE array.  No output."
^IBA(364.7,86,0)="151^N^100^^^^N"
^IBA(364.7,86,1)="K IBXSAVE"
^IBA(364.7,86,3,0)="^^1^1^2990218^^^^"
^IBA(364.7,86,3,1,0)="Cleans up the IBXSAVE array.  No output."
^IBA(364.7,87,0)="150^N^100^^^^N"
^IBA(364.7,87,1)="K IBXSAVE"
^IBA(364.7,87,3,0)="^^1^1^2990218^^^^"
^IBA(364.7,87,3,1,0)="Cleans up IBXSAVE array.  No output."
^IBA(364.7,88,0)="1029^N^5^^^^N^0"
^IBA(364.7,88,1)="S IBXDATA=""01"""
^IBA(364.7,88,3,0)="^^1^1^3030722^^"
^IBA(364.7,88,3,1,0)="Set Unit or Basic for Measurement Code"
^IBA(364.7,89,0)="1030^N^5^^^^N^0"
^IBA(364.7,89,1)="S IBXDATA="""""
^IBA(364.7,89,3,0)="^^1^1^3030722^^"
^IBA(364.7,89,3,1,0)="Patient Weight. Extract from existing data?"
^IBA(364.7,90,0)="147^N^100^^^^N"
^IBA(364.7,90,1)="K IBXSAVE"
^IBA(364.7,90,3,0)="^^1^1^2990218^^^^"
^IBA(364.7,90,3,1,0)="Clean up IBXSAVE array.  No output."
^IBA(364.7,91,0)="146^N^100^^^^N"
^IBA(364.7,91,1)="K IBXSAVE"
^IBA(364.7,91,3,0)="^^1^1^2990218^^^^"
^IBA(364.7,91,3,1,0)="Clean up the IBXSAVE array.  No output."
^IBA(364.7,92,0)="145^N^100^^^^N"
^IBA(364.7,92,1)="K IBXSAVE"
^IBA(364.7,92,3,0)="^^1^1^2990218^^^^"
^IBA(364.7,92,3,1,0)="Cleans up the IBXSAVE array.  No output."
^IBA(364.7,93,0)="144^N^100^^^^N"
^IBA(364.7,93,1)="K IBXSAVE"
^IBA(364.7,93,3,0)="^^1^1^2990218^^^^"
^IBA(364.7,93,3,1,0)="Cleans up the IBXSAVE array ... no output."
^IBA(364.7,94,0)="70^N^88^^^^N"
^IBA(364.7,94,1)="K:'IBXDATA IBXDATA I $D(IBXDATA) S IBXSAVE(""CONDA"")=IBXDATA,IBXDATA=""AA"""
^IBA(364.7,94,3,0)="^^3^3^2960815^^^^"
^IBA(364.7,94,3,1,0)="If IBXDATA does not have a value that is greater than 0, no output.  If  "
^IBA(364.7,94,3,2,0)="data element > 0, save off value in IBXSAVE array for later use, output"
^IBA(364.7,94,3,3,0)="as 'AA'."
^IBA(364.7,95,0)="73^N^159^^^^N"
^IBA(364.7,95,1)="S IBXDATA=$$STATE^IBCEFG1(IBXDATA)"
^IBA(364.7,95,3,0)="^364.73^2^2^3061011^^^^"
^IBA(364.7,95,3,1,0)="Format data element as the 2-character state abbreviation.  If data element"
^IBA(364.7,95,3,2,0)="is null, no output."
^IBA(364.7,96,0)="71^N^87^^^^N"
^IBA(364.7,96,1)="K:'IBXDATA IBXDATA I $D(IBXDATA) S IBXDATA=""EM"""
^IBA(364.7,96,3,0)="^^2^2^2991006^^^^"
^IBA(364.7,96,3,1,0)="If IBXDATA does not have a value that is greater than 0, no output.  If"
^IBA(364.7,96,3,2,0)="data element > 0, output as 'EM'."
^IBA(364.7,97,0)="72^N^89^^^^N"
^IBA(364.7,97,1)="K:'IBXDATA IBXDATA I $D(IBXDATA) S IBXDATA=""OA"""
^IBA(364.7,97,3,0)="^^2^2^2960815^^^^"
^IBA(364.7,97,3,1,0)="If IBXDATA does not have a value that is greater than 0, no output.  If"
^IBA(364.7,97,3,2,0)="data element > 0, output as 'OA'."
^IBA(364.7,98,0)="142^N^78^^^^N"
^IBA(364.7,98,1)="N A,IBZ,%DT,Y,X S IBZ=IBXDATA,A=$S(IBZ?6N:IBZ,1:"""") K IBXDATA S:A="""" Y=IBZ S X=A,%DT=""PX"" D:A'="""" ^%DT S IBXSAVE(""ADMDT"")=$S(Y>0:Y,1:"""")"
^IBA(364.7,98,3,0)="^^1^1^2991019^^^^"
^IBA(364.7,98,3,1,0)="Save off data element's value in IBXSAVE array.  No output."
^IBA(364.7,99,0)="55^N^5^^^^N"
^IBA(364.7,99,1)="K IBXDATA S IBXDATA=$$ADMHR^IBCEU(IBXIEN,$G(IBXSAVE(""ADMDT"")))"
^IBA(364.7,99,3,0)="^^3^3^2991007^^^^"
^IBA(364.7,99,3,1,0)="Extract time from date/time retrieved from IBXSAVE array previously"
^IBA(364.7,99,3,2,0)="extracted.  Format time in HHMM format.  If data element's value is null,"
^IBA(364.7,99,3,3,0)="do not output."
^IBA(364.7,100,0)="143^N^81^^^^N"
^IBA(364.7,100,1)="S IBXSAVE(""DISDT"")=IBXDATA K IBXDATA"
^IBA(364.7,100,3,0)="^^1^1^2960815^^^^"
^IBA(364.7,100,3,1,0)="Save off data element's value in IBXSAVE array.  No output."
^IBA(364.7,101,0)="57^N^5^^^^N"
^IBA(364.7,101,1)="K IBXDATA I $P(IBXSAVE(""DISDT""),""."",2)'="""" S IBXDATA=$E($P(IBXSAVE(""DISDT""),""."",2)_""0000"",1,4)"
^IBA(364.7,101,3,0)="^^3^3^2960815^^^^"
^IBA(364.7,101,3,1,0)="Extract time from date/time retrieved from IBXSAVE array previously"
^IBA(364.7,101,3,2,0)="extracted.  Format time in HHMM format.  If data element's value is null,"
^IBA(364.7,101,3,3,0)="do not output."
^IBA(364.7,102,0)="62^N^80^^^^N"
^IBA(364.7,102,1)="I IBXDATA="""",'$$INPAT^IBCEF(IBXIEN,1) S IBXDATA=2"
^IBA(364.7,102,3,0)="^^1^1^2960815^^^^"
^IBA(364.7,102,3,1,0)="If data element's value is null, do not output."
^IBA(364.7,103,0)="63^N^79^^^^N"
^IBA(364.7,103,3,0)="^^1^1^2960815^^^^"
^IBA(364.7,103,3,1,0)="If data element's value is null, do not output."
^IBA(364.7,104,0)="91^N^11^^^^N"
^IBA(364.7,104,1)="K IBXDATA K:$O(IBFL(24,0))="""" IBFL(24) N Z,Z0,Z1,R S (Z,Z0,R)=0 F  S Z=$O(IBFL(24,Z)) K:'Z&'Z0 IBFL(24) Q:'Z  S Z1=IBFL(24,Z) K IBFL(24,Z) I Z1'="""" S Z0=Z0+1 S IBFL(24,Z0)=Z1 D ID^IBCEF2(Z0,""CC""_$$M^IBCEF2(.R))"
^IBA(364.7,104,3,0)="^^6^6^2960815^^^^"
^IBA(364.7,104,3,1,0)="Data element's array reference is IBFL(24), not default of IBXDATA.  This is"
^IBA(364.7,104,3,2,0)="a group data element so more than 1 occurrence of a value is possible for"
^IBA(364.7,104,3,3,0)="the data element in the IBFL(24) array.  Each entry found is output on its"
^IBA(364.7,104,3,4,0)="own CCn entry where n is a record count that will allow it to be mapped into"
^IBA(364.7,104,3,5,0)="one of the 12 available pieces of the 837 condition code record correctly."
^IBA(364.7,104,3,6,0)="This is done to accommodate Austin's translator and one of its shortcomings."
^IBA(364.7,105,0)="88^N^5^^^^N"
^IBA(364.7,105,1)="K IBXDATA N Z,Z0,R S (Z,R)=0 F  S Z=$O(IBXSAVE(""VALUE"",Z)) Q:'Z  S Z0=$P(IBXSAVE(""VALUE"",Z),U) I Z0'="""" S IBXDATA(Z)=Z0 D ID^IBCEF2(Z,""VC""_$$M^IBCEF2(.R))"
^IBA(364.7,105,3,0)="^^5^5^2960815^^^^"
^IBA(364.7,105,3,1,0)="Each value code found in the IBXSAVE array previously extracted is"
^IBA(364.7,105,3,2,0)="output on its own VCn entry where n is a record count that will allow it"
^IBA(364.7,105,3,3,0)="to be mapped into one of the 12 available pieces of the 837 value code"
^IBA(364.7,105,3,4,0)="record correctly.  This is done to accommodate Austin's translator and one"
^IBA(364.7,105,3,5,0)="of its shortcomings."
^IBA(364.7,106,0)="161^N^12^^^^N"
^IBA(364.7,106,1)="K IBXDATA N Z K:$D(IBFL(39))=1 IBFL(39) S Z=0 F  S Z=$O(IBFL(39,Z)) K:'Z IBFL(39) Q:'Z  S IBXSAVE(""VALUE"",Z)=IBFL(39,Z)"
^IBA(364.7,106,3,0)="^^4^4^2960815^^^^"
^IBA(364.7,106,3,1,0)="Data element's array reference is IBFL(39), not default of IBXDATA.  This is"
^IBA(364.7,106,3,2,0)="a group data element so more than 1 occurrence of a value is possible for"
^IBA(364.7,106,3,3,0)="the data element in the IBFL(39) array.  Save off values in IBXSAVE array"
^IBA(364.7,106,3,4,0)="for later use.  No output."
^IBA(364.7,107,0)="89^N^5^^^^N"
^IBA(364.7,107,1)="K IBXDATA N Z,Z0 S Z="""" F  S Z=$O(IBXSAVE(""VALUE"",Z)) Q:'Z  I $P(IBXSAVE(""VALUE"",Z),U,3) S Z0=$$DOLLAR^IBCEFG1($P(IBXSAVE(""VALUE"",Z),U,2)) S:Z0'="""" IBXDATA(Z)=Z0"
^IBA(364.7,107,3,0)="^^3^3^2991115^^^^"
^IBA(364.7,107,3,1,0)="Each value code amount found in the IBXSAVE array previously extracted is"
^IBA(364.7,107,3,2,0)="formatted into a dollar format that is numeric including cents, without the"
^IBA(364.7,107,3,3,0)="decimal."
^IBA(364.7,108,0)="90^N^5^^^^N"
^IBA(364.7,108,1)="K IBXDATA N Z,Z0 S Z="""" F  S Z=$O(IBXSAVE(""VALUE"",Z)) Q:'Z  I '$P(IBXSAVE(""VALUE"",Z),U,3) S Z0=$P(IBXSAVE(""VALUE"",Z),U,2) S:Z0'="""" IBXDATA(Z)=$TR($J(Z0,$L(Z0),2),"". "")"
^IBA(364.7,108,3,0)="^^2^2^2960815^^^^"
^IBA(364.7,108,3,1,0)="Each value code quantity found in the IBXSAVE array previously extracted is"
^IBA(364.7,108,3,2,0)="output."
^IBA(364.7,109,0)="94^N^5^^^^N"
^IBA(364.7,109,1)="N Z S Z=0 F  S Z=$O(IBXDATA(Z)) K:'Z&($D(IBXDATA)=1) IBXDATA Q:'Z  K:IBXDATA(Z)="""" IBXDATA(Z) D:$D(IBXDATA(Z))&(Z>1) ID^IBCEF2(Z,""COM "")"
^IBA(364.7,109,3,0)="^^3^3^3000224^^^^"
^IBA(364.7,109,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,109,3,2,0)="possible for the data element in the IBXDATA array.  For other than the"
^IBA(364.7,109,3,3,0)="first occurrence, the RECORD ID 'COM ' must be output."
^IBA(364.7,110,0)="1031^N^5^^^^N^0"
^IBA(364.7,110,1)="S IBXDATA="""""
^IBA(364.7,110,3,0)="^^1^1^3030722^^"
^IBA(364.7,110,3,1,0)="Find Pregnancy Indicator."
^IBA(364.7,111,0)="74^N^58^^^^N"
^IBA(364.7,111,1)="S:IBXDATA="""" IBXDATA=""N"""
^IBA(364.7,111,3,0)="^^1^1^2960815^^^^"
^IBA(364.7,111,3,1,0)="If data element is null, output 'N'."
^IBA(364.7,112,0)="95^N^101^^^^N"
^IBA(364.7,112,1)="N IBZ,Z,Z0 M IBZ=IBXDATA K IBXDATA I $O(IBXSAVE(1,0)) S (Z,Z0)=0 F  S Z=$O(IBXSAVE(1,Z)) Q:'Z  S Z0=Z0+1,IBXDATA(Z0)=IBXSAVE(1,Z) I Z0>1 D ID^IBCEF2(Z0,""OI1 "")"
^IBA(364.7,112,3,0)="^364.73^7^7^3040702^^^^"
^IBA(364.7,112,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,112,3,2,0)="possible for the data element in the IBXDATA array.  The IBXSAVE(1) variable"
^IBA(364.7,112,3,3,0)="holds the indicator of which insurance [(P)rimary/(S)econdary/(T)ertiary] is"
^IBA(364.7,112,3,4,0)="currently responsible for the bill.    Using this data as a guide, the next"
^IBA(364.7,112,3,5,0)="insurance for the primary is secondary, then tertiary.  For secondary, it's"
^IBA(364.7,112,3,6,0)="primary then tertiary, and for tertiary, it's primary, then secondary. For"
^IBA(364.7,112,3,7,0)="other than the first occurrence, the RECORD ID 'OI1 ' must be output."
^IBA(364.7,113,0)="96^N^46^^^^N"
^IBA(364.7,113,1)="N C,Z,Z0,IBZ M IBZ=IBXDATA K IBXDATA S C=$$OTHINS1^IBCEF2(IBXIEN) F Z=1,2 I $G(IBZ(Z))'="""",$E(C,Z) S:$$WNRBILL^IBEFUNC(IBXIEN,$E(C,Z)) $P(IBZ(Z),U)=""MEDICARE"" S IBXSAVE(""OI#"",Z)=$P(IBZ(Z),U,2,3),IBXDATA(Z)=$P(IBZ(Z),U)"
^IBA(364.7,113,3,0)="^364.73^6^6^3000830^^^^"
^IBA(364.7,113,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,113,3,2,0)="possible for the data element in the IBXDATA array.  If any other insurance"
^IBA(364.7,113,3,3,0)="insurance company data is found, the data is formatted as the name of the"
^IBA(364.7,113,3,4,0)="insurance company from the insurance company file."
^IBA(364.7,113,3,5,0)="Saves the claim office id and payer id in IBXSAVE array."
^IBA(364.7,113,3,6,0)="If other insurance is MEDICARE WNR, output is MEDICARE."
^IBA(364.7,114,0)="97^N^35^^^^N"
^IBA(364.7,114,1)="N Z,Z0,IBZ M IBZ=IBXDATA K IBXDATA F Z=1,2 I $G(IBZ(Z))'="""",$D(^DGCR(399,IBXIEN,""I""_(Z+1))) S Z0=$$RELATION^IBCEFG1(IBZ(Z)) I Z0'="""" S IBXDATA(Z)=Z0"
^IBA(364.7,114,3,0)="^^4^4^2960815^^^^"
^IBA(364.7,114,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,114,3,2,0)="possible for the data element in the IBXDATA array.  If any other insurance"
^IBA(364.7,114,3,3,0)="is found, the output is formatted as the X12 code for the DHCP value for"
^IBA(364.7,114,3,4,0)="relationship."
^IBA(364.7,115,0)="98^N^33^^^^N"
^IBA(364.7,115,1)="N C,Z,Z0,IBZ M IBZ=IBXDATA K IBXDATA S C=$$OTHINS1^IBCEF2(IBXIEN) F Z=1,2 I $G(IBZ(Z))'="""",$E(C,Z) S IBXDATA(Z)=$$NOPUNCT^IBCEF(IBZ(Z),,""/-"")"
^IBA(364.7,115,3,0)="^364.73^3^3^3040521^^"
^IBA(364.7,115,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,115,3,2,0)="possible for the data element in the IBXDATA array.  If any other insurance"
^IBA(364.7,115,3,3,0)="is found, the other insured data is output."
^IBA(364.7,116,0)="100^N^31^^^^N"
^IBA(364.7,116,1)="K IBXSAVE(""OINUM"") N C,Z,Z0,IBZ M IBZ=IBXDATA K IBXDATA S C=$$OTHINS1^IBCEF2(IBXIEN) F Z=1,2 I $E(C,Z),'$$WNRBILL^IBEFUNC(IBXIEN,$E(C,Z)) S IBXDATA(Z)=$$NOPUNCT^IBCEF($G(IBZ(Z)))"
^IBA(364.7,116,3,0)="^364.73^3^3^3000830^^^^"
^IBA(364.7,116,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,116,3,2,0)="possible for the data element in the IBXDATA array. If the insurance for"
^IBA(364.7,116,3,3,0)="any COB sequence is MEDICARE WNR, output nothing for that insurance."
^IBA(364.7,117,0)="99^N^34^^^^N"
^IBA(364.7,117,1)="N Z,IBZ M IBZ=IBXDATA K IBXDATA F Z=1,2 I $D(^DGCR(399,IBXIEN,""I""_(Z+1))),$G(IBZ(Z))'="""" S IBXDATA(Z)=$$NOPUNCT^IBCEF(IBZ(Z))"
^IBA(364.7,117,3,0)="^364.73^3^3^3000920^^^"
^IBA(364.7,117,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,117,3,2,0)="possible for the data element in the IBXDATA array.  If any other insured"
^IBA(364.7,117,3,3,0)="ID data is found, the data is output."
^IBA(364.7,118,0)="162^N^32^^^^N"
^IBA(364.7,118,1)="N Z,IBZ M IBZ=IBXDATA K IBXDATA F Z=1,2 I $D(^DGCR(399,IBXIEN,""I""_(Z+1))),$G(IBZ(Z))'="""" S IBXSAVE(""OINM"",Z)=$$NAME^IBCEFG1(IBZ(Z))"
^IBA(364.7,118,3,0)="^^4^4^2960815^^"
^IBA(364.7,118,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,118,3,2,0)="possible for the data element in the IBXDATA array.  If any other insurance,"
^IBA(364.7,118,3,3,0)="the name data is saved in the IBXSAVE array for later use, formatted in"
^IBA(364.7,118,3,4,0)="LAST^FIRST^MIDDLE format.  No output."
^IBA(364.7,119,0)="101^N^5^^^^N"
^IBA(364.7,119,1)="K IBXDATA N Z F Z=1,2 S:$P($G(IBXSAVE(""OINM"",Z)),U)'="""" IBXDATA(Z)=$P(IBXSAVE(""OINM"",Z),U)"
^IBA(364.7,119,3,0)="^^3^3^2960815^^"
^IBA(364.7,119,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,119,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,119,3,3,0)="any other insurance name data is found, the last name is output."
^IBA(364.7,120,0)="102^N^5^^^^N"
^IBA(364.7,120,1)="K IBXDATA N Z F Z=1,2 I $P($G(IBXSAVE(""OINM"",Z)),U,2)'="""" S IBXDATA(Z)=$P(IBXSAVE(""OINM"",Z),U,2)"
^IBA(364.7,120,3,0)="^^3^3^2960815^^"
^IBA(364.7,120,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,120,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,120,3,3,0)="any other insurance name data is found, the first name is output."
^IBA(364.7,121,0)="103^N^5^^^^N"
^IBA(364.7,121,1)="K IBXDATA N Z F Z=1,2 I $P($G(IBXSAVE(""OINM"",Z)),U,3)'="""" S IBXDATA(Z)=$P(IBXSAVE(""OINM"",Z),U,3)"
^IBA(364.7,121,3,0)="^^3^3^2960815^^"
^IBA(364.7,121,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,121,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,121,3,3,0)="any other insurance name data is found, the middle name is output."
^IBA(364.7,122,0)="104^N^5^^^^N"
^IBA(364.7,122,1)="K IBXDATA N Z,Z0 F Z=1,2 I $P($G(IBXSAVE(""OIDEM"",Z)),U)'="""",$D(^DGCR(399,IBXIEN,""I""_(Z+1))) S Z0=$$DT^IBCEFG1($P(IBXSAVE(""OIDEM"",Z),U),"""",""D8"") S:Z0'="""" IBXDATA(Z)=Z0"
^IBA(364.7,122,3,0)="^^4^4^2991115^^^^"
^IBA(364.7,122,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,122,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,122,3,3,0)="any other insurance demographics data is found, the data is formatted as a"
^IBA(364.7,122,3,4,0)="date in CCYYMMDD format."
^IBA(364.7,123,0)="163^N^28^^^^N"
^IBA(364.7,123,1)="N Z,IBZ M IBZ=IBXDATA K IBXDATA F Z=1,2 I $D(^DGCR(399,IBXIEN,""I""_(Z+1))),$G(IBZ(Z))'="""" S IBXSAVE(""OIDEM"",Z)=IBZ(Z)"
^IBA(364.7,123,3,0)="^^3^3^2990903^^^^"
^IBA(364.7,123,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,123,3,2,0)="possible for the data element in the IBXDATA array.  If any other insurance,"
^IBA(364.7,123,3,3,0)="the data is saved in the IBXSAVE array for later use.  No output."
^IBA(364.7,124,0)="105^N^5^^^^N"
^IBA(364.7,124,1)="K IBXDATA N Z,M,N S Z=$P($G(^DGCR(399,IBXIEN,0)),U,21) F M=1,2 I $G(IBXSAVE(""OIDEM"",M))'="""",$D(^DGCR(399,IBXIEN,""I""_(M+1))) S N=$P(IBXSAVE(""OIDEM"",M),U,2) S:N=""""!(""MF""'[$E(N)) N=""U"" S IBXDATA(M)=N"
^IBA(364.7,124,3,0)="^^4^4^2960815^^^^"
^IBA(364.7,124,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,124,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,124,3,3,0)="any other insurance demographics data is found, the data is formatted as a"
^IBA(364.7,124,3,4,0)="'U' if not M or F to indicate the sex of the other insured."
^IBA(364.7,125,0)="107^N^49^^^^N"
^IBA(364.7,125,1)="N Z,Z0,IBZ M IBZ=IBXDATA K IBXDATA F Z=1,2 I $D(^DGCR(399,IBXIEN,""I""_(Z+1))),$G(IBZ(Z))'="""" S Z0=$$EMPLST^IBCEFG1(IBZ(Z)) I Z0'="""" S IBXDATA(Z)=Z0"
^IBA(364.7,125,3,0)="^^4^4^2991006^^^^"
^IBA(364.7,125,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,125,3,2,0)="possible for the data element in the IBXDATA array.  If any other insurance"
^IBA(364.7,125,3,3,0)="prior payment data is found, the data is formatted as the X12 code for the"
^IBA(364.7,125,3,4,0)="DHCP code extracted for employment status."
^IBA(364.7,126,0)="164^N^30^^^^N"
^IBA(364.7,126,1)="N Z,IBZ M IBZ=IBXDATA K IBXDATA F Z=1,2 I $D(^DGCR(399,IBXIEN,""I""_(Z+1))),$G(IBZ(Z))'="""" S IBXSAVE(""OIEMP"",Z)=IBZ(Z)"
^IBA(364.7,126,3,0)="^^3^3^2991006^^^"
^IBA(364.7,126,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,126,3,2,0)="possible for the data element in the IBXDATA array.  If any other insurance,"
^IBA(364.7,126,3,3,0)="the employer data is saved in the IBXSAVE array for later use."
^IBA(364.7,127,0)="108^N^5^^^^N"
^IBA(364.7,127,1)="K IBXDATA N Z F Z=1,2 I $D(^DGCR(399,IBXIEN,""I""_(Z+1))),$P($G(IBXSAVE(""OIEMP"",Z)),U)'="""" S IBXDATA(Z)=$P(IBXSAVE(""OIEMP"",Z),U)"
^IBA(364.7,127,3,0)="^^3^3^2991006^^^"
^IBA(364.7,127,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,127,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,127,3,3,0)="any other insurance employer data is found, the data is output."
^IBA(364.7,128,0)="109^N^5^^^^N"
^IBA(364.7,128,1)="K IBXDATA N Z F Z=1,2 I $D(^DGCR(399,IBXIEN,""I""_(Z+1))),$P($G(IBXSAVE(""OIEMP"",Z)),U,2)'="""" S IBXDATA(Z)=$TR($P(IBXSAVE(""OIEMP"",Z),U,2),""-/.,()'"",""  "")"
^IBA(364.7,128,3,0)="^^3^3^2991006^^^"
^IBA(364.7,128,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,128,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,128,3,3,0)="any other insurance employer data is found, the data is output."
^IBA(364.7,129,0)="110^N^5^^^^N"
^IBA(364.7,129,1)="K IBXDATA N Z F Z=1,2 I $P($G(IBXSAVE(""OIEMP"",Z)),U,3)'="""" S IBXDATA(Z)=$P(IBXSAVE(""OIEMP"",Z),U,3)"
^IBA(364.7,129,3,0)="^^4^4^2991006^^^^"
^IBA(364.7,129,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,129,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,129,3,3,0)="any other insurance employer data is found, the data is formatted as the 2"
^IBA(364.7,129,3,4,0)="character state abbreviation."
^IBA(364.7,130,0)="111^N^56^^^^N"
^IBA(364.7,130,1)="N Z,Z1,IBZ M IBZ=IBXDATA K IBXDATA F Z=1,2 I $D(^DGCR(399,IBXIEN,""I""_(Z+1))),$G(IBZ(Z))'="""" S IBXDATA(Z)=IBZ(Z)"
^IBA(364.7,130,3,0)="^^3^3^3070123^"
^IBA(364.7,130,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,130,3,2,0)="possible for the data element in the IBXDATA array.  If any other insurance"
^IBA(364.7,130,3,3,0)="form locator 64 data is found, the data is output."
^IBA(364.7,131,0)="165^N^286^^^^N"
^IBA(364.7,131,1)="I IBXDATA'="""" S IBXDATA=$P(""N^Y"",U,+IBXDATA)"
^IBA(364.7,131,3,0)="^^1^1^2991130^^^^"
^IBA(364.7,131,3,1,0)="If data exists, output Y or N"
^IBA(364.7,132,0)="166^N^85^^^^N"
^IBA(364.7,132,1)="S IBXDATA=$TR(IBXDATA,""."")"
^IBA(364.7,132,3,0)="^^1^1^2980922^^^^"
^IBA(364.7,132,3,1,0)="If data element's value is null, do not output.  Remove decimal points."
^IBA(364.7,133,0)="191^N^48^^^^N"
^IBA(364.7,133,1)="S IBXDATA=$$EMPLST^IBCEFG1(IBXDATA)"
^IBA(364.7,133,3,0)="^^2^2^2991214^^^^"
^IBA(364.7,133,3,1,0)="Calculates the X12 code for employment status from the DHCP code extracted."
^IBA(364.7,133,3,2,0)="If data element's value is null, do not output."
^IBA(364.7,134,0)="192^N^280^^^^N"
^IBA(364.7,134,1)="I $G(IBXDATA)'="""",$$WNRBILL^IBEFUNC(IBXIEN) S IBXDATA=""MEDICARE"""
^IBA(364.7,134,3,0)="^364.73^4^4^3040114^^^^"
^IBA(364.7,134,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR1"",$J) will"
^IBA(364.7,134,3,2,0)="already exist.  Don't want to extract this field again, so kill data"
^IBA(364.7,134,3,3,0)="element so there is no output.  If MEDICARE WNR is current insurance,"
^IBA(364.7,134,3,4,0)="mailing name is MEDICARE."
^IBA(364.7,135,0)="65^N^5^^^^N"
^IBA(364.7,135,1)="S IBXDATA=$P($G(IBXSAVE(""IADR"")),U,6) I IBXDATA="""" D PTSELF^IBCEF73 I $G(IBXDATA)=""18"" S IBXDATA=$G(^UTILITY(""VAPA"",$J,2))"
^IBA(364.7,135,3,0)="^364.73^2^2^3030911^^^^"
^IBA(364.7,135,3,1,0)="Retrieves insured address line 2 data from IBXSAVE array previously"
^IBA(364.7,135,3,2,0)="extracted.  If data element's value is null, do not output."
^IBA(364.7,136,0)="190^N^26^^^^N"
^IBA(364.7,136,1)="S IBXDATA=$S($G(IBXSAVE(""CI3-2""))'="""":"""",'$$WNRBILL^IBEFUNC(IBXIEN):$$NOPUNCT^IBCEF(IBXDATA),1:"""")"
^IBA(364.7,136,3,0)="^^2^2^3050113^"
^IBA(364.7,136,3,1,0)="The GROUP NAME is not sent if the GROUP NUMBER is present. "
^IBA(364.7,136,3,2,0)="If this is an MRA Request, then nothing is sent. "
^IBA(364.7,137,0)="189^N^27^^^^N"
^IBA(364.7,137,1)="S IBXSAVE(""CI3-2"")=IBXDATA S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,,""/-:"") I $$WNRBILL^IBEFUNC(IBXIEN) S IBXDATA="""""
^IBA(364.7,137,3,0)="^364.73^1^1^3050113^^^^"
^IBA(364.7,137,3,1,0)="If the insurance is MEDICARE WNR, do not output the group number."
^IBA(364.7,138,0)="133^N^102^^^^N"
^IBA(364.7,138,1)="N Z,Z0,CT K IBXDATA S (Z,CT)=0,Z0=$G(^TMP($J,""IBLCT"")) F  S Z=$O(IBXSAVE(""OUTPT"",Z)) S:'Z ^TMP($J,""IBLCT"")=Z0+$O(IBXDATA(""""),-1) Q:'Z  I $D(IBXSAVE(""OUTPT"",Z,""RX"")) S IBXDATA(Z)=Z,CT=CT+1 D:CT>1 ID^IBCEF2(Z,""RX1 "")"
^IBA(364.7,138,3,0)="^^6^6^2990223^^^^"
^IBA(364.7,138,3,1,0)="^TMP($J,""IBLCT"") keeps track of the last service line # output.  Data  "
^IBA(364.7,138,3,2,0)="element is a group data element so multiple ocurrences of the data element"
^IBA(364.7,138,3,3,0)="are possible in the IBXDATA array.  Save the data in the IBXSAVE array for"
^IBA(364.7,138,3,4,0)="later use.  For every service line > 1, output the RX1 record id."
^IBA(364.7,138,3,5,0)="If the prescription references a service line already output, use that"
^IBA(364.7,138,3,6,0)="service line # to reference this prescription."
^IBA(364.7,139,0)="134^N^5^^^^N"
^IBA(364.7,139,1)="K IBXDATA N Z S Z="""" F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  I $D(IBXSAVE(""OUTPT"",Z,""RX"")) S:$P(IBXSAVE(""OUTPT"",Z,""RX""),U)'=""""&($P(IBXSAVE(""OUTPT"",Z,""RX""),U,3)'="""") IBXDATA(Z)=$P(IBXSAVE(""OUTPT"",Z,""RX""),U)"
^IBA(364.7,139,3,0)="^^3^3^2990223^^^"
^IBA(364.7,139,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,139,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,139,3,3,0)="any service line data is found, the data is output."
^IBA(364.7,140,0)="137^N^5^^^^N"
^IBA(364.7,140,1)="K IBXDATA N Z S Z="""" F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  I $D(IBXSAVE(""OUTPT"",Z,""RX"")) S IBXDATA(Z)=$P(IBXSAVE(""OUTPT"",Z,""RX""),U,2)"
^IBA(364.7,140,3,0)="^^3^3^2960815^^"
^IBA(364.7,140,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,140,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,140,3,3,0)="any service line data is found, the data is output."
^IBA(364.7,141,0)="135^N^5^^^^N"
^IBA(364.7,141,1)="K IBXDATA N Z S Z="""" F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  I $D(IBXSAVE(""OUTPT"",Z,""RX"")) D PADNDC^IBCEF72(Z) S IBXDATA(Z)=$S($P(IBXSAVE(""OUTPT"",Z,""RX""),U,3)="""":"""",1:$TR($P(IBXSAVE(""OUTPT"",Z,""RX""),U,3),""-""))"
^IBA(364.7,141,3,0)="^364.73^3^3^3040323^^^^"
^IBA(364.7,141,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,141,3,2,0)="possible for the data element in the previously extract IBXSAVE array."
^IBA(364.7,141,3,3,0)="If we don't know the NDC#, output all 9's."
^IBA(364.7,142,0)="136^N^5^^^^N"
^IBA(364.7,142,1)="K IBXDATA N Z S Z="""" F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  I $D(IBXSAVE(""OUTPT"",Z,""RX"")) S IBXDATA(Z)=$P(IBXSAVE(""OUTPT"",Z,""RX""),U,4)"
^IBA(364.7,142,3,0)="^^3^3^2960815^^"
^IBA(364.7,142,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,142,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,142,3,3,0)="any service line data is found, the data is output."
^IBA(364.7,143,0)="138^N^5^^^^N"
^IBA(364.7,143,1)="K IBXDATA N Z S Z="""" F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  I $D(IBXSAVE(""OUTPT"",Z,""RX"")) S IBXDATA(Z)=$S($P(IBXSAVE(""OUTPT"",Z,""RX""),U,5)'="""":$$DT^IBCEFG1($P(IBXSAVE(""OUTPT"",Z,""RX""),U,5),"""",""D8""),1:"""")"
^IBA(364.7,143,3,0)="^^4^4^2991115^^^^"
^IBA(364.7,143,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,143,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,143,3,3,0)="any service line data is found, the data is formatted as date in CCYYMMDD"
^IBA(364.7,143,3,4,0)="format."
^IBA(364.7,144,0)="1032^N^5^^^^N^0"
^IBA(364.7,144,1)="S IBXDATA="""""
^IBA(364.7,144,3,0)="^^2^2^3030722^^^"
^IBA(364.7,144,3,1,0)="INITIAL TREATMENT DATE ON CLAIMS INVOLVING"
^IBA(364.7,144,3,2,0)=" SPINAL MANIPULATION FOR MEDICARE PART B"
^IBA(364.7,145,0)="178^N^104^^^^N"
^IBA(364.7,145,1)="I $D(^TMP(""IBHDR"",$J)) K IBXDATA S IBXNOREQ=1"
^IBA(364.7,145,3,0)="^^4^4^2960815^^^^"
^IBA(364.7,145,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR"",$J) will"
^IBA(364.7,145,3,2,0)="already exist.  Don't want to extract this field again, so kill data"
^IBA(364.7,145,3,3,0)="element so there is no output.  Also don't output data element if its"
^IBA(364.7,145,3,4,0)="value is null."
^IBA(364.7,146,0)="181^N^105^^^^N"
^IBA(364.7,146,1)="K:$D(^TMP(""IBHDR"",$J)) IBXDATA S:'$D(IBXDATA) IBXNOREQ=1 I $D(IBXDATA) S IBXDATA=$TR(IBXDATA,""-/.,()'"",""  "")"
^IBA(364.7,146,3,0)="^^4^4^2960815^^^^"
^IBA(364.7,146,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR"",$J) will"
^IBA(364.7,146,3,2,0)="already exist.  Don't want to extract this field again, so kill data"
^IBA(364.7,146,3,3,0)="element so there is no output.  Also don't output data element if its"
^IBA(364.7,146,3,4,0)="value is null."
^IBA(364.7,147,0)="179^N^106^^^^N"
^IBA(364.7,147,1)="K:$D(^TMP(""IBHDR"",$J)) IBXDATA S:'$D(IBXDATA) IBXNOREQ=1 I $D(IBXDATA) S IBXDATA=$$STATE^IBCEFG1(IBXDATA)"
^IBA(364.7,147,3,0)="^^4^4^2990610^^^^"
^IBA(364.7,147,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR"",$J) will"
^IBA(364.7,147,3,2,0)="already exist.  Don't want to extract this field again, so kill data"
^IBA(364.7,147,3,3,0)="element so there is no output.  If header not yet extracted, format data"
^IBA(364.7,147,3,4,0)="as state's 2-character abbreviation."
^IBA(364.7,148,0)="180^N^107^^^^N"
^IBA(364.7,148,1)="I $D(^TMP(""IBHDR"",$J)) K IBXDATA S IBXNOREQ=1"
^IBA(364.7,148,3,0)="^^4^4^2960815^^^^"
^IBA(364.7,148,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR"",$J) will"
^IBA(364.7,148,3,2,0)="already exist.  Don't want to extract this field again, so kill data"
^IBA(364.7,148,3,3,0)="element so there is no output.  Also don't output data element if its"
^IBA(364.7,148,3,4,0)="value is null."
^IBA(364.7,149,0)="183^N^238^^^^N"
^IBA(364.7,149,1)="K:$D(^TMP(""IBHDR"",$J)) IBXDATA S:'$D(IBXDATA) IBXNOREQ=1 I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF($$EXPAND^IBTRE(350.9,2.11,IBXDATA),1) I IBXDATA="""" D F^IBCEF(""N-AGENT CASHIER PHONE"",,,IBXIEN) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,149,3,0)="^^5^5^2991101^^^^"
^IBA(364.7,149,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR"",$J) will"
^IBA(364.7,149,3,2,0)="already exist.  Don't want to extract this field again, so kill data"
^IBA(364.7,149,3,3,0)="element so there is no output.  Also, if the value of the site contact phone"
^IBA(364.7,149,3,4,0)="is null, use the AGENT CASHIER's phone number (if available) instead."
^IBA(364.7,149,3,5,0)="Strip all punctuation from phone number."
^IBA(364.7,150,0)="182^N^109^^^^N"
^IBA(364.7,150,1)="K:$D(^TMP(""IBHDR"",$J)) IBXDATA S:'$D(IBXDATA) IBXNOREQ=1 I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,150,3,0)="^^4^4^2990915^^^^"
^IBA(364.7,150,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR"",$J) will"
^IBA(364.7,150,3,2,0)="already exist.  Don't want to extract this field again, so kill data"
^IBA(364.7,150,3,3,0)="element so there is no output.  Also don't output data element if its"
^IBA(364.7,150,3,4,0)="value is null.  Must strip dashes from number to pass numeric edits."
^IBA(364.7,151,0)="186^N^5^^^^N"
^IBA(364.7,151,1)="I $P($G(IBXSAVE(""CADR"")),U,4)'="""" S IBXDATA=$TR($P(IBXSAVE(""CADR""),U,4),""-/.,()'"",""  "")"
^IBA(364.7,151,3,0)="^364.73^6^6^3030926^^^^"
^IBA(364.7,151,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR1"",$J) will"
^IBA(364.7,151,3,2,0)="already exist.  Don't want to extract this field again, so kill data"
^IBA(364.7,151,3,3,0)="element so there is no output.  Also don't output data element if its"
^IBA(364.7,151,3,4,0)="value is null."
^IBA(364.7,151,3,5,0)="This data relies on the presence of the IBXSAVE(""CADR"") array that should"
^IBA(364.7,151,3,6,0)="have been set in a previous data field."
^IBA(364.7,152,0)="185^N^5^^^^N"
^IBA(364.7,152,1)="D CHKADD^IBCEF7 I $P($G(IBXSAVE(""CADR"")),U)'="""" S IBXDATA=$P(IBXSAVE(""CADR""),U)"
^IBA(364.7,152,3,0)="^364.73^6^6^3040528^^^^"
^IBA(364.7,152,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR1"",$J) will"
^IBA(364.7,152,3,2,0)="already exist.  Don't want to extract this field again, so kill data"
^IBA(364.7,152,3,3,0)="element so there is no output.  Also don't output data element if its"
^IBA(364.7,152,3,4,0)="value is null."
^IBA(364.7,152,3,5,0)="This data relies on the presence of the IBXSAVE(""CADR"") array that should"
^IBA(364.7,152,3,6,0)="have been set in a previous data field."
^IBA(364.7,153,0)="187^N^5^^^^N"
^IBA(364.7,153,1)="I $P($G(IBXSAVE(""CADR"")),U,5)'="""" S IBXDATA=$$STATE^IBCEFG1($P(IBXSAVE(""CADR""),U,5))"
^IBA(364.7,153,3,0)="^364.73^6^6^3030926^^^^"
^IBA(364.7,153,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR1"",$J) will"
^IBA(364.7,153,3,2,0)="already exist.  Don't want to extract this field again, so kill data"
^IBA(364.7,153,3,3,0)="element so there is no output.  If header not yet extracted, format data"
^IBA(364.7,153,3,4,0)="as state's 2-character abbreviation."
^IBA(364.7,153,3,5,0)="This data relies on the presence of the IBXSAVE(""CADR"") array that should"
^IBA(364.7,153,3,6,0)="have been set in a previous data field."
^IBA(364.7,154,0)="188^N^5^^^^N"
^IBA(364.7,154,1)="K IBXDATA I $P($G(IBXSAVE(""CADR"")),U,6)'="""" S IBXDATA=$P(IBXSAVE(""CADR""),U,6)"
^IBA(364.7,154,3,0)="^364.73^6^6^3030926^^^^"
^IBA(364.7,154,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR1"",$J) will"
^IBA(364.7,154,3,2,0)="already exist.  Don't want to extract this field again, so kill data"
^IBA(364.7,154,3,3,0)="element so there is no output.  Also don't output data element if its"
^IBA(364.7,154,3,4,0)="value is null."
^IBA(364.7,154,3,5,0)="This data relies on the presence of the IBXSAVE(""CADR"") array that should"
^IBA(364.7,154,3,6,0)="have been set in a previous data field."
^IBA(364.7,155,0)="193^N^115^^^^N"
^IBA(364.7,155,1)="K IBXDATA"
^IBA(364.7,155,3,0)="^^2^2^2981124^^^^"
^IBA(364.7,155,3,1,0)="Set ^TMP(""IBHDR"",$J) global node so the header data is not extracted again."
^IBA(364.7,155,3,2,0)="No output needed."
^IBA(364.7,156,0)="170^N^275^^^^N"
^IBA(364.7,156,1)="N A,Z,Q S Q=IBXDATA,A=$P(Q,U,2),Z=$S(+Q=+$P($G(^IBE(350.9,1,0)),U,2):A'=1,1:0) K:'Q IBXDATA I $D(IBXDATA) S IBXSAVE(""IBFAC"")=Q,IBXDATA=$$GETFAC^IBCEP8(+IBXDATA,+A,0,""SUB"")"
^IBA(364.7,156,3,0)="^364.73^3^3^3041221^^^^"
^IBA(364.7,156,3,1,0)="This returns the name of the INSTITUTION file entry for the non-VA or"
^IBA(364.7,156,3,2,0)="remote site where care was rendered.  Save the ien and flag in "
^IBA(364.7,156,3,3,0)="IBXSAVE(""IBFAC"") for later use."
^IBA(364.7,157,0)="171^N^5^^^^N"
^IBA(364.7,157,1)="K IBXSAVE(""PSVC"") K:'$G(IBXSAVE(""IBFAC""))&'$P($G(IBXSAVE(""IBFAC"")),U,3) IBXDATA I $D(IBXDATA) S IBXDATA=$$GETFAC^IBCEP8(+IBXSAVE(""IBFAC""),+$P(IBXSAVE(""IBFAC""),U,2),12,""SUB"")"
^IBA(364.7,157,3,0)="^364.73^3^3^3041217^^^^"
^IBA(364.7,157,3,1,0)="Extract the street address for the rendering facility.  Relies on the"
^IBA(364.7,157,3,2,0)="existence of the array IBXSAVE(""IBFAC"") extracted previously by the"
^IBA(364.7,157,3,3,0)="rendering facility name field."
^IBA(364.7,158,0)="600^N^241^^^^N"
^IBA(364.7,158,1)="S IBXDATA=$S(IBXDATA'="""":""Ref:""_IBXDATA,$O(^DGCR(399,IBXIEN,""PRV"",""B"",1,0)):""Ref:VAD000"",1:"""")"
^IBA(364.7,158,3,0)="^364.73^1^1^3041021^^^^"
^IBA(364.7,158,3,1,0)="ID of Referring Physician"
^IBA(364.7,159,0)="173^N^5^^^^N"
^IBA(364.7,159,1)="K:'$G(IBXSAVE(""IBFAC""))&'$P($G(IBXSAVE(""IBFAC"")),U,3) IBXDATA I $D(IBXDATA) S IBXDATA=$$GETFAC^IBCEP8(+IBXSAVE(""IBFAC""),+$P(IBXSAVE(""IBFAC""),U,2),""3S"",""SUB"")"
^IBA(364.7,159,3,0)="^364.73^3^3^3041217^^^^"
^IBA(364.7,159,3,1,0)="Extract the state abbreviation for the rendering facility.  Relies on the"
^IBA(364.7,159,3,2,0)="existence of the array IBXSAVE(""IBFAC"") extracted previously by the"
^IBA(364.7,159,3,3,0)="rendering facility name field."
^IBA(364.7,160,0)="174^N^5^^^^N"
^IBA(364.7,160,1)="K:'$G(IBXSAVE(""IBFAC""))&'$P($G(IBXSAVE(""IBFAC"")),U,3) IBXDATA I $D(IBXDATA) S IBXDATA=$$GETFAC^IBCEP8(+IBXSAVE(""IBFAC""),+$P(IBXSAVE(""IBFAC""),U,2),""3Z"",""SUB"")"
^IBA(364.7,160,3,0)="^^3^3^3030827^^^^"
^IBA(364.7,160,3,1,0)="Extract the zip code for the rendering facility.  Relies on the"
^IBA(364.7,160,3,2,0)="existence of the array IBXSAVE(""IBFAC"") extracted previously by the"
^IBA(364.7,160,3,3,0)="rendering facility name field."
^IBA(364.7,161,0)="167^N^120^^^^N"
^IBA(364.7,161,1)="S:$D(^TMP(""IBHDR"",$J)) IBXNOREQ=1 S:'$G(IBXDATA)&'$D(^TMP(""IBHDR"",$J)) IBXERR=""Batch number could not be determined"" K:$G(IBXERR)'="""" IBXDATA S:$G(IBXDATA)'="""" IBXSAVE(""BATCH"")=IBXDATA"
^IBA(364.7,161,3,0)="^^3^3^2960815^^^^"
^IBA(364.7,161,3,1,0)="Set an error condition if no batch # and the header fields have not"
^IBA(364.7,161,3,2,0)="already been extracted.  No output if error condition or header fields"
^IBA(364.7,161,3,3,0)="have already been extracted."
^IBA(364.7,162,0)="168^N^121^^^^N"
^IBA(364.7,162,1)="K:$D(^TMP(""IBHDR"",$J)) IBXDATA S:'$D(IBXDATA) IBXNOREQ=1 I $D(IBXDATA) S IBXDATA=$$DT^IBCEFG1(IBXDATA,"""",""D8"")"
^IBA(364.7,162,3,0)="4^^4^4^2991115^^^^"
^IBA(364.7,162,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR"",$J) will"
^IBA(364.7,162,3,2,0)="already exist.  Don't want to extract this field again, so kill data"
^IBA(364.7,162,3,3,0)="element so there is no output.  If header data not already extracted,"
^IBA(364.7,162,3,4,0)="format date as CCYYMMDD."
^IBA(364.7,163,0)="169^N^5^^^^N"
^IBA(364.7,163,1)="K:$D(^TMP(""IBHDR"",$J)) IBXDATA S:'$D(IBXDATA) IBXNOREQ=1 S IBXDATA=$G(IBXSAVE(""BATCH""))"
^IBA(364.7,163,3,0)="^^4^4^2960815^^^^"
^IBA(364.7,163,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR"",$J) will"
^IBA(364.7,163,3,2,0)="already exist.  Don't want to extract this field again, so kill data"
^IBA(364.7,163,3,3,0)="element so there is no output.  If header data not already extracted,"
^IBA(364.7,163,3,4,0)="retrieve data element from IBXSAVE array previously extracted."
^IBA(364.7,164,0)="106^N^125^^^^N"
^IBA(364.7,164,1)="N Z,Z0,IBZ M IBZ=IBXDATA K IBXDATA F Z=1,2 I $D(^DGCR(399,IBXIEN,""I""_(Z+1))),$G(IBZ(Z)) S Z0=$$DOLLAR^IBCEFG1(IBZ(Z)) I Z0 S IBXDATA(Z)=Z0"
^IBA(364.7,164,3,0)="^^4^4^2991115^^^^"
^IBA(364.7,164,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,164,3,2,0)="possible for the data element in the IBXDATA array.  If any other insurance"
^IBA(364.7,164,3,3,0)="prior payment data is found, the data is formatted as a numeric including"
^IBA(364.7,164,3,4,0)="cents, without the decimals."
^IBA(364.7,165,0)="112^N^126^^^^N"
^IBA(364.7,165,1)="N A,Z,Q,IBZ K IBXSAVE(""OUTPT"") D SET1^IBCEF1(IBXIEN,.A,.IBZ,.IBXDATA,.IBXNOREQ) S Z=0,Q=$G(@A) F  S Z=$O(IBZ(Z)) S:'Z @A=Q Q:'Z  M IBXSAVE(""OUTPT"",Z)=IBZ(Z) S Q=Q+1,IBXDATA(Z)=Q D:Z>1 ID^IBCEF2(Z,""PRF "") D SVITM^IBCEF2(.IBXSAVE,Z)"
^IBA(364.7,165,3,0)="^364.73^4^4^3000918^^^^"
^IBA(364.7,165,3,1,0)="^TMP($J,""IBLCT"") keeps track of the last service line # output.  Data"
^IBA(364.7,165,3,2,0)="element is a group data element so multiple ocuurences of the data element"
^IBA(364.7,165,3,3,0)="are possible in the IBXDATA array.  Save the data in the IBXSAVE array for"
^IBA(364.7,165,3,4,0)="later use.  For every service line > 1, output the PRF record id."
^IBA(364.7,166,0)="113^N^5^^^^N"
^IBA(364.7,166,1)="K IBXDATA N Z S Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  I $P(IBXSAVE(""OUTPT"",Z),U,6)'="""" S IBXDATA(Z)=$P(IBXSAVE(""OUTPT"",Z),U,6) I IBXDATA(Z)=""CJ"",'$$WNRBILL^IBEFUNC(IBXIEN) S IBXDATA(Z)=""HC"""
^IBA(364.7,166,3,0)="^^3^3^2991222^^^^"
^IBA(364.7,166,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,166,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,166,3,3,0)="any service line data is found, the data is output."
^IBA(364.7,167,0)="114^N^5^^^^N"
^IBA(364.7,167,1)="K IBXDATA S IBXNOREQ=$$NFT^IBCEF1(2,IBXIEN) N Z S Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  S:$P(IBXSAVE(""OUTPT"",Z),U,8)'="""" IBXDATA(Z)=$$DOLLAR^IBCEFG1($P(IBXSAVE(""OUTPT"",Z),U,8)*$P(IBXSAVE(""OUTPT"",Z),U,9))"
^IBA(364.7,167,3,0)="^^5^5^2991115^^^^"
^IBA(364.7,167,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,167,3,2,0)="possible for the data element in the previously extract IBXSAVE array. The"
^IBA(364.7,167,3,3,0)="data is calculated by unit charge * # of units.  If any service line data is"
^IBA(364.7,167,3,4,0)="found, the data is formatted as a numeric including cents, without the"
^IBA(364.7,167,3,5,0)="decimal."
^IBA(364.7,168,0)="115^N^5^^^^N"
^IBA(364.7,168,1)="K IBXDATA N Z,Z0,Q S IBXNOREQ=$$NFT^IBCEF1(2,IBXIEN),Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  S Z0=$P(IBXSAVE(""OUTPT"",Z),U,4),Q=$S(Z0'=7:9,1:12) S:$P(IBXSAVE(""OUTPT"",Z),U,Q)'="""" IBXDATA(Z)=$P(IBXSAVE(""OUTPT"",Z),U,Q) S:IBXDATA(Z)<1 IBXDATA(Z)=1"
^IBA(364.7,168,3,0)="^^6^6^2990901^^^^"
^IBA(364.7,168,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,168,3,2,0)="possible for the data element in the previously extracted IBXSAVE array.  If"
^IBA(364.7,168,3,3,0)="any service line data is found, the data is output."
^IBA(364.7,168,3,4,0)="If the type of service is not 7 (anesthesia), the units are output.  If the"
^IBA(364.7,168,3,5,0)="type of service is anesthesia, the anesthesia minutes are output.  If the #"
^IBA(364.7,168,3,6,0)="of units is less than 1, 1 is the default."
^IBA(364.7,169,0)="116^N^5^^^^N"
^IBA(364.7,169,1)="K IBXDATA S IBXNOREQ=$$NFT^IBCEF1(2,IBXIEN) N Z S Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  S:$P(IBXSAVE(""OUTPT"",Z),U,3)'="""" IBXDATA(Z)=$P(IBXSAVE(""OUTPT"",Z),U,3)"
^IBA(364.7,169,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,169,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,169,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,169,3,3,0)="any service line data is found, the data is output."
^IBA(364.7,170,0)="117^N^5^^^^N"
^IBA(364.7,170,1)="K IBXDATA S IBXNOREQ=$$NFT^IBCEF1(2,IBXIEN) N Z S Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  S:$P(IBXSAVE(""OUTPT"",Z),U,4)'="""" IBXDATA(Z)=$P(IBXSAVE(""OUTPT"",Z),U,4)"
^IBA(364.7,170,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,170,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,170,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,170,3,3,0)="any service line data is found, the data is output."
^IBA(364.7,171,0)="118^N^5^^^^N"
^IBA(364.7,171,1)="K IBXDATA S IBXNOREQ=$$NFT^IBCEF1(2,IBXIEN) N Z S Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  S:$P(IBXSAVE(""OUTPT"",Z),U)'="""" IBXDATA(Z)=$P(IBXSAVE(""OUTPT"",Z),U)"
^IBA(364.7,171,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,171,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,171,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,171,3,3,0)="any service line data is found, the data is output."
^IBA(364.7,172,0)="119^N^5^^^^N"
^IBA(364.7,172,1)="N Z,Z0 K IBXDATA S Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  S Z0=$P(IBXSAVE(""OUTPT"",Z),U,7) S:$P(Z0,"","")'="""" IBXDATA(Z)=$P(Z0,"","")"
^IBA(364.7,172,3,0)="^^4^4^2990901^^^"
^IBA(364.7,172,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,172,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,172,3,3,0)="any service line data is found, the data is output.  Data is taken from the"
^IBA(364.7,172,3,4,0)="first ',' delimited piece of the extracted data."
^IBA(364.7,173,0)="120^N^5^^^^N"
^IBA(364.7,173,1)="K IBXDATA N Z,Z0 S Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  S Z0=$P(IBXSAVE(""OUTPT"",Z),U,7) S:$P(Z0,"","",2) IBXDATA(Z)=$P(Z0,"","",2)"
^IBA(364.7,173,3,0)="^^4^4^2990901^^^"
^IBA(364.7,173,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,173,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,173,3,3,0)="any service line data is found, the data is output.  Data is taken from the"
^IBA(364.7,173,3,4,0)="second ',' delimited piece of the extracted data.    "
^IBA(364.7,174,0)="121^N^5^^^^N"
^IBA(364.7,174,1)="K IBXDATA N Z,Z0 S Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  S Z0=$P(IBXSAVE(""OUTPT"",Z),U,7) S:$P(Z0,"","",3) IBXDATA(Z)=$P(Z0,"","",3)"
^IBA(364.7,174,3,0)="^^4^4^2990901^^^"
^IBA(364.7,174,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,174,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,174,3,3,0)="any service line data is found, the data is output.  Data is taken from the"
^IBA(364.7,174,3,4,0)="third ',' delimited piece of the extracted data.    "
^IBA(364.7,175,0)="122^N^5^^^^N"
^IBA(364.7,175,1)="K IBXDATA N Z,Z0 S Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  S Z0=$P(IBXSAVE(""OUTPT"",Z),U,7) S:$P(Z0,"","",4) IBXDATA(Z)=$P(Z0,"","",4)"
^IBA(364.7,175,3,0)="^^4^4^2990901^^^"
^IBA(364.7,175,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,175,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,175,3,3,0)="any service line data is found, the data is output.  Data is taken from the"
^IBA(364.7,175,3,4,0)="fourth ',' delimited piece of the extracted data.    "
^IBA(364.7,176,0)="123^N^8^^^^N"
^IBA(364.7,176,1)="N A,Z S Z=0,A=$G(^TMP($J,""IBLCT"")) F  S Z=$O(IBXDATA(Z)) K:'Z&($D(IBXDATA)=1) IBXDATA S:'Z ^TMP($J,""IBLCT"")=A Q:'Z  S A=A+1 M IBXSAVE(""INPT"",Z)=IBXDATA(Z) K IBXDATA(Z) S IBXDATA(Z)=A D:Z>1 ID^IBCEF2(Z,""INS "")"
^IBA(364.7,176,3,0)="^^4^4^3021024^^^^"
^IBA(364.7,176,3,1,0)="^TMP($J,""IBLCT"") keeps track of the last service line # output.  Data  "
^IBA(364.7,176,3,2,0)="element is a group data element so multiple occurences of the data element"
^IBA(364.7,176,3,3,0)="are possible in the IBXDATA array.  Save the data in the IBXSAVE array for"
^IBA(364.7,176,3,4,0)="later use.  For every service line > 1, output the INS record id."
^IBA(364.7,177,0)="124^N^5^^^^N"
^IBA(364.7,177,1)="K IBXDATA N Z S Z=0 F  S Z=$O(IBXSAVE(""INPT"",Z)) Q:'Z  S:$P(IBXSAVE(""INPT"",Z),U)'="""" IBXDATA(Z)=$P(IBXSAVE(""INPT"",Z),U)"
^IBA(364.7,177,3,0)="^^3^3^2990211^^^"
^IBA(364.7,177,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,177,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,177,3,3,0)="any service line data is found, the data is output."
^IBA(364.7,178,0)="126^N^5^^^^N"
^IBA(364.7,178,1)="K IBXDATA S IBXNOREQ='$$REQ^IBCEF1(3,"""",IBXIEN) N Z S Z=0 F  S Z=$O(IBXSAVE(""INPT"",Z)) Q:'Z  S:$P(IBXSAVE(""INPT"",Z),U,4)'="""" IBXDATA(Z)=$P(IBXSAVE(""INPT"",Z),U,4)"
^IBA(364.7,178,3,0)="^^3^3^2960815^^"
^IBA(364.7,178,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,178,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,178,3,3,0)="any service line data is found, the data is output."
^IBA(364.7,179,0)="127^N^5^^^^N"
^IBA(364.7,179,1)="K IBXDATA N Z S Z=0 F  S Z=$O(IBXSAVE(""INPT"",Z)) Q:'Z  S:$P(IBXSAVE(""INPT"",Z),U,3)'="""" IBXDATA(Z)=$$DOLLAR^IBCEFG1($P(IBXSAVE(""INPT"",Z),U,3))"
^IBA(364.7,179,3,0)="^^4^4^2991115^^^^"
^IBA(364.7,179,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,179,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,179,3,3,0)="any service line data is found, the data is formatted as a numeric including"
^IBA(364.7,179,3,4,0)="cents, without the decimal."
^IBA(364.7,180,0)="130^N^5^^^^N"
^IBA(364.7,180,1)="K IBXDATA N Z S Z=0 F  S Z=$O(IBXSAVE(""INPT"",Z)) Q:'Z  S:$P(IBXSAVE(""INPT"",Z),U,5)'="""" IBXDATA(Z)=$$DOLLAR^IBCEFG1($P(IBXSAVE(""INPT"",Z),U,5))"
^IBA(364.7,180,3,0)="^^4^4^2991115^^^"
^IBA(364.7,180,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,180,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,180,3,3,0)="any service line data is found, the data is formatted as a numeric including"
^IBA(364.7,180,3,4,0)="cents, without the decimal."
^IBA(364.7,181,0)="128^N^5^^^^N"
^IBA(364.7,181,1)="N Z S Z=0 F  S Z=$O(IBXSAVE(""INPT"",Z)) Q:'Z  S:$P(IBXSAVE(""INPT"",Z),U,9)'=""""&($P(IBXSAVE(""INPT"",Z),U,2)'="""") IBXSAVE(""PMOD"",Z)=$P(IBXSAVE(""INPT"",Z),U,9),IBXDATA(Z)=$P(IBXSAVE(""PMOD"",Z),"","")"
^IBA(364.7,181,3,0)="^364.73^1^1^3001005^^^^"
^IBA(364.7,181,3,1,0)="Save the data element in the IBXSAVE(""PMOD"") array for later use."
^IBA(364.7,182,0)="129^N^5^^^^N"
^IBA(364.7,182,1)="N Z S Z=0 F  S Z=$O(IBXSAVE(""PMOD"",Z)) Q:'Z  S IBXDATA(Z)=$P(IBXSAVE(""PMOD"",Z),"","",2) I '$O(IBXSAVE(""PMOD"",Z)) K IBXSAVE(""PMOD"")"
^IBA(364.7,182,3,0)="^364.73^2^2^3001005^^^^"
^IBA(364.7,182,3,1,0)="This data element relies on the existence of the variable IBXSAVE(""PMOD"")"
^IBA(364.7,182,3,2,0)="previously extracted."
^IBA(364.7,183,0)="131^N^5^^^^N"
^IBA(364.7,183,1)="N Z S IBXNOREQ='$$REQ^IBCEF1(3,""O"",IBXIEN) K IBXDATA Q:IBXNOREQ!$$INPAT^IBCEF(IBXIEN,1)  S Z=$$SERVDT^IBCEF(IBXIEN,8,1),Q=0 S:Z'="""" IBXSAVE(""DATE"")=Z D RCDT^IBCEFG1(.IBXSAVE,.IBXDATA,Z)"
^IBA(364.7,183,3,0)="^364.73^4^4^3021217^^^^"
^IBA(364.7,183,3,1,0)="If data element's value is null, do not output."
^IBA(364.7,183,3,2,0)="If this is an inpatient bill do not send this data element.  If outpatient,"
^IBA(364.7,183,3,3,0)="output IBXSAVE(""DATE"") - STATEMENT FROM DATE or the date from the"
^IBA(364.7,183,3,4,0)="associated procedure, if it can be determined."
^IBA(364.7,184,0)="132^N^5^^^^N"
^IBA(364.7,184,1)="K:'$$WNRBILL^IBEFUNC(IBXIEN) IBXDATA I $D(IBXDATA),$G(IBXSAVE(""DATE"")) D OUTPDT^IBCEF3(IBXIEN,.IBXSAVE,.IBXDATA)"
^IBA(364.7,184,3,0)="^^2^2^2990211^^^"
^IBA(364.7,184,3,1,0)="If data element's value is null, do not output."
^IBA(364.7,184,3,2,0)="If this is a non-MRA request (through ENVOY), do not send this data element"
^IBA(364.7,185,0)="194^N^5^^^^N"
^IBA(364.7,185,1)="S IBXNOREQ=$$NFT^IBCEF1(2,IBXIEN) K IBXDATA N Z S Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  S:$P(IBXSAVE(""OUTPT"",Z),U,5)'="""" IBXDATA(Z)=$P(IBXSAVE(""OUTPT"",Z),U,5)"
^IBA(364.7,185,3,0)="^^3^3^2990901^^^"
^IBA(364.7,185,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,185,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,185,3,3,0)="any service line data is found, the data is output."
^IBA(364.7,186,0)="1033^N^5^^^^N^0"
^IBA(364.7,186,1)="S IBXDATA="""""
^IBA(364.7,186,3,0)="^^1^1^3030722^^^^"
^IBA(364.7,186,3,1,0)="FIND THE LAST XRAY DATE WHEN CLAIM INVOLVES A SPINAL MANIPULATION"
^IBA(364.7,188,0)="195^N^5^^^^N"
^IBA(364.7,188,1)="D CLEANUP^IBCEF75(.IBXSAVE) D ALLIDS^IBCEF75(IBXIEN,.IBXSAVE,1) K IBXDATA N Z F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(""BILLING PRV"",IBXIEN,""O"",Z,2)),U,2)"
^IBA(364.7,188,3,0)="^364.73^3^3^3060420^^^^"
^IBA(364.7,188,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,188,3,2,0)="possible for the data element in the IBXDATA array.  If any other insurance"
^IBA(364.7,188,3,3,0)="provider # data is found, the data is output."
^IBA(364.7,189,0)="125^N^5^^^^N"
^IBA(364.7,189,1)="K IBXDATA N Z S Z=0 F  S Z=$O(IBXSAVE(""INPT"",Z)) Q:'Z  S:$P(IBXSAVE(""INPT"",Z),U,2)'="""" IBXDATA(Z)=$$PRCD^IBCEF1($P(IBXSAVE(""INPT"",Z),U,2)_"";ICPT("")"
^IBA(364.7,189,3,0)="^^3^3^2960815^^"
^IBA(364.7,189,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,189,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,189,3,3,0)="any service line data is found, the data is output."
^IBA(364.7,190,0)="197^N^100^^^^N"
^IBA(364.7,190,1)="K IBXSAVE"
^IBA(364.7,190,3,0)="^^1^1^2990405^^^^"
^IBA(364.7,190,3,1,0)="Clean up IBXSAVE array.  No output."
^IBA(364.7,191,0)="198^N^100^^^^N"
^IBA(364.7,191,1)="K IBXSAVE"
^IBA(364.7,191,3,0)="^^1^1^2990218^^^"
^IBA(364.7,191,3,1,0)="Clean up the IBXSAVE array.  No output."
^IBA(364.7,192,0)="1034^N^5^^^^N^0"
^IBA(364.7,192,1)="S IBXDATA="""""
^IBA(364.7,192,3,0)="^^1^1^3030722^^^"
^IBA(364.7,192,3,1,0)="HEARING AND VISION PRESCRIPTION DATE"
^IBA(364.7,193,0)="1035^N^5^^^^N^0"
^IBA(364.7,193,1)="K IBXDATA S IBIFN=IBXIEN S IBZZ=$$MCRONBIL^IBEFUNC(IBIFN) S IBXDATA=$S(IBZZ:""A"",IBZZ=0:""C"",1:"""")"
^IBA(364.7,193,3,0)="^^1^1^3030723^^^^"
^IBA(364.7,193,3,1,0)="MEDICARE ASSIGNMENT CODE: A = ASSIGNED and C = Not Assigned."
^IBA(364.7,194,0)="175^N^124^^^^N"
^IBA(364.7,194,1)="I $D(^TMP(""IBHDR"",$J)) K IBXDATA S IBXNOREQ=1"
^IBA(364.7,194,3,0)="^^4^4^2980724^^^^"
^IBA(364.7,194,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR"",$J) will"
^IBA(364.7,194,3,2,0)="already exist.  Don't want to extract this field again, so kill data"
^IBA(364.7,194,3,3,0)="element so there is no output.  Also don't output data element if its"
^IBA(364.7,194,3,4,0)="value is null."
^IBA(364.7,195,0)="196^N^129^^^^N"
^IBA(364.7,195,1)="N Z S Z=$$COID^IBCEF2(IBXIEN) S:Z="""" Z=""0000"" K:IBXDATA="""" IBXDATA I $D(IBXDATA) S IBXDATA=$E(IBXDATA_$J("""",5),1,5)_$E(Z_$J("""",4),1,4)"
^IBA(364.7,195,3,0)="^^5^5^2990608^^^^"
^IBA(364.7,195,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR1"",$J) will"
^IBA(364.7,195,3,2,0)="already exist.  Don't want to extract this field again, so kill data"
^IBA(364.7,195,3,3,0)="element so there is no output.  Positions 1-5 are the id number as assigned"
^IBA(364.7,195,3,4,0)="by ENVOY, positions 6-9 are the claim office id (default if there is none"
^IBA(364.7,195,3,5,0)="is '0000').   Also don't output data element if its value is null."
^IBA(364.7,196,0)="1036^N^111^^^^N^0"
^IBA(364.7,196,1)="I $G(IBXDATA)'="""" S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA),IBXSAVE(""MAMMO"")=1"
^IBA(364.7,196,3,0)="^^3^3^3060117^"
^IBA(364.7,196,3,1,0)="Extract and format the mammo# cert number from the claim.  If a mammo# is "
^IBA(364.7,196,3,2,0)="present for the claim then save that fact in IBXSAVE for later usage for "
^IBA(364.7,196,3,3,0)="the mammo# qualifier field."
^IBA(364.7,197,0)="1037^N^5^^^^N^0"
^IBA(364.7,197,1)="S IBXDATA="""""
^IBA(364.7,197,3,0)="^^2^2^3030722^^^"
^IBA(364.7,197,3,1,0)="SPINAL MANIP. CONDITION CODE; A = Acute Condition, C = Chronic Condition, D = Non-Acute"
^IBA(364.7,197,3,2,0)="E = Non-Life Threatening, F = Routine, G = Symptomatic, M = Acute Manifestation of a Chronic Condition"
^IBA(364.7,198,0)="1038^N^5^^^^N^0"
^IBA(364.7,198,1)="S IBXDATA="""""
^IBA(364.7,198,3,0)="^^2^2^3030722^^^^"
^IBA(364.7,198,3,1,0)="Required when sequence 50 piece 44 (Spinal Manipulation Nature of Condifion Code) = A or M on spinal"
^IBA(364.7,198,3,2,0)="manipulation claims and the payer is Medicare"
^IBA(364.7,199,0)="209^N^131^^^^N"
^IBA(364.7,199,1)="K:$D(^TMP(""IBHDR"",$J)) IBXDATA S:'$D(IBXDATA) IBXNOREQ=1 I $D(IBXDATA) S IBXDATA=""PRV """
^IBA(364.7,199,3,0)="^^4^4^2960815^^^^"
^IBA(364.7,199,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR"",$J) will"
^IBA(364.7,199,3,2,0)="already exist.  Don't want to extract this field again, so kill data"
^IBA(364.7,199,3,3,0)="element so there is no output.  If no header already extracted, output"
^IBA(364.7,199,3,4,0)="the record id for the 'PRV' record."
^IBA(364.7,200,0)="215^N^131^^^^N"
^IBA(364.7,200,1)="S IBXDATA=""PT2 """
^IBA(364.7,200,3,0)="^^1^1^2960815^^^^"
^IBA(364.7,200,3,1,0)="Output RECORD ID for PT2 record."
^IBA(364.7,201,0)="216^N^131^^^^N"
^IBA(364.7,201,1)="S IBXDATA=""CL1 """
^IBA(364.7,201,3,0)="^^1^1^2960815^^^^"
^IBA(364.7,201,3,1,0)="Output RECORD ID for CL1 record."
^IBA(364.7,202,0)="217^N^131^^^^N"
^IBA(364.7,202,1)="S IBXDATA=""UB1 """
^IBA(364.7,202,3,0)="^^1^1^2990405^^^^"
^IBA(364.7,202,3,1,0)="Output RECORD ID for UB1 record."
^IBA(364.7,203,0)="1039^N^5^^^^N^0"
^IBA(364.7,203,1)="K:'$G(IBXSAVE(""IBFAC""))&'$P($G(IBXSAVE(""IBFAC"")),U,3) IBXDATA I $D(IBXDATA) S IBXDATA=$$GETFAC^IBCEP8(+IBXSAVE(""IBFAC""),+$P(IBXSAVE(""IBFAC""),U,2),2,""SUB"")"
^IBA(364.7,203,3,0)="^364.73^1^1^3041221^^^^"
^IBA(364.7,203,3,1,0)="RENDERING PROVIDER FACILITY INFORMATION TO FIND THE SERVICE FACILITY ADDRESS LINE 2"
^IBA(364.7,204,0)="1040^N^5^^^^N^0"
^IBA(364.7,204,1)="D CLEANUP^IBCEF75(.IBXSAVE) D:$$SUB1OK^IBCEP8A(IBXIEN) ALLIDS^IBCEF75(IBXIEN,.IBXSAVE,1,""SUB1"") S IBXDATA=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""C"",1,1)),U,1)"
^IBA(364.7,204,3,0)="^364.73^12^12^3060320^^^^"
^IBA(364.7,204,3,1,0)="If the bill is a professional bill, was performed at an 'outside' facility,"
^IBA(364.7,204,3,2,0)="and the service was purchased THEN"
^IBA(364.7,204,3,3,0)="   If the rendering provider is an outside provider:"
^IBA(364.7,204,3,4,0)="      output the ids for the rendering provider here."
^IBA(364.7,204,3,5,0)="   If the rendering provider is NOT an outside provider:"
^IBA(364.7,204,3,6,0)="      output the ids for the outside facility here."
^IBA(364.7,204,3,7,0)="Output if an ID exists for the 'current insurance'.  Must save the type"
^IBA(364.7,204,3,8,0)="of provider (1 = person or 2 = facility) whose ids were extracted in"
^IBA(364.7,204,3,9,0)="variable IBXSAVE(""NVF"") to be used later in this record.  It must be"
^IBA(364.7,204,3,10,0)="killed in the last piece of the record."
^IBA(364.7,204,3,11,0)="The ids returned are screened for valid id qualifiers for the SUB1 record."
^IBA(364.7,204,3,12,0)="Output the first other id qualifier for the current insurance."
^IBA(364.7,205,0)="1041^N^274^^^^N^0"
^IBA(364.7,205,1)="I $G(IBXDATA) N Z S Z=$P($G(^DGCR(399,IBXIEN,""U2"")),U,11),IBXDATA=$S($P($G(^IBA(355.93,+IBXDATA,0)),U,11)'="""":$P($G(^(0)),U,11),Z&(""24""[Z):""LI"",1:""FA"")"
^IBA(364.7,205,3,0)="^364.73^3^3^3030917^^^^"
^IBA(364.7,205,3,1,0)="If the service is performed at an outside facility, output the"
^IBA(364.7,205,3,2,0)="service facility type of facility if defined for the outside facility."
^IBA(364.7,205,3,3,0)="If none defined, output the default of 'FA' for non-lab and 'LI' for lab."
^IBA(364.7,206,0)="1042^N^274^^^^N^0"
^IBA(364.7,206,1)="I $G(IBXDATA) S IBXDATA=2"
^IBA(364.7,206,3,0)="^364.73^2^2^3030917^^^^"
^IBA(364.7,206,3,1,0)="Output the service facility entity as a non-person (2) if service was"
^IBA(364.7,206,3,2,0)="performed at an outside facility."
^IBA(364.7,207,0)="1043^N^268^^^^N^0"
^IBA(364.7,207,1)="I $D(IBXDATA) S IBXDATA=IBXDATA"
^IBA(364.7,207,3,0)="^364.73^1^1^3030917^^^^"
^IBA(364.7,207,3,1,0)="Output the facility name."
^IBA(364.7,208,0)="1044^N^5^^^^N^0"
^IBA(364.7,208,1)="S IBXDATA=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""C"",1,1)),U,1)"
^IBA(364.7,208,3,0)="^364.73^2^2^3041221^^^^"
^IBA(364.7,208,3,1,0)="The ids returned are screened for valid id qualifiers for the SUB2 record."
^IBA(364.7,208,3,2,0)="Output the first 'other' id qualifier."
^IBA(364.7,209,0)="1045^N^5^^^^N^0"
^IBA(364.7,209,1)="D CLEANUP^IBCEF75(.IBXSAVE) D ALLIDS^IBCEF75(IBXIEN,.IBXSAVE,1) S IBXDATA=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""C"",1,0)),U,1)"
^IBA(364.7,209,3,0)="^364.73^2^2^3041221^^^^"
^IBA(364.7,209,3,1,0)="Save the actual id in IBXSAVE(""EIN"") and output the tax id qualifier here"
^IBA(364.7,209,3,2,0)="if id was found."
^IBA(364.7,211,0)="1046^N^5^^^^N^0"
^IBA(364.7,211,1)="S IBXDATA=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""C"",1,0)),U,2)"
^IBA(364.7,211,3,0)="^364.73^2^2^3041221^^^^"
^IBA(364.7,211,3,1,0)="If the tax id for the outside facility exists, output it here and kill"
^IBA(364.7,211,3,2,0)="IBXSAVE(""EIN"") to clean up."
^IBA(364.7,212,0)="1047^N^318^^^^N^0"
^IBA(364.7,212,1)="S IBXDATA=$P(IBXSAVE(""ID""),U,1)"
^IBA(364.7,212,3,0)="^364.73^1^1^3031014^^^^"
^IBA(364.7,212,3,1,0)="REFERRING PHY ID SSN OR TAX ID"
^IBA(364.7,213,0)="1048^N^318^^^^N"
^IBA(364.7,213,1)="S IBXDATA=$P(IBXDATA,U,1)"
^IBA(364.7,213,3,0)="^364.73^1^1^3031016^^^^"
^IBA(364.7,213,3,1,0)="SEND OPERATING PHYSICIAN NAME SUFFIX"
^IBA(364.7,216,0)="206^N^131^^^^N"
^IBA(364.7,216,1)="S:'$D(^TMP(""IBHDR"",$J)) IBXDATA=""GEN "" I $D(^TMP(""IBHDR"",$J)) S IBXNOREQ=1"
^IBA(364.7,216,3,0)="^^4^4^2960815^^^^"
^IBA(364.7,216,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR"",$J) will"
^IBA(364.7,216,3,2,0)="already exist.  Don't want to extract this field again, so kill data"
^IBA(364.7,216,3,3,0)="element so there is no output.  If no header already extracted, output"
^IBA(364.7,216,3,4,0)="record id for 'GEN' record."
^IBA(364.7,219,0)="207^N^131^^^^N"
^IBA(364.7,219,1)="S IBXDATA=""SUB """
^IBA(364.7,219,3,0)="^^1^1^2990830^^^^"
^IBA(364.7,219,3,1,0)="Output the record id for the 'SUB' record."
^IBA(364.7,220,0)="210^N^131^^^^N"
^IBA(364.7,220,1)="I $D(IBXDATA) S IBXDATA=""CI1 """
^IBA(364.7,220,3,0)="^364.73^4^4^3040114^^^^"
^IBA(364.7,220,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR1"",$J) will"
^IBA(364.7,220,3,2,0)="already exist.  Don't want to extract this field again, so kill data"
^IBA(364.7,220,3,3,0)="element so there is no output.  If no header already extracted, output"
^IBA(364.7,220,3,4,0)="the record id for the 'CI1' record."
^IBA(364.7,221,0)="212^N^131^^^^N"
^IBA(364.7,221,1)="S IBXDATA=""CI2 """
^IBA(364.7,221,3,0)="^^1^1^2981124^^^^"
^IBA(364.7,221,3,1,0)="Output RECORD ID for CI2 record."
^IBA(364.7,222,0)="213^N^131^^^^N"
^IBA(364.7,222,1)="S IBXDATA=""CI3 """
^IBA(364.7,222,3,0)="^^1^1^2960815^^^^"
^IBA(364.7,222,3,1,0)="Output RECORD ID for CI3 record."
^IBA(364.7,223,0)="214^N^131^^^^N"
^IBA(364.7,223,1)="S IBXDATA=""PT1 """
^IBA(364.7,223,3,0)="^^1^1^2960815^^^^"
^IBA(364.7,223,3,1,0)="Output RECORD ID for PT1 record."
^IBA(364.7,224,0)="230^N^101^^^^N"
^IBA(364.7,224,1)="N IBZ,Z,Z0 M IBZ=IBXDATA K IBXDATA I $O(IBXSAVE(1,0)) S (Z,Z0)=0 F  S Z=$O(IBXSAVE(1,Z)) Q:'Z  S Z0=Z0+1,IBXDATA(Z0)=IBXSAVE(1,Z) I Z0>1 D ID^IBCEF2(Z0,""OI2 "")"
^IBA(364.7,224,3,0)="^364.73^7^7^3040702^^^^"
^IBA(364.7,224,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,224,3,2,0)="possible for the data element in the IBXDATA array.  The IBXSAVE(1) variable"
^IBA(364.7,224,3,3,0)="holds the indicator of which insurance [(P)rimary/(S)econdary/(T)ertiary] is"
^IBA(364.7,224,3,4,0)="currently responsible for the bill.  Using this data as a guide, the next"
^IBA(364.7,224,3,5,0)="insurance for the primary is secondary, then tertiary.  For secondary, it's"
^IBA(364.7,224,3,6,0)="primary then tertiary, and for tertiary, it's primary, then secondary. For"
^IBA(364.7,224,3,7,0)="other than the first occurrence, the RECORD ID 'OI2 ' must be output."
^IBA(364.7,225,0)="1051^N^5^^^^N"
^IBA(364.7,225,1)="S IBXDATA="""" I $G(IBXSAVE(""MAMMO"")) S IBXDATA=""EW"" K IBXSAVE(""MAMMO"")"
^IBA(364.7,225,3,0)="^^3^3^3060124^"
^IBA(364.7,225,3,1,0)="This is the mammography certification number qualifier in CL1A-9.  If "
^IBA(364.7,225,3,2,0)="there is a mammo cert number on the claim and transmitted in CL1A-6 then "
^IBA(364.7,225,3,3,0)="this field will be sent as ""EW""."
^IBA(364.7,226,0)="226^N^5^^^^N"
^IBA(364.7,226,1)="D CLEANUP^IBCEF75(.IBXSAVE) D ALLIDS^IBCEF75(IBXIEN,.IBXSAVE,1) S IBXDATA=$P($G(IBXSAVE(""BILLING PRV"",IBXIEN,""C"",1,1)),U,1)"
^IBA(364.7,226,3,0)="^^1^1^3060124^"
^IBA(364.7,226,3,1,0)="CI1A-2 site suffix or facility ID qualifier.  This is hard-coded to be G5."
^IBA(364.7,227,0)="227^N^5^^^^N"
^IBA(364.7,227,1)="S IBXDATA=$P($G(IBXSAVE(""BILLING PRV"",IBXIEN,""C"",1,1)),U,2)"
^IBA(364.7,227,3,0)="^^4^4^3060125^"
^IBA(364.7,227,3,1,0)="Always output 4 characters containing the site suffix padded on the left "
^IBA(364.7,227,3,2,0)="by 0's if necessary.  "
^IBA(364.7,227,3,3,0)="Examples:  For station# 528, this field is sent as ""0000"""
^IBA(364.7,227,3,4,0)="           For station# 605GC, this field is sent as ""00GC"""
^IBA(364.7,228,0)="1056^N^131^^^^N"
^IBA(364.7,228,1)="S IBXDATA=""OPR7"""
^IBA(364.7,228,3,0)="^^1^1^3030814^^^^"
^IBA(364.7,228,3,1,0)="Record ID for Supervising Provider Name, suffix, qualifier, and ID number."
^IBA(364.7,229,0)="1057^N^300^^^^N"
^IBA(364.7,229,1)="N Z S Z=$P(IBXDATA,U,1,2),$P(Z,U,3)=IBXIEN,$P(Z,U,4)=5 S IBXSAVE(""SPNM"")=$$NAME^IBCEFG1(Z),$P(IBXSAVE(""SPNM""),U,4)=$P(IBXDATA,U,4) K IBXDATA"
^IBA(364.7,229,3,0)="^^3^3^3030814^^^^"
^IBA(364.7,229,3,1,0)="Returns name for variable pointer in 2nd piece of IBXDATA in"
^IBA(364.7,229,3,2,0)="LAST^FIRST^MIDDLE^CREDENTIALS^SUFFIX format.  Saves data in IBXSAVE array"
^IBA(364.7,229,3,3,0)="for use by later fields.  No output."
^IBA(364.7,230,0)="1058^N^5^^^^N^0"
^IBA(364.7,230,1)="S:$G(IBXSAVE(""SPNM""))'="""" IBXDATA=$P(IBXSAVE(""SPNM""),U)"
^IBA(364.7,230,3,0)="^^3^3^3030814^^^^"
^IBA(364.7,230,3,1,0)="The FULL NAME data extracted,by SPRVSING PROV FULL NAME,"
^IBA(364.7,230,3,2,0)="into the array IBXSAVE is parsed and the appropiate piece (1)"
^IBA(364.7,230,3,3,0)="LAST NAME, is stored into IBXDATA for transmission."
^IBA(364.7,231,0)="240^N^131^^^^N"
^IBA(364.7,231,1)="S IBXDATA=""OC1 """
^IBA(364.7,231,3,0)="^^1^1^2960815^^^^"
^IBA(364.7,231,3,1,0)="Output RECORD ID for OC1 record."
^IBA(364.7,232,0)="1059^N^5^^^^N"
^IBA(364.7,232,1)="S:$G(IBXSAVE(""SPNM""))'="""" IBXDATA=$P(IBXSAVE(""SPNM""),U,2)"
^IBA(364.7,232,3,0)="^^3^3^3030814^^^^"
^IBA(364.7,232,3,1,0)="The FULL NAME data extracted,by SPRVSING PROV FULL NAME,"
^IBA(364.7,232,3,2,0)="into the array IBXSAVE is parsed and the appropiate piece (2)"
^IBA(364.7,232,3,3,0)="FIRST NAME, is stored into IBXDATA for transmission."
^IBA(364.7,233,0)="242^N^131^^^^N"
^IBA(364.7,233,1)="S IBXDATA=""OS1 """
^IBA(364.7,233,3,0)="^^1^1^2960815^^^^"
^IBA(364.7,233,3,1,0)="Output RECORD ID for OS1 record."
^IBA(364.7,234,0)="243^N^131^^^^N"
^IBA(364.7,234,1)="S IBXDATA=""PC1 """
^IBA(364.7,234,3,0)="^^1^1^2960815^^^^"
^IBA(364.7,234,3,1,0)="Output RECORD ID for PC1 record"
^IBA(364.7,235,0)="244^N^131^^^^N"
^IBA(364.7,235,1)="S IBXDATA=""VC1 """
^IBA(364.7,235,3,0)="^^1^1^2960815^^^^"
^IBA(364.7,235,3,1,0)="Output RECORD ID for VC1 record."
^IBA(364.7,236,0)="245^N^131^^^^N"
^IBA(364.7,236,1)="S IBXDATA=""CC1 """
^IBA(364.7,236,3,0)="^^1^1^2960815^^^^"
^IBA(364.7,236,3,1,0)="Output RECORD ID for CC1 record."
^IBA(364.7,237,0)="246^N^131^^^^N"
^IBA(364.7,237,1)="S IBXDATA=""DC1 """
^IBA(364.7,237,3,0)="^^1^1^2960815^^^^"
^IBA(364.7,237,3,1,0)="Output RECORD ID for DC1 record."
^IBA(364.7,238,0)="247^N^131^^^^N"
^IBA(364.7,238,1)="S IBXDATA=""COM """
^IBA(364.7,238,3,0)="^^1^1^2960815^^^^"
^IBA(364.7,238,3,1,0)="Output RECORD ID for COM record."
^IBA(364.7,239,0)="249^N^131^^^^N"
^IBA(364.7,239,1)="S IBXDATA=""OI1 """
^IBA(364.7,239,3,0)="^^1^1^2960815^^^^"
^IBA(364.7,239,3,1,0)="Output the RECORD ID for 'OI1' record."
^IBA(364.7,240,0)="250^N^131^^^^N"
^IBA(364.7,240,1)="S IBXDATA=""OI2 """
^IBA(364.7,240,3,0)="^^1^1^2960815^^"
^IBA(364.7,240,3,1,0)="Output RECORD ID for 'OI2' record."
^IBA(364.7,241,0)="251^N^131^^^^N"
^IBA(364.7,241,1)="S IBXDATA=""PRF """
^IBA(364.7,241,3,0)="^^1^1^2990901^^^"
^IBA(364.7,241,3,1,0)="Output the record id for 'PRF' record."
^IBA(364.7,242,0)="252^N^131^^^^N"
^IBA(364.7,242,1)="S IBXDATA=""INS """
^IBA(364.7,242,3,0)="^^1^1^2960815^^"
^IBA(364.7,242,3,1,0)="Output record id for 'INS' record."
^IBA(364.7,243,0)="253^N^131^^^^N"
^IBA(364.7,243,1)="S IBXDATA=""RX1 """
^IBA(364.7,243,3,0)="^^1^1^2960815^^"
^IBA(364.7,243,3,1,0)="Output record id for 'RX1' record."
^IBA(364.7,244,0)="1060^N^5^^^^N^0"
^IBA(364.7,244,1)="S:$G(IBXSAVE(""SPNM""))'="""" IBXDATA=$P(IBXSAVE(""SPNM""),U,3)"
^IBA(364.7,244,3,0)="^^3^3^3030814^^^"
^IBA(364.7,244,3,1,0)="The FULL NAME data extracted,by SPRVSING PROV FULL NAME,"
^IBA(364.7,244,3,2,0)="into the array IBXSAVE is parsed and the appropiate piece (3)"
^IBA(364.7,244,3,3,0)="MIDDLE NAME, is stored into IBXDATA for transmission."
^IBA(364.7,245,0)="1061^N^5^^^^N^0"
^IBA(364.7,245,1)="S:$G(IBXSAVE(""SPNM""))'="""" IBXDATA=$P(IBXSAVE(""SPNM""),U,5) K IBXSAVE(""SPNM"")"
^IBA(364.7,245,3,0)="^^3^3^3030814^^^^"
^IBA(364.7,245,3,1,0)="The FULL NAME data extracted,by SPRVSING PROV FULL NAME,"
^IBA(364.7,245,3,2,0)="into the array IBXSAVE is parsed and the appropiate piece (5)"
^IBA(364.7,245,3,3,0)="NAME SUFFIX, is stored into IBXDATA for transmission."
^IBA(364.7,246,0)="1062^N^318^^^^N^0"
^IBA(364.7,246,1)="S IBXDATA=$P(IBXSAVE(""ID""),U,5)"
^IBA(364.7,246,3,0)="^364.73^1^1^3031014^^^^"
^IBA(364.7,246,3,1,0)="Send Supervising Provider ID CODE QUALIFIER 34=SSN"
^IBA(364.7,247,0)="1063^N^5^^^^N^0"
^IBA(364.7,247,1)="S IBXDATA=$P(IBXSAVE,U,5)"
^IBA(364.7,247,3,0)="^364.73^1^1^3031014^^^^"
^IBA(364.7,247,3,1,0)="If supervising prov SSN exists from previous field, output it."
^IBA(364.7,250,0)="489^N^142^^^^N"
^IBA(364.7,250,1)="N Z S Z=$J("""",+$P($G(^IBE(350.9,1,1)),U,27)),IBXDATA=Z_IBXDATA K ^UTILITY(""VADM"",$J),^UTILITY(""VAPA"",$J),^TMP(""IBXSAVE"",$J),IBXSAVE"
^IBA(364.7,250,3,0)="^^3^3^2990223^^"
^IBA(364.7,250,3,1,0)="If the HCFA ADDRESS COLUMN parameter exists, move the text over to this"
^IBA(364.7,250,3,2,0)="column by adding spaces at the start of it.  Initializes utility globals"
^IBA(364.7,250,3,3,0)="and variables used in this form."
^IBA(364.7,251,0)="490^N^280^^^^N"
^IBA(364.7,251,1)="N Z S:$$WNRBILL^IBEFUNC(IBXIEN) IBXDATA=""MEDICARE"" S Z="""",$P(Z,"" "",+$P($G(^IBE(350.9,1,1)),U,27)+1)="""" S IBXSAVE(""INDENT"")=Z S:IBXDATA'="""" IBXDATA=Z_IBXDATA"
^IBA(364.7,251,3,0)="^364.73^4^4^3001129^^^^"
^IBA(364.7,251,3,1,0)="If the HCFA ADDRESS COLUMN parameter exists, move the text over to"
^IBA(364.7,251,3,2,0)="this column by adding spaces at the start of it.  Save the indent parameter"
^IBA(364.7,251,3,3,0)="in IBXSAVE(""INDENT"") for future use.  If the current insurance is MEDICARE"
^IBA(364.7,251,3,4,0)="WNR, output 'MEDICARE'."
^IBA(364.7,252,0)="576^N^192^^^^N"
^IBA(364.7,252,1)="N Y,Z K IBXSAVE(""CADR"") I $O(IBXDATA(0)) S Y=$G(IBXDATA(6)) D ZIPOUT^VAFADDR S:Y'="""" $P(IBXSAVE(""CADR""),U,6)=Y F Z=1:1:5,7 S:$D(IBXDATA(Z)) $P(IBXSAVE(""CADR""),U,Z)=IBXDATA(Z) I Z=7 D CIADDR^IBCEF1(.IBXDATA,.IBXSAVE,,1)"
^IBA(364.7,252,3,0)="^^5^5^2991101^^^^"
^IBA(364.7,252,3,1,0)="If the HCFA ADDRESS COLUMN parameter exists, move the text over to this"
^IBA(364.7,252,3,2,0)="column by adding spaces at the start of it.  Format the address so each"
^IBA(364.7,252,3,3,0)="street address occupies one line, then a line containing city followed by a"
^IBA(364.7,252,3,4,0)="by a comma and space, the state abbreviation, a space and the zip code,"
^IBA(364.7,252,3,5,0)="formatted for zip plus 4 if appropriate."
^IBA(364.7,253,0)="495^N^3^^^^N"
^IBA(364.7,254,0)="496^N^65^^^^N"
^IBA(364.7,255,0)="497^N^66^^^^N"
^IBA(364.7,255,1)="S IBXDATA=$$DATE^IBCF2(+IBXDATA,1)"
^IBA(364.7,255,3,0)="^^1^1^2991115^^^"
^IBA(364.7,255,3,1,0)="Format the date as MM DD YYYY."
^IBA(364.7,256,0)="1065^N^5^^^^N^0"
^IBA(364.7,256,1)="N Z K IBXDATA F Z=1,2 I $D(^DGCR(399,IBXIEN,""I""_(Z+1))) S IBXDATA(Z)=""B"""
^IBA(364.7,256,3,0)="^^3^3^3060217^"
^IBA(364.7,256,3,1,0)="Other insurance patient signature source code.  2320/OI/04."
^IBA(364.7,256,3,2,0)="This is group data element for the other insurances.  Currently, hard "
^IBA(364.7,256,3,3,0)="code a ""B"" for all other insurances."
^IBA(364.7,257,0)="498^N^67^^^^N"
^IBA(364.7,257,1)="S IBXSAVE(""SEX"")=IBXDATA,IBXDATA=$S($G(IBXSAVE(""SEX""))=""M"":""X"",1:"""")"
^IBA(364.7,257,3,0)="^^2^2^2960814^"
^IBA(364.7,257,3,1,0)="Save the value of patient sex in IBXSAVE variable for later use.  If the"
^IBA(364.7,257,3,2,0)="value is 'M', this field's value is 'X'."
^IBA(364.7,258,0)="499^N^5^^^^N"
^IBA(364.7,258,1)="S:$G(IBXSAVE(""SEX""))'=""M"" IBXDATA=""X"" K IBXSAVE(""SEX"")"
^IBA(364.7,258,3,0)="^^3^3^2960814^"
^IBA(364.7,258,3,1,0)="This field relies on the existence of variable IBXSAVE(""SEX"") previously"
^IBA(364.7,258,3,2,0)="extracted.  If its value is not 'M', assume the sex is female and this"
^IBA(364.7,258,3,3,0)="field's value will be 'X'."
^IBA(364.7,259,0)="500^N^2^^^^N"
^IBA(364.7,259,1)="N IBZ D F^IBCEF(""N-CURRENT INSURED RELATIONSHIP"",""IBZ"",,IBXIEN) K:$$WNRBILL^IBEFUNC(IBXIEN,+$$COBN^IBCEF(IBXIEN)) IBXDATA I +IBZ=1 S:$D(IBXDATA) IBXDATA=""SAME"" S IBXSAVE(""IBSAME"")=1"
^IBA(364.7,259,3,0)="^^2^2^3000201^"
^IBA(364.7,259,3,1,0)="If the current insured is the patient, the word 'SAME' is printed instead"
^IBA(364.7,259,3,2,0)="of repeating the name."
^IBA(364.7,260,0)="501^N^157^^^^N"
^IBA(364.7,260,1)="N Z F Z=1:1:3 S IBXDATA=IBXDATA_$S(Z>1:"" "",1:"""")_$G(^UTILITY(""VAPA"",$J,Z))"
^IBA(364.7,260,3,0)="^^1^1^2960814^"
^IBA(364.7,260,3,1,0)="Concatenate all 3 lines of the address together, separated by a space."
^IBA(364.7,261,0)="502^N^25^^^^N"
^IBA(364.7,261,1)="S IBXSAVE(""PREL"")=+IBXDATA,IBXDATA=$S(IBXSAVE(""PREL"")=1:""X"",1:"""")"
^IBA(364.7,261,3,0)="^^2^2^2960814^"
^IBA(364.7,261,3,1,0)="Save the value of patient sex in IBXSAVE variable for later use.  If"
^IBA(364.7,261,3,2,0)="the value is '1' (patient), this field's value is 'X'."
^IBA(364.7,262,0)="503^N^5^^^^N"
^IBA(364.7,262,1)="I $G(IBXSAVE(""PREL""))=2 S IBXDATA=""X"""
^IBA(364.7,262,3,0)="^^3^3^2960814^"
^IBA(364.7,262,3,1,0)="This field relies on the existence of variable IBXSAVE(""PREL"")"
^IBA(364.7,262,3,2,0)="previously extracted.  If its value is '2' (spouse), this field's value"
^IBA(364.7,262,3,3,0)="will be 'X'."
^IBA(364.7,263,0)="504^N^5^^^^N"
^IBA(364.7,263,1)="I $G(IBXSAVE(""PREL""))=3 S IBXDATA=""X"""
^IBA(364.7,263,3,0)="^^2^2^2960814^"
^IBA(364.7,263,3,1,0)="This field relies on the existence of variable IBXSAVE(""PREL"") previously"
^IBA(364.7,263,3,2,0)="extracted.  If its value is '3' (child), this field's value will be 'X'."
^IBA(364.7,264,0)="505^N^5^^^^N"
^IBA(364.7,264,1)="S:$G(IBXSAVE(""PREL""))=""""!(""123""'[$G(IBXSAVE(""PREL""))) IBXDATA=""X"" K IBXSAVE(""PREL"")"
^IBA(364.7,264,3,0)="^^3^3^2990830^^"
^IBA(364.7,264,3,1,0)="This field relies on the existence of variable IBXSAVE(""PREL"") previously"
^IBA(364.7,264,3,2,0)="extracted.  If its value is not a '1', '2', or '3', assume it is other and"
^IBA(364.7,264,3,3,0)="this field's value will be 'X'."
^IBA(364.7,265,0)="506^N^5^^^^N"
^IBA(364.7,265,1)="S IBXDATA=$P($G(IBXSAVE(""IADR"")),U)"
^IBA(364.7,265,3,0)="0"
^IBA(364.7,266,0)="507^N^61^^^^N"
^IBA(364.7,267,0)="508^N^62^^^^N"
^IBA(364.7,267,1)="S IBXDATA=$$STATE^IBCEFG1(IBXDATA)"
^IBA(364.7,267,3,0)="^^1^1^2970519^^"
^IBA(364.7,267,3,1,0)="Output the state abbreviation."
^IBA(364.7,268,0)="509^N^68^^^^N"
^IBA(364.7,268,1)="S IBXSAVE(""MSTAT"")=$$MARITAL^IBCEFG1(+IBXDATA),IBXDATA=$S(IBXSAVE(""MSTAT"")=""I"":""X"",1:"""")"
^IBA(364.7,268,3,0)="^364.73^2^2^3040219^^^"
^IBA(364.7,268,3,1,0)="Save the value of marital status in IBXSAVE variable for later use.  If"
^IBA(364.7,268,3,2,0)="the value is 'I' (NEVER MARRIED), this field's value is 'X'."
^IBA(364.7,269,0)="510^N^5^^^^N"
^IBA(364.7,269,1)="I $G(IBXSAVE(""MSTAT""))'="""",""M""[IBXSAVE(""MSTAT"") S IBXDATA=""X"""
^IBA(364.7,269,3,0)="^364.73^3^3^3010514^^"
^IBA(364.7,269,3,1,0)="This field relies on the existence of variable IBXSAVE(""MSTAT"")"
^IBA(364.7,269,3,2,0)="previously extracted. If its value is 'M' (MARRIED), this field's value"
^IBA(364.7,269,3,3,0)="will be 'X'."
^IBA(364.7,270,0)="511^N^5^^^^N"
^IBA(364.7,270,1)="S IBXDATA=$S($G(IBXSAVE(""MSTAT""))="""":"""",""MI""'[IBXSAVE(""MSTAT""):""X"",1:"""") K IBXSAVE(""MSTAT"")"
^IBA(364.7,270,3,0)="^364.73^3^3^3040220^^^^"
^IBA(364.7,270,3,1,0)="This field relies on the existence of variable IBXSAVE(""MSTAT"") previously"
^IBA(364.7,270,3,2,0)="extracted.  If its value is not a 'M', or 'I', assume it must be other and"
^IBA(364.7,270,3,3,0)="this field's value will be 'X'."
^IBA(364.7,271,0)="512^N^63"
^IBA(364.7,271,1)="N Y S Y=IBXDATA D ZIPOUT^VAFADDR S IBXDATA=Y"
^IBA(364.7,271,3,0)="^^1^1^2960814^"
^IBA(364.7,271,3,1,0)="Format zip code as zip plus 4 if needed."
^IBA(364.7,272,0)="513^N^64^^^^N"
^IBA(364.7,272,1)="I $L(IBXDATA)=10 S IBXDATA=$E(IBXDATA,1,3)_"" ""_$E(IBXDATA,4,10)"
^IBA(364.7,273,0)="514^N^99^^^^N"
^IBA(364.7,273,1)="S IBXDATA=$S("",1,2,4,6,""[("",""_+IBXDATA_"",""):""X"",1:"""")"
^IBA(364.7,273,3,0)="^^3^3^2991006^^^"
^IBA(364.7,273,3,1,0)="If the value of this field is '1' (EMPLOYED FULL TIME), '2' (EMPLOYED"
^IBA(364.7,273,3,2,0)="PART TIME), '4' (SELF EMPLOYED), or '6' (FULL TIME MILITARY), assume"
^IBA(364.7,273,3,3,0)="employed and output this field as 'X'."
^IBA(364.7,274,0)="515^N^32^^^^N"
^IBA(364.7,274,1)="N IBZ M IBZ=IBXDATA K IBXDATA S IBXDATA=$G(IBZ(1))"
^IBA(364.7,275,0)="516^N^27^^^^N"
^IBA(364.7,275,1)="N Z S Z=$$WNRBILL^IBEFUNC(IBXIEN,+$$COBN^IBCEF(IBXIEN)) S:Z IBXDATA=""NONE"" Q:Z  I $$POLICY^IBCEF(IBXIEN,2,$P($G(^DGCR(399,IBXIEN,0)),U,21))="""" S IBXDATA="""""
^IBA(364.7,275,3,0)="^364.73^1^1^3040225^^^^"
^IBA(364.7,275,3,1,0)="Only output the group number if the SUBSCRIBER ID field is non-null."
^IBA(364.7,276,0)="517^N^33^^^^N"
^IBA(364.7,276,1)="N A,IBZ S A=$$WNRBILL^IBEFUNC(IBXIEN) K:A IBXDATA I 'A M IBZ=IBXDATA K IBXDATA,IBXSAVE(""OINUM"") D:$G(IBZ(1))="""" F^IBCEF(""N-OTH INSURED ID"",""IBZ"") S:$E($$OTHINS1^IBCEF2(IBXIEN)) (IBXDATA,IBXSAVE(""OINUM""))=$G(IBZ(1))"
^IBA(364.7,276,3,0)="^364.73^6^6^3001130^^^^"
^IBA(364.7,276,3,1,0)="Save the value of other insured group number in IBXSAVE variable for later"
^IBA(364.7,276,3,2,0)="use.  Use the first occurrence of other insured group number for this"
^IBA(364.7,276,3,3,0)="field's value.  If the other insurance is a medigap (MEDICARE WNR is"
^IBA(364.7,276,3,4,0)="before this insurance on the bill), the group # is preceeded by 'MG'"
^IBA(364.7,276,3,5,0)="on output.  If no other insured group number is found, use the other"
^IBA(364.7,276,3,6,0)="insured's policy id number instead."
^IBA(364.7,277,0)="518^N^87^^^^N"
^IBA(364.7,277,1)="S IBXSAVE(""CONDE"")=IBXDATA,IBXDATA=$S(IBXDATA:""X"",1:"""")"
^IBA(364.7,277,3,0)="^^2^2^2960814^"
^IBA(364.7,277,3,1,0)="Save the value of condition related to employment in IBXSAVE variable for"
^IBA(364.7,277,3,2,0)="later use.  If this value is 1 (yes), this field's value is 'X'."
^IBA(364.7,278,0)="519^N^5^^^^N"
^IBA(364.7,278,1)="S:'$G(IBXSAVE(""CONDE"")) IBXDATA=""X"" K IBXSAVE(""CONDE"")"
^IBA(364.7,278,3,0)="^^3^3^2960814^"
^IBA(364.7,278,3,1,0)="This field relies on the existence of the IBXSAVE(""CONDE"") variable"
^IBA(364.7,278,3,2,0)="previously extracted.  If this variable's value is 0 or null, this assumes"
^IBA(364.7,278,3,3,0)="condition is not related and this field's value is 'X'."
^IBA(364.7,279,0)="520^N^5^^^^N"
^IBA(364.7,279,1)="S IBXDATA=$$DATE^IBCF2($P($G(IBXSAVE(""IDEM"")),U),1)"
^IBA(364.7,279,3,0)="^^2^2^3000201^^^^"
^IBA(364.7,279,3,1,0)="This field relies on the existence of the variable IBXSAVE(""IDEM"")"
^IBA(364.7,279,3,2,0)="previously extracted.  Format the birthdate as MM DD YYYY."
^IBA(364.7,280,0)="521^N^5^^^^N"
^IBA(364.7,280,1)="S:$P($G(IBXSAVE(""IDEM"")),U,2)=""M"" IBXDATA=""X"""
^IBA(364.7,280,3,0)="^^3^3^3000201^^"
^IBA(364.7,280,3,1,0)="This field relies on the existence of the IBXSAVE(""IDEM"") variable"
^IBA(364.7,280,3,2,0)="previously extracted.  The second '^' piece contains the sex and if this"
^IBA(364.7,280,3,3,0)="is an 'M', this field's value is 'X'."
^IBA(364.7,281,0)="522^N^5^^^^N"
^IBA(364.7,281,1)="S:""M""'[$P($G(IBXSAVE(""IDEM"")),U,2) IBXDATA=""X"""
^IBA(364.7,281,3,0)="^^3^3^2960814^"
^IBA(364.7,281,3,1,0)="This field relies on the existence of the IBXSAVE(""IDEM"") variable"
^IBA(364.7,281,3,2,0)="previously extracted.  The second '^' piece contains the sex and if this"
^IBA(364.7,281,3,3,0)="is not an 'M', this field's value is 'X'."
^IBA(364.7,282,0)="523^N^28^^^^N"
^IBA(364.7,282,1)="S IBXDATA="""" I $O(IBXDATA("""")) N Z S Z=$G(IBXDATA(1)) K IBXDATA S IBXSAVE(""OIDEM"")=Z,IBXDATA=$$DATE^IBCF2($P(Z,U),1)"
^IBA(364.7,282,3,0)="^^2^2^2991115^^^"
^IBA(364.7,282,3,1,0)="Save the other insured's demographic data in IBXSAVE for later use. Format"
^IBA(364.7,282,3,2,0)="the birthdate as MM DD YYYY."
^IBA(364.7,283,0)="524^N^5^^^^N"
^IBA(364.7,283,1)="I $P($G(IBXSAVE(""OIDEM"")),U,2)=""M"" S IBXDATA=""X"""
^IBA(364.7,283,3,0)="^^3^3^2960814^"
^IBA(364.7,283,3,1,0)="This field relies on the existence of the IBXSAVE(""OIDEM"") variable"
^IBA(364.7,283,3,2,0)="previously extracted.  The second '^' piece contains the sex and if this"
^IBA(364.7,283,3,3,0)="is an 'M', this field's value is 'X'."
^IBA(364.7,284,0)="525^N^5^^^^N"
^IBA(364.7,284,1)="N Z S Z=$P($G(IBXSAVE(""OIDEM"")),U,2) S:Z'=""M""&(Z'="""") IBXDATA=""X"" K IBXSAVE(""OIDEM"")"
^IBA(364.7,284,3,0)="^^3^3^2960814^"
^IBA(364.7,284,3,1,0)="This field relies on the existence of the IBXSAVE(""OIDEM"") variable"
^IBA(364.7,284,3,2,0)="previously extracted.  The second '^' piece contains the sex and if this"
^IBA(364.7,284,3,3,0)="is not a null and is not an 'M', this field's value is 'X'."
^IBA(364.7,285,0)="526^N^88^^^^N"
^IBA(364.7,285,1)="S IBXSAVE(""CONDA"")=IBXDATA,IBXDATA=$S(IBXDATA:""X"",1:"""")"
^IBA(364.7,285,3,0)="^^2^2^2960814^"
^IBA(364.7,285,3,1,0)="Save the value of condition related to auto accident in IBXSAVE variable"
^IBA(364.7,285,3,2,0)="for later use.  If this value is 1 (yes), this field's value is 'X'."
^IBA(364.7,286,0)="527^N^5^^^^N"
^IBA(364.7,286,1)="S:'$G(IBXSAVE(""CONDA"")) IBXDATA=""X"""
^IBA(364.7,286,3,0)="^^3^3^2960814^"
^IBA(364.7,286,3,1,0)="This field relies on the existence of the IBXSAVE(""CONDA"") variable"
^IBA(364.7,286,3,2,0)="previously extracted.  If this variable's value is 0 or null, this assumes"
^IBA(364.7,286,3,3,0)="condition is not related and this field's value is 'X'."
^IBA(364.7,287,0)="528^N^159^^^^N"
^IBA(364.7,287,1)="S IBXDATA=$$STATE^IBCEFG1(IBXDATA) K IBXSAVE(""CONDA"")"
^IBA(364.7,287,3,0)="^^1^1^3000201^^^"
^IBA(364.7,287,3,1,0)="Output state abbreviation."
^IBA(364.7,288,0)="529^N^7^^^^N"
^IBA(364.7,288,1)="S IBXDATA=$P(IBXDATA,U)"
^IBA(364.7,288,3,0)="^^1^1^2991006^^^"
^IBA(364.7,288,3,1,0)="Employer name is the first '^' piece of field's value."
^IBA(364.7,289,0)="530^N^30^^^^N"
^IBA(364.7,289,1)="S IBXDATA="""" I $O(IBXDATA("""")) N Z S Z=$G(IBXDATA(1)) K IBXDATA S IBXDATA=$P(Z,U)"
^IBA(364.7,289,3,0)="^^2^2^3000201^^^"
^IBA(364.7,289,3,1,0)="Use the first occurrence of other insured employer information.  The first"
^IBA(364.7,289,3,2,0)="'^' piece is the employer's name."
^IBA(364.7,290,0)="531^N^89^^^^N"
^IBA(364.7,290,1)="S IBXSAVE(""CONDOA"")=IBXDATA,IBXDATA=$S(IBXDATA:""X"",1:"""")"
^IBA(364.7,290,3,0)="^^2^2^2960814^"
^IBA(364.7,290,3,1,0)="Save the value of condition related to other accident in IBXSAVE variable"
^IBA(364.7,290,3,2,0)="for later use.  If this value is 1 (yes), this field's value is 'X'."
^IBA(364.7,291,0)="532^N^5^^^^N"
^IBA(364.7,291,1)="S:'$G(IBXSAVE(""CONDOA"")) IBXDATA=""X"" K IBXSAVE(""CONDOA"")"
^IBA(364.7,291,3,0)="^^3^3^2960814^"
^IBA(364.7,291,3,1,0)="This field relies on the existence of the IBXSAVE(""CONDOA"") variable"
^IBA(364.7,291,3,2,0)="previously extracted.  If this variable's value is 0 or null, this assumes"
^IBA(364.7,291,3,3,0)="condition is not related and this field's value is 'X'."
^IBA(364.7,292,0)="533^N^26^^^^N"
^IBA(364.7,292,1)="I $$WNRBILL^IBEFUNC(IBXIEN) S IBXDATA="""""
^IBA(364.7,293,0)="534^N^31^^^^N"
^IBA(364.7,293,1)="K IBXSAVE(""OINUM"") S IBXDATA="""" I $O(IBXDATA("""")) N C,Z,Z0 S C=$$OTHINS1^IBCEF2(IBXIEN),Z=$G(IBXDATA(1)) K IBXDATA I $E(C) S IBXDATA=$S($$MCRWNR^IBEFUNC(+$G(^DGCR(399,IBXIEN,""I""_$E(C)))):""MEDICARE"",$P(Z,U,2):$P($G(^DIC(36,+Z,0)),U),1:$P(Z,U))"
^IBA(364.7,293,3,0)="^364.73^6^6^3040114^^^^"
^IBA(364.7,293,3,1,0)="Use the first occurrence of other insured group name.  The first '^' piece"
^IBA(364.7,293,3,2,0)="of this value has either the group name or the insurance company pointer."
^IBA(364.7,293,3,3,0)="If the second '^' piece is a 1, the insurance company name is extracted"
^IBA(364.7,293,3,4,0)="using the insurance company pointer in the first '^' piece, otherwise, the"
^IBA(364.7,293,3,5,0)="name in the first '^' piece is output."
^IBA(364.7,293,3,6,0)="MEDICARE WNR always outputs MEDICARE."
^IBA(364.7,294,0)="535^N^144^^^^N"
^IBA(364.7,294,1)="S IBXSAVE(""OI"")=IBXDATA,IBXDATA=$S(IBXDATA:""X"",1:"""")"
^IBA(364.7,294,3,0)="^^2^2^2960814^"
^IBA(364.7,294,3,1,0)="Save the other insurance exists data in the IBXSAVE variable for later"
^IBA(364.7,294,3,2,0)="use.  If the value is 1, output an 'X'."
^IBA(364.7,295,0)="536^N^5^^^^N"
^IBA(364.7,295,1)="S:'$G(IBXSAVE(""OI"")) IBXDATA=""X"" K IBXSAVE(""OI"")"
^IBA(364.7,295,3,0)="^^3^3^2960814^"
^IBA(364.7,295,3,1,0)="This field relies on the existence of the IBXSAVE(""OI"") variable"
^IBA(364.7,295,3,2,0)="previously extracted.  If the value of this data element is null or 0,"
^IBA(364.7,295,3,3,0)="output an 'X' in this field"
^IBA(364.7,296,0)="537^N^65^^^^N"
^IBA(364.7,296,1)="N Z S Z=$$NAME^IBCEFG1(IBXDATA),IBXDATA=$P(Z,U,2)_"" ""_$S($P(Z,U,3)'="""":$E($P(Z,U,3))_"" "",1:"""")_$P(Z,U)"
^IBA(364.7,296,3,0)="^^1^1^2991102^"
^IBA(364.7,296,3,1,0)="Output the patient's name as the signature first middle last name."
^IBA(364.7,297,0)="538^N^2^^^^N"
^IBA(364.7,297,1)="N Z S Z=$$NAME^IBCEFG1(IBXDATA),IBXDATA=$P(Z,U,2)_"" ""_$S($P(Z,U,3)'="""":$E($P(Z,U,3))_"" "",1:"""")_$P(Z,U)"
^IBA(364.7,297,3,0)="^^2^2^2991102^^"
^IBA(364.7,297,3,1,0)="Output the current insured's name as the signature first name, middle name"
^IBA(364.7,297,3,2,0)="last name"
^IBA(364.7,298,0)="539^N^232^^^^N"
^IBA(364.7,298,1)="S IBXDATA=$$DATE^IBCF2(IBXDATA,1)"
^IBA(364.7,298,3,0)="^^1^1^2991115^^^^"
^IBA(364.7,298,3,1,0)="Format date as MM DD YYYY."
^IBA(364.7,299,0)="540^N^90^^^^N"
^IBA(364.7,299,1)="S IBXDATA=$$DATE^IBCF2(IBXDATA,1)"
^IBA(364.7,299,3,0)="^^1^1^2991115^^^"
^IBA(364.7,299,3,1,0)="Format date as MM DD YYYY."
^IBA(364.7,300,0)="541^N^93^^^^N"
^IBA(364.7,300,1)="S IBXDATA=$$DATE^IBCF2(IBXDATA,1)"
^IBA(364.7,300,3,0)="^^1^1^2991115^^^^"
^IBA(364.7,300,3,1,0)="Format date as MM DD YYYY."
^IBA(364.7,301,0)="542^N^94^^^^N"
^IBA(364.7,301,1)="S IBXDATA=$$DATE^IBCF2(IBXDATA,1)"
^IBA(364.7,301,3,0)="^^1^1^2991115^^^^"
^IBA(364.7,301,3,1,0)="Format date as MM DD YYYY."
^IBA(364.7,303,0)="546^N^5^^^^N"
^IBA(364.7,303,1)="D:'$D(IBXSAVE(""BOX19"")) F^IBCEF(""N-HCFA 1500 BOX 19"",,,IBXIEN) S IBXDATA=$E($G(IBXSAVE(""BOX19"")),49,96) K IBXSAVE(""BOX19"")"
^IBA(364.7,303,3,0)="^364.73^2^2^3001004^^^^"
^IBA(364.7,303,3,1,0)="If the array that holds the entire box 19 data is not defined, extract it."
^IBA(364.7,303,3,2,0)="This field will hold the 49th through 96th characters of the box's data."
^IBA(364.7,304,0)="543^N^147^^^^N"
^IBA(364.7,304,1)="S IBXDATA=$$DATE^IBCF2(IBXDATA,1)"
^IBA(364.7,304,3,0)="^^1^1^2991115^^^^"
^IBA(364.7,304,3,1,0)="'From' date is the first '^' piece of this data.  Format date as MM DD YYYY."
^IBA(364.7,305,0)="544^N^160^^^^N"
^IBA(364.7,305,1)="D:'IBXDATA&'$$INPAT^IBCEF(IBXIEN,1) F^IBCEF(""N-STATEMENT COVERS TO DATE"",,,IBXIEN) S IBXDATA=$$DATE^IBCF2(IBXDATA,1)"
^IBA(364.7,305,3,0)="^364.73^2^2^3040226^^^^"
^IBA(364.7,305,3,1,0)="If there is no date in IBXDATA, set it to Statement Covers To Date then "
^IBA(364.7,305,3,2,0)="format the resulted date."
^IBA(364.7,306,0)="548^N^86^^^^N"
^IBA(364.7,306,1)="N IB,IBCT M IB=IBXDATA K IBXDATA X ""N Z S (Z,IBCT)=0 F  S Z=$O(IB(Z)) Q:'Z  I $G(IB(Z)) S IBCT=IBCT+1 M IBXSAVE(""""DX"""",IBCT)=IB(Z)"" S IBXDATA=$P($G(^ICD9(+$G(IBXSAVE(""DX"",1)),0)),U) D PGDX^IBCEF31(1,IBX0,IBXDA,IBXLN,IBXCOL,.IBXSIZE,.IBXSAVE)"
^IBA(364.7,306,3,0)="^364.73^4^4^3040121^^^^"
^IBA(364.7,306,3,1,0)="Save the diagnoses in the IBXSAVE array for later use. Output the"
^IBA(364.7,306,3,2,0)="diagnosis code for the first diagnosis. Check for any diagnosis codes"
^IBA(364.7,306,3,3,0)="that should display in the first position on pages subsequent to page 1"
^IBA(364.7,306,3,4,0)="and output them."
^IBA(364.7,307,0)="547^N^150^^^^N"
^IBA(364.7,307,1)="S IBXDATA=$S(IBXDATA:"" "",1:$J("""",5))_""X"""
^IBA(364.7,308,0)="549^N^163^^^^N"
^IBA(364.7,308,1)="S IBXDATA=$P($G(^ICD9(+IBXDATA,0)),U) D PGDX^IBCEF31(3,IBX0,IBXDA,IBXLN,IBXCOL,.IBXSIZE,.IBXSAVE)"
^IBA(364.7,308,3,0)="^364.73^3^3^3040121^^^^"
^IBA(364.7,308,3,1,0)="Output the third diagnosis code. Check for any diagnosis codes that should"
^IBA(364.7,308,3,2,0)="display in the third position on pages subsequent to page 1 and output"
^IBA(364.7,308,3,3,0)="them."
^IBA(364.7,309,0)="550^N^162^^^^N"
^IBA(364.7,309,1)="S IBXDATA=$P($G(^ICD9(+IBXDATA,0)),U) D PGDX^IBCEF31(2,IBX0,IBXDA,IBXLN,IBXCOL,.IBXSIZE,.IBXSAVE)"
^IBA(364.7,309,3,0)="^364.73^3^3^3040121^^^^"
^IBA(364.7,309,3,1,0)="Output the second diagnosis code.  Check for any diagnosis codes that should"
^IBA(364.7,309,3,2,0)="display in the second position on pages subsequent to page 1 and output"
^IBA(364.7,309,3,3,0)="them."
^IBA(364.7,310,0)="551^N^164^^^^N"
^IBA(364.7,310,1)="S IBXDATA=$P($G(^ICD9(+IBXDATA,0)),U) D PGDX^IBCEF31(4,IBX0,IBXDA,IBXLN,IBXCOL,.IBXSIZE,.IBXSAVE) K IBXSAVE(""DX"")"
^IBA(364.7,310,3,0)="^364.73^3^3^3040121^^^^"
^IBA(364.7,310,3,1,0)="Output the forth diagnosis code. Check for any diagnosis codes that should"
^IBA(364.7,310,3,2,0)="display in the forth position on pages subsequent to page 1 and output"
^IBA(364.7,310,3,3,0)="them."
^IBA(364.7,311,0)="552^N^262^^^^N"
^IBA(364.7,311,1)="I $$OLAB^IBCEU(IBXIEN) N IBZ S IBZ=IBXDATA D F^IBCEF(""N-LAB CLIA #"",,,IBXIEN) I IBXDATA="""",IBZ'="""" S IBXDATA=IBZ"
^IBA(364.7,311,3,0)="^364.73^2^2^3021108^^^^"
^IBA(364.7,311,3,1,0)="If the bill is for services rendered at an outside lab, get the CLIA number."
^IBA(364.7,311,3,2,0)="If this # is not available, use the prior authorization #."
^IBA(364.7,312,0)="562^N^109^^^^N"
^IBA(364.7,313,0)="563^N^151^^^^N"
^IBA(364.7,314,0)="564^N^210^^^^N"
^IBA(364.7,315,0)="565^N^95^^^^N"
^IBA(364.7,315,1)="S IBXSAVE(""TOT"")=IBXDATA K IBXDATA S:IBXSAVE(""TOT"")'=""""&($O(^TMP(""IBXDATA"",$J,IBXREC,""""),-1)'>1) IBXDATA=$J(IBXSAVE(""TOT""),10,2)"
^IBA(364.7,315,3,0)="^^3^3^3000124^^^^"
^IBA(364.7,315,3,1,0)="Save the total charges in IBXSAVE array for later use.  If"
^IBA(364.7,315,3,2,0)="total is not null, output as numeric with 2 decimal places in 10 spaces."
^IBA(364.7,315,3,3,0)="Only output totals on last page of form."
^IBA(364.7,317,0)="567^N^296^^^^N"
^IBA(364.7,317,1)="N IBZ D F^IBCEF(""N-EDI SITE CONTACT PHONE"",""IBZ"") S IBZ=$$EXPAND^IBTRE(350.9,2.11,IBZ) D:IBZ="""" F^IBCEF(""N-AGENT CASHIER PHONE"",""IBZ"") S:$L(IBZ)>12 IBZ=$E($$NOPUNCT^IBCEF(IBZ),1,12) S IBXDATA=$E(IBXDATA,1,18)_($J("""",30-$L(IBZ)-$L(IBXDATA)))_IBZ"
^IBA(364.7,317,3,0)="^^1^1^2991115^"
^IBA(364.7,317,3,1,0)="This is the constant we will use as the name of the billing entity."
^IBA(364.7,318,0)="568^N^83^^^^N"
^IBA(364.7,318,1)="S IBXSAVE(""BOX31"")=IBXDATA,IBXDATA=$$NAME31^IBCF2(IBXIEN,IBXDATA)"
^IBA(364.7,318,3,0)="^^2^2^3000323^^^^"
^IBA(364.7,318,3,1,0)="Formats the name in 21 spaces for block 31 of the HCFA 1500."
^IBA(364.7,318,3,2,0)="IBXSAVE(""BOX31"") is the name in format Last,first mi^ien in file 200"
^IBA(364.7,319,0)="569^N^5^^^^N"
^IBA(364.7,319,1)="K:'$G(IBXSAVE(""REMOTE"")) IBXDATA I $D(IBXDATA) S IBXDATA=$$GETFAC^IBCEP8(+$G(IBXSAVE(""IBFAC"")),+$G(IBXSAVE(""OFAC"")),12)"
^IBA(364.7,319,3,0)="^^3^3^2991202^^^^"
^IBA(364.7,319,3,1,0)="Extract the street address for the rendering facility.  Relies on the"
^IBA(364.7,319,3,2,0)="existence of the array IBXSAVE(""IBFAC"") extracted previously by the"
^IBA(364.7,319,3,3,0)="rendering facility name field."
^IBA(364.7,320,0)="584^N^116^^^^N"
^IBA(364.7,320,1)="S IBXSAVE(""FSTREET1"")=IBXDATA"
^IBA(364.7,320,3,0)="^^1^1^2960814^"
^IBA(364.7,320,3,1,0)="Save the data in the IBXSAVE array for later use."
^IBA(364.7,321,0)="585^N^155^^^^N"
^IBA(364.7,321,1)="S IBXSAVE(""FSTREET2"")=IBXDATA"
^IBA(364.7,321,3,0)="^^1^1^2960814^"
^IBA(364.7,321,3,1,0)="Save the data in the IBXSAVE array for later use."
^IBA(364.7,322,0)="570^N^104^^^^N"
^IBA(364.7,322,1)="N IBZ D F^IBCEF(""N-AGENT CASHIER MAIL SYMBOL"",""IBZ"",,IBXIEN) I $G(IBZ)'="""" S IBXDATA=IBXDATA_"" ""_IBZ"
^IBA(364.7,322,3,0)="^364.73^2^2^3040120^^^"
^IBA(364.7,322,3,1,0)="Concatenate Agent Cashier Mail Symbol to the end of Agent Cashier Street"
^IBA(364.7,322,3,2,0)="Address."
^IBA(364.7,323,0)="571^N^209^^^^N"
^IBA(364.7,323,1)="N A,P,Q,Z S Q=IBXIEN,Z=$$DATE31^IBCF2(IBXDATA,Q),A=$G(IBXSAVE(""BOX31"")) D GETPRV^IBCEU(Q,3,.P) S P=$G(P(3,1)),A=$S($P(P,U,4)'="""":$P(P,U,4),'$D(^DGCR(399,Q,""PRV"",0)):$E($P(P,U),22,42),1:$$CRED^IBCEU($P(P,U,3),Q,,3)),IBXDATA=A_$J("""",11-$L(A))_Z"
^IBA(364.7,323,3,0)="^^2^2^3000131^^^^"
^IBA(364.7,323,3,1,0)="Print credentials left justified and date right justified. Format date as"
^IBA(364.7,323,3,2,0)="MM/DD/YYYY."
^IBA(364.7,326,0)="1072^N^315^^^^N^0"
^IBA(364.7,326,1)="D ELMADDR^IBCEF7(IBXIEN,0,.IBXDATA)"
^IBA(364.7,326,3,0)="^364.73^1^1^3030929^^^^"
^IBA(364.7,326,3,1,0)="Use the File 364.5, N-OTHER INSURED FULL ADDRESS, to save the data into array IBXSAVE*"
^IBA(364.7,327,0)="572^N^5^^^^N"
^IBA(364.7,327,1)="K:'$G(IBXSAVE(""REMOTE"")) IBXDATA S:$D(IBXDATA) IBXDATA=$$GETFAC^IBCEP8(+$G(IBXSAVE(""IBFAC"")),+$G(IBXSAVE(""OFAC"")),3)"
^IBA(364.7,327,3,0)="^^3^3^2991202^^^^"
^IBA(364.7,327,3,1,0)="Extract the city, state abbreviation and zip code for the rendering"
^IBA(364.7,327,3,2,0)="facility.  Relies on the existence of the array IBXSAVE(""IBFAC"") extracted"
^IBA(364.7,327,3,3,0)="previously by the rendering facility name field."
^IBA(364.7,328,0)="589^N^105^^^^N"
^IBA(364.7,328,1)="S IBXSAVE(""ACCITY"")=IBXDATA"
^IBA(364.7,328,3,0)="^^1^1^2960814^"
^IBA(364.7,328,3,1,0)="Save the data in the IBXSAVE array for later use."
^IBA(364.7,329,0)="590^N^106^^^^N"
^IBA(364.7,329,1)="S IBXSAVE(""ACSTATE"")=IBXDATA"
^IBA(364.7,329,3,0)="^^1^1^2960814^"
^IBA(364.7,329,3,1,0)="Save the data in the IBXSAVE array for later use."
^IBA(364.7,330,0)="591^N^107^^^^N"
^IBA(364.7,330,1)="S IBXSAVE(""ACZIP"")=$E(IBXDATA,1,5)_$S($E(IBXDATA,6,9)'="""":""-""_$E(IBXDATA,6,9),1:"""")"
^IBA(364.7,330,3,0)="^^1^1^2960814^"
^IBA(364.7,330,3,1,0)="Save the data in the IBXSAVE array for later use."
^IBA(364.7,331,0)="573^N^5^^^^N"
^IBA(364.7,331,1)="N Z S Z=$$STATE^IBCEFG1($G(IBXSAVE(""ACSTATE"")))_"" ""_$G(IBXSAVE(""ACZIP"")),IBXDATA=$E($G(IBXSAVE(""ACCITY"")),1,26-2-$L(Z))_"", ""_Z F Z=""ACCITY"",""ACSTATE"",""ACZIP"" K IBXSAVE(Z)"
^IBA(364.7,331,3,0)="^^5^5^2991115^^"
^IBA(364.7,331,3,1,0)="This data relies on the existence of the IBXSAVE(""ACCITY""),"
^IBA(364.7,331,3,2,0)="IBXSAVE(""ACSTATE"") and IBXSAVE(""ACZIP"") variables previously extracted."
^IBA(364.7,331,3,3,0)="The data consists of the city concatenated with a , and space, the state"
^IBA(364.7,331,3,4,0)="abbreviation, a space and the zip code.  The city name is shortened to fit"
^IBA(364.7,331,3,5,0)="in the whole state and zip in the space allowed."
^IBA(364.7,332,0)="574^N^5^^^^N"
^IBA(364.7,332,1)="I '$D(^DGCR(399,IBXIEN,""PRV"",0)) S IBXDATA=$E($P($G(IBXSAVE(""BOX31"")),U),43,63)"
^IBA(364.7,332,3,0)="^^1^1^2991215^^^^"
^IBA(364.7,332,3,1,0)="This line is no longer printed on the standard HCFA 1500."
^IBA(364.7,333,0)="1073^N^5^^^^N^0"
^IBA(364.7,333,1)="D ELMADDR^IBCEF7(IBXIEN,1,.IBXDATA)"
^IBA(364.7,333,3,0)="^364.73^1^1^3030929^^^^"
^IBA(364.7,333,3,1,0)="Extracted from the array IBXSAVE(""ARRAY"") from the 364.5 file OTHER INSURED FULL ADDRESS when LIne 1 is done first."
^IBA(364.7,334,0)="1074^N^5^^^^N^0"
^IBA(364.7,334,1)="K IBXDATA D ELMADDR^IBCEF7(IBXIEN,2,.IBXDATA)"
^IBA(364.7,334,3,0)="^364.73^2^2^3030926^^^^"
^IBA(364.7,334,3,1,0)="Extracted from the array IBXSAVE(""ARRAY"") from the 364.5 file OTHER INSURED FULL ADDRESS when Line 1 is"
^IBA(364.7,334,3,2,0)="done first."
^IBA(364.7,335,0)="592^N^5^^^^N"
^IBA(364.7,335,1)="I '$O(IBXSAVE(""BOX24"",0)) D B24^IBCEF3(.IBXSAVE,IBXIEN,1)"
^IBA(364.7,335,3,0)="^^1^1^3000105^^^^"
^IBA(364.7,335,3,1,0)="If array doesn't already exist, extract it"
^IBA(364.7,336,0)="554^N^165^^^^N"
^IBA(364.7,336,1)="N Z S Z=12 F  S Z=$O(IBXDATA(Z)) Q:'Z  D PG^IBCEF3(IBXDATA(Z),Z)"
^IBA(364.7,336,3,0)="^^2^2^3000105^^^^"
^IBA(364.7,336,3,1,0)="If more than 6 service dates (12 lines) exist"
^IBA(364.7,336,3,2,0)="for the bill, this outputs the rest on additional bill pages."
^IBA(364.7,337,0)="555^N^166^^^^N"
^IBA(364.7,337,1)="N Z S Z=12 F  S Z=$O(IBXDATA(Z)) Q:'Z  D PG^IBCEF3(IBXDATA(Z),Z)"
^IBA(364.7,337,3,0)="^^2^2^3000105^^^^"
^IBA(364.7,337,3,1,0)="If more than 6 service dates (12 lines) exists for the bill, this outputs"
^IBA(364.7,337,3,2,0)="the rest on additional bill pages."
^IBA(364.7,338,0)="556^N^167^^^^N"
^IBA(364.7,338,1)="N Z S Z=12 F  S Z=$O(IBXDATA(Z)) Q:'Z  D PG^IBCEF3(IBXDATA(Z),Z)"
^IBA(364.7,338,3,0)="^^2^2^3000105^^^"
^IBA(364.7,338,3,1,0)="If more than 6 service dates (12 lines) exists for the bill, this outputs"
^IBA(364.7,338,3,2,0)="the rest on additional bill pages."
^IBA(364.7,339,0)="557^N^168^^^^N"
^IBA(364.7,339,1)="N Z S Z=12 F  S Z=$O(IBXDATA(Z)) Q:'Z  D PG^IBCEF3(IBXDATA(Z),Z)"
^IBA(364.7,339,3,0)="^^2^2^3000105^^"
^IBA(364.7,339,3,1,0)="If more than 6 service dates (12 lines) exists for the bill, this outputs"
^IBA(364.7,339,3,2,0)="the rest on additional bill pages."
^IBA(364.7,340,0)="558^N^169^^^^N"
^IBA(364.7,340,1)="N IBZ,IBZ1,Z,Q M IBZ=IBXDATA K IBXDATA D TEXT24^IBCEU3(""D1"",.IBXSAVE,.IBXDATA) M IBZ1=IBXDATA K IBXDATA S Z=0 F  S Z=$O(IBZ(Z)) Q:'Z  S Q=$J(IBZ(Z),6)_"" ""_$TR($G(IBZ1(Z)),"","") S:Z'>12 IBXDATA(Z)=Q I Z>12 D PG^IBCEF3(Q,Z)"
^IBA(364.7,340,3,0)="^364.73^2^2^3001113^^^"
^IBA(364.7,340,3,1,0)="If more than 6 service dates (12 lines) exists for the bill, this outputs"
^IBA(364.7,340,3,2,0)="the rest on additional bill pages."
^IBA(364.7,341,0)="559^N^170^^^^N"
^IBA(364.7,341,1)="N Z S Z=12 F  S Z=$O(IBXDATA(Z)) Q:'Z  D PG^IBCEF3(IBXDATA(Z),Z)"
^IBA(364.7,341,3,0)="^^2^2^3000105^^"
^IBA(364.7,341,3,1,0)="If more than 6 service dates (12 lines) exist for the bill, this outputs"
^IBA(364.7,341,3,2,0)="the rest on additional bill pages."
^IBA(364.7,342,0)="560^N^171^^^^N"
^IBA(364.7,342,1)="N Z,Z0,IBZ M IBZ=IBXDATA K IBXDATA S Z=0 F  S Z=$O(IBZ(Z)) Q:'Z  S Z0=$S('$G(IBZ(Z,""T"")):$S(IBZ(Z)?0.1""-""1N.N0.1""."".N:$J(IBZ(Z),9,2),1:IBZ(Z)),1:IBZ(Z)) S:Z'>12 IBXDATA(Z)=Z0 I Z>12 D PG^IBCEF3(Z0,Z)"
^IBA(364.7,342,3,0)="^^3^3^3000105^^^"
^IBA(364.7,342,3,1,0)="Print total charge (units * rate) only if not 0.  Format numeric values"
^IBA(364.7,342,3,2,0)="with 2 decimal points.  If more than 6 service dates (12 lines) exist for"
^IBA(364.7,342,3,3,0)="the bill, this outputs the rest on additional bill pages."
^IBA(364.7,343,0)="561^N^172^^^^N"
^IBA(364.7,343,1)="N Z,Z0,IBZ M IBZ=IBXDATA K IBXDATA S Z=0 F  S Z=$O(IBZ(Z)) Q:'Z  S Z0=$S('$G(IBZ(Z,""T"")):$S(IBZ(Z):$J(IBZ(Z),$S($L(IBZ)<3:2,1:3)),1:""""),1:IBZ(Z)) S:Z'>12 IBXDATA(Z)=Z0 D:Z>12 PG^IBCEF3(Z0,Z)"
^IBA(364.7,343,3,0)="^^4^4^3000105^^^^"
^IBA(364.7,343,3,1,0)="Right justify numeric values in 3 spaces.  If more than 6 service dates"
^IBA(364.7,343,3,2,0)="(12 lines) exist for the bill, this outputs the rest on additional"
^IBA(364.7,343,3,3,0)="bill pages.  If the units are being output and they are less than 1, 1 is"
^IBA(364.7,343,3,4,0)="the default."
^IBA(364.7,344,0)="593^N^5^^^^N"
^IBA(364.7,344,1)="I $O(^TMP(""IBXDATA"",$J,IBXREC,1)) N Z,FLDS X ""F Z=1:1:+$O(^IBA(364.6,""""ASEQ"""",2,1,""""""""),-1) S:(Z'>44!(Z'<57))&(Z'=6)&(Z'=39)&(Z'=41) FLDS(Z)="""""""""" F Z=2:1:+$O(^TMP(""IBXDATA"",$J,IBXREC,Z),-1) D MPG^IBCEF3(Z,.FLDS,2)"
^IBA(364.7,344,3,0)="^^4^4^2960814^"
^IBA(364.7,344,3,1,0)="If there is more than 1 page of bill extracted, the variable"
^IBA(364.7,344,3,2,0)="FLDS(line,column) holds the lines and columns that should be duplicated on"
^IBA(364.7,344,3,3,0)="pages after the first.  This takes care of the population of these static"
^IBA(364.7,344,3,4,0)="fields on these subsequent pages."
^IBA(364.7,345,0)="545^N^148"
^IBA(364.7,345,1)="S IBXSAVE(""BOX19"")=$S($L(IBXDATA)<49:$J("""",48),$L(IBXDATA)<84:$J("""",13),1:"""")_IBXDATA,IBXDATA=$E(IBXSAVE(""BOX19""),1,48)"
^IBA(364.7,345,3,0)="^364.73^1^1^3000823^^^^"
^IBA(364.7,345,3,1,0)="This field holds the 1st through 48th characters of the box's data."
^IBA(364.7,346,0)="594^N^5^^^^N"
^IBA(364.7,346,1)="K IBXDATA S IBXSAVE(""PAID"")=$J(0,7,2) I $O(^TMP(""IBXDATA"",$J,IBXREC,""""),-1)'>1 S IBXDATA=IBXSAVE(""PAID"") K IBXSAVE(""PAID"")"
^IBA(364.7,346,3,0)="^^2^2^3000124^^^^"
^IBA(364.7,346,3,1,0)="This field is the prior amounts the patient has paid.  This will always"
^IBA(364.7,346,3,2,0)="be 0 unless VA changes policy."
^IBA(364.7,347,0)="595^N^173^^^^N"
^IBA(364.7,347,1)="S IBXSAVE(""BDUE"")=$S(IBXDATA:$J(IBXDATA,7,2),1:"""") K IBXDATA I $O(^TMP(""IBXDATA"",$J,IBXREC,""""),-1)'>1 S IBXDATA=IBXSAVE(""BDUE"") K IBXSAVE(""BDUE""),IBXSAVE(""PTOT""),IBXSAVE(""TOT"")"
^IBA(364.7,347,3,0)="^^2^2^3000124^^^"
^IBA(364.7,347,3,1,0)="If not 0, output as numeric with 2 decimals in 7 characters."
^IBA(364.7,347,3,2,0)="Only output total on last page of form."
^IBA(364.7,348,0)="566^N^275^^^^N"
^IBA(364.7,348,1)="N A,Q,Z K IBXSAVE(""OFAC"") S A=IBXDATA,Z=$P(A,U,2),IBXSAVE(""IBFAC"")=+A,Q=$$FAC^IBCEU3(IBXIEN) S:+A=+$P($G(^IBE(350.9,1,0)),U,2)&'Z&'Q IBXDATA=""SAME"" S IBXSAVE(""REMOTE"")=(IBXDATA>0) S:IBXDATA IBXDATA=$$GETFAC^IBCEP8(+A,+Z,0) S:Z IBXSAVE(""OFAC"")=1"
^IBA(364.7,348,3,0)="^364.73^4^4^3001017^^^^"
^IBA(364.7,348,3,1,0)="This returns the name of the INSTITUTION file entry for the non-VA or"
^IBA(364.7,348,3,2,0)="remote site where care was rendered.  Save the ien in IBXSAVE(""IBFAC"") for"
^IBA(364.7,348,3,3,0)="later use.  If the rendering facility is the same as the main facility,"
^IBA(364.7,348,3,4,0)="'SAME' prints as the facility name."
^IBA(364.7,349,0)="596^N^5^^^^N"
^IBA(364.7,349,1)="K IBXSAVE(""DX""),IBXSAVE(""BOX24""),IBXSAVE(""OCC""),IBXSAVE(""OCCS""),IBXSAVE(""IDEM""),IBXSAVE(""IADR"")"
^IBA(364.7,349,3,0)="^^1^1^2970519^^^"
^IBA(364.7,349,3,1,0)="Clean up IBXSAVE array."
^IBA(364.7,350,0)="597^N^235^^^^N"
^IBA(364.7,350,1)="N Z S Z=IBXDATA D F^IBCEF(""N-CURRENT INSURANCE CO TYPE"") S IBXDATA=$J("""",$S(Z=16!(Z=""MB"")!(Z=""MA""):0,Z=""TV""!(Z=""MC""):7,Z=""CH"":14,$$CHAMPVA^IBCEU3(IBXIEN)&($P($G(^DIC(36,+$$CURR^IBCEF2(IBXIEN),0)),U,2)=""Y""):23,IBXDATA=5:30,1:44))_""X"""
^IBA(364.7,350,3,0)="^364.73^1^1^3000919^^^^"
^IBA(364.7,350,3,1,0)="Check appropriate box for type of insurance"
^IBA(364.7,351,0)="598^N^5^^^^N"
^IBA(364.7,352,0)="599^N^240^^^^N"
^IBA(364.7,354,0)="601^N^283^^^^N"
^IBA(364.7,354,1)="K IBXDATA S:$G(IBXSAVE(""OLAB"")) IBXDATA=$J($G(IBXSAVE(""OLAB"")),10,2) K IBXSAVE(""OLAB"")"
^IBA(364.7,355,0)="602^N^5^^^^N"
^IBA(364.7,356,0)="603^N^5^^^^N"
^IBA(364.7,357,0)="604^N^24^^^^N"
^IBA(364.7,357,1)="N Z S Z=$S(IBXDATA=""""!(""Nn0""'[IBXDATA):1,1:6) S IBXDATA=$J(""X"",Z)"
^IBA(364.7,357,3,0)="^^2^2^2990630^^^^"
^IBA(364.7,357,3,1,0)="Print indicator of ASSIGNMENT OF BENEFITS.  Check Yes if data element value"
^IBA(364.7,357,3,2,0)="returned is null or is not 0,'n', or 'N', otherwise check No."
^IBA(364.7,358,0)="1075^N^5^^^^N^0"
^IBA(364.7,358,1)="N Z D ELMADDR^IBCEF7(IBXIEN,3,.IBXDATA) S Z=0 F  S Z=$O(IBXDATA(Z)) Q:'Z  S IBXDATA(Z)=$TR(IBXDATA(Z),""-/.,()'"",""  "")"
^IBA(364.7,358,3,0)="^364.73^2^2^3030926^^^^"
^IBA(364.7,358,3,1,0)="Extracted from the array IBXSAVE(""ARRAY"") from the 364.5 file OTHER INSURED FULL ADDRESS when Line 1 is"
^IBA(364.7,358,3,2,0)="DONE FIRST."
^IBA(364.7,359,0)="1076^N^5^^^^N^0"
^IBA(364.7,359,1)="D ELMADDR^IBCEF7(IBXIEN,4,.IBXDATA)"
^IBA(364.7,359,3,0)="^364.73^2^2^3030926^^^^"
^IBA(364.7,359,3,1,0)="Extracted from the array IBXSAVE(""ARRAY"") from the 364.5 file OTHER INSURED FULL ADDRESS when Line 1 is"
^IBA(364.7,359,3,2,0)="done first."
^IBA(364.7,360,0)="1077^N^5^^^^N^0"
^IBA(364.7,360,1)="D ELMADDR^IBCEF7(IBXIEN,5,.IBXDATA)"
^IBA(364.7,360,3,0)="^364.73^2^2^3030926^^^^"
^IBA(364.7,360,3,1,0)="Extracted from the array IBXSAVE(""ARRAY"") from the 364.5 file OTHER INSURED FULL ADDRESS when Line 1 is"
^IBA(364.7,360,3,2,0)="done first."
^IBA(364.7,361,0)="1078^N^5^^^^N^0"
^IBA(364.7,361,1)="S IBXDATA=$P(IBXSAVE,"","",1)_"">23>""_$E($P(IBXSAVE,"","",2),1,6)_"">1G>""_""Insurance Policy Number""_"">SY>Social Security Number"""
^IBA(364.7,361,3,0)="^^1^1^3030714^^^^"
^IBA(364.7,361,3,1,0)="Use IBXSAVE extracted in File 364.5, N-OTHER INSURED QUALIFIER/ID#. used as a set of codes."
^IBA(364.7,362,0)="1080^N^304^^^^N^0"
^IBA(364.7,362,1)="S IBXSAVE=IBZZ"
^IBA(364.7,362,3,0)="^^1^1^3030821^^"
^IBA(364.7,362,3,1,0)="capture all the Other Insured Qulaifiers and ID Numbers to be transmitted."
^IBA(364.7,363,0)="1081^N^316^^^^N"
^IBA(364.7,363,1)="S IBXDATA="""""
^IBA(364.7,363,3,0)="^^1^1^3030806^^"
^IBA(364.7,363,3,1,0)="Other Insurance Subscriber name Suffix."
^IBA(364.7,364,0)="1082^N^131^^^^N"
^IBA(364.7,364,1)="S IBXDATA=""OI3 """
^IBA(364.7,364,3,0)="^364.73^1^1^3030916^^^^"
^IBA(364.7,364,3,1,0)="Record ID for LOOP 2330, Other Payer Patient Information. One record per 2320 record"
^IBA(364.7,365,0)="1083^N^5^^^^N^1"
^IBA(364.7,365,1)="N Z,Z1 S (Z,Z1)=0 F  S Z=$O(IBXSAVE(1,Z)) Q:'Z  S Z1=Z1+1,IBXDATA(Z1)=1"
^IBA(364.7,366,0)="1085^N^5^^^^N"
^IBA(364.7,366,1)="N Z,Z1,Q S (Z,Z1)=0,Q=$$PTDEM^IBCEF(IBXIEN,2) F  S Z=$O(IBXSAVE(1,Z)) Q:'Z  S Z1=Z1+1,IBXDATA(Z1)=Q"
^IBA(364.7,366,3,0)="^364.73^1^1^3030916^^^^"
^IBA(364.7,366,3,1,0)="PATIENT SSN"
^IBA(364.7,368,0)="1086^N^5^^^^N^0"
^IBA(364.7,368,1)="K IBXDATA"
^IBA(364.7,369,0)="1087^N^306^^^^N"
^IBA(364.7,369,1)="K IBXDATA"
^IBA(364.7,369,3,0)="^364.73^1^1^3030916^^^^"
^IBA(364.7,369,3,1,0)="364.5 file N-OTH PAYER PAT ID QUALIF 1-3 will extract the data into IBXSAVE for parsing here. 111, 6 has the qualifier 1W and 111,7 will have the number."
^IBA(364.7,370,0)="1088^N^5^^^^N"
^IBA(364.7,370,1)="K IBXDATA"
^IBA(364.7,370,3,0)="^364.73^1^1^3030916^^^^"
^IBA(364.7,370,3,1,0)="Piece 111,6 extracts al the data for the remaining pices. Each piece exttracts the data from IBXSAVE."
^IBA(364.7,371,0)="1089^N^5^^^^N"
^IBA(364.7,371,1)="K IBXDATA"
^IBA(364.7,371,3,0)="^364.73^1^1^3030916^^^^"
^IBA(364.7,371,3,1,0)="Extract piece 3 and then piece 4 from IBXSAVE that first extracted the data in 111,6."
^IBA(364.7,372,0)="1090^N^5^^^^N"
^IBA(364.7,372,1)="K IBXDATA"
^IBA(364.7,372,3,0)="^^1^1^3030805^^^^"
^IBA(364.7,372,3,1,0)="Extract from IBXSAVE piece 4, Insurance Policy Number for OTHER PAYER."
^IBA(364.7,373,0)="1091^N^5^^^^N"
^IBA(364.7,373,1)="K IBXDATA"
^IBA(364.7,373,3,0)="^^1^1^3030805^^^"
^IBA(364.7,373,3,1,0)="Extract piece 5 from IBXSAVE, the ID Qualifier , SY"
^IBA(364.7,374,0)="1092^N^5^^^^N"
^IBA(364.7,374,1)="K IBXDATA"
^IBA(364.7,374,3,0)="^^1^1^3030805^^^"
^IBA(364.7,374,3,1,0)="Extract piece 6, Social Security Number, from IBXSAVE created in 111,6."
^IBA(364.7,375,0)="1094^N^5^^^^N"
^IBA(364.7,375,1)="S IBXDATA=$P($G(IBXSAVE(""BILLING PRV"",IBXIEN,""C"",1,3)),U,2)"
^IBA(364.7,375,3,0)="^364.73^2^2^3041202^^^^"
^IBA(364.7,375,3,1,0)="Extract the 364.5 definition into an array. Then use piece 1, Blue Cross "
^IBA(364.7,375,3,2,0)="Number for 8,16 piece 3.. The array will be used for the remaining pieces."
^IBA(364.7,376,0)="1095^N^5^^^^N"
^IBA(364.7,376,1)="S IBXDATA=$P($G(IBXSAVE(""BILLING PRV"",IBXIEN,""C"",1,4)),U,1)"
^IBA(364.7,377,0)="1096^N^5^^^^N"
^IBA(364.7,377,1)="S IBXDATA=$P($G(IBXSAVE(""BILLING PRV"",IBXIEN,""C"",1,4)),U,2)"
^IBA(364.7,378,0)="1097^N^5^^^^N"
^IBA(364.7,378,1)="S IBXDATA=$P($G(IBXSAVE(""BILLING PRV"",IBXIEN,""C"",1,5)),U,1)"
^IBA(364.7,379,0)="1098^N^5^^^^N"
^IBA(364.7,379,1)="S IBXDATA=$P($G(IBXSAVE(""BILLING PRV"",IBXIEN,""C"",1,5)),U,2)"
^IBA(364.7,380,0)="1099^N^5^^^^N"
^IBA(364.7,380,1)="S IBXDATA=$P($G(IBXSAVE(""BILLING PRV"",IBXIEN,""C"",1,6)),U,1)"
^IBA(364.7,381,0)="1100^N^5^^^^N"
^IBA(364.7,381,1)="S IBXDATA=$P($G(IBXSAVE(""BILLING PRV"",IBXIEN,""C"",1,6)),U,2)"
^IBA(364.7,382,0)="1101^N^5^^^^N"
^IBA(364.7,382,1)="S IBXDATA=$P($G(IBXSAVE(""BILLING PRV"",IBXIEN,""C"",1,7)),U,1)"
^IBA(364.7,383,0)="1102^N^5^^^^N"
^IBA(364.7,383,1)="S IBXDATA=$P($G(IBXSAVE(""BILLING PRV"",IBXIEN,""C"",1,7)),U,2)"
^IBA(364.7,384,0)="1103^N^5^^^^N"
^IBA(364.7,384,1)="S IBXDATA=$P($G(IBXSAVE(""BILLING PRV"",IBXIEN,""C"",1,8)),U,1)"
^IBA(364.7,385,0)="1104^N^5^^^^N"
^IBA(364.7,385,1)="S IBXDATA=$P($G(IBXSAVE(""BILLING PRV"",IBXIEN,""C"",1,8)),U,2) D CLEANUP^IBCEF75(.IBXSAVE)"
^IBA(364.7,385,3,0)="^364.73^1^1^3031210^^^^"
^IBA(364.7,385,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR1"",$J) will already exist.  Don't want to extract this field again, so kill data element so there is no output."
^IBA(364.7,386,0)="1189^N^131^^^^N"
^IBA(364.7,386,1)="S IBXDATA=""CL1A """
^IBA(364.7,386,3,0)="^^1^1^3030718^^"
^IBA(364.7,386,3,1,0)="Output RECORD ID for CL1A record."
^IBA(364.7,387,0)="1190^N^131^^^^N"
^IBA(364.7,387,1)="S IBXDATA=""CI1A"""
^IBA(364.7,387,3,0)="^^4^4^3060124^"
^IBA(364.7,387,3,1,0)="Record ID CI1A (Sequence# 28) piece 1.  Hard code ""CI1A"" as the "
^IBA(364.7,387,3,2,0)="first piece."
^IBA(364.7,387,3,3,0)="IB patch 320 - the CI1A segment is a new segment basically replacing the "
^IBA(364.7,387,3,4,0)="PRV1 segment.  Billing provider secondary ID's."
^IBA(364.7,388,0)="1192^N^5^^^^N"
^IBA(364.7,388,1)="S IBXDATA=$P($G(IBXSAVE(""BILLING PRV"",IBXIEN,""C"",1,2)),U,2)"
^IBA(364.7,388,3,0)="^364.73^2^2^3041202^^^^"
^IBA(364.7,388,3,1,0)="Provider number for the current insurance company for bill entry "
^IBA(364.7,388,3,2,0)="IBXIEN."
^IBA(364.7,389,0)="1191^N^5^^^^N"
^IBA(364.7,389,1)="S IBXDATA=$P($G(IBXSAVE(""BILLING PRV"",IBXIEN,""C"",1,2)),U,1)"
^IBA(364.7,389,3,0)="^364.73^4^4^3041202^^^^"
^IBA(364.7,389,3,1,0)="Kept N-CURRENT INS POLICY TYPE because didn't want to touch previous logic "
^IBA(364.7,389,3,2,0)="that may set array or TMP."
^IBA(364.7,389,3,3,0)="the format code sets array to string with QUALIF and ID for the first "
^IBA(364.7,389,3,4,0)="seven insurances in file #355.97 except some."
^IBA(364.7,390,0)="172^N^5^^^^N"
^IBA(364.7,390,1)="K:'$G(IBXSAVE(""IBFAC""))&'$P($G(IBXSAVE(""IBFAC"")),U,3) IBXDATA I $D(IBXDATA) S IBXDATA=$$GETFAC^IBCEP8(+IBXSAVE(""IBFAC""),+$P(IBXSAVE(""IBFAC""),U,2),""3C"",""SUB""),IBXDATA=$TR(IBXDATA,""-/.,()'"",""  "")"
^IBA(364.7,390,3,0)="^^3^3^3040901^"
^IBA(364.7,390,3,1,0)="Extract the city for the rendering facility.  Relies on the"
^IBA(364.7,390,3,2,0)="existence of the array IBXSAVE(""IBFAC"") extracted previously by the"
^IBA(364.7,390,3,3,0)="rendering facility name field."
^IBA(364.7,391,0)="1194^N^5^^^^N"
^IBA(364.7,391,1)="K IBXDATA"
^IBA(364.7,392,0)="1195^N^5^^^^N"
^IBA(364.7,392,1)="S IBXDATA="""" I $$SUB1OK^IBCEP8A(IBXIEN) S IBXDATA=24"
^IBA(364.7,392,3,0)="^^2^2^3060303^"
^IBA(364.7,392,3,1,0)="For purchased services, must pass checks in $$SUB1OK.  If true, then "
^IBA(364.7,392,3,2,0)="always 24 qualifer."
^IBA(364.7,393,0)="1196^N^5^^^^N"
^IBA(364.7,393,1)="S IBXDATA="""" I $$SUB1OK^IBCEP8A(IBXIEN) S IBXDATA=2"
^IBA(364.7,393,3,0)="^^2^2^3060303^"
^IBA(364.7,393,3,1,0)="For purchased services must pass checks in $$SUB1OK.  If true, this is "
^IBA(364.7,393,3,2,0)="always a ""2"" for non-person."
^IBA(364.7,394,0)="1197^N^131^^^^N"
^IBA(364.7,394,1)="S IBXDATA=""SUB1"""
^IBA(364.7,395,0)="1198^N^5^^^^N"
^IBA(364.7,395,1)="S IBXDATA=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""C"",1,1)),U,2)"
^IBA(364.7,395,3,0)="^364.73^1^1^3030904^^^^"
^IBA(364.7,395,3,1,0)="Output the first other id for the current insurance."
^IBA(364.7,396,0)="1199^N^5^^^^N"
^IBA(364.7,396,1)="S IBXDATA=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""C"",1,2)),U,1)"
^IBA(364.7,396,3,0)="^364.73^1^1^3030904^^^"
^IBA(364.7,396,3,1,0)="Output the second id qualifier for the current insurance."
^IBA(364.7,397,0)="1200^N^5^^^^N"
^IBA(364.7,397,1)="S IBXDATA=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""C"",1,2)),U,2)"
^IBA(364.7,397,3,0)="^364.73^1^1^3030904^^^"
^IBA(364.7,397,3,1,0)="Output the second id for the current insurance."
^IBA(364.7,398,0)="1201^N^5^^^^N"
^IBA(364.7,398,1)="S IBXDATA=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""C"",1,3)),U,1)"
^IBA(364.7,398,3,0)="^364.73^1^1^3030904^^^"
^IBA(364.7,398,3,1,0)="Output the third other id qualifier for the current insurance."
^IBA(364.7,399,0)="1202^N^5^^^^N"
^IBA(364.7,399,1)="S IBXDATA=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""C"",1,3)),U,2)"
^IBA(364.7,399,3,0)="^364.73^1^1^3030904^^^"
^IBA(364.7,399,3,1,0)="Output the third other id for the current insurance."
^IBA(364.7,400,0)="1203^N^5^^^^N"
^IBA(364.7,400,1)="S IBXDATA=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""C"",1,4)),U,1)"
^IBA(364.7,400,3,0)="^364.73^1^1^3030904^^^"
^IBA(364.7,400,3,1,0)="Output the fourth other id qualifier for the current insurance."
^IBA(364.7,401,0)="1204^N^5^^^^N"
^IBA(364.7,401,1)="S IBXDATA=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""C"",1,4)),U,2)"
^IBA(364.7,401,3,0)="^364.73^1^1^3030904^^^"
^IBA(364.7,401,3,1,0)="Output the fourth other id for the current insurance."
^IBA(364.7,402,0)="1205^N^5^^^^N"
^IBA(364.7,402,1)="S IBXDATA=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""C"",1,5)),U,1)"
^IBA(364.7,402,3,0)="^364.73^1^1^3030904^^^"
^IBA(364.7,402,3,1,0)="Output the fifth other id qualifier for the current insurance."
^IBA(364.7,403,0)="1206^N^5^^^^N"
^IBA(364.7,403,1)="S IBXDATA=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""C"",1,5)),U,2) D CLEANUP^IBCEF75(.IBXSAVE)"
^IBA(364.7,403,3,0)="^364.73^3^3^3030904^^^^"
^IBA(364.7,403,3,1,0)="Output the fifth other id for the current insurance."
^IBA(364.7,403,3,2,0)="Kill the IBXSAVE(""NVF"") and IBXSAVE(""PROVINF"",IBXIEN) or"
^IBA(364.7,403,3,3,0)="IBXSAVE(""PROVINF_FAC"",IBXIEN) variables to clean up."
^IBA(364.7,404,0)="1207^N^131^^^^N"
^IBA(364.7,404,1)="S IBXDATA=""SUB2"""
^IBA(364.7,405,0)="1209^N^5^^^^N"
^IBA(364.7,405,1)="S IBXDATA=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""C"",1,1)),U,2)"
^IBA(364.7,405,3,0)="^364.73^1^1^3041221^^^^"
^IBA(364.7,405,3,1,0)="Output the first 'other' id."
^IBA(364.7,406,0)="1210^N^5^^^^N"
^IBA(364.7,406,1)="S IBXDATA=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""C"",1,2)),U,1)"
^IBA(364.7,406,3,0)="^364.73^1^1^3041221^^^^"
^IBA(364.7,406,3,1,0)="Output the second 'other' id qualifier."
^IBA(364.7,407,0)="1211^N^5^^^^N"
^IBA(364.7,407,1)="S IBXDATA=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""C"",1,2)),U,2)"
^IBA(364.7,407,3,0)="^364.73^1^1^3030904^^^^"
^IBA(364.7,407,3,1,0)="Output the second 'other' id."
^IBA(364.7,408,0)="1212^N^5^^^^N"
^IBA(364.7,408,1)="S IBXDATA=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""C"",1,3)),U,1)"
^IBA(364.7,408,3,0)="^364.73^1^1^3030904^^^^"
^IBA(364.7,408,3,1,0)="Output the third 'other' id qualifier."
^IBA(364.7,409,0)="1213^N^5^^^^N"
^IBA(364.7,409,1)="S IBXDATA=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""C"",1,3)),U,2)"
^IBA(364.7,409,3,0)="^364.73^1^1^3030904^^^"
^IBA(364.7,409,3,1,0)="Output the third 'other' id."
^IBA(364.7,410,0)="1214^N^5^^^^N"
^IBA(364.7,410,1)="S IBXDATA=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""C"",1,4)),U,1)"
^IBA(364.7,410,3,0)="^364.73^1^1^3030904^^^^"
^IBA(364.7,410,3,1,0)="Output the fourth 'other' id qualifier."
^IBA(364.7,411,0)="1215^N^5^^^^N"
^IBA(364.7,411,1)="S IBXDATA=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""C"",1,4)),U,2)"
^IBA(364.7,411,3,0)="^364.73^1^1^3030904^^^"
^IBA(364.7,411,3,1,0)="Output the fourth 'other' id."
^IBA(364.7,412,0)="1216^N^5^^^^N"
^IBA(364.7,412,1)="S IBXDATA=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""C"",1,5)),U,1)"
^IBA(364.7,412,3,0)="^364.73^1^1^3041221^^^^"
^IBA(364.7,412,3,1,0)="Output the fifth 'other' id qualifier."
^IBA(364.7,413,0)="1217^N^5^^^^N"
^IBA(364.7,413,1)="S IBXDATA=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""C"",1,5)),U,2) D CLEANUP^IBCEF75(.IBXSAVE)"
^IBA(364.7,413,3,0)="^364.73^2^2^3041221^^^^"
^IBA(364.7,413,3,1,0)="Output the fifth 'other' id."
^IBA(364.7,413,3,2,0)="Delete the 'filtered' id array IBXSAVE(""PROVINF_FAC"",IBXIEN)."
^IBA(364.7,414,0)="1219^N^131^^^^N"
^IBA(364.7,414,1)="S IBXDATA=""OPR8"""
^IBA(364.7,414,3,0)="^^1^1^3030815^^^^"
^IBA(364.7,414,3,1,0)="Record ID for SUPERVISING PROVIDER SECONDARY ID'S AND QUALIFIERS"
^IBA(364.7,416,0)="1220^N^131^^^^N"
^IBA(364.7,416,1)="S IBXDATA=""OPR3"""
^IBA(364.7,416,3,0)="^^1^1^3030807^^^"
^IBA(364.7,416,3,1,0)="Record ID ofr Operating Physician Secondary ID and Qualifier."
^IBA(364.7,417,0)="1221^N^131^^^^N"
^IBA(364.7,417,1)="S IBXDATA=""OPR2"""
^IBA(364.7,417,3,0)="^^1^1^3030807^^^^"
^IBA(364.7,417,3,1,0)="Record ID for Attending Provider Secondary ID and Qualifier"
^IBA(364.7,418,0)="1222^N^131^^^^N"
^IBA(364.7,418,1)="S IBXDATA=""OPR1"""
^IBA(364.7,418,3,0)="^364.73^1^1^3031007^^^^"
^IBA(364.7,418,3,1,0)="Record ID for Insurance Specific Provider Information LOPP 2310 , one claim per Claim Data record set."
^IBA(364.7,419,0)="1223^N^131^^^^N"
^IBA(364.7,419,1)="S IBXDATA=""OPR """
^IBA(364.7,419,3,0)="^364.73^1^1^3030910^^^^"
^IBA(364.7,419,3,1,0)="Record ID for Attending/Other Provider Information, LOOP 2310, one claim per Claim Data record set."
^IBA(364.7,420,0)="1224^N^312^^^^N"
^IBA(364.7,420,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,4,1)),""^"",3) S:IBXDATA="""" IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,3,1)),""^"",3)"
^IBA(364.7,420,3,0)="0^364.73^5^5^3040728^^^^"
^IBA(364.7,420,3,1,0)="Attending Provider Secondary ID Qualifier."
^IBA(364.7,420,3,2,0)="EI=EMPLOYER, SY=SSN, 0B=STATE LICENSE NUMBER, 1A=BLUE CROSS, 1B=BLUE SHIELD,"
^IBA(364.7,420,3,3,0)="1C=MEDICARE PARTA and PARTB, 1D=MEDICAID, 1G=UPIN Number, 1H=TRICARE"
^IBA(364.7,420,3,4,0)="G2=COMMERCAIL NUMBER, X5=STATE INDUSTRIAL ACCIDENT PROVIDER NUMBER"
^IBA(364.7,420,3,5,0)="N5=PROVIDER PLAN NETWORK ID"
^IBA(364.7,421,0)="1225^N^312^^^^N"
^IBA(364.7,421,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,4,1)),""^"",4) S:IBXDATA="""" IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,3,1)),""^"",4) I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,422,0)="1226^N^312^^^^N"
^IBA(364.7,422,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,4,2)),""^"",3) S:IBXDATA="""" IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,3,2)),""^"",3)"
^IBA(364.7,423,0)="1227^N^312^^^^N"
^IBA(364.7,423,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,4,2)),""^"",4) S:IBXDATA="""" IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,3,2)),""^"",4) I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,424,0)="1228^N^312^^^^N"
^IBA(364.7,424,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,4,3)),""^"",3) S:IBXDATA="""" IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,3,3)),""^"",3)"
^IBA(364.7,425,0)="1229^N^312^^^^N"
^IBA(364.7,425,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,4,3)),""^"",4) S:IBXDATA="""" IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,3,3)),""^"",4) I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,426,0)="1230^N^312^^^^N"
^IBA(364.7,426,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,4,4)),""^"",3) S:IBXDATA="""" IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,3,4)),""^"",3)"
^IBA(364.7,427,0)="1231^N^312^^^^N"
^IBA(364.7,427,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,4,4)),""^"",4) S:IBXDATA="""" IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,3,4)),""^"",4) I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,428,0)="1232^N^312^^^^N"
^IBA(364.7,428,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,4,5)),""^"",3) S:IBXDATA="""" IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,3,5)),""^"",3)"
^IBA(364.7,429,0)="1233^N^312^^^^N"
^IBA(364.7,429,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,4,5)),""^"",4) S:IBXDATA="""" IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,3,5)),""^"",4) I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,430,0)="1234^N^312^^^^N"
^IBA(364.7,430,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,2,1)),""^"",3)"
^IBA(364.7,430,3,0)="^^1^1^3030812^^^^"
^IBA(364.7,430,3,1,0)="Operating Physician Secondary ID and Qualifier."
^IBA(364.7,431,0)="1235^N^312^^^^N"
^IBA(364.7,431,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,2,1)),""^"",4) I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,432,0)="1236^N^312^^^^N"
^IBA(364.7,432,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,2,2)),""^"",3)"
^IBA(364.7,433,0)="1237^N^312^^^^N"
^IBA(364.7,433,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,2,2)),""^"",4) I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,434,0)="1238^N^312^^^^N"
^IBA(364.7,434,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,2,3)),""^"",3)"
^IBA(364.7,435,0)="1239^N^312^^^^N"
^IBA(364.7,435,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,2,3)),""^"",4) I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,436,0)="1240^N^312^^^^N"
^IBA(364.7,436,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,2,4)),""^"",3)"
^IBA(364.7,437,0)="1241^N^312^^^^N"
^IBA(364.7,437,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,2,4)),""^"",4) I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,438,0)="1242^N^312^^^^N"
^IBA(364.7,438,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,2,5)),""^"",3)"
^IBA(364.7,439,0)="1243^N^312^^^^N"
^IBA(364.7,439,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,2,5)),""^"",4) I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,440,0)="1245^N^312^^^^N"
^IBA(364.7,440,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,9,1)),""^"",4) I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,440,3,0)="^364.73^4^4^3030930^^^^"
^IBA(364.7,440,3,1,0)="Other Provider Secondary Qualifier 1."
^IBA(364.7,440,3,2,0)="EI=EMPLOYER ID, SY=SSN, 0B=STATE LICENSE #, 1A=BLUE CROSS, 1B=BLUE SHIELD,"
^IBA(364.7,440,3,3,0)="1C=MEDICARE PARTA or PARTB, 1D=MEDICAID, 1G=UPIN #, 1H=TRICARE, G2=COMMERCIAL #"
^IBA(364.7,440,3,4,0)="X5=STATE INDUSTRIAL ACCIDENT PROVIDER #, LU=LOCATION #, N5=PROVIDER PLAN NETWORK ID"
^IBA(364.7,441,0)="1218^N^131^^^^N"
^IBA(364.7,441,1)="S IBXDATA=""OPR5"""
^IBA(364.7,441,3,0)="^364.73^4^4^3040722^^^"
^IBA(364.7,441,3,1,0)="Referring Provider Secondary ID and Qualifier."
^IBA(364.7,441,3,2,0)="0B=STATE LICENSE #, 1B=BLUE SHILED #, 1C=MEDICARE #, 1D=MEDICAID #"
^IBA(364.7,441,3,3,0)="1G=UPIN #, 1H=TRICARE ID #, G2=COMMERCIAL #, X5=STATE INDUSTRIAL ACCIDENT PROVIDER #"
^IBA(364.7,441,3,4,0)="LU=LOCATION #"
^IBA(364.7,443,0)="1277^N^312^^^^N"
^IBA(364.7,443,1)="I $P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,5,1)),U,4)'="""" S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,5,1)),U,3)"
^IBA(364.7,443,3,0)="^364.73^5^5^3030923^^^^"
^IBA(364.7,443,3,1,0)="Supervising Provider Secondary ID Qualifier"
^IBA(364.7,443,3,2,0)="EI=EMPLOYER, SY=SSN, 0B=STATE LICENSE NUMBER, 1A=BLUE CROSS, 1B=BLUE SHIELD,"
^IBA(364.7,443,3,3,0)="1C=MEDICARE PARTA aqnd PARTB, 1D=MEDICAID, 1G=UPIN Number, 1H=TRICARE"
^IBA(364.7,443,3,4,0)="G2=COMMERCAIL NUMBER, X5=STATE INDUSTRIAL ACCIDENT PROVIDER NUMBER"
^IBA(364.7,443,3,5,0)="N5=PROVIDER PLAN NETWORK ID"
^IBA(364.7,444,0)="1278^N^312^^^^N"
^IBA(364.7,444,1)="I $P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,5,1)),U,4)'="""" S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,5,1)),U,4) I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,444,3,0)="^364.73^1^1^3030930^^^"
^IBA(364.7,444,3,1,0)="Supervising Provider Secondary ID"
^IBA(364.7,445,0)="1279^N^312^^^^N"
^IBA(364.7,445,1)="I $P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,5,2)),U,4)'="""" S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,5,2)),U,3)"
^IBA(364.7,446,0)="1280^N^312^^^^N"
^IBA(364.7,446,1)="I $P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,5,2)),U,4)'="""" S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,5,2)),U,4) I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,447,0)="1281^N^312^^^^N"
^IBA(364.7,447,1)="I $P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,5,3)),U,4)'="""" S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,5,3)),U,3)"
^IBA(364.7,448,0)="1282^N^312^^^^N"
^IBA(364.7,448,1)="I $P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,5,3)),U,4)'="""" S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,5,3)),U,4) I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,449,0)="1283^N^312^^^^N"
^IBA(364.7,449,1)="I $P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,5,4)),U,4)'="""" S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,5,4)),U,3)"
^IBA(364.7,450,0)="1284^N^312^^^^N"
^IBA(364.7,450,1)="I $P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,5,4)),U,4)'="""" S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,5,4)),U,4) I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,451,0)="1285^N^312^^^^N"
^IBA(364.7,451,1)="I $P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,5,5)),U,4)'="""" S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,5,5)),U,3)"
^IBA(364.7,452,0)="1286^N^312^^^^N"
^IBA(364.7,452,1)="I $P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,5,5)),U,4)'="""" S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,5,5)),U,4) I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,453,0)="1287^N^131^^^^N"
^IBA(364.7,453,1)="S IBXDATA=""OI4 """
^IBA(364.7,453,3,0)="^364.73^1^1^3030916^^^^"
^IBA(364.7,453,3,1,0)="Other Insured Information, LOOP 2330, one record per 2320 record."
^IBA(364.7,454,0)="1288^N^131^^^^N"
^IBA(364.7,454,1)="S IBXDATA=""OI5 """
^IBA(364.7,454,3,0)="^364.73^1^1^3040728^^^"
^IBA(364.7,454,3,1,0)="Other Insurance Subscriber Information, LOOP 2330"
^IBA(364.7,455,0)="1289^N^5^^^^N"
^IBA(364.7,455,1)="D ELMADD2^IBCEF7(IBXIEN,1,.IBXDATA)"
^IBA(364.7,456,0)="1290^N^5^^^^N"
^IBA(364.7,456,1)="D ELMADD2^IBCEF7(IBXIEN,2,.IBXDATA)"
^IBA(364.7,457,0)="1291^N^5^^^^N"
^IBA(364.7,457,1)="N Z D ELMADD2^IBCEF7(IBXIEN,3,.IBXDATA) S Z=0 F  S Z=$O(IBXDATA(Z)) Q:'Z  S IBXDATA(Z)=$TR(IBXDATA(Z),""-/.,()'"",""  "")"
^IBA(364.7,458,0)="1292^N^5^^^^N"
^IBA(364.7,458,1)="D ELMADD2^IBCEF7(IBXIEN,4,.IBXDATA)"
^IBA(364.7,459,0)="1293^N^5^^^^N"
^IBA(364.7,459,1)="D ELMADD2^IBCEF7(IBXIEN,5,.IBXDATA)"
^IBA(364.7,460,0)="1294^N^5^^^^N"
^IBA(364.7,460,3,0)="^364.73^1^1^3030922^^"
^IBA(364.7,460,3,1,0)="Checks if SUBSCR IDs for all ""other insurances"". if so then sets to ""1W"" D OTHSBID^IBCEF7(IBXIEN,.IBXDATA) N IBZ F IBZ=1,2 S:$G(IBXDATA(IBZ))'="""" IBXDATA(IBZ)=""1W"""
^IBA(364.7,461,0)="1295^N^5^^^^N"
^IBA(364.7,461,3,0)="^364.73^1^1^3030922^^"
^IBA(364.7,461,3,1,0)="SUBSCRIBER ID from #399 that actually is subfile (#.3121) of #2, field #1. D OTHSBID^IBCEF7(IBXIEN,.IBXDATA)"
^IBA(364.7,462,0)="1296^N^5^^^^N"
^IBA(364.7,462,1)="S IBXDATA="""""
^IBA(364.7,463,0)="1297^N^5^^^^N"
^IBA(364.7,463,1)="S IBXDATA="""""
^IBA(364.7,464,0)="1298^N^5^^^^N"
^IBA(364.7,464,1)="S IBXDATA="""""
^IBA(364.7,465,0)="1299^N^5^^^^N"
^IBA(364.7,465,1)="S IBXDATA="""""
^IBA(364.7,466,0)="1116^N^131^^^^N"
^IBA(364.7,466,1)="S IBXDATA=""OP2 """
^IBA(364.7,467,0)="1126^N^131^^^^N"
^IBA(364.7,467,1)="S IBXDATA=""OP3 """
^IBA(364.7,469,0)="1135^N^131^^^^N"
^IBA(364.7,469,1)="S IBXDATA=""OP4 """
^IBA(364.7,470,0)="1153^N^131^^^^N"
^IBA(364.7,470,1)="S IBXDATA=""OP6 """
^IBA(364.7,471,0)="1162^N^131^^^^N"
^IBA(364.7,471,1)="S IBXDATA=""OP7 """
^IBA(364.7,472,0)="488^N^319^^^^N"
^IBA(364.7,472,1)="K:$D(^TMP(""IBHDR"",$J)) IBXDATA S:'$D(IBXDATA) IBXNOREQ=1"
^IBA(364.7,472,3,0)="3^^3^3^2990610^^^^"
^IBA(364.7,472,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR"",$J) will"
^IBA(364.7,472,3,2,0)="already exist.  Don't want to extract this field again, so kill data"
^IBA(364.7,472,3,3,0)="element so there is no output."
^IBA(364.7,473,0)="479^N^133^^^^N"
^IBA(364.7,473,1)="S IBXNOREQ=$$NFT^IBCEF1(3,IBXIEN) S IBXDATA=$$DT^IBCEFG1(IBXDATA,"""",""D8"")"
^IBA(364.7,473,3,0)="^^2^2^2991115^^^^"
^IBA(364.7,473,3,1,0)="Format date in CCYYMMDD format.  If data element's value is null, do not"
^IBA(364.7,473,3,2,0)="output."
^IBA(364.7,474,0)="481^N^5^^^^N"
^IBA(364.7,474,1)="K IBXDATA N Z,Z0 S Z=0 F  S Z=$O(IBXSAVE(""OCCS"",Z)) Q:'Z  S Z0=$P($$DT^IBCEFG1($P(IBXSAVE(""OCCS"",Z),U,2),$P(IBXSAVE(""OCCS"",Z),U,3),""RD8""),""-"",2) I Z0'="""" S IBXDATA(Z)=Z0"
^IBA(364.7,474,3,0)="^^2^2^2991115^^^^"
^IBA(364.7,474,3,1,0)="Each occurrence span code to date found in the IBXSAVE array previously"
^IBA(364.7,474,3,2,0)="extracted is formatted into CCYYMMDD date format and is output."
^IBA(364.7,475,0)="483^N^5^^^^N"
^IBA(364.7,475,1)="K IBXDATA N Z,Z0,A,A1 S Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  S A=$P(IBXSAVE(""OUTPT"",Z),U),A1=$P(IBXSAVE(""OUTPT"",Z),U,2),Z0=$S('$$INPAT^IBCEF(IBXIEN):$S(A:A,1:A1),1:A1) I Z0 S IBXDATA(Z)=Z0"
^IBA(364.7,475,3,0)="^^4^4^2990901^^^"
^IBA(364.7,475,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,475,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,475,3,3,0)="any service line data is found, the data is output.  Data is taken from"
^IBA(364.7,475,3,4,0)="the 'from' date if there is no 'to' date."
^IBA(364.7,476,0)="578^N^135^^^^N"
^IBA(364.7,476,1)="K:$D(^TMP(""IBHDR1"",$J)) IBXDATA N Z S Z=0 F  S Z=$O(IBXDATA(Z)) K:'Z&($D(IBXDATA)=1) IBXDATA Q:'Z  K:IBXDATA(Z)="""" IBXDATA(Z) D:$D(IBXDATA(Z))&(Z>1) ID^IBCEF2(Z,""CCOM"")"
^IBA(364.7,476,3,0)="^^7^7^2981124^^^^"
^IBA(364.7,476,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR1"",$J) will"
^IBA(364.7,476,3,2,0)="already exist.  Don't want to extract this field again, so kill data"
^IBA(364.7,476,3,3,0)="element so there is no output.  Also kill data element and no output if"
^IBA(364.7,476,3,4,0)="there are no common remarks extracted or remark is null.  This is a group"
^IBA(364.7,476,3,5,0)="data element so more than 1 occurrence of a value for the data element in"
^IBA(364.7,476,3,6,0)="the IBXDATA array is possible.  Output the 'CCOM' id record manually on"
^IBA(364.7,476,3,7,0)="encountering comments after the first one."
^IBA(364.7,477,0)="577^N^131^^^^N"
^IBA(364.7,477,1)="S:'$D(^TMP(""IBHDR1"",$J)) IBXDATA=""CCOM"" S:IBXDATA="""" IBXNOREQ=1"
^IBA(364.7,477,3,0)="^^4^4^2981124^^^^"
^IBA(364.7,477,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR1"",$J) will"
^IBA(364.7,477,3,2,0)="already exist.  Don't want to extract this field again, so kill data"
^IBA(364.7,477,3,3,0)="element so there is no output.  If no header already extracted, output"
^IBA(364.7,477,3,4,0)="the record id for the 'CCOM' record."
^IBA(364.7,478,0)="582^N^131^^^^N"
^IBA(364.7,478,1)="S:'$O(^TMP(""IBXMSG"",$J,""""),-1) IBXDATA=""BGN "" S:$G(IBXDATA)="""" IBXNOREQ=1 S ^TMP(""IBTX"",$J,IBXIEN)=1"
^IBA(364.7,478,3,0)="^364.73^3^3^3011002^^^^"
^IBA(364.7,478,3,1,0)="If header data has already been extracted, then kill data element so"
^IBA(364.7,478,3,2,0)="there is no output.  If no header already extracted, output record"
^IBA(364.7,478,3,3,0)="id for 'BGN' record."
^IBA(364.7,479,0)="583^N^136^^^^N"
^IBA(364.7,479,1)="I $D(^TMP(""IBHDR"",$J)) K IBXDATA S IBXNOREQ=1"
^IBA(364.7,479,3,0)="^^3^3^2960815^^^^"
^IBA(364.7,479,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR"",$J) will"
^IBA(364.7,479,3,2,0)="already exist.  Don't want to extract this field again, so kill data"
^IBA(364.7,479,3,3,0)="element so there is no output."
^IBA(364.7,480,0)="580^N^5^^^^N"
^IBA(364.7,480,1)="K IBXDATA N Z S Z="""" F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  I $D(IBXSAVE(""OUTPT"",Z,""RX"")) S IBXDATA(Z)=$P(IBXSAVE(""OUTPT"",Z,""RX""),U,6)"
^IBA(364.7,480,3,0)="^^3^3^2990223^^^"
^IBA(364.7,480,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,480,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,480,3,3,0)="any service line data is found, the quantity '1' is output."
^IBA(364.7,481,0)="581^N^5^^^^N"
^IBA(364.7,481,1)="K IBXDATA N Z S Z="""" F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  I $D(IBXSAVE(""OUTPT"",Z,""RX"")) S IBXDATA(Z)=$P(IBXSAVE(""OUTPT"",Z,""RX""),U,7)"
^IBA(364.7,481,3,0)="^^3^3^2960815^^"
^IBA(364.7,481,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,481,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,481,3,3,0)="any service line data is found, the data is output."
^IBA(364.7,482,0)="579^N^5^^^^N"
^IBA(364.7,482,3,0)="^^1^1^2990614^^^"
^IBA(364.7,482,3,1,0)="If data element's value is null, do not output."
^IBA(364.7,483,0)="605^N^174^^^^N"
^IBA(364.7,483,1)="N Z,Q S Z=0 F  S Z=$O(IBXDATA(Z)) Q:'Z  S Q=$S('$G(IBXDATA(Z,""T"")):"" "",1:"""")_IBXDATA(Z) S:Z'>12 IBXDATA(Z)=Q I Z>12 D PG^IBCEF3(Q,Z)"
^IBA(364.7,483,3,0)="^^2^2^3000105^^^^"
^IBA(364.7,483,3,1,0)="If more than 6 service dates (12 lines) exists for the bill, this outputs"
^IBA(364.7,483,3,2,0)="the rest on additional bill pages."
^IBA(364.7,484,0)="606^N^229^^^^N"
^IBA(364.7,484,1)="N Z,Z0,IBZ M IBZ=IBXDATA K IBXDATA S Z=0 F  S Z=$O(IBZ(Z)) Q:'Z  S Z0=$S('$G(IBZ(Z,""T"")):$S(IBZ(Z)=""Y"":"" Y"",1:""""),1:IBZ(Z)) S:Z'>12 IBXDATA(Z)=Z0 D:Z>12 PG^IBCEF3(Z0,Z)"
^IBA(364.7,484,3,0)="^^3^3^3000105^^^"
^IBA(364.7,484,3,1,0)="Print a space before the 'Y' if an emergency procedure is indicated."
^IBA(364.7,484,3,2,0)="If more than 6 service dates (12 lines) exists for the bill, this outputs"
^IBA(364.7,484,3,3,0)="the rest on additional bill pages."
^IBA(364.7,485,0)="607^N^176^^^^N"
^IBA(364.7,485,1)="N Z S Z=12 F  S Z=$O(IBXDATA(Z)) Q:'Z  D PG^IBCEF3(IBXDATA(Z),Z)"
^IBA(364.7,485,3,0)="^^2^2^3000105^^^"
^IBA(364.7,485,3,1,0)="If more than 6 service dates (12 lines) exists for the bill, this outputs"
^IBA(364.7,485,3,2,0)="the rest on additional bill pages."
^IBA(364.7,486,0)="608^N^177^^^^N"
^IBA(364.7,486,1)="N Z S Z=12 F  S Z=$O(IBXDATA(Z)) Q:'Z  D PG^IBCEF3(IBXDATA(Z),Z)"
^IBA(364.7,486,3,0)="^^2^2^3000105^^"
^IBA(364.7,486,3,1,0)="If more than 6 service dates (12 lines) exists for the bill, this outputs"
^IBA(364.7,486,3,2,0)="the rest on additional bill pages."
^IBA(364.7,487,0)="1171^N^131^^^^N"
^IBA(364.7,487,1)="S IBXDATA=""OP8 """
^IBA(364.7,488,0)="610^N^178^^^^N"
^IBA(364.7,488,1)="N Z,Z0 S Z=0 F  S Z=$O(IBXDATA(Z)) Q:'Z  D SETMODS^IBCVA1(IBXDATA(Z),Z,.IBXSAVE) S Z0=$P($G(IBXSAVE(""PROCMODS"",Z)),"","") I Z0'="""" S IBXDATA(Z)=Z0"
^IBA(364.7,488,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,488,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,488,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,488,3,3,0)="any service line data is found, the data is output."
^IBA(364.7,489,0)="611^N^5^^^^N"
^IBA(364.7,489,1)="K IBXDATA"
^IBA(364.7,489,3,0)="^^1^1^2990609^^^^"
^IBA(364.7,489,3,1,0)="Not currently used. No output"
^IBA(364.7,490,0)="612^N^142^^^^N"
^IBA(364.7,491,0)="613^N^296^^^^N"
^IBA(364.7,492,0)="614^N^72^^^^N"
^IBA(364.7,492,1)="I IBXDATA'="""" S IBXSAVE(""FL2"")=$E(IBXDATA,30,59),IBXDATA=$E(IBXDATA,1,29)"
^IBA(364.7,492,3,0)="^^6^6^2990609^^^^"
^IBA(364.7,492,3,1,0)="If this data element returns a value other than null, it can be output on"
^IBA(364.7,492,3,2,0)="2 lines where characters 1-29 print on line 1 and 30-59 print on line 2."
^IBA(364.7,492,3,3,0)="Save off characters 30-59 in IBXSAVE(""FL2"") array and set value of this"
^IBA(364.7,492,3,4,0)="data element to the first 29 characters.  If the right margin is 81 instead"
^IBA(364.7,492,3,5,0)="of 80, move the field over 1 space.  IBXSAVE(""FL2"") will be printed at a"
^IBA(364.7,492,3,6,0)="later time."
^IBA(364.7,493,0)="615^N^104^^^^N"
^IBA(364.7,493,1)="N IBZ D F^IBCEF(""N-AGENT CASHIER MAIL SYMBOL"",""IBZ"",,IBXIEN) I $G(IBZ)'="""" S IBXDATA=IBXDATA_"" ""_IBZ"
^IBA(364.7,493,3,0)="^364.73^2^2^3040204^^"
^IBA(364.7,493,3,1,0)="Concatenate Agent Cashier Mail Symbol to the end of Agent Cashier Street "
^IBA(364.7,493,3,2,0)="Address."
^IBA(364.7,494,0)="616^N^5^^^^N"
^IBA(364.7,494,1)="S:$D(IBXSAVE(""FL2"")) IBXDATA=IBXSAVE(""FL2"") K IBXSAVE(""FL2"")"
^IBA(364.7,494,3,0)="^^4^4^2990609^^^^"
^IBA(364.7,494,3,1,0)="This data element's value relies on the existence of the IBXSAVE(""FL2"")"
^IBA(364.7,494,3,2,0)="variable previously extracted.  Form Locator 2 on the UB92 is split into"
^IBA(364.7,494,3,3,0)="2 lines and this is the 30th-59th character entered for this field."
^IBA(364.7,494,3,4,0)="If the right margin is 81 instead of 80, move the field over 1 space."
^IBA(364.7,495,0)="617^N^210^^^^N"
^IBA(364.7,496,0)="618^N^5^^^^N"
^IBA(364.7,496,1)="K IBXDATA S:$D(IBXSAVE(""TOB"")) IBXDATA=IBXSAVE(""TOB"") K IBXSAVE(""TOB"") I '$D(IBXDATA) S IBXDATA=$$TOB^IBCEF1(IBXIEN)"
^IBA(364.7,497,0)="619^N^5^^^^N"
^IBA(364.7,497,1)="N Z S IBXDATA=$G(IBXSAVE(""ACCITY""))_$G(IBXSAVE(""ACSTATE""))_$G(IBXSAVE(""ACZIP"")) F Z=""ACCITY"",""ACSTATE"",""ACZIP"" K IBXSAVE(Z)"
^IBA(364.7,497,3,0)="^^3^3^2990609^^^^"
^IBA(364.7,497,3,1,0)="This field consists of a concatenation of 3 fields previously extracted"
^IBA(364.7,497,3,2,0)="and saved in the IBXSAVE array.  This is the city, state and zip for the"
^IBA(364.7,497,3,3,0)="agent cashier address line."
^IBA(364.7,498,0)="620^N^186^^^^N"
^IBA(364.7,498,1)="I IBXDATA'="""" S IBXSAVE(""FL11"")=$E(IBXDATA,13,25),IBXDATA=$S($G(^TMP(""IBXSAVE"",$J,""RM"")):"" "",1:"""")_$E(IBXDATA,1,12)"
^IBA(364.7,498,3,0)="^^6^6^2990609^^^^"
^IBA(364.7,498,3,1,0)="If this data element returns a value other than null, it can be output on"
^IBA(364.7,498,3,2,0)="2 lines where characters 1-12 print on line 1 and 13-25 print on line 2."
^IBA(364.7,498,3,3,0)="Save off characters 13-25 in IBXSAVE(""FL11"") array and set value of this"
^IBA(364.7,498,3,4,0)="data element to the first 12 characters.  If the right margin is 81 instead"
^IBA(364.7,498,3,5,0)="of 80, move the field over 1 space.  IBXSAVE(""FL11"") will be printed at a"
^IBA(364.7,498,3,6,0)="later time."
^IBA(364.7,499,0)="621^N^255^^^^N"
^IBA(364.7,499,1)="D:IBXDATA="""" F^IBCEF(""N-AGENT CASHIER PHONE"","""","""",IBXIEN) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA)"
^IBA(364.7,499,3,0)="^364.73^2^2^3000822^^^^"
^IBA(364.7,499,3,1,0)="Print the site contact phone or if no site contact phone #, use agent"
^IBA(364.7,499,3,2,0)="cashier's phone #."
^IBA(364.7,500,0)="622^N^109^^^^N"
^IBA(364.7,501,0)="623^N^71^^^^N"
^IBA(364.7,501,1)="S IBXDATA=$$DATE^IBCF2(IBXDATA,,1)"
^IBA(364.7,501,3,0)="^^1^1^2991115^^^^"
^IBA(364.7,501,3,1,0)="Format date in MMDDYY format."
^IBA(364.7,502,0)="624^N^133^^^^N"
^IBA(364.7,502,1)="S IBXDATA=$$DATE^IBCF2(IBXDATA,,1)"
^IBA(364.7,502,3,0)="^^1^1^2991115^^^^"
^IBA(364.7,502,3,1,0)="Format date in MMDDYY format."
^IBA(364.7,503,0)="625^N^75^^^^N"
^IBA(364.7,503,1)="I IBXDATA S IBXDATA=$E(""000"",1,3-$L(IBXDATA))_IBXDATA"
^IBA(364.7,503,3,0)="^^1^1^3040217^"
^IBA(364.7,503,3,1,0)="Format Covered Days to have leading zeroes."
^IBA(364.7,504,0)="626^N^76^^^^N"
^IBA(364.7,504,1)="I 'IBXDATA S IBXDATA="""""
^IBA(364.7,504,3,0)="^^1^1^3040217^"
^IBA(364.7,504,3,1,0)="Display a blank if non-covered days field is zero."
^IBA(364.7,505,0)="627^N^218^^^^N"
^IBA(364.7,505,3,0)="^^1^1^2991004^^^^"
^IBA(364.7,505,3,1,0)="Not currently used"
^IBA(364.7,506,0)="628^N^5^^^^N"
^IBA(364.7,506,1)="K IBXDATA"
^IBA(364.7,506,3,0)="^^1^1^2990609^^^"
^IBA(364.7,506,3,1,0)="Not currently used."
^IBA(364.7,507,0)="629^N^5^^^^N"
^IBA(364.7,507,1)="S:$D(IBXSAVE(""FL11"")) IBXDATA=$S($G(^TMP(""IBXSAVE"",$J,""RM"")):"" "",1:"""")_IBXSAVE(""FL11"") K IBXSAVE(""FL11"")"
^IBA(364.7,507,3,0)="^^4^4^2990609^^^^"
^IBA(364.7,507,3,1,0)="This data element's value relies on the existence of the IBXSAVE(""FL11"")"
^IBA(364.7,507,3,2,0)="variable previously extracted.  Form Locator 11 on the UB92 is split into"
^IBA(364.7,507,3,3,0)="2 lines and this is the 13th-25th character entered for this field."
^IBA(364.7,507,3,4,0)="If the right margin is 81 instead of 80, move the field over 1 space."
^IBA(364.7,508,0)="630^N^65^^^^N"
^IBA(364.7,509,0)="631^N^187^^^^N"
^IBA(364.7,510,0)="632^N^15^^^^N"
^IBA(364.7,510,1)="I IBXDATA'="""" S IBXSAVE(""FL31"")=$E(IBXDATA,6,11),IBXDATA=$S($G(^TMP(""IBXSAVE"",$J,""RM"")):"" "",1:"""")_$E(IBXDATA,1,5)"
^IBA(364.7,510,3,0)="^^6^6^2990609^^^^"
^IBA(364.7,510,3,1,0)="If this data element returns a value other than null, it can be output on"
^IBA(364.7,510,3,2,0)="2 lines where characters 1-5 print on line 1 and 6-11 print on line 2."
^IBA(364.7,510,3,3,0)="Save off characters 6-11 in IBXSAVE(""FL31"") array and set value of this"
^IBA(364.7,510,3,4,0)="data element to the first 5 characters.  If the right margin is 81 instead"
^IBA(364.7,510,3,5,0)="of 80, move the field over 1 space.  IBXSAVE(""FL31"") will be printed at a"
^IBA(364.7,510,3,6,0)="later time."
^IBA(364.7,511,0)="633^N^66^^^^N"
^IBA(364.7,511,1)="S IBXDATA=$$DATE^IBCF2(IBXDATA,1,1) S:IBXDATA="""" IBXDATA=""00000000"""
^IBA(364.7,511,3,0)="^^2^2^2991115^^^^"
^IBA(364.7,511,3,1,0)="If BIRTHDATE exists, format it MMDDYYYY.  If it doesn't exist, output"
^IBA(364.7,511,3,2,0)="00000000."
^IBA(364.7,512,0)="634^N^67^^^^N"
^IBA(364.7,512,1)="S:IBXDATA="""" IBXDATA=""U"""
^IBA(364.7,512,3,0)="^^1^1^2990609^^^"
^IBA(364.7,512,3,1,0)="If the data element's value is null, set it equal to 'U'."
^IBA(364.7,513,0)="635^N^68^^^^N"
^IBA(364.7,513,1)="S IBXDATA=$$MARITAL^IBCEFG1(+IBXDATA),IBXDATA=$S(IBXDATA=""I"":""S"",""K""[IBXDATA:""U"",1:IBXDATA)"
^IBA(364.7,513,3,0)="^364.73^2^2^3010514^^"
^IBA(364.7,513,3,1,0)="Translate the marital status X12 code to external UB92 format."
^IBA(364.7,513,3,2,0)="D=='D'  M=='M'  W=='W'  X=='X'  I=='S'  anything else is 'U'."
^IBA(364.7,514,0)="636^N^78^^^^N"
^IBA(364.7,514,1)="S IBXSAVE(""ADTM"")=$$TIME^IBCF3(IBXDATA),IBXDATA=$$DATE^IBCF2($P(IBXDATA,"".""),,1)"
^IBA(364.7,514,3,0)="^^2^2^2991115^^^^"
^IBA(364.7,514,3,1,0)="Save the admission time in IBXSAVE array for later use.  Format date"
^IBA(364.7,514,3,2,0)="without the time as MMDDYY."
^IBA(364.7,515,0)="637^N^5^^^^N"
^IBA(364.7,515,1)="S IBXDATA=$S('$$INPAT^IBCEF(IBXIEN,1):"""",$G(IBXSAVE(""ADTM""))'="""":$E(IBXSAVE(""ADTM""),1,2),1:99)"
^IBA(364.7,516,0)="638^N^79^^^^N"
^IBA(364.7,517,0)="639^N^80^^^^N"
^IBA(364.7,518,0)="640^N^81^^^^N"
^IBA(364.7,518,1)="K:'$$INPAT^IBCEF(IBXIEN,1) IBXDATA I $D(IBXDATA) S IBXDATA=$S($P(IBXDATA,""."",2)'="""":$$TIME^IBCF3(IBXDATA),1:"""")"
^IBA(364.7,518,3,0)="^^2^2^2990609^^^^"
^IBA(364.7,518,3,1,0)="If this is an outpatient bill, no output.  For inpatient bills, output the"
^IBA(364.7,518,3,2,0)="time portion of the discharge date/time or 99 if no time found."
^IBA(364.7,519,0)="641^N^9^^^^N"
^IBA(364.7,520,0)="642^N^10^^^^N"
^IBA(364.7,520,1)="S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,521,0)="643^N^11^^^^N"
^IBA(364.7,521,1)="N Z S Z=0 K IBXDATA M IBXSAVE(""CC"")=IBFL(24)"
^IBA(364.7,522,0)="644^N^5^^^^N"
^IBA(364.7,522,1)="K IBXDATA I $G(IBXSAVE(""CC"",1))'="""" S IBXDATA=IBXSAVE(""CC"",1) K IBXSAVE(""CC"",1)"
^IBA(364.7,522,3,0)="^^7^7^2990610^^^^"
^IBA(364.7,522,3,1,0)="Data element's array reference is IBFL(24), not default of IBXDATA.  This is"
^IBA(364.7,522,3,2,0)="a group data element so more than 1 occurrence of a value is possible for"
^IBA(364.7,522,3,3,0)="the data element in the IBFL(24) array.  All occurrences of the data element"
^IBA(364.7,522,3,4,0)="are saved in the IBXSAVE(""CC"",n) array and only IBXSAVE(""CC"",1) is output"
^IBA(364.7,522,3,5,0)="in this field. Note: hard code is used to output the"
^IBA(364.7,522,3,6,0)="codes that exceed the # that will fit on one page if multiple pages of bill"
^IBA(364.7,522,3,7,0)="are printed."
^IBA(364.7,523,0)="645^N^5^^^^N"
^IBA(364.7,523,1)="K IBXDATA I $G(IBXSAVE(""CC"",2))'="""" S IBXDATA=IBXSAVE(""CC"",2) K IBXSAVE(""CC"",2)"
^IBA(364.7,523,3,0)="^^2^2^2990609^^^^"
^IBA(364.7,523,3,1,0)="Data element relies on the data in array IBXSAVE(""CC"") extracted previously."
^IBA(364.7,523,3,2,0)="This field reports the data in the second occurrence of the array."
^IBA(364.7,524,0)="646^N^5^^^^N"
^IBA(364.7,524,1)="K IBXDATA I $G(IBXSAVE(""CC"",3))'="""" S IBXDATA=IBXSAVE(""CC"",3) K IBXSAVE(""CC"",3)"
^IBA(364.7,524,3,0)="^^2^2^2990609^^^^"
^IBA(364.7,524,3,1,0)="Data element relies on the data in array IBXSAVE(""CC"") extracted previously."
^IBA(364.7,524,3,2,0)="This field reports the data in the third occurrence of the array."
^IBA(364.7,525,0)="647^N^5^^^^N"
^IBA(364.7,525,1)="K IBXDATA I $G(IBXSAVE(""CC"",4))'="""" S IBXDATA=IBXSAVE(""CC"",4) K IBXSAVE(""CC"",4)"
^IBA(364.7,525,3,0)="^^2^2^2990609^^^^"
^IBA(364.7,525,3,1,0)="Data element relies on the data in array IBXSAVE(""CC"") extracted previously."
^IBA(364.7,525,3,2,0)="This field reports the data in the fourth occurrence of the array."
^IBA(364.7,526,0)="648^N^5^^^^N"
^IBA(364.7,526,1)="K IBXDATA I $G(IBXSAVE(""CC"",5))'="""" S IBXDATA=IBXSAVE(""CC"",5) K IBXSAVE(""CC"",5)"
^IBA(364.7,526,3,0)="^^2^2^2990609^^^^"
^IBA(364.7,526,3,1,0)="Data element relies on the data in array IBXSAVE(""CC"") extracted previously."
^IBA(364.7,526,3,2,0)="This field reports the data in the fifth occurrence of the array."
^IBA(364.7,527,0)="649^N^5^^^^N"
^IBA(364.7,527,1)="K IBXDATA I $G(IBXSAVE(""CC"",6))'="""" S IBXDATA=IBXSAVE(""CC"",6) K IBXSAVE(""CC"",6)"
^IBA(364.7,527,3,0)="^^2^2^2990609^^^^"
^IBA(364.7,527,3,1,0)="Data element relies on the data in array IBXSAVE(""CC"") extracted previously."
^IBA(364.7,527,3,2,0)="This field reports the data in the sixth occurrence of the array."
^IBA(364.7,528,0)="650^N^5^^^^N"
^IBA(364.7,528,1)="S:$G(IBXSAVE(""CC"",7))'="""" IBXDATA=IBXSAVE(""CC"",7) K IBXSAVE(""CC"",7) S Z=0 F  S Z=$O(IBXSAVE(""CC"",Z)) Q:'Z  D XCC^IBCEF3(IBXSAVE(""CC"",Z),Z)"
^IBA(364.7,528,3,0)="^^4^4^2990609^^^^"
^IBA(364.7,528,3,1,0)="Data element relies on the data in array IBXSAVE(""CC"") extracted previously."
^IBA(364.7,528,3,2,0)="This field reports the data in the seventh occurrence of the array."
^IBA(364.7,528,3,3,0)="If there are more than 7 condition codes present, save them in the global"
^IBA(364.7,528,3,4,0)="overflow array."
^IBA(364.7,529,0)="651^N^5^^^^N"
^IBA(364.7,529,1)="S:$D(IBXSAVE(""FL31"")) IBXDATA=$S($G(^TMP(""IBXSAVE"",$J,""RM"")):"" "",1:"""")_IBXSAVE(""FL31"") K IBXSAVE(""FL31"")"
^IBA(364.7,529,3,0)="^^4^4^2990609^^^^"
^IBA(364.7,529,3,1,0)="This data element's value relies on the existence of the IBXSAVE(""FL31"")"
^IBA(364.7,529,3,2,0)="variable previously extracted.  Form Locator 31 on the UB92 is split into"
^IBA(364.7,529,3,3,0)="2 lines and this is the 6th-11th character entered for this field."
^IBA(364.7,529,3,4,0)="If the right margin is 81 instead of 80, move the field over 1 space."
^IBA(364.7,530,0)="652^N^191^^^^N"
^IBA(364.7,530,1)="I $G(IBXDATA)'="""" S:$G(^TMP(""IBXSAVE"",$J,""RM"")) IBXDATA="" ""_IBXDATA"
^IBA(364.7,530,3,0)="^^1^1^2991004^^^^"
^IBA(364.7,530,3,1,0)="If the right margin is 81 instead of 80, move the output over 1 space."
^IBA(364.7,531,0)="1180^N^131^^^^N"
^IBA(364.7,531,1)="S IBXDATA=""OP9 """
^IBA(364.7,532,0)="1300^N^131^^^^N"
^IBA(364.7,532,1)="S IBXDATA=""OPR4"""
^IBA(364.7,532,3,0)="^^1^1^3030807^^^^"
^IBA(364.7,532,3,1,0)="RECORD ID FOR OTHER PROVIDER SECONDARY ID"
^IBA(364.7,533,0)="655^N^190^^^^N"
^IBA(364.7,533,1)="N Z,Z0 K IBXDATA S Z0=0 F Z=1,5 S Z0=Z0+1 S:$G(IBXSAVE(""OCC"",Z))'="""" IBXDATA(Z0)=$P(IBXSAVE(""OCC"",Z),U)"
^IBA(364.7,533,3,0)="^^3^3^2991014^^^^"
^IBA(364.7,533,3,1,0)="The data element extracts multiply-occurring data for the occurrence codes"
^IBA(364.7,533,3,2,0)="and occurrence span codes and outputs the first occurrence code here."
^IBA(364.7,533,3,3,0)="Overflow codes are printed on a separate page."
^IBA(364.7,534,0)="656^N^5^^^^N"
^IBA(364.7,534,1)="N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=1:4 Q:$G(IBXSAVE(""OCC"",Z))=""""  S Z0=Z0+1,Z1=$$DATE^IBCF2($P(IBXSAVE(""OCC"",Z),U,2),,1) S:Z'>5 IBXDATA(Z0)=Z1 D:Z>5 XOCC^IBCEF3($P(IBXSAVE(""OCC"",Z),U)_U_Z1,Z0,32) K IBXSAVE(""OCC"",Z)"
^IBA(364.7,534,3,0)="^^6^6^2991115^^^^"
^IBA(364.7,534,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,534,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,534,3,3,0)="IBXSAVE(""OCC"") extracted previously.  This field outputs the 1st and 5th"
^IBA(364.7,534,3,4,0)="occurrences of occurrence code 'from date' formatted as MMDDYY found in the"
^IBA(364.7,534,3,5,0)="second '^' piece of the IBXSAVE(""OCC"",n) array data element."
^IBA(364.7,534,3,6,0)="Overflow codes (9,13,...) are printed on a separate page."
^IBA(364.7,535,0)="1182^N^312^^^^N"
^IBA(364.7,535,1)="K IBXDATA D OTHPAYC^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,9,""1"")"
^IBA(364.7,535,3,0)="^^1^1^3030805^^"
^IBA(364.7,535,3,1,0)="HARD CODE PERSON QUALIFIER"
^IBA(364.7,536,0)="658^N^5^^^^N"
^IBA(364.7,536,1)="N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=2:4 Q:$G(IBXSAVE(""OCC"",Z))=""""  S Z0=Z0+1,Z1=$$DATE^IBCF2($P(IBXSAVE(""OCC"",Z),U,2),,1) S:Z'>6 IBXDATA(Z0)=Z1 D:Z>6 XOCC^IBCEF3($P(IBXSAVE(""OCC"",Z),U)_U_Z1,Z0,33) K IBXSAVE(""OCC"",Z)"
^IBA(364.7,536,3,0)="^^6^6^2991115^^^^"
^IBA(364.7,536,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,536,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,536,3,3,0)="IBXSAVE(""OCC"") extracted previously.  This field outputs the 2nd and 6th"
^IBA(364.7,536,3,4,0)="occurrences of occurrence code 'from date' formatted as MMDDYY found in the"
^IBA(364.7,536,3,5,0)="second '^' piece of the IBXSAVE(""OCC"",n) array data element."
^IBA(364.7,536,3,6,0)="Overflow codes (10,14,...) are printed on a separate page."
^IBA(364.7,537,0)="1107^N^312^^^^N^0"
^IBA(364.7,537,1)="K IBXDATA D PROVSEQ^IBCEF72(IBXIEN,.IBXSAVE,.IBXDATA,3,""OP1 "") I $D(IBXDATA) N I S I=$E($$RECVR^IBCEF2(IBXIEN),$L($$RECVR^IBCEF2(IBXIEN))) N Z S Z=$S(I=""P""!(I=""B""):82,I=""H""!(I=""A""):71,1:"""") N Y S Y="""" F  S Y=$O(IBXDATA(Y)) Q:Y=""""  S IBXDATA(Y)=Z"
^IBA(364.7,537,3,0)="^364.73^1^1^3030923^^^^"
^IBA(364.7,537,3,1,0)="QUAL IS 71 FOR INST AND 82 FOR PROF"
^IBA(364.7,538,0)="1113^N^312^^^^N^0"
^IBA(364.7,538,1)="K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,3,""I"",2) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)"
^IBA(364.7,539,0)="661^N^5^^^^N"
^IBA(364.7,539,1)="N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=3:4 Q:$G(IBXSAVE(""OCC"",Z))=""""  S Z0=Z0+1,Z1=$$DATE^IBCF2($P(IBXSAVE(""OCC"",Z),U,2),,1) S:Z'>7 IBXDATA(Z0)=Z1 D:Z>7 XOCC^IBCEF3($P(IBXSAVE(""OCC"",Z),U)_U_Z1,Z0,34) K IBXSAVE(""OCC"",Z)"
^IBA(364.7,539,3,0)="^^6^6^2991115^^^^"
^IBA(364.7,539,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,539,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,539,3,3,0)="IBXSAVE(""OCC"") extracted previously.  This field outputs the 3rd and 7th"
^IBA(364.7,539,3,4,0)="occurrences of occurrence code 'from date' formatted as MMDDYY found in the"
^IBA(364.7,539,3,5,0)="second '^' piece of the IBXSAVE(""OCC"",n) array data element."
^IBA(364.7,539,3,6,0)="Any overflow codes (11,15,...) are output on a separate page."
^IBA(364.7,540,0)="1115^N^312^^^^N"
^IBA(364.7,540,1)="K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,3,""I"",3) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)"
^IBA(364.7,541,0)="1108^N^312^^^^N^0"
^IBA(364.7,541,1)="K IBXDATA D OTHPAYC^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,3,""1"")"
^IBA(364.7,541,3,0)="^364.73^1^1^3030916^^^"
^IBA(364.7,541,3,1,0)="HARD CODE PERSON CODE ""1"""
^IBA(364.7,542,0)="1111^N^312^^^^N^0"
^IBA(364.7,542,1)="K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,3,""I"",1) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)"
^IBA(364.7,542,3,0)="^364.73^1^1^3031107^^^^"
^IBA(364.7,542,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,543,0)="1110^N^312^^^^N^0"
^IBA(364.7,543,1)="K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,3,""Q"",1)"
^IBA(364.7,543,3,0)="^364.73^1^1^3031029^^^^"
^IBA(364.7,543,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,544,0)="1112^N^312^^^^N^0"
^IBA(364.7,544,1)="K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,3,""Q"",2)"
^IBA(364.7,544,3,0)="^^1^1^3030821^^^^"
^IBA(364.7,544,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,545,0)="1118^N^312^^^^N^0"
^IBA(364.7,545,1)="K IBXDATA D OTHPAYC^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,2,""1"")"
^IBA(364.7,545,3,0)="^^1^1^3030821^^"
^IBA(364.7,545,3,1,0)="HARD CODE ENTITY TYPE QUALIFIER 1=PERSON"
^IBA(364.7,546,0)="1119^N^312^^^^N^0"
^IBA(364.7,546,1)="K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,2,""Q"",1)"
^IBA(364.7,546,3,0)="^^1^1^3030821^^"
^IBA(364.7,546,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,547,0)="1121^N^312^^^^N^0"
^IBA(364.7,547,1)="K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,2,""Q"",2)"
^IBA(364.7,547,3,0)="^^1^1^3030804^"
^IBA(364.7,547,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,548,0)="1123^N^312^^^^N^0"
^IBA(364.7,548,1)="K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,2,""Q"",3)"
^IBA(364.7,548,3,0)="^^1^1^3030804^"
^IBA(364.7,548,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,549,0)="1120^N^312^^^^N^0"
^IBA(364.7,549,1)="K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,2,""I"",1) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)"
^IBA(364.7,549,3,0)="^364.73^1^1^3030930^^^^"
^IBA(364.7,549,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,550,0)="1124^N^312^^^^N^0"
^IBA(364.7,550,1)="K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,2,""I"",3) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)"
^IBA(364.7,550,3,0)="^364.73^1^1^3030930^^^^"
^IBA(364.7,550,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,551,0)="1117^N^312^^^^N^0"
^IBA(364.7,551,1)="K IBXDATA D OTHPAYC^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,2,""72"")"
^IBA(364.7,551,3,0)="^^1^1^3030821^^"
^IBA(364.7,551,3,1,0)="HARD CODE ""72"" OTHER PAYER OPERATING PROVIDER NAME QUALIFIER"
^IBA(364.7,552,0)="1128^N^5^^^^N^0"
^IBA(364.7,552,1)="N Z K IBXDATA S Z=0 F  S Z=$O(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z)) Q:'Z  I $O(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z,0)) S IBXDATA(Z)=2"
^IBA(364.7,552,3,0)="^^2^2^3060314^"
^IBA(364.7,552,3,1,0)="OP3-4"
^IBA(364.7,552,3,2,0)="Hard code ""2""."
^IBA(364.7,553,0)="1131^N^5^^^^N^0"
^IBA(364.7,553,1)="N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z,2)),U,1)"
^IBA(364.7,553,3,0)="^^2^2^3060314^"
^IBA(364.7,553,3,1,0)="OP3-7"
^IBA(364.7,553,3,2,0)="Lab/Facility, Other Payer, Qualifier #2"
^IBA(364.7,554,0)="1129^N^5^^^^N^0"
^IBA(364.7,554,1)="N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z,1)),U,1)"
^IBA(364.7,554,3,0)="^^2^2^3060314^"
^IBA(364.7,554,3,1,0)="OP3-5"
^IBA(364.7,554,3,2,0)="Lab/Facility, Other Payer, Qualifier #1"
^IBA(364.7,555,0)="1133^N^5^^^^N^0"
^IBA(364.7,555,1)="N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z,3)),U,1)"
^IBA(364.7,555,3,0)="^^2^2^3060314^"
^IBA(364.7,555,3,1,0)="OP3-9"
^IBA(364.7,555,3,2,0)="Lab/Facility, Other Payer, Qualifier #3"
^IBA(364.7,556,0)="1130^N^5^^^^N^0"
^IBA(364.7,556,1)="N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z,1)),U,2)"
^IBA(364.7,556,3,0)="^^2^2^3060314^"
^IBA(364.7,556,3,1,0)="OP3-6"
^IBA(364.7,556,3,2,0)="Lab/Facility, Other Payer, ID #1"
^IBA(364.7,557,0)="1132^N^5^^^^N^0"
^IBA(364.7,557,1)="N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z,2)),U,2)"
^IBA(364.7,557,3,0)="^^2^2^3060314^"
^IBA(364.7,557,3,1,0)="OP3-8"
^IBA(364.7,557,3,2,0)="Lab/Facility, Other Payer, ID #2"
^IBA(364.7,558,0)="1134^N^5^^^^N^0"
^IBA(364.7,558,1)="N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z,3)),U,2) D:Z=2 CLEANUP^IBCEF75(.IBXSAVE)"
^IBA(364.7,558,3,0)="^^3^3^3060314^"
^IBA(364.7,558,3,1,0)="OP3-10"
^IBA(364.7,558,3,2,0)="Lab/Facility, Other Payer, ID #3"
^IBA(364.7,558,3,3,0)="Clean up IBXSAVE array when done with this segment."
^IBA(364.7,559,0)="1127^N^5^^^^N^0"
^IBA(364.7,559,1)="N Z K IBXDATA S Z=0 F  S Z=$O(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z)) Q:'Z  I $O(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z,0)) S IBXDATA(Z)=""FA"""
^IBA(364.7,559,3,0)="^^2^2^3060314^"
^IBA(364.7,559,3,1,0)="OP3-3"
^IBA(364.7,559,3,2,0)="Hard code ""FA"""
^IBA(364.7,560,0)="1137^N^312^^^^N^0"
^IBA(364.7,560,1)="K IBXDATA D OTHPAYC^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,1,""1"")"
^IBA(364.7,560,3,0)="^^1^1^3030821^^^"
^IBA(364.7,560,3,1,0)="HARD CODE ENTITY TYPE"
^IBA(364.7,561,0)="1136^N^312^^^^N^0"
^IBA(364.7,561,1)="K IBXDATA D OTHPAYC^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,1,""DN"")"
^IBA(364.7,561,3,0)="^^1^1^3030821^^^"
^IBA(364.7,561,3,1,0)="HARD CODE REFERRING PROVIDER CODE"
^IBA(364.7,562,0)="1138^N^312^^^^N^0"
^IBA(364.7,562,1)="K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,1,""Q"",1)"
^IBA(364.7,563,0)="1140^N^312^^^^N^0"
^IBA(364.7,563,1)="K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,1,""Q"",2)"
^IBA(364.7,564,0)="1142^N^312^^^^N^0"
^IBA(364.7,564,1)="K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,1,""Q"",3)"
^IBA(364.7,565,0)="1139^N^312^^^^N^0"
^IBA(364.7,565,1)="K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,1,""I"",1) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)"
^IBA(364.7,565,3,0)="^364.73^1^1^3030930^^^^"
^IBA(364.7,565,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,566,0)="1141^N^312^^^^N^0"
^IBA(364.7,566,1)="K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,1,""I"",2) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)"
^IBA(364.7,566,3,0)="^364.73^1^1^3030930^^^^"
^IBA(364.7,566,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,567,0)="1143^N^312^^^^N^0"
^IBA(364.7,567,1)="K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,1,""I"",3) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)"
^IBA(364.7,567,3,0)="^364.73^1^1^3030930^^^^"
^IBA(364.7,567,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,576,0)="1155^N^5^^^^N^0"
^IBA(364.7,576,1)="N Z K IBXDATA S Z=0 F  S Z=$O(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z)) Q:'Z  I $O(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z,0)) S IBXDATA(Z)=2"
^IBA(364.7,576,3,0)="^^2^2^3060314^"
^IBA(364.7,576,3,1,0)="Use the IBXSAVE array for all of the other payers and output a 2 for "
^IBA(364.7,576,3,2,0)="facility."
^IBA(364.7,577,0)="1156^N^5^^^^N^0"
^IBA(364.7,577,1)="N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z,1)),U,1)"
^IBA(364.7,577,3,0)="^364.73^2^2^3060314^^"
^IBA(364.7,577,3,1,0)="OP6-5"
^IBA(364.7,577,3,2,0)="lab/facility, other payer, secondary qualifier #1."
^IBA(364.7,578,0)="1154^N^5^^^^N^0"
^IBA(364.7,578,1)="N Z K IBXDATA S Z=0 F  S Z=$O(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z)) Q:'Z  I $O(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z,0)) S IBXDATA(Z)=""QB"""
^IBA(364.7,578,3,0)="^^2^2^3060314^"
^IBA(364.7,578,3,1,0)="Use the previously built IBXSAVE array to determine which other "
^IBA(364.7,578,3,2,0)="payers exist for the claim.  Output the qualifier 'QB'."
^IBA(364.7,579,0)="1158^N^5^^^^N^0"
^IBA(364.7,579,1)="N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z,2)),U,1)"
^IBA(364.7,579,3,0)="^364.73^2^2^3060314^^"
^IBA(364.7,579,3,1,0)="OP6-7"
^IBA(364.7,579,3,2,0)="lab/facility, other payer, secondary qualifier #2."
^IBA(364.7,580,0)="1160^N^5^^^^N^0"
^IBA(364.7,580,1)="N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z,3)),U,1)"
^IBA(364.7,580,3,0)="^^2^2^3060314^"
^IBA(364.7,580,3,1,0)="OP6-9"
^IBA(364.7,580,3,2,0)="lab/facility, other payer, secondary qualifier #3."
^IBA(364.7,581,0)="1157^N^5^^^^N^0"
^IBA(364.7,581,1)="N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z,1)),U,2)"
^IBA(364.7,581,3,0)="^364.73^2^2^3060314^^"
^IBA(364.7,581,3,1,0)="OP6-6"
^IBA(364.7,581,3,2,0)="lab/facility, other payer, secondary ID #1."
^IBA(364.7,582,0)="1159^N^5^^^^N^0"
^IBA(364.7,582,1)="N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z,2)),U,2)"
^IBA(364.7,582,3,0)="^^2^2^3060314^"
^IBA(364.7,582,3,1,0)="OP6-8"
^IBA(364.7,582,3,2,0)="lab/facility, other payer, secondary ID #2."
^IBA(364.7,583,0)="1161^N^5^^^^N^0"
^IBA(364.7,583,1)="N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z,3)),U,2) D:Z=2 CLEANUP^IBCEF75(.IBXSAVE)"
^IBA(364.7,583,3,0)="^^3^3^3060314^"
^IBA(364.7,583,3,1,0)="OP6-10"
^IBA(364.7,583,3,2,0)="lab/facility, other payer, secondary ID #3.  Clean up IBXSAVE array nodes "
^IBA(364.7,583,3,3,0)="used here."
^IBA(364.7,584,0)="1165^N^5^^^^N^0"
^IBA(364.7,584,1)="N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z,1)),U,1)"
^IBA(364.7,584,3,0)="^^2^2^3060314^"
^IBA(364.7,584,3,1,0)="OP7-5"
^IBA(364.7,584,3,2,0)="Lab/Facility, Other Payer, Qualifier #1"
^IBA(364.7,585,0)="1167^N^5^^^^N^0"
^IBA(364.7,585,1)="N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z,2)),U,1)"
^IBA(364.7,585,3,0)="^^2^2^3060314^"
^IBA(364.7,585,3,1,0)="OP7-7"
^IBA(364.7,585,3,2,0)="Lab/Facility, Other Payer, Qualifier #2"
^IBA(364.7,586,0)="1169^N^5^^^^N^0"
^IBA(364.7,586,1)="N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z,3)),U,1)"
^IBA(364.7,586,3,0)="^^2^2^3060314^"
^IBA(364.7,586,3,1,0)="OP7-9"
^IBA(364.7,586,3,2,0)="Lab/Facility, Other Payer, Qualifier #3"
^IBA(364.7,587,0)="1166^N^5^^^^N^0"
^IBA(364.7,587,1)="N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z,1)),U,2)"
^IBA(364.7,587,3,0)="^^2^2^3060314^"
^IBA(364.7,587,3,1,0)="OP7-6"
^IBA(364.7,587,3,2,0)="Lab/Facility, Other Payer, ID #1"
^IBA(364.7,588,0)="1168^N^5^^^^N^0"
^IBA(364.7,588,1)="N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z,2)),U,2)"
^IBA(364.7,588,3,0)="^^2^2^3060314^"
^IBA(364.7,588,3,1,0)="OP7-8"
^IBA(364.7,588,3,2,0)="Lab/Facility, Other Payer, ID #2"
^IBA(364.7,589,0)="1170^N^5^^^^N^0"
^IBA(364.7,589,1)="N Z K IBXDATA F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z,3)),U,2) D:Z=2 CLEANUP^IBCEF75(.IBXSAVE)"
^IBA(364.7,589,3,0)="^^3^3^3060314^"
^IBA(364.7,589,3,1,0)="OP7-10"
^IBA(364.7,589,3,2,0)="Lab/Facility, Other Payer, ID #3"
^IBA(364.7,589,3,3,0)="Cleanup array when done with segment."
^IBA(364.7,590,0)="1164^N^5^^^^N^0"
^IBA(364.7,590,1)="N Z K IBXDATA S Z=0 F  S Z=$O(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z)) Q:'Z  I $O(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z,0)) S IBXDATA(Z)=2"
^IBA(364.7,590,3,0)="^^2^2^3060314^"
^IBA(364.7,590,3,1,0)="OP7-4"
^IBA(364.7,590,3,2,0)="Default a 2 for non-person."
^IBA(364.7,591,0)="1163^N^5^^^^N^0"
^IBA(364.7,591,1)="N Z,NVA,TYP S NVA=+$P($G(^DGCR(399,IBXIEN,""U2"")),U,10),TYP="""" S:NVA TYP=$P($G(^IBA(355.93,NVA,0)),U,11) S:TYP="""" TYP=""FA"" K IBXDATA S Z=0 F  S Z=$O(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z)) Q:'Z  I $O(IBXSAVE(""LAB/FAC"",IBXIEN,""O"",Z,0)) S IBXDATA(Z)=TYP"
^IBA(364.7,591,3,0)="^^3^3^3060314^"
^IBA(364.7,591,3,1,0)="OP7-3"
^IBA(364.7,591,3,2,0)="Determine if there is a non-VA facility on the claim.  If so, capture the "
^IBA(364.7,591,3,3,0)=".11 field from file 355.93 - X12 Type of Facility.  Default FA otherwise."
^IBA(364.7,592,0)="1173^N^5^^^^N^0"
^IBA(364.7,592,1)="N Z S Z=0 F  S Z=$O(IBXSAVE(""OSQ"",Z)) Q:'Z  S IBXDATA(IBXSAVE(""OSQ"",Z))=1"
^IBA(364.7,592,3,0)="^^2^2^3030902^^^^"
^IBA(364.7,592,3,1,0)="Use the IBXSAVE(""OSQ"",n) record to determine which 'OTHER PAYER' ids exist."
^IBA(364.7,592,3,2,0)="Output the qualifier for a person (1)."
^IBA(364.7,593,0)="1174^N^5^^^^N^0"
^IBA(364.7,593,1)="K IBXDATA D OTHID^IBCEF71(.IBXSAVE,.IBXDATA,IBXIEN,1,5,1,0)"
^IBA(364.7,593,3,0)="^^2^2^3030902^^^^"
^IBA(364.7,593,3,1,0)="Use the IBXSAVE(""OSQ"",n) record to determine which 'OTHER PAYER' ids"
^IBA(364.7,593,3,2,0)="exist for the first 'other' id qualifier."
^IBA(364.7,594,0)="1176^N^5^^^^N^0"
^IBA(364.7,594,1)="K IBXDATA D OTHID^IBCEF71(.IBXSAVE,.IBXDATA,IBXIEN,2,5,1,0)"
^IBA(364.7,594,3,0)="^^2^2^3030902^^^^"
^IBA(364.7,594,3,1,0)="Use the IBXSAVE(""OSQ"",n) record to determine which 'OTHER PAYER' ids"
^IBA(364.7,594,3,2,0)="exist for the second 'other' id qualifier."
^IBA(364.7,595,0)="1178^N^5^^^^N^0"
^IBA(364.7,595,1)="K IBXDATA D OTHID^IBCEF71(.IBXSAVE,.IBXDATA,IBXIEN,3,5,1,0)"
^IBA(364.7,595,3,0)="^^2^2^3030902^^^^"
^IBA(364.7,595,3,1,0)="Use the IBXSAVE(""OSQ"",n) record to determine which 'OTHER PAYER' ids"
^IBA(364.7,595,3,2,0)="exist for the third 'other' id qualifier."
^IBA(364.7,596,0)="1175^N^5^^^^N^0"
^IBA(364.7,596,1)="K IBXDATA D OTHID^IBCEF71(.IBXSAVE,.IBXDATA,IBXIEN,1,5,0,0) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)"
^IBA(364.7,596,3,0)="^364.73^2^2^3030930^^^^"
^IBA(364.7,596,3,1,0)="Use the IBXSAVE(""OSQ"",n) record to determine which 'OTHER PAYER' ids"
^IBA(364.7,596,3,2,0)="exist for the first 'other' id."
^IBA(364.7,597,0)="1177^N^5^^^^N^0"
^IBA(364.7,597,1)="K IBXDATA D OTHID^IBCEF71(.IBXSAVE,.IBXDATA,IBXIEN,2,5,0,0) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)"
^IBA(364.7,597,3,0)="^364.73^2^2^3030930^^^^"
^IBA(364.7,597,3,1,0)="Use the IBXSAVE(""OSQ"",n) record to determine which 'OTHER PAYER' ids"
^IBA(364.7,597,3,2,0)="exist for the second 'other' id."
^IBA(364.7,598,0)="1179^N^5^^^^N^0"
^IBA(364.7,598,1)="K IBXDATA D OTHID^IBCEF71(.IBXSAVE,.IBXDATA,IBXIEN,3,5,0,0) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1) K IBXSAVE(""OSQ"")"
^IBA(364.7,598,3,0)="^364.73^2^2^3030930^^^^"
^IBA(364.7,598,3,1,0)="Use the IBXSAVE(""OSQ"",n) record to determine which 'OTHER PAYER' ids"
^IBA(364.7,598,3,2,0)="exist for the third 'other' id.  Kill the IBXSAVE(""OSQ"") array to clean up."
^IBA(364.7,599,0)="1172^N^5^^^^N^0"
^IBA(364.7,599,1)="N Z S Z=0 F  S Z=$O(IBXSAVE(""OSQ"",Z)) Q:'Z  S IBXDATA(IBXSAVE(""OSQ"",Z))=""DQ"""
^IBA(364.7,599,3,0)="^^2^2^3030902^^^^"
^IBA(364.7,599,3,1,0)="Use the IBXSAVE(""OSQ"",n) record to determine which 'OTHER PAYER' ids exist."
^IBA(364.7,599,3,2,0)="Output the qualifier 'DQ'."
^IBA(364.7,600,0)="1183^N^312^^^^N^0"
^IBA(364.7,600,1)="K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,9,""Q"",1)"
^IBA(364.7,601,0)="1185^N^312^^^^N^0"
^IBA(364.7,601,1)="K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,9,""Q"",2)"
^IBA(364.7,602,0)="1187^N^312^^^^N^0"
^IBA(364.7,602,1)="K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,9,""Q"",3)"
^IBA(364.7,602,3,0)="^^1^1^3030805^"
^IBA(364.7,602,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,603,0)="1184^N^312^^^^N^0"
^IBA(364.7,603,1)="K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,9,""I"",1) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)"
^IBA(364.7,603,3,0)="^364.73^1^1^3030930^^^^"
^IBA(364.7,603,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,604,0)="1186^N^312^^^^N^0"
^IBA(364.7,604,1)="K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,9,""I"",2) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)"
^IBA(364.7,604,3,0)="^364.73^1^1^3030930^^^^"
^IBA(364.7,604,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,605,0)="1188^N^312^^^^N^0"
^IBA(364.7,605,1)="K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,9,""I"",3) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)"
^IBA(364.7,605,3,0)="^364.73^1^1^3030930^^^^"
^IBA(364.7,605,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,606,0)="728^N^5^^^^N"
^IBA(364.7,606,1)="I $D(IBXSAVE(""DX"",5)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(""DX"",5),0)),U) K IBXSAVE(""DX"",5)"
^IBA(364.7,606,3,0)="^^1^1^2960814^^"
^IBA(364.7,606,3,1,0)="If there is a fifth diagnosis, print its name."
^IBA(364.7,607,0)="729^N^5^^^^N"
^IBA(364.7,607,1)="I $D(IBXSAVE(""DX"",6)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(""DX"",6),0)),U) K IBXSAVE(""DX"",6)"
^IBA(364.7,607,3,0)="^^1^1^2960814^^"
^IBA(364.7,607,3,1,0)="If there is a sixth diagnosis, print its name."
^IBA(364.7,608,0)="730^N^5^^^^N"
^IBA(364.7,608,1)="I $D(IBXSAVE(""DX"",7)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(""DX"",7),0)),U) K IBXSAVE(""DX"",7)"
^IBA(364.7,608,3,0)="^^1^1^2960814^^"
^IBA(364.7,608,3,1,0)="If there is a seventh diagnosis, print its name."
^IBA(364.7,609,0)="731^N^5^^^^N"
^IBA(364.7,609,1)="I $D(IBXSAVE(""DX"",8)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(""DX"",8),0)),U) K IBXSAVE(""DX"",8)"
^IBA(364.7,609,3,0)="^^1^1^2960814^^"
^IBA(364.7,609,3,1,0)="If there is an eighth diagnosis, print its name."
^IBA(364.7,610,0)="732^N^5^^^^N"
^IBA(364.7,610,1)="S:$D(IBXSAVE(""DX"",9)) IBXDATA=$P($G(^ICD9(+IBXSAVE(""DX"",9),0)),U)"
^IBA(364.7,610,3,0)="^^2^2^2991014^^^^"
^IBA(364.7,610,3,1,0)="If there is a ninth diagnosis, print its name."
^IBA(364.7,610,3,2,0)="Check for more than 8 other diagnoses on file. If there is, output on new pg."
^IBA(364.7,611,0)="733^N^85^^^^N"
^IBA(364.7,612,0)="734^N^253^^^^N"
^IBA(364.7,612,3,0)="^^3^3^2991014^^^^"
^IBA(364.7,612,3,1,0)="This data element relies on the existence of the array containing the"
^IBA(364.7,612,3,2,0)="diagnoses for the bill, previously extracted.  This data will be output if"
^IBA(364.7,612,3,3,0)="it is the first 'E-code' dx found."
^IBA(364.7,613,0)="735^N^5^^^^N"
^IBA(364.7,613,1)="S:$D(IBXSAVE(""FL78"")) IBXDATA=$S($G(^TMP(""IBXSAVE"",$J,""RM"")):"" "",1:"""")_IBXSAVE(""FL78"") K IBXSAVE(""FL78"")"
^IBA(364.7,613,3,0)="^^6^6^2960814^^^"
^IBA(364.7,613,3,1,0)="This data element's value relies on the existence of the IBXSAVE(""FL78"")"
^IBA(364.7,613,3,2,0)="variable previously extracted.  Form Locator 78 on the UB92 is split into"
^IBA(364.7,613,3,3,0)="2 lines and this is the 3rd-5th character entered for this field if the"
^IBA(364.7,613,3,4,0)="entire text is greater than 3 characters in length, or is the entire text"
^IBA(364.7,613,3,5,0)="if not.  If the right margin is 81 instead of 80, move the field over 1"
^IBA(364.7,613,3,6,0)="space."
^IBA(364.7,614,0)="736^N^5^^^^N"
^IBA(364.7,614,1)="K IBXSAVE(""PRV-82"") D BOX82NM^IBCEU4(IBXIEN,.IBXSAVE) K IBXDATA S IBXDATA=$G(IBXSAVE(""PRV-82"",1))"
^IBA(364.7,614,3,0)="^364.73^2^2^3040303^^^^"
^IBA(364.7,614,3,1,0)="Extracts all the possible providers into the appropriate line for box 82"
^IBA(364.7,614,3,2,0)="of the UB-92 print claim form.  This is the first line extracted."
^IBA(364.7,615,0)="737^N^203^^^^N"
^IBA(364.7,615,1)="I IBXDATA=4 S IBXDATA=5"
^IBA(364.7,615,3,0)="^^1^1^2991222^^"
^IBA(364.7,615,3,1,0)="Data can only be 5 (HCPCS) or 9 (ICD9).  CPT-4 (4) has been rolled into 5"
^IBA(364.7,616,0)="738^N^16^^^^N"
^IBA(364.7,616,1)="N Z S Z="""" F  S Z=$O(IBXDATA(Z)) Q:'Z  S $P(IBXDATA(Z),U,2)=$$DATE^IBCF3($P(IBXDATA(Z),U,2)),IBXSAVE(""PROC"",Z)=IBXDATA(Z) K IBXDATA(Z)"
^IBA(364.7,616,3,0)="^^5^5^2991115^^^^"
^IBA(364.7,616,3,1,0)="This is a group data element so more than one occurrence of IBXDATA(n) is"
^IBA(364.7,616,3,2,0)="possible.  Save off the procedures in the IBXSAVE array.  Six procedures"
^IBA(364.7,616,3,3,0)="will fit on a single page of a bill.  If more than 6 procedure codes are"
^IBA(364.7,616,3,4,0)="on the bill, multiple pages are used.  The format of the IBXSAVE array is:"
^IBA(364.7,616,3,5,0)="   the actual code for the ICD9 or ICD0 code^proc date formatted as MMDDYY"
^IBA(364.7,617,0)="739^N^5^^^^N"
^IBA(364.7,617,1)="K IBXDATA I $D(IBXSAVE(""PROC"",1)) S IBXDATA=$P(IBXSAVE(""PROC"",1),U),IBXDATA=$S(IBXDATA[""ICPT""!(IBXDATA[""ICD0""):$P($$PRCD^IBCEF1(IBXDATA),U),1:IBXDATA)"
^IBA(364.7,617,3,0)="^^3^3^2991013^^^^"
^IBA(364.7,617,3,1,0)="This data element relies on the existence of the IBXSAVE(""PROC"") array"
^IBA(364.7,617,3,2,0)="previously extracted.  If the first occurrence exists, output the code"
^IBA(364.7,617,3,3,0)="referenced by its first '^' piece."
^IBA(364.7,618,0)="740^N^5^^^^N"
^IBA(364.7,618,1)="K IBXDATA I $D(IBXSAVE(""PROC"",1)) S IBXDATA=$P(IBXSAVE(""PROC"",1),U,2) K IBXSAVE(""PROC"",1)"
^IBA(364.7,618,3,0)="^^3^3^2991013^^^^"
^IBA(364.7,618,3,1,0)="This data element relies on the existence of the IBXSAVE(""PROC"") array"
^IBA(364.7,618,3,2,0)="previously extracted.  If the first occurrence exists, output the date"
^IBA(364.7,618,3,3,0)="found in its second '^' piece."
^IBA(364.7,619,0)="741^N^5^^^^N"
^IBA(364.7,619,1)="K IBXDATA I $D(IBXSAVE(""PROC"",2)) S IBXDATA=$P(IBXSAVE(""PROC"",2),U),IBXDATA=$S(IBXDATA[""ICD0""!(IBXDATA[""ICPT""):$P($$PRCD^IBCEF1(IBXDATA),U),1:IBXDATA)"
^IBA(364.7,619,3,0)="^^3^3^2991014^^^^"
^IBA(364.7,619,3,1,0)="This data element relies on the existence of the IBXSAVE(""PROC"") array"
^IBA(364.7,619,3,2,0)="previously extracted.  If the second occurrence exists, output the code"
^IBA(364.7,619,3,3,0)="referenced by its first '^' piece."
^IBA(364.7,620,0)="742^N^5^^^^N"
^IBA(364.7,620,1)="K IBXDATA I $D(IBXSAVE(""PROC"",2)) S IBXDATA=$P(IBXSAVE(""PROC"",2),U,2) K IBXSAVE(""PROC"",2)"
^IBA(364.7,620,3,0)="^^3^3^2991014^^^^"
^IBA(364.7,620,3,1,0)="This data element relies on the existence of the IBXSAVE(""PROC"") array"
^IBA(364.7,620,3,2,0)="previously extracted.  If the second occurrence exists, output the date"
^IBA(364.7,620,3,3,0)="found in its second '^' piece."
^IBA(364.7,621,0)="743^N^5^^^^N"
^IBA(364.7,621,1)="K IBXDATA I $D(IBXSAVE(""PROC"",3)) S IBXDATA=$P(IBXSAVE(""PROC"",3),U),IBXDATA=$S(IBXDATA[""ICD0""!(IBXDATA[""ICPT""):$P($$PRCD^IBCEF1(IBXDATA),U),1:IBXDATA)"
^IBA(364.7,621,3,0)="^^3^3^2991014^^^^"
^IBA(364.7,621,3,1,0)="This data element relies on the existence of the IBXSAVE(""PROC"") array"
^IBA(364.7,621,3,2,0)="previously extracted.  If the third occurrence exists, output the code"
^IBA(364.7,621,3,3,0)="referenced by its first '^' piece."
^IBA(364.7,622,0)="744^N^5^^^^N"
^IBA(364.7,622,1)="K IBXDATA I $D(IBXSAVE(""PROC"",3)) S IBXDATA=$P(IBXSAVE(""PROC"",3),U,2) K IBXSAVE(""PROC"",3)"
^IBA(364.7,622,3,0)="^^3^3^2991014^^^^"
^IBA(364.7,622,3,1,0)="This data element relies on the existence of the IBXSAVE(""PROC"") array"
^IBA(364.7,622,3,2,0)="previously extracted.  If the third occurrence exists, output the date"
^IBA(364.7,622,3,3,0)="found in its second '^' piece."
^IBA(364.7,623,0)="745^N^5^^^^N"
^IBA(364.7,623,1)="D:'$D(IBXSAVE(""PRV-82"")) BOX82NM^IBCEU4(IBXIEN,.IBXSAVE) K IBXDATA S IBXDATA=$E($G(IBXSAVE(""PRV-82"",2)),1,30+$G(^TMP(""IBXSAVE"",$J,""RM"")))"
^IBA(364.7,623,3,0)="^364.73^3^3^3040317^^^^"
^IBA(364.7,623,3,1,0)="If not already done, extract all the possible providers into the"
^IBA(364.7,623,3,2,0)="appropriate line for box 82 on the UB-92 print claim form.  This is the"
^IBA(364.7,623,3,3,0)="second line extracted."
^IBA(364.7,624,0)="746^N^5^^^^N"
^IBA(364.7,624,1)="K IBXDATA I $D(IBXSAVE(""PROC"",4)) S IBXDATA=$P(IBXSAVE(""PROC"",4),U),IBXDATA=$S(IBXDATA[""ICD0""!(IBXDATA[""ICPT""):$P($$PRCD^IBCEF1(IBXDATA),U),1:IBXDATA)"
^IBA(364.7,624,3,0)="^^3^3^2991014^^^^"
^IBA(364.7,624,3,1,0)="This data element relies on the existence of the IBXSAVE(""PROC"") array"
^IBA(364.7,624,3,2,0)="previously extracted.  If the fourth occurrence exists, output the code"
^IBA(364.7,624,3,3,0)="referenced by its first '^' piece."
^IBA(364.7,625,0)="747^N^5^^^^N"
^IBA(364.7,625,1)="K IBXDATA I $D(IBXSAVE(""PROC"",4)) S IBXDATA=$P(IBXSAVE(""PROC"",4),U,2) K IBXSAVE(""PROC"",4)"
^IBA(364.7,625,3,0)="^^3^3^2991014^^^^"
^IBA(364.7,625,3,1,0)="This data element relies on the existence of the IBXSAVE(""PROC"") array"
^IBA(364.7,625,3,2,0)="previously extracted.  If the fourth occurrence exists, output the date"
^IBA(364.7,625,3,3,0)="found in its second '^' piece."
^IBA(364.7,626,0)="748^N^5^^^^N"
^IBA(364.7,626,1)="K IBXDATA I $D(IBXSAVE(""PROC"",5)) S IBXDATA=$P(IBXSAVE(""PROC"",5),U),IBXDATA=$S(IBXDATA[""ICD0""!(IBXDATA[""ICPT""):$P($$PRCD^IBCEF1(IBXDATA),U),1:IBXDATA)"
^IBA(364.7,626,3,0)="^^3^3^2991014^^^^"
^IBA(364.7,626,3,1,0)="This data element relies on the existence of the IBXSAVE(""PROC"") array"
^IBA(364.7,626,3,2,0)="previously extracted.  If the fifth occurrence exists, output the code"
^IBA(364.7,626,3,3,0)="referenced by its first '^' piece."
^IBA(364.7,627,0)="749^N^5^^^^N"
^IBA(364.7,627,1)="K IBXDATA I $D(IBXSAVE(""PROC"",5)) S IBXDATA=$P(IBXSAVE(""PROC"",5),U,2) K IBXSAVE(""PROC"",5)"
^IBA(364.7,627,3,0)="^^3^3^2991014^^^^"
^IBA(364.7,627,3,1,0)="This data element relies on the existence of the IBXSAVE(""PROC"") array"
^IBA(364.7,627,3,2,0)="previously extracted.  If the fifth occurrence exists, output the date"
^IBA(364.7,627,3,3,0)="found in its second '^' piece."
^IBA(364.7,628,0)="750^N^5^^^^N"
^IBA(364.7,628,1)="K IBXDATA I $D(IBXSAVE(""PROC"",6)) S IBXDATA=$P(IBXSAVE(""PROC"",6),U),IBXDATA=$S(IBXDATA[""ICD0""!(IBXDATA[""ICPT""):$P($$PRCD^IBCEF1(IBXDATA),U),1:IBXDATA)"
^IBA(364.7,628,3,0)="^^3^3^2991014^^^^"
^IBA(364.7,628,3,1,0)="This data element relies on the existence of the IBXSAVE(""PROC"") array"
^IBA(364.7,628,3,2,0)="previously extracted.  If the sixth occurrence exists, output the code"
^IBA(364.7,628,3,3,0)="referenced by its first '^' piece."
^IBA(364.7,629,0)="751^N^5^^^^N"
^IBA(364.7,629,1)="N Z,Q,R S:$D(IBXSAVE(""PROC"",6)) IBXDATA=$P(IBXSAVE(""PROC"",6),U,2) S Z=6 F  S Z=$O(IBXSAVE(""PROC"",Z)) Q:'Z  S R=IBXSAVE(""PROC"",Z),Q=$P(R,U,2) D XPROC^IBCEF3($S(R[""ICPT""!(R[""ICD0""):$P($$PRCD^IBCEF1(R),U),1:$P(R,U))_U_Q,Z)"
^IBA(364.7,629,3,0)="^^3^3^2991014^^^^"
^IBA(364.7,629,3,1,0)="This data element relies on the existence of the IBXSAVE(""PROC"") array"
^IBA(364.7,629,3,2,0)="previously extracted.  If the sixth occurrence exists, output the date"
^IBA(364.7,629,3,3,0)="found in its second '^' piece."
^IBA(364.7,630,0)="752^N^5^^^^N"
^IBA(364.7,630,1)="D:'$D(IBXSAVE(""PRV-82"")) BOX82NM^IBCEU4(IBXIEN,.IBXSAVE) K IBXDATA S IBXDATA=$E($G(IBXSAVE(""PRV-82"",4)),1,30+$G(^TMP(""IBXSAVE"",$J,""RM"")))"
^IBA(364.7,630,3,0)="^364.73^3^3^3040317^^^^"
^IBA(364.7,630,3,1,0)="If not already done, extract all the possible providers into the"
^IBA(364.7,630,3,2,0)="appropriate line for box 82 on the UB-92 print claim form.  This is the"
^IBA(364.7,630,3,3,0)="fourth line extracted."
^IBA(364.7,631,0)="753^N^5^^^^N"
^IBA(364.7,631,1)="D:'$D(IBXSAVE(""PRV-82"")) BOX82NM^IBCEU4(IBXIEN,.IBXSAVE) K IBXDATA S IBXDATA=$G(IBXSAVE(""PRV-82"",3))"
^IBA(364.7,631,3,0)="^^3^3^3000107^^^^"
^IBA(364.7,631,3,1,0)="If not already done, extract all the possible providers into the"
^IBA(364.7,631,3,2,0)="appropriate line for box 82 on the UB-92 print claim form.  This is the"
^IBA(364.7,631,3,3,0)="third line extracted."
^IBA(364.7,632,0)="754^N^5^^^^N"
^IBA(364.7,632,1)="K IBXDATA"
^IBA(364.7,632,3,0)="^^1^1^2991006^^"
^IBA(364.7,632,3,1,0)="Not currently used"
^IBA(364.7,633,0)="755^N^5^^^^N"
^IBA(364.7,633,1)="D:'$D(IBXSAVE(""PRV-82"")) BOX82NM^IBCEU4(IBXIEN,.IBXSAVE) K IBXDATA S IBXDATA=$G(IBXSAVE(""PRV-82"",5))"
^IBA(364.7,633,3,0)="^364.73^3^3^3040317^^^^"
^IBA(364.7,633,3,1,0)="If not already done, extract all the possible providers into the"
^IBA(364.7,633,3,2,0)="appropriate line for box 82 on the UB-92 print claim form.  This is the"
^IBA(364.7,633,3,3,0)="fifth line extracted."
^IBA(364.7,634,0)="756^N^280^^^^N"
^IBA(364.7,634,1)="S:$$WNRBILL^IBEFUNC(IBXIEN) IBXDATA=""MEDICARE"" S:'$D(IBXSAVE(""LM-UB"")) IBXSAVE(""LM-UB"")=$P($G(^IBE(350.9,1,1)),U,31)-1 I IBXSAVE(""LM-UB"") S IBXDATA=$J("""",IBXSAVE(""LM-UB""))_IBXDATA"
^IBA(364.7,634,3,0)="^364.73^4^4^3010123^^^^"
^IBA(364.7,634,3,1,0)="Extracts the insurance company name from the first piece of IBXDATA."
^IBA(364.7,634,3,2,0)="If MEDICARE WNR is current insurance, mailing name is MEDICARE."
^IBA(364.7,634,3,3,0)="If the parameter says move the data to another column, set spaces at the"
^IBA(364.7,634,3,4,0)="beginning to accommodate this."
^IBA(364.7,635,0)="757^N^5^^^^N"
^IBA(364.7,635,1)="D:'$D(IBXSAVE(""PRV-82"")) BOX82NM^IBCEU4(IBXIEN,.IBXSAVE) K IBXDATA S IBXDATA=$E($G(IBXSAVE(""PRV-82"",6)),1,30+$G(^TMP(""IBXSAVE"",$J,""RM""))) K IBXSAVE(""PRV-82"")"
^IBA(364.7,635,3,0)="^364.73^3^3^3040317^^^^"
^IBA(364.7,635,3,1,0)="If not already done, extract all the possible providers into the"
^IBA(364.7,635,3,2,0)="appropriate line for box 82 on the UB-92 print claim form.  This is the"
^IBA(364.7,635,3,3,0)="sixth line extracted."
^IBA(364.7,636,0)="758^N^192^^^^N"
^IBA(364.7,636,1)="N Y,Z K IBXSAVE(""CADR"") I $O(IBXDATA(0)) S Y=$G(IBXDATA(6)) D ZIPOUT^VAFADDR S:Y'="""" $P(IBXSAVE(""CADR""),U,6)=Y F Z=1:1:5,7 S:$D(IBXDATA(Z)) $P(IBXSAVE(""CADR""),U,Z)=IBXDATA(Z) I Z=7 D CIADDR^IBCEF1(.IBXDATA,.IBXSAVE,1,2)"
^IBA(364.7,636,3,0)="^364.73^6^6^3010123^^^^"
^IBA(364.7,636,3,1,0)="Data element extracts full address data into IBXDATA array,"
^IBA(364.7,636,3,2,0)="saves the data in IBXSAVE(""CADR"")=Street addr 1^Street addr 2^Street addr 3^"
^IBA(364.7,636,3,3,0)="City^State^Zip^claim office id # for later use and resets IBXDATA to street"
^IBA(364.7,636,3,4,0)="1 and street 2 of address."
^IBA(364.7,636,3,5,0)="If the parameter says move the data to another column, set spaces at the"
^IBA(364.7,636,3,6,0)="beginning to accommodate this."
^IBA(364.7,637,0)="759^N^5^^^^N"
^IBA(364.7,637,1)="K:$G(IBXSAVE(""CADR""))="""" IBXDATA I $D(IBXDATA) D CIADDR^IBCEF1(.IBXDATA,.IBXSAVE,2,2)"
^IBA(364.7,637,3,0)="^364.73^3^3^3001220^^^^"
^IBA(364.7,637,3,1,0)="Combine the city, state and zip code for one line of the address."
^IBA(364.7,637,3,2,0)="If the parameter says move the data to another column, set spaces at the"
^IBA(364.7,637,3,3,0)="beginning to accommodate this."
^IBA(364.7,638,0)="760^N^5^^^^N"
^IBA(364.7,638,1)="K IBXDATA S IBXDATA=""SIGNATURE ON FILE"""
^IBA(364.7,638,3,0)="^^1^1^2990610^^"
^IBA(364.7,638,3,1,0)="Use a constant SIGNATURE ON FILE."
^IBA(364.7,639,0)="761^N^267^^^^N"
^IBA(364.7,639,1)="S IBXDATA=$S($G(IBPNT)!'IBXDATA:DT,1:IBXDATA),IBXDATA=$$FMTE^XLFDT(IBXDATA,""2D"")"
^IBA(364.7,639,3,0)="^^2^2^2991115^^^^"
^IBA(364.7,639,3,1,0)="Use data element value unless the variable IBPNT>0 (indicates reprint) or"
^IBA(364.7,639,3,2,0)="if data element value is null.  Format as date in MMDDYY format."
^IBA(364.7,640,0)="1181^N^312^^^^N^0"
^IBA(364.7,640,1)="K IBXDATA D OTHPAYC^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,9,""73"")"
^IBA(364.7,640,3,0)="^^1^1^3030805^^"
^IBA(364.7,640,3,1,0)="HARD CODE FORMAT OTH PAYER OTH PROV ID"
^IBA(364.7,641,0)="1106^N^131^^^^N"
^IBA(364.7,641,1)="S IBXDATA=""OP1 """
^IBA(364.7,643,0)="765^N^5^^^^N"
^IBA(364.7,643,1)="K ^UTILITY(""VADM"",$J),^UTILITY(""VAPA"",$J),^TMP(""IBXSAVE"",$J),IBXSAVE S ^TMP(""IBXSAVE"",$J,""RM"")=$S($G(IOM)>80:1,1:0)"
^IBA(364.7,643,3,0)="^^1^1^2990609^^^^"
^IBA(364.7,643,3,1,0)="Kills off globals,other variables to be used, sets right margin variable."
^IBA(364.7,644,0)="1254^N^312^^^^N"
^IBA(364.7,644,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,1,1)),""^"",3)"
^IBA(364.7,644,3,0)="^364.73^5^5^3040722^^^^"
^IBA(364.7,644,3,1,0)="Refering Provider Secondary ID Qualifier"
^IBA(364.7,644,3,2,0)="EI=EMPLOYER, SY=SSN, 0B=STATE LICENSE NUMBER, 1A=BLUE CROSS, 1B=BLUE SHIELD,"
^IBA(364.7,644,3,3,0)="1C=MEDICARE PARTA aqnd PARTB, 1D=MEDICAID, 1G=UPIN Number, 1H=TRICARE"
^IBA(364.7,644,3,4,0)="G2=COMMERCIAL NUMBER, X5=STATE INDUSTRIAL ACCIDENT PROVIDER NUMBER"
^IBA(364.7,644,3,5,0)="N5=PROVIDER PLAN NETWORK ID"
^IBA(364.7,645,0)="1255^N^312^^^^N"
^IBA(364.7,645,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,1,1)),""^"",4) I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,645,3,0)="^364.73^1^1^3030930^^^"
^IBA(364.7,645,3,1,0)="Refering Provider Secondary ID"
^IBA(364.7,646,0)="1256^N^312^^^^N"
^IBA(364.7,646,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,1,2)),""^"",3)"
^IBA(364.7,646,3,0)="^^5^5^3030815^^"
^IBA(364.7,646,3,1,0)="Refering Provider Secondary ID Qualifier."
^IBA(364.7,646,3,2,0)="EI=EMPLOYER, SY=SSN, 0B=STATE LICENSE NUMBER, 1A=BLUE CROSS, 1B=BLUE SHIELD,"
^IBA(364.7,646,3,3,0)="1C=MEDICARE PARTA aqnd PARTB, 1D=MEDICAID, 1G=UPIN Number, 1H=TRICARE"
^IBA(364.7,646,3,4,0)="G2=COMMERCAIL NUMBER, X5=STATE INDUSTRIAL ACCIDENT PROVIDER NUMBER"
^IBA(364.7,646,3,5,0)="N5=PROVIDER PLAN NETWORK ID"
^IBA(364.7,647,0)="1257^N^312^^^^N"
^IBA(364.7,647,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,1,2)),""^"",4) I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,647,3,0)="^364.73^1^1^3030930^^^^"
^IBA(364.7,647,3,1,0)="Refering Provider Secondary ID"
^IBA(364.7,648,0)="1258^N^312^^^^N"
^IBA(364.7,648,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,1,3)),""^"",3)"
^IBA(364.7,648,3,0)="^^5^5^3030804^"
^IBA(364.7,648,3,1,0)="Refering Provider Secondary ID Qualifier."
^IBA(364.7,648,3,2,0)="EI=EMPLOYER, SY=SSN, 0B=STATE LICENSE NUMBER, 1A=BLUE CROSS, 1B=BLUE SHIELD,"
^IBA(364.7,648,3,3,0)="1C=MEDICARE PARTA aqnd PARTB, 1D=MEDICAID, 1G=UPIN Number, 1H=TRICARE"
^IBA(364.7,648,3,4,0)="G2=COMMERCAIL NUMBER, X5=STATE INDUSTRIAL ACCIDENT PROVIDER NUMBER"
^IBA(364.7,648,3,5,0)="N5=PROVIDER PLAN NETWORK ID"
^IBA(364.7,649,0)="1259^N^312^^^^N"
^IBA(364.7,649,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,1,3)),""^"",4) I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,649,3,0)="^364.73^1^1^3030930^^"
^IBA(364.7,649,3,1,0)="Refering Provider Secondary ID"
^IBA(364.7,650,0)="1260^N^312^^^^N"
^IBA(364.7,650,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,1,4)),""^"",3)"
^IBA(364.7,650,3,0)="^364.73^5^5^3040722^^"
^IBA(364.7,650,3,1,0)="Refering Provider Secondary ID Qualifier."
^IBA(364.7,650,3,2,0)="EI=EMPLOYER, SY=SSN, 0B=STATE LICENSE NUMBER, 1A=BLUE CROSS, 1B=BLUE SHIELD,"
^IBA(364.7,650,3,3,0)="1C=MEDICARE PARTA aqnd PARTB, 1D=MEDICAID, 1G=UPIN Number, 1H=TRICARE"
^IBA(364.7,650,3,4,0)="G2=COMMERCAIL NUMBER, X5=STATE INDUSTRIAL ACCIDENT PROVIDER NUMBER"
^IBA(364.7,650,3,5,0)="N5=PROVIDER PLAN NETWORK ID"
^IBA(364.7,651,0)="1261^N^312^^^^N"
^IBA(364.7,651,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,1,4)),""^"",4) I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,651,3,0)="^364.73^1^1^3030930^^"
^IBA(364.7,651,3,1,0)="Refering Provider Secondary ID"
^IBA(364.7,652,0)="1262^N^312^^^^N"
^IBA(364.7,652,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,1,5)),""^"",3)"
^IBA(364.7,652,3,0)="^^5^5^3030804^"
^IBA(364.7,652,3,1,0)="Refering Provider Secondary ID Qualifier."
^IBA(364.7,652,3,2,0)="EI=EMPLOYER, SY=SSN, 0B=STATE LICENSE NUMBER, 1A=BLUE CROSS, 1B=BLUE SHIELD,"
^IBA(364.7,652,3,3,0)="1C=MEDICARE PARTA aqnd PARTB, 1D=MEDICAID, 1G=UPIN Number, 1H=TRICARE"
^IBA(364.7,652,3,4,0)="G2=COMMERCAIL NUMBER, X5=STATE INDUSTRIAL ACCIDENT PROVIDER NUMBER"
^IBA(364.7,652,3,5,0)="N5=PROVIDER PLAN NETWORK ID"
^IBA(364.7,653,0)="1263^N^312^^^^N"
^IBA(364.7,653,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,1,5)),""^"",4) I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,653,3,0)="^364.73^1^1^3030930^^^^"
^IBA(364.7,653,3,1,0)="Refering Provider Secondary ID"
^IBA(364.7,654,0)="1247^N^312^^^^N^0"
^IBA(364.7,654,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,9,2)),""^"",4) I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,654,3,0)="^364.73^1^1^3030930^^^"
^IBA(364.7,654,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,655,0)="1249^N^312^^^^N^0"
^IBA(364.7,655,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,9,3)),""^"",4) I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,655,3,0)="^364.73^1^1^3030930^^^"
^IBA(364.7,655,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,656,0)="1251^N^312^^^^N^0"
^IBA(364.7,656,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,9,4)),""^"",4) I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,656,3,0)="^364.73^1^1^3030930^^^^"
^IBA(364.7,656,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,657,0)="1253^N^312^^^^N^0"
^IBA(364.7,657,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,9,5)),""^"",4) I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,657,3,0)="^364.73^1^1^3030930^^^^"
^IBA(364.7,657,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,658,0)="1244^N^312^^^^N^0"
^IBA(364.7,658,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,9,1)),""^"",3)"
^IBA(364.7,658,3,0)="^364.73^1^1^3030825^^^^"
^IBA(364.7,658,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,659,0)="1246^N^312^^^^N^0"
^IBA(364.7,659,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,9,2)),""^"",3)"
^IBA(364.7,659,3,0)="^^1^1^3030812^^"
^IBA(364.7,659,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,660,0)="1248^N^312^^^^N^0"
^IBA(364.7,660,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,9,3)),""^"",3)"
^IBA(364.7,660,3,0)="^^1^1^3030812^^"
^IBA(364.7,660,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,661,0)="1250^N^312^^^^N^0"
^IBA(364.7,661,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,9,4)),""^"",3)"
^IBA(364.7,661,3,0)="^^1^1^3030812^^"
^IBA(364.7,661,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,662,0)="1252^N^312^^^^N^0"
^IBA(364.7,662,1)="S IBXDATA=$P($G(IBXSAVE(""PROVINF"",IBXIEN,""C"",1,9,5)),""^"",3)"
^IBA(364.7,662,3,0)="^^1^1^3030812^^^"
^IBA(364.7,662,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,663,0)="1114^N^312^^^^N^0"
^IBA(364.7,663,1)="K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,3,""Q"",3)"
^IBA(364.7,663,3,0)="^^1^1^3030804^^"
^IBA(364.7,663,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,664,0)="1122^N^312^^^^N^0"
^IBA(364.7,664,1)="K IBXDATA D OTHPAYV^IBCEF71(IBXIEN,.IBXSAVE,.IBXDATA,2,""I"",2) I $D(IBXDATA) D NOPUNCT^IBCEF73(.IBXDATA,1)"
^IBA(364.7,664,3,0)="^364.73^1^1^3030930^^^^"
^IBA(364.7,664,3,1,0)="FROM FORMAT IN PROVINF^IBCEF7"
^IBA(364.7,692,0)="663^N^5^^^^N"
^IBA(364.7,692,1)="N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=4:4 Q:$G(IBXSAVE(""OCC"",Z))=""""  S Z0=Z0+1,Z1=$$DATE^IBCF2($P(IBXSAVE(""OCC"",Z),U,2),,1) S:Z'>8 IBXDATA(Z0)=Z1 D:Z>8 XOCC^IBCEF3($P(IBXSAVE(""OCC"",Z),U)_U_Z1,Z0,35) K IBXSAVE(""OCC"",Z)"
^IBA(364.7,692,3,0)="^^6^6^2991115^^^^"
^IBA(364.7,692,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,692,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,692,3,3,0)="IBXSAVE(""OCC"") extracted previously.  This field outputs the 4th and 8th"
^IBA(364.7,692,3,4,0)="occurrences of occurrence code 'from date' formatted as MMDDYY found in the"
^IBA(364.7,692,3,5,0)="second '^' piece of the IBXSAVE(""OCC"",n) array data element."
^IBA(364.7,692,3,6,0)="Any overflow codes (12,16,...) are output on a separate page."
^IBA(364.7,693,0)="664^N^5^^^^N"
^IBA(364.7,693,1)="N Z,Z0 K IBXDATA S Z0=0 F Z=1,2 S Z0=Z0+1 S:$G(IBXSAVE(""OCCS"",Z))'="""" IBXDATA(Z0)=$P(IBXSAVE(""OCCS"",Z),U)"
^IBA(364.7,693,3,0)="^^5^5^2991014^^^^"
^IBA(364.7,693,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,693,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,693,3,3,0)="IBXSAVE(""OCCS"") extracted previously.  This field outputs the 1st and 2nd"
^IBA(364.7,693,3,4,0)="occurrences of occurrence span codes found in the IBXSAVE(""OCCS"",n) array"
^IBA(364.7,693,3,5,0)="data element.  Overflow codes are printed on a separate page."
^IBA(364.7,694,0)="665^N^5^^^^N"
^IBA(364.7,694,1)="N Z,Z0 K IBXDATA S Z0=0 F Z=1,2 S Z0=Z0+1 S:$G(IBXSAVE(""OCCS"",Z))'="""" IBXDATA(Z0)=$$DATE^IBCF2($P(IBXSAVE(""OCCS"",Z),U,2),,1)"
^IBA(364.7,694,3,0)="^^5^5^2991115^^^^"
^IBA(364.7,694,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,694,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,694,3,3,0)="IBXSAVE(""OCCS"") extracted previously.  This field outputs the 1st and 2nd"
^IBA(364.7,694,3,4,0)="occurrences of occurrence span code 'from date' formatted as MMDDYY found"
^IBA(364.7,694,3,5,0)="in the second '^' piece of the IBXSAVE(""OCCS"",n) array data element."
^IBA(364.7,695,0)="666^N^5^^^^N"
^IBA(364.7,695,1)="N Z,Q K IBXDATA F Z=1:1 Q:$G(IBXSAVE(""OCCS"",Z))=""""  S Q=$$DATE^IBCF2($P(IBXSAVE(""OCCS"",Z),U,3),,1) S:Z'>2 IBXDATA(Z)=Q D:Z>2 XOCCS^IBCEF3($P(IBXSAVE(""OCCS"",Z),U)_U_$$DATE^IBCF2($P(IBXSAVE(""OCCS"",Z),U,2),,1)_U_Q,Z) K IBXSAVE(""OCCS"",Z)"
^IBA(364.7,695,3,0)="^^5^5^2991115^^^^"
^IBA(364.7,695,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,695,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,695,3,3,0)="IBXSAVE(""OCCS"") extracted previously.  This field outputs the 1st and 2nd"
^IBA(364.7,695,3,4,0)="occurrences of occurrence span code 'to date' formatted as MMDDYY found"
^IBA(364.7,695,3,5,0)="in the third '^' piece of the IBXSAVE(""OCCS"",n) array data element."
^IBA(364.7,698,0)="678^N^2^^^^N"
^IBA(364.7,699,0)="679^N^5^^^^N"
^IBA(364.7,699,1)="I $G(IBXSAVE(""RP"",1))'="""" S IBXDATA=IBXSAVE(""RP"",1)"
^IBA(364.7,699,3,0)="^^2^2^2990609^^^^"
^IBA(364.7,699,3,1,0)="This field relies on the IBXSAVE(""RP"") array that was previously extracted."
^IBA(364.7,699,3,2,0)="If the first occurrence of this array has a non-null value, print it."
^IBA(364.7,700,0)="680^N^12^^^^N"
^IBA(364.7,700,1)="N Z,Z0,Z1 S Z=0 F  S Z=$O(IBFL(39,Z)) K:'Z IBFL(39) Q:'Z  S Z0=$P(IBFL(39,Z),U,2),Z1=$P(IBFL(39,Z),U,3),IBXSAVE(""VC"",Z)=$P(IBFL(39,Z),U)_U_$S(+Z0'=0:$TR($J(Z0,10,2),""."","" ""),1:""   0000 00"")"
^IBA(364.7,700,3,0)="^364.73^5^5^3001212^^^^"
^IBA(364.7,700,3,1,0)="Save all value codes extracted into IBXSAVE array for later use.  The 2"
^IBA(364.7,700,3,2,0)="pieces that constitute the IBXSAVE(""VC"") array are: CODE^VALUE formatted"
^IBA(364.7,700,3,3,0)="using 8 characters for quantity and using 9 or 10 characters for a dollar"
^IBA(364.7,700,3,4,0)="amount.  Use 9 if right margin is 80 or less, 10 if > 80."
^IBA(364.7,700,3,5,0)="Overflow fields are printed on a separate page."
^IBA(364.7,701,0)="681^N^5^^^^N"
^IBA(364.7,701,1)="N Z,Z0 S Z0=0 F Z=1:3:10 Q:'$D(IBXSAVE(""VC"",Z))  S Z0=Z0+1,IBXDATA(Z0)=$P(IBXSAVE(""VC"",Z),U)"
^IBA(364.7,701,3,0)="^^3^3^2991014^^^^"
^IBA(364.7,701,3,1,0)="This data element relies on the array IBXSAVE(""VC"") previously extracted."
^IBA(364.7,701,3,2,0)="This is a group data element and can have multiple occurrences.  Output is"
^IBA(364.7,701,3,3,0)="the first piece of each occurrence found."
^IBA(364.7,702,0)="682^N^5^^^^N"
^IBA(364.7,702,1)="N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=1:3 Q:$G(IBXSAVE(""VC"",Z))=""""  S Z0=Z0+1,Z1=$P(IBXSAVE(""VC"",Z),U,2) S:Z'>10 IBXDATA(Z0)=Z1 D:Z>10 XVAL^IBCEF3(IBXSAVE(""VC"",Z),Z) K IBXSAVE(""VC"",Z)"
^IBA(364.7,702,3,0)="^^3^3^2991014^^^^"
^IBA(364.7,702,3,1,0)="This data element relies on the array IBXSAVE(""VC"") previously extracted."
^IBA(364.7,702,3,2,0)="This is a group data element and can have multiple occurrences.  Output is"
^IBA(364.7,702,3,3,0)="the second piece of each occurrence found."
^IBA(364.7,703,0)="683^N^5^^^^N"
^IBA(364.7,703,1)="N Z,Z0 S Z0=0 F Z=2:3:11 Q:'$D(IBXSAVE(""VC"",Z))  S Z0=Z0+1,IBXDATA(Z0)=$P(IBXSAVE(""VC"",Z),U)"
^IBA(364.7,703,3,0)="^^3^3^2991014^^^^"
^IBA(364.7,703,3,1,0)="This data element relies on the array IBXSAVE(""VC"") previously extracted."
^IBA(364.7,703,3,2,0)="This is a group data element and can have multiple occurrences.  Output is"
^IBA(364.7,703,3,3,0)="the first piece of each occurrence found."
^IBA(364.7,704,0)="684^N^5^^^^N"
^IBA(364.7,704,1)="N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=2:3 Q:$G(IBXSAVE(""VC"",Z))=""""  S Z0=Z0+1,Z1=$P(IBXSAVE(""VC"",Z),U,2) S:Z'>11 IBXDATA(Z0)=Z1 D:Z>11 XVAL^IBCEF3(IBXSAVE(""VC"",Z),Z) K IBXSAVE(""VC"",Z)"
^IBA(364.7,704,3,0)="^^3^3^2991014^^^^"
^IBA(364.7,704,3,1,0)="This data element relies on the array IBXSAVE(""VC"") previously extracted."
^IBA(364.7,704,3,2,0)="This is a group data element and can have multiple occurrences.  Output is"
^IBA(364.7,704,3,3,0)="the second piece of each occurrence found."
^IBA(364.7,705,0)="685^N^5^^^^N"
^IBA(364.7,705,1)="N Z,Z0 S Z0=0 F Z=3:3:12 Q:'$D(IBXSAVE(""VC"",Z))  S Z0=Z0+1,IBXDATA(Z0)=$P(IBXSAVE(""VC"",Z),U)"
^IBA(364.7,705,3,0)="^^4^4^2991014^^^^"
^IBA(364.7,705,3,1,0)="This data element relies on the array IBXSAVE(""VC"") previously extracted."
^IBA(364.7,705,3,2,0)="This is a group data element and can have multiple occurrences.  Output is"
^IBA(364.7,705,3,3,0)="the first piece of each occurrence found.  If there are more than 12"
^IBA(364.7,705,3,4,0)="value codes, they are stored in the overflow array."
^IBA(364.7,706,0)="686^N^5^^^^N"
^IBA(364.7,706,1)="N Z,Z1,Z0 K IBXDATA S Z0=0 F Z=3:3 Q:$G(IBXSAVE(""VC"",Z))=""""  S Z0=Z0+1,Z1=$E($P(IBXSAVE(""VC"",Z),U,2),2-$G(^TMP(""IBXSAVE"",$J,""RM"")),10) S:Z'>12 IBXDATA(Z0)=Z1 D:Z>12 XVAL^IBCEF3(Z1,Z) K IBXSAVE(""VC"",Z)"
^IBA(364.7,706,3,0)="^^3^3^2991014^^^^"
^IBA(364.7,706,3,1,0)="This data element relies on the array IBXSAVE(""VC"") previously extracted."
^IBA(364.7,706,3,2,0)="This is a group data element and can have multiple occurrences.  Output is"
^IBA(364.7,706,3,3,0)="the second piece of each occurrence found."
^IBA(364.7,707,0)="687^N^5^^^^N"
^IBA(364.7,707,1)="I $G(IBXSAVE(""RP"",2))'="""" S IBXDATA=IBXSAVE(""RP"",2)"
^IBA(364.7,707,3,0)="^^2^2^2990609^^^^"
^IBA(364.7,707,3,1,0)="This field relies on the IBXSAVE(""RP"") array that was previously extracted."
^IBA(364.7,707,3,2,0)="If the second occurrence of this array has a non-null value, print it."
^IBA(364.7,708,0)="688^N^5^^^^N"
^IBA(364.7,708,1)="I $G(IBXSAVE(""RP"",3))'="""" S IBXDATA=IBXSAVE(""RP"",3)"
^IBA(364.7,708,3,0)="^^2^2^2990609^^^^"
^IBA(364.7,708,3,1,0)="This field relies on the IBXSAVE(""RP"") array that was previously extracted."
^IBA(364.7,708,3,2,0)="If the second occurrence of this array has a non-null value, print it."
^IBA(364.7,709,0)="689^N^5^^^^N"
^IBA(364.7,709,1)="I $G(IBXSAVE(""RP"",4))'="""" S IBXDATA=IBXSAVE(""RP"",4)"
^IBA(364.7,709,3,0)="^^2^2^2990609^^^^"
^IBA(364.7,709,3,1,0)="This field relies on the IBXSAVE(""RP"") array that was previously extracte"
^IBA(364.7,709,3,2,0)="If the fourth occurrence of this array has a non-null value, print it."
^IBA(364.7,710,0)="690^N^193^^^^N"
^IBA(364.7,711,0)="691^N^5^^^^N"
^IBA(364.7,711,1)="N Z,Q,R F Z=1:1 Q:'$D(^TMP($J,""IBC-RC"",Z))  S R=^(Z),Q=$S(+R=1:$P(R,U,2),+R=2:$E($P(R,U,2),1,5),1:"""") S:Z'>21 IBXDATA(Z)=Q D:Z>21 CKREV^IBCEF3(Z,Q) I '$O(^TMP($J,""IBC-RC"",Z)),Z>23 D FILL^IBCEF3(Z)"
^IBA(364.7,711,3,0)="^^14^14^2991118^^^^"
^IBA(364.7,711,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,711,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,711,3,3,0)="IBXSAVE(""REV"",n) extracted previously.  The first '^' piece of the array"
^IBA(364.7,711,3,4,0)="indicates whether this is a 'normal' service data line (=1) or a text line"
^IBA(364.7,711,3,5,0)="(=2 or =3).  For a normal service line, the data is found in the second '^'"
^IBA(364.7,711,3,6,0)="piece of the array.  For text line where the first piece = 2, the text is"
^IBA(364.7,711,3,7,0)="assumed to start in column 1, so the data is extracted from positions 1-5."
^IBA(364.7,711,3,8,0)="For text line where the first piece = 3, the text is assumed to start in"
^IBA(364.7,711,3,9,0)="column 6, so there is no data extracted for this field."
^IBA(364.7,711,3,10,0)="Since only 23 lines of service line can appear on one form, if there"
^IBA(364.7,711,3,11,0)="are more than 23 lines, subsequent pages are forced for the remaining data"
^IBA(364.7,711,3,12,0)="lines after 23.  Since the page number must print on line 23 for multi-page"
^IBA(364.7,711,3,13,0)="bills, the FILL^IBCEF3 call places the page number text on the last line of"
^IBA(364.7,711,3,14,0)="the last page."
^IBA(364.7,712,0)="692^N^5^^^^N"
^IBA(364.7,712,1)="N Z,Z0,Z1 F Z=1:1 Q:'$D(^TMP($J,""IBC-RC"",Z))  S Z1=^(Z),Z0=$S(+Z1=1:$P(Z1,U,3),+Z1=2:$E($P(Z1,U,2),6,30),1:$E($P(Z1,U,2),1,25)) S:Z'>21 IBXDATA(Z)=Z0 D:Z'<21 CKREV^IBCEF3(Z,Z0)"
^IBA(364.7,712,3,0)="^^12^12^2990629^^^^"
^IBA(364.7,712,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,712,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,712,3,3,0)="IBXSAVE(""REV"",n) extracted previously.  The first '^' piece of the array"
^IBA(364.7,712,3,4,0)="indicates whether this is a 'normal' service data line (=1) or a text line"
^IBA(364.7,712,3,5,0)="(=2 or =3).  For a normal service line, the data is found in the third '^'"
^IBA(364.7,712,3,6,0)="piece of the array.  For text line where the first piece = 2, the text is"
^IBA(364.7,712,3,7,0)="assumed to start in column 1, so the data is extracted from positions 6-30."
^IBA(364.7,712,3,8,0)="For text line where the first piece = 3, the text is assumed to start in"
^IBA(364.7,712,3,9,0)="column 6, so the data for this field is extracted from positions 1-25."
^IBA(364.7,712,3,10,0)="Since only 23 lines of service line can appear on one form, if there"
^IBA(364.7,712,3,11,0)="are more than 23 lines, subsequent pages are forced for the remaining data"
^IBA(364.7,712,3,12,0)="lines after 23."
^IBA(364.7,713,0)="693^N^5^^^^N"
^IBA(364.7,713,1)="N Z,Z0,D,T,T4,T5 F Z=1:1 Q:'$G(^TMP($J,""IBC-RC"",Z))  S D=^(Z),T=$P(D,U,2),T5=$P(D,U,5),T4=$P(D,U,4),Z0=$S(+D=2:$E(T,31,40),+D=3:$E(T,26,35),T4'=""""&(T>219):T4,T5'=""""&(T<220)&(T>1):$J(T5,7,2),1:"""") S:Z'>21 IBXDATA(Z)=Z0 D:Z'<21 CKREV^IBCEF3(Z,Z0)"
^IBA(364.7,713,3,0)="^364.73^13^13^3010308^^^^"
^IBA(364.7,713,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,713,3,2,0)="might be expected.  It relies on the presence of data in global"
^IBA(364.7,713,3,3,0)="^TMP($J,""IBC-RC"",n) extracted previously.  The first '^' piece of the array"
^IBA(364.7,713,3,4,0)="indicates whether this is a 'normal' service data line (=1) or a text line"
^IBA(364.7,713,3,5,0)="(=2 or =3).  For a normal service line, the data is found in the fourth"
^IBA(364.7,713,3,6,0)="(procedure code and modifiers) or fifth (unit charge) '^' pieces of the"
^IBA(364.7,713,3,7,0)="array. If there is a procedure and a unit charge, only the procedure code"
^IBA(364.7,713,3,8,0)="and its modifiers will print. If there is a unit charge and this is an"
^IBA(364.7,713,3,9,0)="inpatient bill and the revenue code is 100-219, it is printed and"
^IBA(364.7,713,3,10,0)="formatted in 7 spaces with 2 decimal places. Since only 23 lines of service"
^IBA(364.7,713,3,11,0)="can appear on one form, if there are more than 23 lines, subsequent"
^IBA(364.7,713,3,12,0)="pages are forced for the remaining data lines after 21 to leave room for a"
^IBA(364.7,713,3,13,0)="blank separating line and the page indicator."
^IBA(364.7,714,0)="694^N^5^^^^N"
^IBA(364.7,714,1)="K IBXDATA D DATE45^IBCF33(IBXIEN,.IBXDATA,$G(IBXSAVE(""DATE"")))"
^IBA(364.7,714,3,0)="^^13^13^3000105^^^^"
^IBA(364.7,714,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,714,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,714,3,3,0)="IBXSAVE(""REV"",n) extracted previously.  The first '^' piece of the array"
^IBA(364.7,714,3,4,0)="indicates whether this is a 'normal' service data line (=1) or a text line"
^IBA(364.7,714,3,5,0)="(=2 or =3).   For a normal service line, output the OUTPATIENT from date that"
^IBA(364.7,714,3,6,0)="was previously extracted into IBXSAVE(""DATE""). For text line where the first"
^IBA(364.7,714,3,7,0)="piece = 2, the text is assumed to start in column 1, so the data is"
^IBA(364.7,714,3,8,0)="extracted from positions 41-47.  For text line where the first piece = 3,"
^IBA(364.7,714,3,9,0)="the text is assumed to start in column 6, so the data for this field is"
^IBA(364.7,714,3,10,0)="extracted from positions 36-42."
^IBA(364.7,714,3,11,0)="Since only 23 lines of service line can appear on one form, if there"
^IBA(364.7,714,3,12,0)="are more than 23 lines, subsequent pages are forced for the remaining data"
^IBA(364.7,714,3,13,0)="lines after 23."
^IBA(364.7,715,0)="695^N^5^^^^N"
^IBA(364.7,715,1)="N Z,Z0,Z1 F Z=1:1 Q:'$D(^TMP($J,""IBC-RC"",Z))  S Z1=^(Z),Z0=$S(+Z1=1:"" ""_$P(Z1,U,6),+Z1=2:$E($P(Z1,U,2),48,53),1:$E($P(Z1,U,2),43,48)) S:Z'>21 IBXDATA(Z)=Z0 D:Z'<21 CKREV^IBCEF3(Z,Z0)"
^IBA(364.7,715,3,0)="^^13^13^2991018^^^^"
^IBA(364.7,715,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,715,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,715,3,3,0)="IBXSAVE(""REV"",n) extracted previously.  The first '^' piece of the array"
^IBA(364.7,715,3,4,0)="indicates whether this is a 'normal' service data line (=1) or a text line"
^IBA(364.7,715,3,5,0)="(=2 or =3).  For a normal service line, the data is found in the sixth '^'"
^IBA(364.7,715,3,6,0)="piece of the array and is formmatted preceeded by a space.  For text line"
^IBA(364.7,715,3,7,0)="where the first piece = 2, the text is assumed to start in column 1, so the"
^IBA(364.7,715,3,8,0)="data is extracted from positions 48-53.  For text line where the first"
^IBA(364.7,715,3,9,0)="piece = 3, the text is assumed to start in column 6, so the data for this"
^IBA(364.7,715,3,10,0)="field is extracted from positions 43-48."
^IBA(364.7,715,3,11,0)="Since only 23 lines of service line can appear on one form, if there"
^IBA(364.7,715,3,12,0)="are more than 23 lines, subsequent pages are forced for the remaining data"
^IBA(364.7,715,3,13,0)="lines after 23."
^IBA(364.7,716,0)="696^N^5^^^^N"
^IBA(364.7,716,1)="N Z,Z0,Z1 F Z=1:1 Q:'$D(^TMP($J,""IBC-RC"",Z))  S Z1=^(Z),Z0=$S(+Z1=1:$J($P(Z1,U,7),11,2),+Z1=2:$E($P(Z1,U,2),54,66),1:$E($P(Z1,U,2),49,61)) S:Z'>21 IBXDATA(Z)=Z0 D:Z'<21 CKREV^IBCEF3(Z,Z0)"
^IBA(364.7,716,3,0)="^^13^13^2990629^^^^"
^IBA(364.7,716,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,716,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,716,3,3,0)="IBXSAVE(""REV"",n) extracted previously.  The first '^' piece of the array"
^IBA(364.7,716,3,4,0)="indicates whether this is a 'normal' service data line (=1) or a text line"
^IBA(364.7,716,3,5,0)="(=2 or =3).  For a normal service line, the data is found in the seventh '^'"
^IBA(364.7,716,3,6,0)="piece of the array and is formmatted preceeded by a space.  For text line"
^IBA(364.7,716,3,7,0)="where the first piece = 2, the text is assumed to start in column 1, so the"
^IBA(364.7,716,3,8,0)="data is extracted from positions 54-66.  For text line where the first"
^IBA(364.7,716,3,9,0)="piece = 3, the text is assumed to start in column 6, so the data for this"
^IBA(364.7,716,3,10,0)="field is extracted from positions 49-61."
^IBA(364.7,716,3,11,0)="Since only 23 lines of service line can appear on one form, if there"
^IBA(364.7,716,3,12,0)="are more than 23 lines, subsequent pages are forced for the remaining data"
^IBA(364.7,716,3,13,0)="lines after 23."
^IBA(364.7,717,0)="697^N^5^^^^N"
^IBA(364.7,717,1)="N Z,Z0,Z1 F Z=1:1 Q:'$D(^TMP($J,""IBC-RC"",Z))  S Z1=^(Z),Z0=$S(+Z1=1:$S($P(Z1,U,8):$J($P(Z1,U,8),9,2),1:$J(0,9,2)),+Z1=2:$E($P(Z1,U,2),67,77),1:$E($P(Z1,U,2),62,72)) S:Z'>21 IBXDATA(Z)=Z0 D:Z'<21 CKREV^IBCEF3(Z,Z0)"
^IBA(364.7,717,3,0)="^^13^13^2990629^^^^"
^IBA(364.7,717,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,717,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,717,3,3,0)="IBXSAVE(""REV"",n) extracted previously.  The first '^' piece of the array"
^IBA(364.7,717,3,4,0)="indicates whether this is a 'normal' service data line (=1) or a text line"
^IBA(364.7,717,3,5,0)="(=2 or =3).  For a normal service line, the data is found in the eighth '^'"
^IBA(364.7,717,3,6,0)="piece of the array and is formatted preceeded by a space.  For text line"
^IBA(364.7,717,3,7,0)="where the first piece = 2, the text is assumed to start in column 1, so the"
^IBA(364.7,717,3,8,0)="data is extracted from positions 67-77.  For text line where the first"
^IBA(364.7,717,3,9,0)="piece = 3, the text is assumed to start in column 6, so the data for this"
^IBA(364.7,717,3,10,0)="field is extracted from positions 62-72."
^IBA(364.7,717,3,11,0)="Since only 23 lines of service line can appear on one form, if there"
^IBA(364.7,717,3,12,0)="are more than 23 lines, subsequent pages are forced for the remaining data"
^IBA(364.7,717,3,13,0)="lines after 23."
^IBA(364.7,718,0)="698^N^5^^^^N"
^IBA(364.7,718,1)="N Z,Z0,Z1,R S R=$G(^TMP(""IBXSAVE"",$J,""RM"")) F Z=1:1 Q:'$D(^TMP($J,""IBC-RC"",Z))  S Z1=^(Z),Z0=$S(+Z1=1:$P(Z1,U,9),+Z1=2:$E($P(Z1,U,2),78,80+R),1:$E($P(Z1,U,2),73,75+R)) S:Z'>21 IBXDATA(Z)=Z0 D:Z'<21 CKREV^IBCEF3(Z,Z0)"
^IBA(364.7,718,3,0)="^^13^13^2990629^^^^"
^IBA(364.7,718,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,718,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,718,3,3,0)="^TMP(""IBC-RC"",n) extracted previously.  The first '^' piece of the array"
^IBA(364.7,718,3,4,0)="indicates whether this is a 'normal' service data line (=1) or a text line"
^IBA(364.7,718,3,5,0)="(=2 or =3).  For a normal service line, the data is found in the ninth '^'"
^IBA(364.7,718,3,6,0)="piece of the array.  For text line where the first piece = 2, the text is"
^IBA(364.7,718,3,7,0)="assumed to start in column 1, so the data is extracted from positions 78-81."
^IBA(364.7,718,3,8,0)="For text line where the first piece = 3, the text is assumed to start in"
^IBA(364.7,718,3,9,0)="column 6, so the data for this field is extracted from positions 73-76."
^IBA(364.7,718,3,10,0)="The ending extract point is one less in each case if the right margin is"
^IBA(364.7,718,3,11,0)="only 80, not 81. Since only 23 lines of service line can appear on one form,"
^IBA(364.7,718,3,12,0)="if there are more than 23 lines, subsequent pages are forced for the"
^IBA(364.7,718,3,13,0)="remaining data lines after 23."
^IBA(364.7,719,0)="699^N^13^^^^N"
^IBA(364.7,719,1)="N Z,IBZ M IBZ=IBXDATA K IBXDATA K IBXSAVE(""FL56"") F Z=1:1:4 S IBXSAVE(""FL56"",Z+1)=$E(IBZ,14*Z,(14*(Z+1)-1)) I Z=1 S IBXDATA=$E("" "",+$G(^TMP(""IBXSAVE"",$J,""RM"")))_$E(IBZ,1,13)"
^IBA(364.7,719,3,0)="^^9^9^2990611^^^^"
^IBA(364.7,719,3,1,0)="If this data element returns a value other than null, it can be output on"
^IBA(364.7,719,3,2,0)="5 lines where characters 1-13 print on line 1, 14-27 print on line 2, 28-41"
^IBA(364.7,719,3,3,0)="print on line 3, 42-55 print on line 4 and 56-69 print on line 5."
^IBA(364.7,719,3,4,0)="Save off characters 14-69 in IBXSAVE(""FL56"",line #) array and set value of"
^IBA(364.7,719,3,5,0)="this data element to the first 13 characters.  If the right margin is 81"
^IBA(364.7,719,3,6,0)="instead of 80, move the field over 1 space.  The rest of IBXSAVE(""FL56"")"
^IBA(364.7,719,3,7,0)="will be printed at a later time."
^IBA(364.7,719,3,8,0)=" "
^IBA(364.7,719,3,9,0)="If the Form Locator 56 field has no data then the Prior Bills will be used."
^IBA(364.7,720,0)="700^N^5^^^^N"
^IBA(364.7,720,1)="S:$D(IBXSAVE(""FL56"",2)) IBXDATA=$E("" "",+$G(^TMP(""IBXSAVE"",$J,""RM"")))_IBXSAVE(""FL56"",2)"
^IBA(364.7,720,3,0)="^^4^4^2990611^^^^"
^IBA(364.7,720,3,1,0)="This data element's value relies on the existence of the IBXSAVE(""FL56"")"
^IBA(364.7,720,3,2,0)="variable previously extracted.  Form Locator 56 on the UB92 is split into"
^IBA(364.7,720,3,3,0)="5 lines and this is the 2nd line (14th-27th characters entered) for this"
^IBA(364.7,720,3,4,0)="field. If the right margin is 81 instead of 80, move the field over 1 space."
^IBA(364.7,721,0)="701^N^5^^^^N"
^IBA(364.7,721,1)="S:$D(IBXSAVE(""FL56"",3)) IBXDATA=$E("" "",+$G(^TMP(""IBXSAVE"",$J,""RM"")))_IBXSAVE(""FL56"",3)"
^IBA(364.7,721,3,0)="^^4^4^2990611^^^^"
^IBA(364.7,721,3,1,0)="This data element's value relies on the existence of the IBXSAVE(""FL56"")"
^IBA(364.7,721,3,2,0)="variable previously extracted.  Form Locator 56 on the UB92 is split into"
^IBA(364.7,721,3,3,0)="5 lines and this is the 3rd line (28th-41th characters entered) for this"
^IBA(364.7,721,3,4,0)="field. If the right margin is 81 instead of 80, move the field over 1 space."
^IBA(364.7,722,0)="702^N^5^^^^N"
^IBA(364.7,722,1)="S:$D(IBXSAVE(""FL56"",4)) IBXDATA=$E("" "",+$G(^TMP(""IBXSAVE"",$J,""RM"")))_IBXSAVE(""FL56"",4)"
^IBA(364.7,722,3,0)="^^4^4^2990609^^^^"
^IBA(364.7,722,3,1,0)="This data element's value relies on the existence of the IBXSAVE(""FL56"")"
^IBA(364.7,722,3,2,0)="variable previously extracted.  Form Locator 56 on the UB92 is split into"
^IBA(364.7,722,3,3,0)="5 lines and this is the 4th line (42nd-55th characters entered) for this"
^IBA(364.7,722,3,4,0)="field. If the right margin is 81 instead of 80, move the field over 1 space."
^IBA(364.7,723,0)="703^N^5^^^^N"
^IBA(364.7,723,1)="S:$D(IBXSAVE(""FL56"",5)) IBXDATA=$E("" "",+$G(^TMP(""IBXSAVE"",$J,""RM"")))_IBXSAVE(""FL56"",5)"
^IBA(364.7,723,3,0)="^^4^4^2990609^^^^"
^IBA(364.7,723,3,1,0)="This data element's value relies on the existence of the IBXSAVE(""FL56"")"
^IBA(364.7,723,3,2,0)="variable previously extracted.  Form Locator 56 on the UB92 is split into"
^IBA(364.7,723,3,3,0)="5 lines and this is the 5th line (56th-69th characters entered) for this"
^IBA(364.7,723,3,4,0)="field. If the right margin is 81 instead of 80, move the field over 1 space."
^IBA(364.7,724,0)="704^N^194^^^^N"
^IBA(364.7,724,1)="N Z,Z0 M Z0=IBXDATA K IBXDATA S Z="""" F  S Z=$O(Z0(Z)) Q:'Z  I $D(^DGCR(399,IBXIEN,""I""_Z)) S IBXDATA(Z)=$S(Z<3&$$WNRBILL^IBEFUNC(IBXIEN,Z):""MEDICARE"",1:$E($P(Z0(Z),U),1,15))_$S($P(Z0(Z),U,2)'="""":"" ""_$P(Z0(Z),U,2),1:"""")"
^IBA(364.7,724,3,0)="^364.73^4^4^3000830^^^^"
^IBA(364.7,724,3,1,0)="The first 15 characters of the name of the primary, secondary, and tertiary"
^IBA(364.7,724,3,2,0)="insurance companies along with the claim office number and payer id, if"
^IBA(364.7,724,3,3,0)="known.  If the primary or secondary insurance is MEDICARE WNR, output"
^IBA(364.7,724,3,4,0)="'MEDICARE'."
^IBA(364.7,725,0)="705^N^195^^^^N"
^IBA(364.7,726,0)="706^N^23^^^^N"
^IBA(364.7,726,1)="N Z,Z0 S Z0=$S(IBXDATA:""R"",1:""Y"") F Z=1:1:3 I $S(Z=1:1,1:$D(^DGCR(399,IBXIEN,""I""_Z))) S IBXDATA(Z)=Z0"
^IBA(364.7,726,3,0)="^^2^2^2990609^^^^"
^IBA(364.7,726,3,1,0)="For each insurance on file in the bill, print the ROI indicator = 'Y' if"
^IBA(364.7,726,3,2,0)="the record is not a sensitive record, or 'R' if it is a sensitive record."
^IBA(364.7,727,0)="707^N^24^^^^N"
^IBA(364.7,727,1)="N Z,Z0 S Z0=$S(IBXDATA=""""!(""Nn0""'[IBXDATA):""Y"",1:""N"") F Z=1:1:3 I $S(Z=1:1,1:$D(^DGCR(399,IBXIEN,""I""_Z))) S IBXDATA(Z)=Z0"
^IBA(364.7,727,3,0)="^^3^3^2990609^^^^"
^IBA(364.7,727,3,1,0)="For each insurance on file in the bill, print the ASSIGNMENT OF BENEFITS"
^IBA(364.7,727,3,2,0)="indicator = 'Y' if the data element value returned is null or is not 0,'n'"
^IBA(364.7,727,3,3,0)="or 'N', otherwise print 'N'."
^IBA(364.7,728,0)="708^N^156^^^^N"
^IBA(364.7,728,1)="N Z F Z=1:1:3 K:'$D(^DGCR(399,IBXIEN,""I""_Z)) IBXDATA(Z) I $D(IBXDATA(Z)) S IBXDATA(Z)=$S(IBXDATA(Z)'="""":$J(IBXDATA(Z),10,2),1:$J(0,10,2))"
^IBA(364.7,728,3,0)="^364.73^2^2^3040218^^^^"
^IBA(364.7,728,3,1,0)="If the insurance company for the prior payment does not exist for the bill,"
^IBA(364.7,728,3,2,0)="don't output the prior payment information."
^IBA(364.7,729,0)="709^N^152^^^^N"
^IBA(364.7,729,1)="N Z,Z0,IBZ S IBZ=$G(IBXDATA) K IBXDATA S Z0=$$COBN^IBCEF(IBXIEN),IBXDATA(Z0)=$J(+IBZ,9,2) F Z=1:1:3 I Z'=Z0,$D(^DGCR(399,IBXIEN,""I""_Z)) S IBXDATA(Z)=$J(0,9,2)"
^IBA(364.7,729,3,0)="^364.73^2^2^3040218^^^^"
^IBA(364.7,729,3,1,0)="Set the estimated amt for the current insurance equal to the balance on the"
^IBA(364.7,729,3,2,0)="bill."
^IBA(364.7,730,0)="710^N^5^^^^N"
^IBA(364.7,730,1)="K IBXDATA"
^IBA(364.7,730,3,0)="^^1^1^2991001^"
^IBA(364.7,730,3,1,0)="Not used"
^IBA(364.7,731,0)="711^N^5^^^^N"
^IBA(364.7,731,1)="K IBXDATA"
^IBA(364.7,731,3,0)="^^1^1^2990614^^^^"
^IBA(364.7,731,3,1,0)="Not used yet.  No output."
^IBA(364.7,732,0)="712^N^5^^^^N"
^IBA(364.7,732,1)="K IBXDATA"
^IBA(364.7,732,3,0)="^^1^1^2990609^^^"
^IBA(364.7,732,3,1,0)="Not used yet.  No output."
^IBA(364.7,733,0)="713^N^196^^^^N"
^IBA(364.7,733,1)="N Z F Z=1:1:3 I $G(IBXDATA(Z))'="""",IBXDATA(Z)'["","" S Q=$$NAME^IBCEFG1(IBXDATA(Z),1),IBXDATA(Z)=$P(Q,U)_$S($P(Q,U,2)'="""":"",""_$P(Q,U,2),1:"""")"
^IBA(364.7,734,0)="714^N^197^^^^N"
^IBA(364.7,735,0)="715^N^198^^^^N"
^IBA(364.7,736,0)="716^N^199^^^^N"
^IBA(364.7,736,1)="N Z,Z0 S Z0=$$COBN^IBCEF(IBXIEN) F Z=1:1:3 S IBXDATA(Z)=$G(IBXDATA(Z))_"" "" I $D(^DGCR(399,IBXIEN,""I""_Z)),$$WNRBILL^IBEFUNC(IBXIEN,Z) S IBXDATA(Z)="""""
^IBA(364.7,736,3,0)="^364.73^3^3^3040226^^^"
^IBA(364.7,736,3,1,0)="If the insurance is MEDICARE WNR, do not output the group name."
^IBA(364.7,736,3,2,0)="Add a space to the end of the Group Name to separate it from"
^IBA(364.7,736,3,3,0)="the next field , Group Number."
^IBA(364.7,737,0)="717^N^200^^^^N"
^IBA(364.7,737,1)="N Z,Z0 S Z0=$$COBN^IBCEF(IBXIEN) F Z=1:1:3 I $D(^DGCR(399,IBXIEN,""I""_Z)),Z0=Z,$$WNRBILL^IBEFUNC(IBXIEN,Z) S IBXDATA(Z)="""""
^IBA(364.7,737,3,0)="^364.73^1^1^3000830^^^"
^IBA(364.7,737,3,1,0)="If the insurance is MEDICARE WNR, do not output the group number."
^IBA(364.7,738,0)="718^N^265^^^^N"
^IBA(364.7,739,0)="719^N^202^^^^N"
^IBA(364.7,739,1)="N Z,Z0,A,IBZ S A=""OIEMP"" M Z0=IBXDATA K IBXSAVE(A),IBXDATA D F^IBCEF(""N-ALL INSURED EMPLOYER INFO"",""IBZ"") M IBXSAVE(A)=IBZ I $O(IBXSAVE(A,0)) F Z=1:1:3 I $S(Z=1:1,1:$D(^DGCR(399,IBXIEN,""I""_Z))) S IBXDATA(Z)=$S(Z0(Z)="""":9,1:+Z0(Z))"
^IBA(364.7,740,0)="720^N^5^^^^N"
^IBA(364.7,740,1)="N Z,IBZ D:'$D(IBXSAVE(""OIEMP"")) F^IBCEF(""N-ALL INSURED EMPLOYER INFO"",""IBZ"",,IBXIEN) K IBXDATA M:$O(IBZ("""")) IBXSAVE(""OIEMP"")=IBZ F Z=1:1:3 I $D(IBXSAVE(""OIEMP"",Z)) S IBXDATA(Z)=$P(IBXSAVE(""OIEMP"",Z),U)"
^IBA(364.7,740,3,0)="^^3^3^2991210^^^^"
^IBA(364.7,740,3,1,0)="If the array IBXSAVE(""OIEMP"") doesn't already exist, extract it.  For each"
^IBA(364.7,740,3,2,0)="insured on the bill, extract the first piece of the data element for output"
^IBA(364.7,740,3,3,0)="in this field."
^IBA(364.7,741,0)="721^N^5^^^^N"
^IBA(364.7,741,1)="N Z,IBZ S Z="""" F  S Z=$O(IBXSAVE(""OIEMP"",Z)) K:'Z IBXSAVE(""OIEMP"") Q:'Z  S IBZ=$P(IBXSAVE(""OIEMP"",Z),U,2),IBZ=IBZ_$S(IBZ'="""":"", "",1:"""")_$P(IBXSAVE(""OIEMP"",Z),U,3),IBXDATA(Z)=$E($P(IBXSAVE(""OIEMP"",Z),U,5),1,36-$L(IBZ)-1)_"" ""_IBZ"
^IBA(364.7,741,3,0)="^^5^5^2991015^^^^"
^IBA(364.7,741,3,1,0)="This data element relies on the existence of the IBXSAVE(""OIEMP"") array"
^IBA(364.7,741,3,2,0)="extracted previously.  The output here is as much of the street address (5th"
^IBA(364.7,741,3,3,0)="piece) that will fit if the whole city and state are printed, then the"
^IBA(364.7,741,3,4,0)="second piece (city), a comma if city not null, and the third piece for the"
^IBA(364.7,741,3,5,0)="state abbreviation."
^IBA(364.7,742,0)="722^N^53^^^^N"
^IBA(364.7,742,1)="I IBXDATA'="""" N Z S Z=$L(IBXDATA) S:Z>3 IBXSAVE(""FL78"")=$E(IBXDATA,3,5),IBXDATA=$S($G(^TMP(""IBXSAVE"",$J,""RM"")):"" "",1:"""")_$E(IBXDATA,1,2) S:Z'>3 IBXSAVE(""FL78"")=$S($G(^TMP(""IBXSAVE"",$J,""RM"")):"" "",1:"""")_IBXDATA,IBXDATA="""""
^IBA(364.7,742,3,0)="^^8^8^2990609^^^^"
^IBA(364.7,742,3,1,0)="If this data element returns a value other than null, it can be output on"
^IBA(364.7,742,3,2,0)="2 lines if its length is bigger than 3 characters.  If less than 3"
^IBA(364.7,742,3,3,0)="characters in length, the text prints on line 2 and the entire text is"
^IBA(364.7,742,3,4,0)="saved in IBXSAVE(""FL78"").  If the length is greater than 3, characters 1-2"
^IBA(364.7,742,3,5,0)="print on line 1 and 3-5 print on line 2, save off characters 3-5 in"
^IBA(364.7,742,3,6,0)="IBXSAVE(""FL78"") array and set value of this data element to the first 2"
^IBA(364.7,742,3,7,0)="characters.  If the right margin is 81 instead of 80, move the field over 1"
^IBA(364.7,742,3,8,0)="space.  IBXSAVE(""FL78"") will be printed at a later time."
^IBA(364.7,744,0)="724^N^86^^^^N"
^IBA(364.7,744,1)="N C,Z,Z0,IBZ M IBZ=IBXDATA K IBXDATA S (C,Z)=0 F  S Z=$O(IBZ(Z)) Q:'Z  I '$$ECODE^IBCEU4(+IBZ(Z)) S C=C+1 S:C=1 IBXDATA=$P($G(^ICD9(+IBZ(Z),0)),U) I C>1 S IBXSAVE(""DX"",C)=+IBZ(Z)"
^IBA(364.7,744,3,0)="^^3^3^3000110^^^^"
^IBA(364.7,744,3,1,0)="The principal dx is found in the first occurrence of the data element's"
^IBA(364.7,744,3,2,0)="values.  The rest of the diagnoses are saved off in the IBXSAVE(""DX"") array"
^IBA(364.7,744,3,3,0)="for later use.  Only allow 1 E-code."
^IBA(364.7,745,0)="725^N^5^^^^N"
^IBA(364.7,745,1)="I $D(IBXSAVE(""DX"",2)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(""DX"",2),0)),U) K IBXSAVE(""DX"",2)"
^IBA(364.7,745,3,0)="^^1^1^2991014^^^"
^IBA(364.7,745,3,1,0)="If there is a second diagnosis, print its name."
^IBA(364.7,746,0)="726^N^5^^^^N"
^IBA(364.7,746,1)="I $D(IBXSAVE(""DX"",3)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(""DX"",3),0)),U) K IBXSAVE(""DX"",3)"
^IBA(364.7,746,3,0)="^^1^1^2960814^^^"
^IBA(364.7,746,3,1,0)="If there is a third diagnosis, print its name."
^IBA(364.7,747,0)="727^N^5^^^^N"
^IBA(364.7,747,1)="I $D(IBXSAVE(""DX"",4)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(""DX"",4),0)),U) K IBXSAVE(""DX"",4)"
^IBA(364.7,747,3,0)="^^1^1^2960814^^"
^IBA(364.7,747,3,1,0)="If there is a fourth diagnosis, print its name."
^IBA(364.7,779,0)="766^N^5^^^^N"
^IBA(364.7,779,1)="N Z,Z0 K IBXDATA S Z0=0 F Z=2,6 S Z0=Z0+1 S:$G(IBXSAVE(""OCC"",Z))'="""" IBXDATA(Z0)=$P(IBXSAVE(""OCC"",Z),U)"
^IBA(364.7,779,3,0)="^^5^5^2991014^^^^"
^IBA(364.7,779,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,779,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,779,3,3,0)="IBXSAVE(""OCC"") extracted previously.  This field outputs the 2nd and 6th"
^IBA(364.7,779,3,4,0)="occurrences of occurrence codes found in the IBXSAVE(""OCC"",n) array data"
^IBA(364.7,779,3,5,0)="element.  Overflow codes are printed on a separate page."
^IBA(364.7,780,0)="767^N^5^^^^N"
^IBA(364.7,780,1)="N Z,Z0 K IBXDATA S Z0=0 F Z=3,7 S Z0=Z0+1 S:$G(IBXSAVE(""OCC"",Z))'="""" IBXDATA(Z0)=$P(IBXSAVE(""OCC"",Z),U)"
^IBA(364.7,780,3,0)="^^5^5^2991014^^^^"
^IBA(364.7,780,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,780,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,780,3,3,0)="IBXSAVE(""OCC"") extracted previously.  This field outputs the 3rd and 7th"
^IBA(364.7,780,3,4,0)="occurrences of occurrence codes found in the IBXSAVE(""OCC"",n) array data"
^IBA(364.7,780,3,5,0)="element.  Overflow codes are printed on a separate page."
^IBA(364.7,781,0)="768^N^5^^^^N"
^IBA(364.7,781,1)="N Z,Z0 K IBXDATA S Z0=0 F Z=4,8 S Z0=Z0+1 S:$G(IBXSAVE(""OCC"",Z))'="""" IBXDATA(Z0)=$P(IBXSAVE(""OCC"",Z),U)"
^IBA(364.7,781,3,0)="^^5^5^2991014^^^^"
^IBA(364.7,781,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,781,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,781,3,3,0)="IBXSAVE(""OCC"") extracted previously.  This field outputs the 4th and 8th"
^IBA(364.7,781,3,4,0)="occurrences of occurrence codes found in the IBXSAVE(""OCC"",n) array data"
^IBA(364.7,781,3,5,0)="element.  Overflow codes are printed on a separate page."
^IBA(364.7,782,0)="769^N^105^^^^N"
^IBA(364.7,782,1)="S:IBXDATA'="""" IBXSAVE(""ACCITY"")=IBXDATA_"" """
^IBA(364.7,782,3,0)="^^2^2^2990609^^^"
^IBA(364.7,782,3,1,0)="If the agent cashier city is defined, save it in array IBXSAVE for later"
^IBA(364.7,782,3,2,0)="use.  Include the space to be used between city and state."
^IBA(364.7,783,0)="770^N^106^^^^N"
^IBA(364.7,783,1)="I IBXDATA'="""" S IBXSAVE(""ACSTATE"")=$$STATE^IBCEFG1(IBXDATA)_"" """
^IBA(364.7,783,3,0)="^^3^3^2990609^^^^"
^IBA(364.7,783,3,1,0)="If the agent cashier state is defined, save the 2-character state"
^IBA(364.7,783,3,2,0)="abbreviation in array IBXSAVE for later use.  Include the space to be used"
^IBA(364.7,783,3,3,0)="between state and zip code."
^IBA(364.7,784,0)="771^N^107"
^IBA(364.7,784,1)="I IBXDATA'="""" S IBXSAVE(""ACZIP"")=$E(IBXDATA,1,5)_$S($E(IBXDATA,6,9)'="""":""-""_$E(IBXDATA,6,9),1:"""")"
^IBA(364.7,784,3,0)="^^2^2^2960814^^"
^IBA(364.7,784,3,1,0)="If the agent cashier zip code is defined, save the zip code in array IBXSAVE"
^IBA(364.7,784,3,2,0)="for later use."
^IBA(364.7,785,0)="772^N^4^^^^N"
^IBA(364.7,785,1)="I $TR(IBXDATA,"" ^"")'="""" N Q,Y S IBXSAVE(""RP"",1)=$P(IBXDATA,U,5),Q=1 X ""N Z,A F Z=6,7 S A=$P(IBXDATA,U,Z) I A'="""""""" S Q=Q+1,IBXSAVE(""""RP"""",Q)=A"" S Y=$P(IBXDATA,U,4) D ZIPOUT^VAFADDR S IBXSAVE(""RP"",Q+1)=$P(IBXDATA,U,2)_"", ""_$P(IBXDATA,U,3)_"" ""_Y"
^IBA(364.7,785,3,0)="^^2^2^2990609^^^^"
^IBA(364.7,785,3,1,0)="Takes data extracted from current insured's address and the city/state/zip"
^IBA(364.7,785,3,2,0)="and saves the values in IBXSAVE array."
^IBA(364.7,787,0)="774^N^5^^^^N"
^IBA(364.7,787,1)="D CKPGUB^IBCEF3"
^IBA(364.7,787,3,0)="^^1^1^2991118^^^"
^IBA(364.7,787,3,1,0)="Checks for multi-page output, adds the static fields to subsequent pages."
^IBA(364.7,788,0)="775^N^223^^^^N"
^IBA(364.7,788,3,0)="^^1^1^2961023^^^^"
^IBA(364.7,788,3,1,0)="If data element's value is null, do not output."
^IBA(364.7,790,0)="777^N^5^^^^N"
^IBA(364.7,790,1)="S IBXDATA=$P($G(IBXSAVE(""IADR"")),U,2)"
^IBA(364.7,790,3,0)="^^2^2^2970519^"
^IBA(364.7,790,3,1,0)="This field relies on the existence of variable IBXSAVE(""IADR"") previously"
^IBA(364.7,790,3,2,0)="extracted."
^IBA(364.7,791,0)="781^N^4^^^^N"
^IBA(364.7,791,1)="I '$G(IBXSAVE(""IBSAME"")) S IBXSAVE(""IADR"")=IBXDATA"
^IBA(364.7,792,0)="778^N^5^^^^N"
^IBA(364.7,792,1)="S IBXDATA=$P($G(IBXSAVE(""IADR"")),U,3)"
^IBA(364.7,792,3,0)="^^2^2^2970519^^"
^IBA(364.7,792,3,1,0)="This field relies on the existence of variable IBXSAVE(""IADR"") previously"
^IBA(364.7,792,3,2,0)="extracted.  Output the state abbreviation."
^IBA(364.7,793,0)="779^N^5^^^^N"
^IBA(364.7,793,1)="S IBXDATA=$P($G(IBXSAVE(""IADR"")),U,4)"
^IBA(364.7,793,3,0)="^^2^2^2970519^"
^IBA(364.7,793,3,1,0)="This field relies on the existence of variable IBXSAVE(""IADR"") previously"
^IBA(364.7,793,3,2,0)="extracted.  Output the insured's zip code."
^IBA(364.7,794,0)="780^N^5^^^^N"
^IBA(364.7,794,1)="S IBXDATA=$S('$G(IBXSAVE(""IBSAME"")):$P($G(IBXSAVE(""IDEM"")),U,3),1:"""") K IBXSAVE(""IBSAME"") I $L(IBXDATA)=10 S IBXDATA=$E(IBXDATA,1,3)_"" ""_$E(IBXDATA,4,10)"
^IBA(364.7,794,3,0)="^^2^2^2970519^"
^IBA(364.7,794,3,1,0)="This field relies on the existence of the variable IBXSAVE(""IDEM"")"
^IBA(364.7,794,3,2,0)="previously extracted."
^IBA(364.7,795,0)="782^N^6^^^^N"
^IBA(364.7,795,1)="S IBXSAVE(""IDEM"")=IBXDATA"
^IBA(364.7,795,3,0)="^^1^1^2970519^"
^IBA(364.7,795,3,1,0)="Save the insured's demographic data in IBXSAVE(""IDEM"")."
^IBA(364.7,796,0)="784^N^218^^^^N"
^IBA(364.7,797,0)="785^N^5^^^^N"
^IBA(364.7,797,1)="K IBXDATA"
^IBA(364.7,797,3,0)="^^1^1^2981214^"
^IBA(364.7,797,3,1,0)="Field is not currently used by the V.A"
^IBA(364.7,798,0)="943^N^83^^^^N"
^IBA(364.7,798,1)="N Z0 S Z0=$G(IBXSAVE(""ATTP"")) S:Z0="""" Z0=$$NAME^IBCEFG1($P(IBXDATA,U,1),1) K IBXDATA S:$P(Z0,U,5)'="""" IBXDATA=$$NOPUNCT^IBCEF($P(Z0,U,5))"
^IBA(364.7,798,3,0)="^364.73^1^1^3031006^^^^"
^IBA(364.7,798,3,1,0)="Finds SSN for ATTENDING or RENDERING PROVIDER"
^IBA(364.7,799,0)="788^N^127^^^^N"
^IBA(364.7,799,1)="N IBZ S IBZ=$$WNRBILL^IBEFUNC(IBXIEN,+$$COBN^IBCEF(IBXIEN)) S:IBZ IBXDATA=""VA0""_$P($$SITE^VASITE,U,3)"
^IBA(364.7,799,3,0)="^364.73^2^2^3000509^^^^"
^IBA(364.7,799,3,1,0)="If MRA is needed, use default of VA0 and the site #.  For other than MRA,"
^IBA(364.7,799,3,2,0)="use the provider number assigned to the site by the insurance co."
^IBA(364.7,800,0)="789^N^5^^^^N"
^IBA(364.7,800,1)="S IBXDATA=$P($G(IBXSAVE(""IADR"")),U,3) I IBXDATA="""" D PTSELF^IBCEF73 I $G(IBXDATA)=""18"" S IBXDATA=$$PTADDR^IBCEF(IBXIEN,5)"
^IBA(364.7,800,3,0)="^364.73^2^2^3030911^^^"
^IBA(364.7,800,3,1,0)="Retrieves insured state data from IBXSAVE array previously extracted.  If"
^IBA(364.7,800,3,2,0)="data element's value is null, do not output."
^IBA(364.7,801,0)="790^N^64^^^^N"
^IBA(364.7,801,1)="S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,801,3,0)="^^1^1^2990921^^"
^IBA(364.7,801,3,1,0)="Strip all punctuation from phone number."
^IBA(364.7,802,0)="791^N^224^^^^N"
^IBA(364.7,802,1)="K IBXDATA"
^IBA(364.7,802,3,0)="^^2^2^2981124^^^^"
^IBA(364.7,802,3,1,0)="Set ^TMP(""IBHDR"",$J) global node so the header data is not extracted again."
^IBA(364.7,802,3,2,0)="No output needed."
^IBA(364.7,803,0)="807^N^131^^^^N"
^IBA(364.7,803,1)="S IBXDATA=""COB1"""
^IBA(364.7,804,0)="808^N^5^^^^N"
^IBA(364.7,804,1)="N Z,IBZ K IBXDATA S (Z,IBZ)=0 F  S IBZ=$O(IBXSAVE(""CCOB"",IBZ)) Q:'IBZ  S Z=Z+1,IBXDATA(Z)=IBZ I Z>1 D ID^IBCEF2(Z,""COB1"")"
^IBA(364.7,804,3,0)="^^5^5^2990901^^^^"
^IBA(364.7,804,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,804,3,2,0)="possible for the data element in the IBXDATA array.  It relies on the"
^IBA(364.7,804,3,3,0)="existence of the IBXSAVE(""CCOB"",COBSEQ) array that was previously extracted."
^IBA(364.7,804,3,4,0)="For other than the first occurrence, the RECORD ID 'COB1' must be output."
^IBA(364.7,804,3,5,0)="Only output 1 record per COB sequence."
^IBA(364.7,805,0)="864^N^5^^^^N"
^IBA(364.7,805,1)="K IBXDATA N Z,Z0 S Z=0 F  S Z=$O(IBXSAVE(""INPT"",Z)) Q:'Z  S:$P(IBXSAVE(""INPT"",Z),U)'="""" Z0=$P(IBXSAVE(""INPT"",Z),U) S IBXDATA(Z)=$S(Z0="""":"""",Z0'<100&(Z0'>219):""DA"",1:""UN"") K:IBXDATA(Z)="""" IBXDATA(Z)"
^IBA(364.7,805,3,0)="^^2^2^2990211^^"
^IBA(364.7,805,3,1,0)="Depending on the revenue code found, this field is set to DA or UN to"
^IBA(364.7,805,3,2,0)="specify the type of units being billed for."
^IBA(364.7,806,0)="793^N^5^^^^N"
^IBA(364.7,806,1)="K IBXDATA I $P($G(IBXSAVE(""CADR"")),U,2)'="""" S IBXDATA=$E($P(IBXSAVE(""CADR""),U,2)_"" ""_$P(IBXSAVE(""CADR""),U,3),1,30)"
^IBA(364.7,806,3,0)="^364.73^6^6^3030926^^^^"
^IBA(364.7,806,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR1"",$J) will"
^IBA(364.7,806,3,2,0)="already exist.  Don't want to extract this field again, so kill data"
^IBA(364.7,806,3,3,0)="element so there is no output.  Also don't output data element if its"
^IBA(364.7,806,3,4,0)="value is null."
^IBA(364.7,806,3,5,0)="This data relies on the presence of the IBXSAVE(""CADR"") array that should"
^IBA(364.7,806,3,6,0)="have been set in a previous data field."
^IBA(364.7,807,0)="885^N^192^^^^N"
^IBA(364.7,807,1)="K IBXSAVE(""CADR"") I $D(IBXDATA) N Q,Y,Z S Q=""CADR"",Y=$G(IBXDATA(6)) D ZIPOUT^VAFADDR S:Y'="""" $P(IBXSAVE(Q),U,6)=Y F Z=1:1:5,7 I $D(IBXDATA(Z)) S $P(IBXSAVE(Q),U,Z)=IBXDATA(Z)"
^IBA(364.7,807,3,0)="^^3^3^2991101^^^^"
^IBA(364.7,807,3,1,0)="Data element extracts address data into IBXDATA array"
^IBA(364.7,807,3,2,0)="Save the data in IBXSAVE(""CADR"")=Street addr 1^Street addr 2^Street addr 3^"
^IBA(364.7,807,3,3,0)="City^State^Zip^claim office id # for later use."
^IBA(364.7,808,0)="886^N^225^^^^N"
^IBA(364.7,808,1)="M IBXSAVE(""CCOB"")=IBXDATA K IBXDATA"
^IBA(364.7,808,3,0)="^^1^1^2990901^^"
^IBA(364.7,808,3,1,0)="Move data to IBXSAVE for later use."
^IBA(364.7,809,0)="809^N^5^^^^N"
^IBA(364.7,809,1)="N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F  S IBZ=$O(IBXSAVE(""CCOB"",IBZ)) Q:'IBZ  S Z0=Z0+1,Z=0 F  S Z=$O(IBXSAVE(""CCOB"",IBZ,Z)) Q:'Z  I $P($G(IBXSAVE(""CCOB"",IBZ,Z,1)),U,2) S IBXDATA(Z0)=$$DOLLAR^IBCEFG1($G(IBXDATA(Z0))+$P(IBXSAVE(""CCOB"",IBZ,Z,1),U,2))"
^IBA(364.7,809,3,0)="^^3^3^3030220^^^^"
^IBA(364.7,809,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,809,3,2,0)="insurance into the IBXSAVE(""CCOB"",COB,n,1) array.  Extract the second piece"
^IBA(364.7,809,3,3,0)="for this data.  Output the sum of each COB sequence as 1 IBXDATA(n) entry."
^IBA(364.7,810,0)="816^N^131^^^^N"
^IBA(364.7,810,1)="S IBXDATA=""MOA1"""
^IBA(364.7,811,0)="827^N^131^^^^N"
^IBA(364.7,811,1)="S IBXDATA=""MIA1"""
^IBA(364.7,812,0)="839^N^131^^^^N"
^IBA(364.7,812,1)="S IBXDATA=""MIA2"""
^IBA(364.7,813,0)="853^N^131^^^^N"
^IBA(364.7,813,1)="S IBXDATA=""CCAS"""
^IBA(364.7,814,0)="817^N^5^^^^N"
^IBA(364.7,814,1)="K:$$INPAT^IBCEF(IBXIEN,1) IBXDATA I $D(IBXDATA) N Z,IBZ K IBXDATA S (Z,IBZ)=0 F  S IBZ=$O(IBXSAVE(""MOA"",IBZ)) Q:'IBZ  S Z=Z+1,IBXDATA(Z)=IBZ I Z>1 D ID^IBCEF2(Z,""MOA1"")"
^IBA(364.7,814,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,814,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,814,3,2,0)="possible for the data element in the IBXDATA array.  It relies on the"
^IBA(364.7,814,3,3,0)="existence of the IBXSAVE(""MOA"") array that was previously extracted."
^IBA(364.7,814,3,4,0)="For other than the first occurrence, the RECORD ID 'MOA1' must be output."
^IBA(364.7,815,0)="828^N^5^^^^N"
^IBA(364.7,815,1)="K:'$$INPAT^IBCEF(IBXIEN,1) IBXDATA I $D(IBXDATA) N Z,IBZ K IBXDATA S (Z,IBZ)=0 F  S IBZ=$O(IBXSAVE(""MIA45"",IBZ)) Q:'IBZ  S Z=Z+1,IBXDATA(Z)=IBZ I Z>1 D ID^IBCEF2(Z,""MIA1"")"
^IBA(364.7,815,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,815,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,815,3,2,0)="possible for the data element in the IBXDATA array.  It relies on the"
^IBA(364.7,815,3,3,0)="existence of the IBXSAVE(""MIA45"") array that was previously extracted."
^IBA(364.7,815,3,4,0)="For other than the first occurrence, the RECORD ID 'MIA1' must be output."
^IBA(364.7,816,0)="840^N^5^^^^N"
^IBA(364.7,816,1)="K:'$$INPAT^IBCEF(IBXIEN,1) IBXDATA I $D(IBXDATA) N Z,IBZ K IBXDATA S (Z,IBZ)=0 F  S IBZ=$O(IBXSAVE(""MIA45"",IBZ)) Q:'IBZ  S Z=Z+1,IBXDATA(Z)=IBZ I Z>1 D ID^IBCEF2(Z,""MOA1"")"
^IBA(364.7,816,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,816,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,816,3,2,0)="possible for the data element in the IBXDATA array.  It relies on the"
^IBA(364.7,816,3,3,0)="existence of the IBXSAVE(""MIA45"") array that was previously extracted."
^IBA(364.7,816,3,4,0)="For other than the first occurrence, the RECORD ID 'MIA2' must be output."
^IBA(364.7,817,0)="854^N^5^^^^N"
^IBA(364.7,817,1)="N Z,Z0 K IBXDATA S (Z,Z1)=0 F  S Z=$O(IBXSAVE(""CCAS"",Z)) Q:'Z  S Z0=0 F  S Z0=$O(IBXSAVE(""CCAS"",Z,Z0)) Q:'Z0  S Z1=Z1+1,IBXDATA(Z1)=Z I Z1>1 D ID^IBCEF2(Z1,""CCAS"")"
^IBA(364.7,817,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,817,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,817,3,2,0)="possible for the data element in the IBXDATA array.  It relies on the"
^IBA(364.7,817,3,3,0)="existence of the IBXSAVE(""CCAS"") array that was previously extracted."
^IBA(364.7,817,3,4,0)="For other than the first occurrence, the RECORD ID 'CCAS' must be output."
^IBA(364.7,818,0)="887^N^227^^^^N"
^IBA(364.7,818,1)="K IBXSAVE(""MOA"") M IBXSAVE(""MOA"")=IBXDATA K IBXDATA"
^IBA(364.7,818,3,0)="^^1^1^2990901^^^^"
^IBA(364.7,818,3,1,0)="Move the IBXDATA array to the IBXSAVE array for later use."
^IBA(364.7,819,0)="888^N^226^^^^N"
^IBA(364.7,819,1)="K IBXSAVE(""MIA45"") M IBXSAVE(""MIA45"")=IBXDATA K IBXDATA"
^IBA(364.7,819,3,0)="^^1^1^2990901^^^^"
^IBA(364.7,819,3,1,0)="Move the IBXDATA array to the IBXSAVE array for later use."
^IBA(364.7,821,0)="890^N^228^^^^N"
^IBA(364.7,821,1)="K IBXSAVE(""CCAS"") M IBXSAVE(""CCAS"")=IBXDATA K IBXDATA"
^IBA(364.7,821,3,0)="^^1^1^2990901^^^^"
^IBA(364.7,821,3,1,0)="Move the IBXDATA array to the IBXSAVE array for later use."
^IBA(364.7,822,0)="841^N^5^^^^N"
^IBA(364.7,822,1)="N Z1,Z2,Z3 S Z1=""MIA45"",Z2=4,Z3=12 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)"
^IBA(364.7,822,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,822,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,822,3,2,0)="insurance into the IBXSAVE(""MIA45"",COB,n,4) array.  Extract the twelveth"
^IBA(364.7,822,3,3,0)="piece for this data.  Output the sum of each COB sequence as 1 IBXDATA(n)"
^IBA(364.7,822,3,4,0)="entry."
^IBA(364.7,823,0)="818^N^5^^^^N"
^IBA(364.7,823,1)="N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F  S IBZ=$O(IBXSAVE(""MOA"",IBZ)) Q:'IBZ  S Z0=Z0+1,Z=0 F  S Z=$O(IBXSAVE(""MOA"",IBZ,Z)) Q:'Z  I $P($G(IBXSAVE(""MOA"",IBZ,Z,3)),U) S IBXDATA(Z0)=$G(IBXDATA(Z0))+$$DOLLAR^IBCEFG1($P(IBXSAVE(""MOA"",IBZ,Z,3),U))"
^IBA(364.7,823,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,823,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,823,3,2,0)="insurance into the IBXSAVE(""MOA"",COB,n,3) array.  Extract the first piece"
^IBA(364.7,823,3,3,0)="for this data.  Output the sum of each COB sequence as 1 IBXDATA(n) entry."
^IBA(364.7,824,0)="829^N^5^^^^N"
^IBA(364.7,824,1)="N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F  S IBZ=$O(IBXSAVE(""MIA45"",IBZ)) Q:'IBZ  S Z0=Z0+1,Z=0 F  S Z=$O(IBXSAVE(""MIA45"",IBZ,Z)) Q:'Z  I $P($G(IBXSAVE(""MIA45"",IBZ,Z,4)),U,1)'="""" S IBXDATA(Z0)=$G(IBXDATA(Z0))+$P(IBXSAVE(""MIA45"",IBZ,Z,4),U)"
^IBA(364.7,824,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,824,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,824,3,2,0)="insurance into the IBXSAVE(""MIA45"",COB,n,4) array.  Extract the first piece"
^IBA(364.7,824,3,3,0)="for this data.  Output the sum of each COB sequence as 1 IBXDATA(n) entry."
^IBA(364.7,825,0)="855^N^5^^^^N"
^IBA(364.7,825,1)="N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F  S Z=$O(IBXSAVE(""CCAS"",Z)) Q:'Z  S Z0=0 F  S Z0=$O(IBXSAVE(""CCAS"",Z,Z0)) Q:'Z0  S Z1=Z1+1 I $P($G(IBXSAVE(""CCAS"",Z,Z0)),U)'="""",$O(IBXSAVE(""CCAS"",Z,Z0,0)) S IBXDATA(Z1)=$P(IBXSAVE(""CCAS"",Z,Z0),U)"
^IBA(364.7,825,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,825,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,825,3,2,0)="insurance into the IBXSAVE(""CCAS"",COB,n) array.  Extract the first"
^IBA(364.7,825,3,3,0)="piece for this data."
^IBA(364.7,826,0)="848^N^5^^^^N"
^IBA(364.7,826,1)="N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F  S IBZ=$O(IBXSAVE(""MIA45"",IBZ)) Q:'IBZ  S Z0=Z0+1,Z=0 F  S Z=$O(IBXSAVE(""MIA45"",IBZ,Z)) Q:'Z  I $P($G(IBXSAVE(""MIA45"",IBZ,Z,5)),U)'="""" S IBXDATA(Z0)=$P(IBXSAVE(""MIA45"",IBZ,Z,5),U) Q"
^IBA(364.7,826,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,826,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,826,3,2,0)="insurance into the IBXSAVE(""MIA45"",COB,n,5) array.  Extract the first"
^IBA(364.7,826,3,3,0)="piece for this data.  Output only the first REMARKS CODE(1) found for each"
^IBA(364.7,826,3,4,0)="COB sequence."
^IBA(364.7,827,0)="856^N^5^^^^N"
^IBA(364.7,827,1)="N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F  S Z=$O(IBXSAVE(""CCAS"",Z)) Q:'Z  S Z0=0 F  S Z0=$O(IBXSAVE(""CCAS"",Z,Z0)) Q:'Z0  S Z1=Z1+1 I $P($G(IBXSAVE(""CCAS"",Z,Z0,1)),U)'="""" S IBXDATA(Z1)=$P(IBXSAVE(""CCAS"",Z,Z0,1),U)"
^IBA(364.7,827,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,827,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,827,3,2,0)="insurance into the IBXSAVE(""CCAS"",COB,n,1) array.  Extract the first piece"
^IBA(364.7,827,3,3,0)="if not null for this data."
^IBA(364.7,828,0)="892^N^5^^^^N"
^IBA(364.7,828,1)="N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F  S Z=$O(IBXSAVE(""CCAS"",Z)) Q:'Z  S Z0=0 F  S Z0=$O(IBXSAVE(""CCAS"",Z,Z0)) Q:'Z0  S Z1=Z1+1 I $P($G(IBXSAVE(""CCAS"",Z,Z0,2)),U)'="""" S IBXDATA(Z1)=$P(IBXSAVE(""CCAS"",Z,Z0,2),U)"
^IBA(364.7,828,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,828,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,828,3,2,0)="insurance into the IBXSAVE(""CCAS"",COB,n,2) array.  Extract the first piece"
^IBA(364.7,828,3,3,0)="for this data, if not null."
^IBA(364.7,829,0)="810^N^5^^^^N"
^IBA(364.7,829,1)="N Z,M,N,P,L K IBXDATA S L=""LCOB"",(Z,N)=0 F  S Z=$O(IBXSAVE(L,Z)) Q:'Z  S M=0 F  S M=$O(IBXSAVE(L,Z,M)) Q:'M  S N=N+1,P=+$O(IBXSAVE(L,Z,M,0)) Q:'P  S:$P($G(IBXSAVE(L,Z,M,P)),U,3) IBXDATA(N)=$$DOLLAR^IBCEFG1($P(IBXSAVE(L,Z,M,P),U,3))"
^IBA(364.7,829,3,0)="^^4^4^2991115^^^^"
^IBA(364.7,829,3,1,0)="This data element assumes the existence of the IBXSAVE array for each line"
^IBA(364.7,829,3,2,0)="item (LCOB) that was previously extracted.  If the line has COB data"
^IBA(364.7,829,3,3,0)="associated with it, output the allowed amt/amt paid for each COB sequence"
^IBA(364.7,829,3,4,0)="found for the line."
^IBA(364.7,830,0)="866^N^5^^^^N"
^IBA(364.7,830,1)="N Z,A,B K IBXDATA S:'$D(IBXSAVE(""LCOB"")) IBXNOREQ=1 S (Z,B)=0 F  S Z=$O(IBXSAVE(""LCOB"",Z)) Q:'Z  S:'$O(IBXSAVE(""LCOB"",Z,""COB"",0)) IBXNOREQ=1 S A=0 F  S A=$O(IBXSAVE(""LCOB"",Z,""COB"",A)) Q:'A  S B=B+1,IBXDATA(B)=Z I B>1 D ID^IBCEF2(B,""LCOB"")"
^IBA(364.7,830,3,0)="^^4^4^2990902^^^^"
^IBA(364.7,830,3,1,0)="This data element assumes the existence of the IBXSAVE array for each line"
^IBA(364.7,830,3,2,0)="item (LCOB) that was previously extracted.  If the line has COB data"
^IBA(364.7,830,3,3,0)="associated with it, output the line # for each COB sequence found for the"
^IBA(364.7,830,3,4,0)="line.  For every line output > 1, output the 'LCOB' record id."
^IBA(364.7,831,0)="865^N^131^^^^N"
^IBA(364.7,831,1)="S IBXDATA=""LCOB"""
^IBA(364.7,831,3,0)="^^1^1^2990902^^^^"
^IBA(364.7,831,3,1,0)="Output record id for 'LCOB' record."
^IBA(364.7,832,0)="867^N^5^^^^N"
^IBA(364.7,832,1)="I $$COBN^IBCEF(IBXIEN)>1 D COBPYRID^IBCEU1(IBXIEN,.IBXSAVE,.IBXDATA)"
^IBA(364.7,832,3,0)="^^4^4^2990902^^^^"
^IBA(364.7,832,3,1,0)="This data element assumes the existence of the IBXSAVE array for each line"
^IBA(364.7,832,3,2,0)="item (LCOB) that was previously extracted.  If the line has COB data"
^IBA(364.7,832,3,3,0)="associated with it, output the payer id for each COB sequence found for the"
^IBA(364.7,832,3,4,0)="line."
^IBA(364.7,833,0)="878^N^131^^^^N"
^IBA(364.7,833,1)="S IBXDATA=""LCAS"""
^IBA(364.7,833,3,0)="^^1^1^2990902^^^^"
^IBA(364.7,833,3,1,0)="Output record id for 'LCAS' record."
^IBA(364.7,834,0)="879^N^5^^^^N"
^IBA(364.7,834,1)="D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,2)"
^IBA(364.7,834,3,0)="^^5^5^2990902^^^^"
^IBA(364.7,834,3,1,0)="This data element assumes the existence of the IBXSAVE(""LCOB"") array that"
^IBA(364.7,834,3,2,0)="was previously extracted with COB data for specific line items.  Each time"
^IBA(364.7,834,3,3,0)="we encounter a new line item (after the first), a new group code, or more"
^IBA(364.7,834,3,4,0)="than 6 reason codes for a given group code, output the 'LCAS' record id as"
^IBA(364.7,834,3,5,0)="these each need a new record."
^IBA(364.7,835,0)="880^N^5^^^^N"
^IBA(364.7,835,1)="D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,3)"
^IBA(364.7,835,3,0)="^^4^4^2990902^^^^"
^IBA(364.7,835,3,1,0)="This data element assumes the existence of the IBXSAVE(""LCOB"") array that"
^IBA(364.7,835,3,2,0)="was previously extracted with COB data for specific line items.  Each time"
^IBA(364.7,835,3,3,0)="we encounter a new group code, or more than 6 reason codes for a given"
^IBA(364.7,835,3,4,0)="group code, output the group code as these each need a new record."
^IBA(364.7,837,0)="881^N^5^^^^N"
^IBA(364.7,837,1)="D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,4)"
^IBA(364.7,837,3,0)="^^4^4^2990902^^^^"
^IBA(364.7,837,3,1,0)="This data element assumes the existence of the IBXSAVE(""LCOB"") array that"
^IBA(364.7,837,3,2,0)="was previously extracted with COB data for specific line items.  Up to 6"
^IBA(364.7,837,3,3,0)="reason codes can be output on a single record for the same line and group"
^IBA(364.7,837,3,4,0)="code.  This extracts the first, seventh, etc onto separate records."
^IBA(364.7,838,0)="907^N^5^^^^N"
^IBA(364.7,838,1)="D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,7)"
^IBA(364.7,838,3,0)="^^4^4^2990902^^^^"
^IBA(364.7,838,3,1,0)="This data element assumes the existence of the IBXSAVE(""LCOB"") array that"
^IBA(364.7,838,3,2,0)="was previously extracted with COB data for specific line items.  Up to 6"
^IBA(364.7,838,3,3,0)="reason codes can be output on a single record for the same line and group"
^IBA(364.7,838,3,4,0)="code.  This extracts the second, eighth, etc onto separate records."
^IBA(364.7,839,0)="882^N^5^^^^N"
^IBA(364.7,839,1)="N Z D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,5) I $D(IBXDATA) S Z=0 F  S Z=$O(IBXDATA(Z)) Q:'Z  S IBXDATA(Z)=$$DOLLAR^IBCEFG1(IBXDATA(Z))"
^IBA(364.7,839,3,0)="^^4^4^2990902^^^^"
^IBA(364.7,839,3,1,0)="This data element assumes the existence of the IBXSAVE(""LCOB"") array that"
^IBA(364.7,839,3,2,0)="was previously extracted with COB data for specific line items.  Up to 6"
^IBA(364.7,839,3,3,0)="adj amts can be output on a single record for the same line and group"
^IBA(364.7,839,3,4,0)="code.  This extracts the first, seventh, etc onto separate records."
^IBA(364.7,840,0)="811^N^5^^^^N"
^IBA(364.7,840,1)="N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F  S IBZ=$O(IBXSAVE(""CCOB"",IBZ)) Q:'IBZ  S Z0=Z0+1,Z=0 F  S Z=$O(IBXSAVE(""CCOB"",IBZ,Z)) Q:'Z  I $P($G(IBXSAVE(""CCOB"",IBZ,Z,1)),U,4) S IBXDATA(Z0)=$G(IBXDATA(Z0))+$P(IBXSAVE(""CCOB"",IBZ,Z,1),U,4)"
^IBA(364.7,840,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,840,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,840,3,2,0)="insurance into the IBXSAVE(""CCOB"",COB,n,1) array.  Extract the fourth piece"
^IBA(364.7,840,3,3,0)="for this data.  Output the sum of each COB sequence as 1 IBXDATA(n) entry."
^IBA(364.7,842,0)="812^N^5^^^^N"
^IBA(364.7,842,1)="N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F  S IBZ=$O(IBXSAVE(""CCOB"",IBZ)) Q:'IBZ  S Z0=Z0+1,Z=0 F  S Z=$O(IBXSAVE(""CCOB"",IBZ,Z)) Q:'Z  I $P($G(IBXSAVE(""CCOB"",IBZ,Z,1)),U,5) S IBXDATA(Z0)=$$DOLLAR^IBCEFG1($G(IBXDATA(Z0))+$P(IBXSAVE(""CCOB"",IBZ,Z,1),U,5))"
^IBA(364.7,842,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,842,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,842,3,2,0)="insurance into the IBXSAVE(""CCOB"",COB,n,1) array.  Extract the fifth piece"
^IBA(364.7,842,3,3,0)="for this data.  Output the sum of each COB sequence as 1 IBXDATA(n) entry."
^IBA(364.7,843,0)="813^N^5^^^^N"
^IBA(364.7,843,1)="N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F  S IBZ=$O(IBXSAVE(""CCOB"",IBZ)) Q:'IBZ  S Z0=Z0+1,Z=0 F  S Z=$O(IBXSAVE(""CCOB"",IBZ,Z)) Q:'Z  I $P($G(IBXSAVE(""CCOB"",IBZ,Z,1)),U,7) S IBXDATA(Z0)=$G(IBXDATA(Z0))+$P(IBXSAVE(""CCOB"",IBZ,Z,1),U,7)"
^IBA(364.7,843,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,843,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,843,3,2,0)="insurance into the IBXSAVE(""CCOB"",COB,n,1) array.  Extract the seventh piece"
^IBA(364.7,843,3,3,0)="for this data.  Output the sum of each COB sequence as 1 IBXDATA(n) entry."
^IBA(364.7,844,0)="814^N^5^^^^N"
^IBA(364.7,844,1)="N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F  S IBZ=$O(IBXSAVE(""CCOB"",IBZ)) Q:'IBZ  S Z0=Z0+1,Z=0 F  S Z=$O(IBXSAVE(""CCOB"",IBZ,Z)) Q:'Z  I $P($G(IBXSAVE(""CCOB"",IBZ,Z,1)),U,8) S IBXDATA(Z0)=$G(IBXDATA(Z0))+$P(IBXSAVE(""CCOB"",IBZ,Z,1),U,8)"
^IBA(364.7,844,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,844,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,844,3,2,0)="insurance into the IBXSAVE(""CCOB"",COB,n,1) array.  Extract the eighth piece"
^IBA(364.7,844,3,3,0)="for this data.  Output the sum of each COB sequence as 1 IBXDATA(n) entry."
^IBA(364.7,845,0)="815^N^5^^^^N"
^IBA(364.7,845,1)="N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F  S IBZ=$O(IBXSAVE(""CCOB"",IBZ)) Q:'IBZ  S Z0=Z0+1,Z=0 F  S Z=$O(IBXSAVE(""CCOB"",IBZ,Z)) Q:'Z  I $P($G(IBXSAVE(""CCOB"",IBZ,Z,1)),U,9) S IBXDATA(Z0)=$G(IBXDATA(Z0))+$P(IBXSAVE(""CCOB"",IBZ,Z,1),U,9)"
^IBA(364.7,845,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,845,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,845,3,2,0)="insurance into the IBXSAVE(""CCOB"",COB,n,1) array.  Extract the ninth piece"
^IBA(364.7,845,3,3,0)="for this data.  Output the sum of each COB sequence as 1 IBXDATA(n) entry."
^IBA(364.7,846,0)="819^N^5^^^^N"
^IBA(364.7,846,1)="N Z1,Z2,Z3 S Z1=""MOA"",Z2=3,Z3=2 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)"
^IBA(364.7,846,3,0)="^^3^3^3030724^^^^"
^IBA(364.7,846,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,846,3,2,0)="insurance into the IBXSAVE(""MOA"",COB,n,3) array.  Extract the second piece"
^IBA(364.7,846,3,3,0)="for this data.  Output the sum of each COB sequence as 1 IBXDATA(n) entry."
^IBA(364.7,847,0)="820^N^5^^^^N"
^IBA(364.7,847,1)="N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F  S IBZ=$O(IBXSAVE(""MOA"",IBZ)) Q:'IBZ  S Z0=Z0+1,Z=0 F  S Z=$O(IBXSAVE(""MOA"",IBZ,Z)) Q:'Z  I $P($G(IBXSAVE(""MOA"",IBZ,Z,3)),U,3)'="""" S IBXDATA(Z0)=$P(IBXSAVE(""MOA"",IBZ,Z,3),U,3) Q"
^IBA(364.7,847,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,847,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,847,3,2,0)="insurance into the IBXSAVE(""MOA"",COB,n,3) array.  Extract the third"
^IBA(364.7,847,3,3,0)="piece for this data.  Output only the first REMARKS CODE(1) found for each"
^IBA(364.7,847,3,4,0)="COB sequence."
^IBA(364.7,848,0)="821^N^5^^^^N"
^IBA(364.7,848,1)="N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F  S IBZ=$O(IBXSAVE(""MOA"",IBZ)) Q:'IBZ  S Z0=Z0+1,Z=0 F  S Z=$O(IBXSAVE(""MOA"",IBZ,Z)) Q:'Z  I $P($G(IBXSAVE(""MOA"",IBZ,Z,3)),U,4)'="""" S IBXDATA(Z0)=$P(IBXSAVE(""MOA"",IBZ,Z,3),U,4) Q"
^IBA(364.7,848,3,0)="^^4^4^2991006^^^^"
^IBA(364.7,848,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,848,3,2,0)="insurance into the IBXSAVE(""MOA"",COB,n,3) array.  Extract the fourth"
^IBA(364.7,848,3,3,0)="piece for this data.  Output only the first REMARKS CODE(2) found for each"
^IBA(364.7,848,3,4,0)="COB sequence."
^IBA(364.7,849,0)="822^N^5^^^^N"
^IBA(364.7,849,1)="N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F  S IBZ=$O(IBXSAVE(""MOA"",IBZ)) Q:'IBZ  S Z0=Z0+1,Z=0 F  S Z=$O(IBXSAVE(""MOA"",IBZ,Z)) Q:'Z  I $P($G(IBXSAVE(""MOA"",IBZ,Z,3)),U,5)'="""" S IBXDATA(Z0)=$P(IBXSAVE(""MOA"",IBZ,Z,3),U,5) Q"
^IBA(364.7,849,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,849,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,849,3,2,0)="insurance into the IBXSAVE(""MOA"",COB,n,3) array.  Extract the fifth"
^IBA(364.7,849,3,3,0)="piece for this data.  Output only the first REMARKS CODE(3) found for each"
^IBA(364.7,849,3,4,0)="COB sequence."
^IBA(364.7,850,0)="823^N^5^^^^N"
^IBA(364.7,850,1)="N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F  S IBZ=$O(IBXSAVE(""MOA"",IBZ)) Q:'IBZ  S Z0=Z0+1,Z=0 F  S Z=$O(IBXSAVE(""MOA"",IBZ,Z)) Q:'Z  I $P($G(IBXSAVE(""MOA"",IBZ,Z,3)),U,6)'="""" S IBXDATA(Z0)=$P(IBXSAVE(""MOA"",IBZ,Z,3),U,6) Q"
^IBA(364.7,850,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,850,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,850,3,2,0)="insurance into the IBXSAVE(""MOA"",COB,n,3) array.  Extract the sixth"
^IBA(364.7,850,3,3,0)="piece for this data.  Output only the first REMARKS CODE(4) found for each"
^IBA(364.7,850,3,4,0)="COB sequence."
^IBA(364.7,851,0)="825^N^5^^^^N"
^IBA(364.7,851,1)="N Z1,Z2,Z3 S Z1=""MOA"",Z2=3,Z3=8 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)"
^IBA(364.7,851,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,851,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,851,3,2,0)="insurance into the IBXSAVE(""MOA"",COB,n,3) array.  Extract the eighth piece"
^IBA(364.7,851,3,3,0)="for this data.  Output the sum of each COB sequence as 1 IBXDATA(n) entry."
^IBA(364.7,852,0)="826^N^5^^^^N"
^IBA(364.7,852,1)="N Z1,Z2,Z3 S Z1=""MOA"",Z2=3,Z3=9 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)"
^IBA(364.7,852,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,852,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,852,3,2,0)="insurance into the IBXSAVE(""MOA"",COB,n,3) array.  Extract the ninth piece"
^IBA(364.7,852,3,3,0)="for this data.  Output the sum of each COB sequence as 1 IBXDATA(n) entry."
^IBA(364.7,853,0)="830^N^5^^^^N"
^IBA(364.7,853,1)="N Z1,Z2,Z3 S Z1=""MIA45"",Z2=4,Z3=3 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)"
^IBA(364.7,853,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,853,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,853,3,2,0)="insurance into the IBXSAVE(""MIA45"",COB,n,4) array.  Extract the third piece"
^IBA(364.7,853,3,3,0)="for this data.  Output the sum of each COB sequence as 1 IBXDATA(n) entry."
^IBA(364.7,854,0)="831^N^257^^^^N"
^IBA(364.7,854,1)="I +IBXDATA=0 K IBXDATA"
^IBA(364.7,855,0)="832^N^5^^^^N"
^IBA(364.7,855,1)="N Z1,Z2,Z3 S Z1=""MIA45"",Z2=4,Z3=5 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)"
^IBA(364.7,855,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,855,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,855,3,2,0)="insurance into the IBXSAVE(""MIA45"",COB,n,4) array.  Extract the fifth piece"
^IBA(364.7,855,3,3,0)="for this data.  Output the sum of each COB sequence as 1 IBXDATA(n) entry."
^IBA(364.7,856,0)="833^N^5^^^^N"
^IBA(364.7,856,1)="N Z1,Z2,Z3 S Z1=""MIA45"",Z2=4,Z3=6 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)"
^IBA(364.7,856,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,856,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,856,3,2,0)="insurance into the IBXSAVE(""MIA45"",COB,n,4) array.  Extract the sixth piece"
^IBA(364.7,856,3,3,0)="for this data.  Output the sum of each COB sequence as 1 IBXDATA(n) entry."
^IBA(364.7,857,0)="834^N^5^^^^N"
^IBA(364.7,857,1)="N Z1,Z2,Z3 S Z1=""MIA45"",Z2=4,Z3=7 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)"
^IBA(364.7,857,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,857,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,857,3,2,0)="insurance into the IBXSAVE(""MIA45"",COB,n,4) array.  Extract the seventh"
^IBA(364.7,857,3,3,0)="piece for this data.  Output the sum of each COB sequence as 1 IBXDATA(n)"
^IBA(364.7,857,3,4,0)="entry."
^IBA(364.7,858,0)="835^N^5^^^^N"
^IBA(364.7,858,1)="N Z1,Z2,Z3 S Z1=""MIA45"",Z2=4,Z3=8 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)"
^IBA(364.7,858,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,858,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,858,3,2,0)="insurance into the IBXSAVE(""MIA45"",COB,n,4) array.  Extract the eighth"
^IBA(364.7,858,3,3,0)="piece for this data.  Output the sum of each COB sequence as 1 IBXDATA(n)"
^IBA(364.7,858,3,4,0)="entry."
^IBA(364.7,859,0)="836^N^5^^^^N"
^IBA(364.7,859,1)="N Z1,Z2,Z2 S Z1=""MIA45"",Z2=4,Z3=9 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)"
^IBA(364.7,859,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,859,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,859,3,2,0)="insurance into the IBXSAVE(""MIA45"",COB,n,4) array.  Extract the ninth"
^IBA(364.7,859,3,3,0)="piece for this data.  Output the sum of each COB sequence as 1 IBXDATA(n)"
^IBA(364.7,859,3,4,0)="entry."
^IBA(364.7,860,0)="837^N^5^^^^N"
^IBA(364.7,860,1)="N Z1,Z2,Z3 S Z1=""MIA45"",Z2=4,Z3=10 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)"
^IBA(364.7,860,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,860,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,860,3,2,0)="insurance into the IBXSAVE(""MIA45"",COB,n,4) array.  Extract the tenth"
^IBA(364.7,860,3,3,0)="piece for this data.  Output the sum of each COB sequence as 1 IBXDATA(n)"
^IBA(364.7,860,3,4,0)="entry."
^IBA(364.7,861,0)="838^N^5^^^^N"
^IBA(364.7,861,1)="N Z1,Z2,Z3 S Z1=""MIA45"",Z2=4,Z3=11 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)"
^IBA(364.7,861,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,861,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,861,3,2,0)="insurance into the IBXSAVE(""MIA45"",COB,n,4) array.  Extract the eleventh"
^IBA(364.7,861,3,3,0)="piece for this data.  Output the sum of each COB sequence as 1 IBXDATA(n)"
^IBA(364.7,861,3,4,0)="entry."
^IBA(364.7,862,0)="842^N^5^^^^N"
^IBA(364.7,862,1)="N Z1,Z2,Z3 S Z1=""MIA45"",Z2=4,Z3=13 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)"
^IBA(364.7,862,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,862,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,862,3,2,0)="insurance into the IBXSAVE(""MIA45"",COB,n,4) array.  Extract the thirteenth"
^IBA(364.7,862,3,3,0)="piece for this data.  Output the sum of each COB sequence as 1 IBXDATA(n)"
^IBA(364.7,862,3,4,0)="entry."
^IBA(364.7,863,0)="843^N^5^^^^N"
^IBA(364.7,863,1)="N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F  S IBZ=$O(IBXSAVE(""MIA45"",IBZ)) Q:'IBZ  S Z0=Z0+1,Z=0 F  S Z=$O(IBXSAVE(""MIA45"",IBZ,Z)) Q:'Z  I $P($G(IBXSAVE(""MIA45"",IBZ,Z,4)),U,14) S IBXDATA(Z0)=$G(IBXDATA(Z0))+$P(IBXSAVE(""MIA45"",IBZ,Z,4),U,14)"
^IBA(364.7,863,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,863,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,863,3,2,0)="insurance into the IBXSAVE(""MIA45"",COB,n,4) array.  Extract the fourteenth"
^IBA(364.7,863,3,3,0)="piece for this data.  Output the sum of each COB sequence as 1 IBXDATA(n)"
^IBA(364.7,863,3,4,0)="entry."
^IBA(364.7,864,0)="844^N^5^^^^N"
^IBA(364.7,864,1)="N Z1,Z2,Z3 S Z1=""MIA45"",Z2=4,Z3=15 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)"
^IBA(364.7,864,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,864,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,864,3,2,0)="insurance into the IBXSAVE(""MIA45"",COB,n,4) array.  Extract the fifteenth"
^IBA(364.7,864,3,3,0)="piece for this data.  Output the sum of each COB sequence as 1 IBXDATA(n)"
^IBA(364.7,864,3,4,0)="entry."
^IBA(364.7,865,0)="847^N^5^^^^N"
^IBA(364.7,865,1)="N Z1,Z2,Z3 S Z1=""MIA45"",Z2=4,Z3=18 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)"
^IBA(364.7,865,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,865,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,865,3,2,0)="insurance into the IBXSAVE(""MIA45"",COB,n,4) array.  Extract the eighteenth"
^IBA(364.7,865,3,3,0)="piece for this data.  Output the sum of each COB sequence as 1 IBXDATA(n)"
^IBA(364.7,865,3,4,0)="entry."
^IBA(364.7,866,0)="849^N^5^^^^N"
^IBA(364.7,866,1)="N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F  S IBZ=$O(IBXSAVE(""MIA45"",IBZ)) Q:'IBZ  S Z0=Z0+1,Z=0 F  S Z=$O(IBXSAVE(""MIA45"",IBZ,Z)) Q:'Z  I $P($G(IBXSAVE(""MIA45"",IBZ,Z,5)),U,2)'="""" S IBXDATA(Z0)=$P(IBXSAVE(""MIA45"",IBZ,Z,5),U,2) Q"
^IBA(364.7,866,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,866,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,866,3,2,0)="insurance into the IBXSAVE(""MIA45"",COB,n,5) array.  Extract the second"
^IBA(364.7,866,3,3,0)="piece for this data.  Output only the first REMARKS CODE(2) found for each"
^IBA(364.7,866,3,4,0)="COB sequence."
^IBA(364.7,867,0)="850^N^5^^^^N"
^IBA(364.7,867,1)="N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F  S IBZ=$O(IBXSAVE(""MIA45"",IBZ)) Q:'IBZ  S Z0=Z0+1,Z=0 F  S Z=$O(IBXSAVE(""MIA45"",IBZ,Z)) Q:'Z  I $P($G(IBXSAVE(""MIA45"",IBZ,Z,5)),U,3)'="""" S IBXDATA(Z0)=$P(IBXSAVE(""MIA45"",IBZ,Z,5),U,3) Q"
^IBA(364.7,867,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,867,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,867,3,2,0)="insurance into the IBXSAVE(""MIA45"",COB,n,5) array.  Extract the third"
^IBA(364.7,867,3,3,0)="piece for this data.  Output only the first REMARKS CODE(3) found for each"
^IBA(364.7,867,3,4,0)="COB sequence."
^IBA(364.7,868,0)="851^N^5^^^^N"
^IBA(364.7,868,1)="N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F  S IBZ=$O(IBXSAVE(""MIA45"",IBZ)) Q:'IBZ  S Z0=Z0+1,Z=0 F  S Z=$O(IBXSAVE(""MIA45"",IBZ,Z)) Q:'Z  I $P($G(IBXSAVE(""MIA45"",IBZ,Z,5)),U,4)'="""" S IBXDATA(Z0)=$P(IBXSAVE(""MIA45"",IBZ,Z,5),U,4) Q"
^IBA(364.7,868,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,868,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,868,3,2,0)="insurance into the IBXSAVE(""MIA45"",COB,n,5) array.  Extract the fourth"
^IBA(364.7,868,3,3,0)="piece for this data.  Output only the first REMARKS CODE(4) found for each"
^IBA(364.7,868,3,4,0)="COB sequence."
^IBA(364.7,869,0)="924^N^5^^^^N"
^IBA(364.7,869,1)="N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F  S IBZ=$O(IBXSAVE(""MIA45"",IBZ)) Q:'IBZ  S Z0=Z0+1,Z=0 F  S Z=$O(IBXSAVE(""MIA45"",IBZ,Z)) Q:'Z  I $P($G(IBXSAVE(""MIA45"",IBZ,Z,5)),U,5)'="""" S IBXDATA(Z0)=$P(IBXSAVE(""MIA45"",IBZ,Z,5),U,5) Q"
^IBA(364.7,869,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,869,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,869,3,2,0)="insurance into the IBXSAVE(""MIA45"",COB,n,4) array.  Extract the fifth"
^IBA(364.7,869,3,3,0)="piece for this data.  Output only the first REMARKS CODE(5) found for each"
^IBA(364.7,869,3,4,0)="COB sequence."
^IBA(364.7,870,0)="845^N^5^^^^N"
^IBA(364.7,870,1)="N Z1,Z2,Z3 S Z1=""MIA45"",Z2=4,Z3=16 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)"
^IBA(364.7,870,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,870,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,870,3,2,0)="insurance into the IBXSAVE(""MIA45"",COB,n,4) array.  Extract the sixteenth"
^IBA(364.7,870,3,3,0)="piece for this data.  Output the sum of each COB sequence as 1 IBXDATA(n)"
^IBA(364.7,871,0)="846^N^5^^^^N"
^IBA(364.7,871,1)="N Z1,Z2,Z3 S Z1=""MIA45"",Z2=4,Z3=17 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)"
^IBA(364.7,871,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,871,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,871,3,2,0)="insurance into the IBXSAVE(""MIA45"",COB,n,4) array.  Extract the seventeenth"
^IBA(364.7,871,3,3,0)="piece for this data.  Output the sum of each COB sequence as 1 IBXDATA(n)"
^IBA(364.7,871,3,4,0)="entry."
^IBA(364.7,872,0)="857^N^5^^^^N"
^IBA(364.7,872,1)="N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F  S Z=$O(IBXSAVE(""CCAS"",Z)) Q:'Z  S Z0=0 F  S Z0=$O(IBXSAVE(""CCAS"",Z,Z0)) Q:'Z0  S Z1=Z1+1 I $P($G(IBXSAVE(""CCAS"",Z,Z0,1)),U,2)'="""" S IBXDATA(Z1)=$$DOLLAR^IBCEFG1($P(IBXSAVE(""CCAS"",Z,Z0,1),U,2))"
^IBA(364.7,872,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,872,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,872,3,2,0)="insurance into the IBXSAVE(""CCAS"",COB,n,1) array.  Extract the second piece"
^IBA(364.7,872,3,3,0)="if not null for this data."
^IBA(364.7,873,0)="893^N^5^^^^N"
^IBA(364.7,873,1)="N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F  S Z=$O(IBXSAVE(""CCAS"",Z)) Q:'Z  S Z0=0 F  S Z0=$O(IBXSAVE(""CCAS"",Z,Z0)) Q:'Z0  S Z1=Z1+1 I $P($G(IBXSAVE(""CCAS"",Z,Z0,3)),U)'="""" S IBXDATA(Z1)=$P(IBXSAVE(""CCAS"",Z,Z0,3),U)"
^IBA(364.7,873,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,873,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,873,3,2,0)="insurance into the IBXSAVE(""CCAS"",COB,n,3) array.  Extract the first piece"
^IBA(364.7,873,3,3,0)="for this data, if not null."
^IBA(364.7,874,0)="858^N^5^^^^N"
^IBA(364.7,874,1)="N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F  S Z=$O(IBXSAVE(""CCAS"",Z)) Q:'Z  S Z0=0 F  S Z0=$O(IBXSAVE(""CCAS"",Z,Z0)) Q:'Z0  S Z1=Z1+1 I $P($G(IBXSAVE(""CCAS"",Z,Z0,1)),U,3)'="""" S IBXDATA(Z1)=$P(IBXSAVE(""CCAS"",Z,Z0,1),U,3)"
^IBA(364.7,874,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,874,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,874,3,2,0)="insurance into the IBXSAVE(""CCAS"",COB,n,1) array.  Extract the third piece"
^IBA(364.7,874,3,3,0)="for this data, if not null."
^IBA(364.7,875,0)="897^N^5^^^^N"
^IBA(364.7,875,1)="N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F  S Z=$O(IBXSAVE(""CCAS"",Z)) Q:'Z  S Z0=0 F  S Z0=$O(IBXSAVE(""CCAS"",Z,Z0)) Q:'Z0  S Z1=Z1+1 I $P($G(IBXSAVE(""CCAS"",Z,Z0,2)),U,2)'="""" S IBXDATA(Z1)=$$DOLLAR^IBCEFG1($P(IBXSAVE(""CCAS"",Z,Z0,2),U,2))"
^IBA(364.7,875,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,875,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,875,3,2,0)="insurance into the IBXSAVE(""CCAS"",COB,n,2) array.  Extract the second piece"
^IBA(364.7,875,3,3,0)="for this data, if not null."
^IBA(364.7,876,0)="898^N^5^^^^N"
^IBA(364.7,876,1)="N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F  S Z=$O(IBXSAVE(""CCAS"",Z)) Q:'Z  S Z0=0 F  S Z0=$O(IBXSAVE(""CCAS"",Z,Z0)) Q:'Z0  S Z1=Z1+1 I $P($G(IBXSAVE(""CCAS"",Z,Z0,3)),U,2)'="""" S IBXDATA(Z1)=$$DOLLAR^IBCEFG1($P(IBXSAVE(""CCAS"",Z,Z0,3),U,2))"
^IBA(364.7,876,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,876,3,1,0)="his data element relies on the previous extract of COB data for other"
^IBA(364.7,876,3,2,0)="nsurance into the IBXSAVE(""CCAS"",COB,n,3) array.  Extract the second piece"
^IBA(364.7,876,3,3,0)="or this data, if not null."
^IBA(364.7,877,0)="902^N^5^^^^N"
^IBA(364.7,877,1)="N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F  S Z=$O(IBXSAVE(""CCAS"",Z)) Q:'Z  S Z0=0 F  S Z0=$O(IBXSAVE(""CCAS"",Z,Z0)) Q:'Z0  S Z1=Z1+1 I $P($G(IBXSAVE(""CCAS"",Z,Z0,2)),U,3)'="""" S IBXDATA(Z1)=$P(IBXSAVE(""CCAS"",Z,Z0,2),U,3)"
^IBA(364.7,877,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,877,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,877,3,2,0)="insurance into the IBXSAVE(""CCAS"",COB,n,2) array.  Extract the third piece"
^IBA(364.7,877,3,3,0)="for this data, if not null."
^IBA(364.7,878,0)="903^N^5^^^^N"
^IBA(364.7,878,1)="N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F  S Z=$O(IBXSAVE(""CCAS"",Z)) Q:'Z  S Z0=0 F  S Z0=$O(IBXSAVE(""CCAS"",Z,Z0)) Q:'Z0  S Z1=Z1+1 I $P($G(IBXSAVE(""CCAS"",Z,Z0,3)),U,3)'="""" S IBXDATA(Z1)=$P(IBXSAVE(""CCAS"",Z,Z0,3),U,3)"
^IBA(364.7,878,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,878,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,878,3,2,0)="insurance into the IBXSAVE(""CCAS"",COB,n,3) array.  Extract the third piece"
^IBA(364.7,878,3,3,0)="for this data, if not null."
^IBA(364.7,879,0)="904^N^5^^^^N"
^IBA(364.7,879,1)="N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F  S Z=$O(IBXSAVE(""CCAS"",Z)) Q:'Z  S Z0=0 F  S Z0=$O(IBXSAVE(""CCAS"",Z,Z0)) Q:'Z0  S Z1=Z1+1 I $P($G(IBXSAVE(""CCAS"",Z,Z0,4)),U,3)'="""" S IBXDATA(Z1)=$P(IBXSAVE(""CCAS"",Z,Z0,4),U,3)"
^IBA(364.7,879,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,879,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,879,3,2,0)="insurance into the IBXSAVE(""CCAS"",COB,n,4) array.  Extract the third piece"
^IBA(364.7,879,3,3,0)="for this data, if not null."
^IBA(364.7,880,0)="905^N^5^^^^N"
^IBA(364.7,880,1)="N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F  S Z=$O(IBXSAVE(""CCAS"",Z)) Q:'Z  S Z0=0 F  S Z0=$O(IBXSAVE(""CCAS"",Z,Z0)) Q:'Z0  S Z1=Z1+1 I $P($G(IBXSAVE(""CCAS"",Z,Z0,5)),U,3)'="""" S IBXDATA(Z1)=$P(IBXSAVE(""CCAS"",Z,Z0,5),U,3)"
^IBA(364.7,880,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,880,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,880,3,2,0)="insurance into the IBXSAVE(""CCAS"",COB,n,5) array.  Extract the third piece"
^IBA(364.7,880,3,3,0)="for this data, if not null."
^IBA(364.7,881,0)="906^N^5^^^^N"
^IBA(364.7,881,1)="N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F  S Z=$O(IBXSAVE(""CCAS"",Z)) Q:'Z  S Z0=0 F  S Z0=$O(IBXSAVE(""CCAS"",Z,Z0)) Q:'Z0  S Z1=Z1+1 I $P($G(IBXSAVE(""CCAS"",Z,Z0,6)),U,3)'="""" S IBXDATA(Z1)=$P(IBXSAVE(""CCAS"",Z,Z0,6),U,3)"
^IBA(364.7,881,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,881,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,881,3,2,0)="insurance into the IBXSAVE(""CCAS"",COB,n,6) array.  Extract the third piece"
^IBA(364.7,881,3,3,0)="for this data, if not null."
^IBA(364.7,882,0)="899^N^5^^^^N"
^IBA(364.7,882,1)="N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F  S Z=$O(IBXSAVE(""CCAS"",Z)) Q:'Z  S Z0=0 F  S Z0=$O(IBXSAVE(""CCAS"",Z,Z0)) Q:'Z0  S Z1=Z1+1 I $P($G(IBXSAVE(""CCAS"",Z,Z0,4)),U,2)'="""" S IBXDATA(Z1)=$$DOLLAR^IBCEFG1($P(IBXSAVE(""CCAS"",Z,Z0,4),U,2))"
^IBA(364.7,882,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,882,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,882,3,2,0)="insurance into the IBXSAVE(""CCAS"",COB,n,4) array.  Extract the second piece"
^IBA(364.7,882,3,3,0)="for this data, if not null."
^IBA(364.7,883,0)="901^N^5^^^^N"
^IBA(364.7,883,1)="N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F  S Z=$O(IBXSAVE(""CCAS"",Z)) Q:'Z  S Z0=0 F  S Z0=$O(IBXSAVE(""CCAS"",Z,Z0)) Q:'Z0  S Z1=Z1+1 I $P($G(IBXSAVE(""CCAS"",Z,Z0,6)),U,2)'="""" S IBXDATA(Z1)=$$DOLLAR^IBCEFG1($P(IBXSAVE(""CCAS"",Z,Z0,6),U,2))"
^IBA(364.7,883,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,883,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,883,3,2,0)="insurance into the IBXSAVE(""CCAS"",COB,n,6) array.  Extract the second piece"
^IBA(364.7,883,3,3,0)="for this data, if not null."
^IBA(364.7,884,0)="894^N^5^^^^N"
^IBA(364.7,884,1)="N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F  S Z=$O(IBXSAVE(""CCAS"",Z)) Q:'Z  S Z0=0 F  S Z0=$O(IBXSAVE(""CCAS"",Z,Z0)) Q:'Z0  S Z1=Z1+1 I $P($G(IBXSAVE(""CCAS"",Z,Z0,4)),U)'="""" S IBXDATA(Z1)=$P(IBXSAVE(""CCAS"",Z,Z0,4),U)"
^IBA(364.7,884,3,0)="^^3^3^2990901^^"
^IBA(364.7,884,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,884,3,2,0)="insurance into the IBXSAVE(""CCAS"",COB,n,4) array.  Extract the first piece"
^IBA(364.7,884,3,3,0)="for this data, if not null."
^IBA(364.7,885,0)="895^N^5^^^^N"
^IBA(364.7,885,1)="N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F  S Z=$O(IBXSAVE(""CCAS"",Z)) Q:'Z  S Z0=0 F  S Z0=$O(IBXSAVE(""CCAS"",Z,Z0)) Q:'Z0  S Z1=Z1+1 I $P($G(IBXSAVE(""CCAS"",Z,Z0,5)),U)'="""" S IBXDATA(Z1)=$P(IBXSAVE(""CCAS"",Z,Z0,5),U)"
^IBA(364.7,885,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,885,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,885,3,2,0)="insurance into the IBXSAVE(""CCAS"",COB,n,5) array.  Extract the first piece"
^IBA(364.7,885,3,3,0)="for this data, if not null."
^IBA(364.7,886,0)="900^N^5^^^^N"
^IBA(364.7,886,1)="N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F  S Z=$O(IBXSAVE(""CCAS"",Z)) Q:'Z  S Z0=0 F  S Z0=$O(IBXSAVE(""CCAS"",Z,Z0)) Q:'Z0  S Z1=Z1+1 I $P($G(IBXSAVE(""CCAS"",Z,Z0,5)),U,2)'="""" S IBXDATA(Z1)=$$DOLLAR^IBCEFG1($P(IBXSAVE(""CCAS"",Z,Z0,5),U,2))"
^IBA(364.7,886,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,886,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,886,3,2,0)="insurance into the IBXSAVE(""CCAS"",COB,n,5) array.  Extract the second piece"
^IBA(364.7,886,3,3,0)="for this data, if not null."
^IBA(364.7,887,0)="896^N^5^^^^N"
^IBA(364.7,887,1)="N Z,Z0,Z1 K IBXDATA S (Z,Z1)=0 F  S Z=$O(IBXSAVE(""CCAS"",Z)) Q:'Z  S Z0=0 F  S Z0=$O(IBXSAVE(""CCAS"",Z,Z0)) Q:'Z0  S Z1=Z1+1 I $P($G(IBXSAVE(""CCAS"",Z,Z0,6)),U)'="""" S IBXDATA(Z1)=$P(IBXSAVE(""CCAS"",Z,Z0,6),U)"
^IBA(364.7,887,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,887,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,887,3,2,0)="insurance into the IBXSAVE(""CCAS"",COB,n,6) array.  Extract the first piece"
^IBA(364.7,887,3,3,0)="for this data, if not null."
^IBA(364.7,888,0)="923^N^5^^^^N"
^IBA(364.7,888,1)="N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F  S IBZ=$O(IBXSAVE(""MOA"",IBZ)) Q:'IBZ  S Z0=Z0+1,Z=0 F  S Z=$O(IBXSAVE(""MOA"",IBZ,Z)) Q:'Z  I $P($G(IBXSAVE(""MOA"",IBZ,Z,3)),U,7)'="""" S IBXDATA(Z0)=$P(IBXSAVE(""MOA"",IBZ,Z,3),U,7) Q"
^IBA(364.7,888,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,888,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,888,3,2,0)="insurance into the IBXSAVE(""MOA"",COB,n,3) array.  Extract the seventh"
^IBA(364.7,888,3,3,0)="piece for this data.  Output only the first REMARKS CODE(5) found for each"
^IBA(364.7,888,3,4,0)="COB sequence."
^IBA(364.7,889,0)="862^N^5^^^^N"
^IBA(364.7,889,1)="K IBXDATA N Z S Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  S:$P(IBXSAVE(""OUTPT"",Z),U,13)'="""" IBXDATA(Z)=$P(""N^Y"",U,$P(IBXSAVE(""OUTPT"",Z),U,13)+1)"
^IBA(364.7,889,3,0)="^^3^3^2991015^^^^"
^IBA(364.7,889,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,889,3,2,0)="possible for the data element in the previously extracted IBXSAVE array."
^IBA(364.7,889,3,3,0)="Only output the data for service lines that have data."
^IBA(364.7,890,0)="852^N^5^^^^N"
^IBA(364.7,890,1)="N Z1,Z2,Z3 S Z1=""MIA45"",Z2=4,Z3=4 D AMTOUT^IBCEF2(Z1,Z2,Z3,.IBXSAVE)"
^IBA(364.7,890,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,890,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,890,3,2,0)="insurance into the IBXSAVE(""MIA45"",COB,n,4) array.  Extract the fourth"
^IBA(364.7,890,3,3,0)="piece for this data.  Output the sum of each COB sequence as 1 IBXDATA(n)"
^IBA(364.7,890,3,4,0)="entry."
^IBA(364.7,891,0)="863^N^5^^^^N"
^IBA(364.7,891,1)="K IBXDATA N Z,Z0 S Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  S Z0=$P(IBXSAVE(""OUTPT"",Z),U,4) S IBXDATA(Z)=$S(Z0'=7:""UN"",1:""MJ"")"
^IBA(364.7,891,3,0)="^^5^5^2990901^^^^"
^IBA(364.7,891,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,891,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,891,3,3,0)="any service line data is found, the data is output."
^IBA(364.7,891,3,4,0)="If the type of service not = 7 (anesthesia), this is units (UN) and for"
^IBA(364.7,891,3,5,0)="anesthesia, it's minutes (MJ)"
^IBA(364.7,892,0)="783^N^302^^^^N"
^IBA(364.7,892,1)="K IBXDATA S:$G(IBXSAVE(""OLAB"")) IBXDATA=$$DOLLAR^IBCEFG1(IBXSAVE(""OLAB"")) K IBXSAVE(""OLAB"")"
^IBA(364.7,893,0)="936^N^5^^^^N"
^IBA(364.7,893,1)="N IBZ,Z0 D GETPRV^IBCEU(IBXIEN,1,.IBZ) S Z0=$$NAME^IBCEFG1($P($G(IBZ(1,1)),U),1) K IBXDATA S:$P(Z0,U,5)'="""" IBXDATA=$P(Z0,U,5)"
^IBA(364.7,893,3,0)="^364.73^1^1^3031015^^^^"
^IBA(364.7,893,3,1,0)="Finds SSN for REFERING PROVIDER"
^IBA(364.7,894,0)="938^N^240^^^^N"
^IBA(364.7,894,1)="S IBXSAVE(""REFP"")=$$NAME^IBCEFG1(IBXDATA) K IBXDATA S:$P(IBXSAVE(""REFP""),U)'="""" IBXDATA=$P(IBXSAVE(""REFP""),U)"
^IBA(364.7,894,3,0)="^^2^2^2990614^^^^"
^IBA(364.7,894,3,1,0)="Changes data element (name) into LAST^FIRST^MIDDLE format.  Saves data in"
^IBA(364.7,894,3,2,0)="IBXSAVE array for use by later fields."
^IBA(364.7,896,0)="948^N^242^^^^N"
^IBA(364.7,896,1)="S IBXSAVE(""OPP"")=$$NAME^IBCEFG1(IBXDATA) K IBXDATA S:$P(IBXSAVE(""OPP""),U)'="""" IBXDATA=$P(IBXSAVE(""OPP""),U)"
^IBA(364.7,896,3,0)="^^2^2^2990614^^^^"
^IBA(364.7,896,3,1,0)="Changes data element (name) into LAST^FIRST^MIDDLE format.  Saves data in"
^IBA(364.7,896,3,2,0)="IBXSAVE array for use by later fields."
^IBA(364.7,897,0)="950^N^310^^^^N"
^IBA(364.7,897,1)="N Z0 S Z0=$$NAME^IBCEFG1(IBXDATA,1) K IBXDATA S:$P(Z0,U,5)'="""" IBXDATA=$P(Z0,U,5)"
^IBA(364.7,897,3,0)="^364.73^1^1^3031001^^^^"
^IBA(364.7,897,3,1,0)="Finds the Operating Physicians SSN "
^IBA(364.7,898,0)="794^N^235^^^^N"
^IBA(364.7,898,3,0)="^^2^2^3000204^^^^"
^IBA(364.7,898,3,1,0)="This is the X12 definition for the current insurance plan type"
^IBA(364.7,898,3,2,0)="(Refer to the 837 v4010 field 2000B/SBR/09.)"
^IBA(364.7,900,0)="804^N^5^^^^N"
^IBA(364.7,900,1)="K IBXDATA N Z F Z=1,2 S IBXDATA(Z)=$P($G(IBXSAVE(""BILLING PRV"",IBXIEN,""O"",Z,2,""PTQ"")),U,1) D:Z=2 CLEANUP^IBCEF75(.IBXSAVE)"
^IBA(364.7,900,3,0)="^364.73^4^4^3060420^^^^"
^IBA(364.7,900,3,1,0)="If any 'other' insurance company data is found, the data is formatted"
^IBA(364.7,900,3,2,0)="from the electronic type of plan of the insurance company policy in X12"
^IBA(364.7,900,3,3,0)="format.  Refer to the 837 V4010 (professional) field 2330/REF(3)/01"
^IBA(364.7,900,3,4,0)="for details."
^IBA(364.7,901,0)="805^N^236^^^^N"
^IBA(364.7,901,1)="N Z,IBZ M IBZ=IBXDATA K IBXDATA F Z=1,2 I $P($G(IBZ),U,Z)'="""",$D(^DGCR(399,IBXIEN,""I""_(Z+1))) S IBXDATA(Z)=$P(IBZ,U,Z)"
^IBA(364.7,901,3,0)="^^11^11^3000203^^^^"
^IBA(364.7,901,3,1,0)="This is the X12 interpretation of the 'other' insurance plan types"
^IBA(364.7,901,3,2,0)="(see codes below or refer to the 837 v4010 field 2000B/SBR/09.)"
^IBA(364.7,901,3,3,0)="    X12 CODES: MA = MEDICARE PART A    3"
^IBA(364.7,901,3,4,0)="               MB = MEDICARE PART B    3"
^IBA(364.7,901,3,5,0)="               HM = HMO"
^IBA(364.7,901,3,6,0)="               MC = MEDICAID    4"
^IBA(364.7,901,3,7,0)="               12 = PPO"
^IBA(364.7,901,3,8,0)="               CH = TRICARE     5"
^IBA(364.7,901,3,9,0)="               WC = WORKERS COMP"
^IBA(364.7,901,3,10,0)="               CI = COMMERCIAL  (default if none defined),1,2"
^IBA(364.7,901,3,11,0)="               15 = INDEMNITY"
^IBA(364.7,902,0)="806^N^5^^^^N"
^IBA(364.7,902,1)="K IBXDATA D OTHINSID^IBCEF72(IBXIEN,.IBXDATA)"
^IBA(364.7,902,3,0)="^364.73^5^5^3030917^^^^"
^IBA(364.7,902,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,902,3,2,0)="possible for the data element in the IBXDATA array.  If any other insurance"
^IBA(364.7,902,3,3,0)="insurance company data is found, the data is output."
^IBA(364.7,902,3,4,0)="old code:"
^IBA(364.7,902,3,5,0)="K IBXDATA ;NEED TO REMOVE THIS COMMENT I $$FT^IBCEF(IBXIEN)=3 N Z,Z0 F Z=1,2 S Z0=$P($G(IBXSAVE(""OI#"",Z)),U,2) I Z0'="""",Z0'?1A1""PRNT"",$D(^DGCR(399,IBXIEN,""I""_(Z+1))) S IBXDATA(Z)=Z0"
^IBA(364.7,914,0)="941^N^83^^^^N"
^IBA(364.7,914,1)="N Z,Z0 S Z=$P(IBXDATA,U,1,2),$P(Z,U,3,4)=(IBXIEN_U_($$INSFT^IBCEU5(IBXIEN)+3)),Z0=$$NAME^IBCEFG1(Z,1),IBXSAVE(""ATTP"")=Z0 S:$S($P(Z0,U)'="""":0,1:$$SLF^IBCEU4(IBXIEN)) IBXNOREQ=1 K IBXDATA S:$P(Z0,U)'="""" IBXDATA=$$NOPUNCT^IBCEF($P(Z0,U))"
^IBA(364.7,914,3,0)="^364.73^4^4^3030826^^^^"
^IBA(364.7,914,3,1,0)="Changes data element (name) into LAST^FIRST^MIDDLE^CREDENTIALS format. Saves"
^IBA(364.7,914,3,2,0)="data in IBXSAVE array for use by later fields."
^IBA(364.7,914,3,3,0)="If the provider name is blank and the provider id is SLF000 (self), this"
^IBA(364.7,914,3,4,0)="field is not required."
^IBA(364.7,915,0)="942^N^5^^^^N"
^IBA(364.7,915,1)="K IBXDATA S:$P($G(IBXSAVE(""ATTP"")),U,2)'="""" IBXDATA=$P(IBXSAVE(""ATTP""),U,2) K IBXSAVE(""ATTP"")"
^IBA(364.7,915,3,0)="^364.73^2^2^3031006^^^^"
^IBA(364.7,915,3,1,0)="If the attending/rendering provider exists, output the first name from the"
^IBA(364.7,915,3,2,0)="second '^' piece."
^IBA(364.7,916,0)="946^N^5^^^^N"
^IBA(364.7,916,1)="N IBZ D GETPRV^IBCEU(IBXIEN,9,.IBZ) N IBZZ S IBZZ=$P($G(IBZ(9,1)),U),IBXDATA=$$GETNMEL^IBCEF7(IBZZ,""GIVEN"")"
^IBA(364.7,916,3,0)="^364.73^1^1^3041223^^^^"
^IBA(364.7,916,3,1,0)="Operating provider first name"
^IBA(364.7,917,0)="949^N^5^^^^N"
^IBA(364.7,917,1)="K IBXDATA S:$P($G(IBXSAVE(""OPP"")),U,2)'="""" IBXDATA=$P(IBXSAVE(""OPP""),U,2) K IBXSAVE(""OPP"")"
^IBA(364.7,917,3,0)="^^2^2^2990614^^^^"
^IBA(364.7,917,3,1,0)="If the operating provider exists, output the first name from the second '^'"
^IBA(364.7,917,3,2,0)="piece."
^IBA(364.7,918,0)="937^N^5^^^^N"
^IBA(364.7,918,1)="K IBXDATA S:$P($G(IBXSAVE(""REFP"")),U,2)'="""" IBXDATA=$P(IBXSAVE(""REFP""),U,2) K IBXSAVE(""REFP"")"
^IBA(364.7,918,3,0)="^^2^2^2990504^^^^"
^IBA(364.7,918,3,1,0)="If the referring provider exists, output the first name from the second '^'"
^IBA(364.7,918,3,2,0)="piece."
^IBA(364.7,919,0)="947^N^5^^^^N"
^IBA(364.7,919,1)="N IBZ D GETPRV^IBCEU(IBXIEN,9,.IBZ) N IBZZ S IBZZ=$P($G(IBZ(9,1)),U),IBZZ=$$NAME^IBCEFG1(IBZZ,1),IBXDATA=$P(IBZZ,U,5)"
^IBA(364.7,920,0)="939^N^5^^^^N"
^IBA(364.7,920,1)="K IBXDATA"
^IBA(364.7,921,0)="944^N^249^^^^N"
^IBA(364.7,921,1)="I IBXDATA="""" N Z D GETPRV^IBCEU(IBXIEN,""3,4"",.Z) I $D(Z(3,1))!$D(Z(4,1)) S IBXDATA=""99"""
^IBA(364.7,921,3,0)="^^2^2^3010228^^^^"
^IBA(364.7,921,3,1,0)="Default to 99 if no specialty found and there is a rendering or attending"
^IBA(364.7,921,3,2,0)="provider defined."
^IBA(364.7,922,0)="935^N^5^^^^N"
^IBA(364.7,922,1)="K IBXDATA"
^IBA(364.7,922,3,0)="^^1^1^2991216^"
^IBA(364.7,922,3,1,0)="Not currently used."
^IBA(364.7,923,0)="951^N^5^^^^N"
^IBA(364.7,923,1)="K IBXDATA"
^IBA(364.7,924,0)="952^N^253^^^^N"
^IBA(364.7,924,1)="S IBXDATA=$TR(IBXDATA,""."")"
^IBA(364.7,924,3,0)="^^1^1^2990614^^^^"
^IBA(364.7,924,3,1,0)="Strip the '.' from the DX code"
^IBA(364.7,925,0)="859^N^5^^^^N"
^IBA(364.7,925,1)="K IBXDATA N Z,Z0 S Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  S Z0=$P($G(IBXSAVE(""PROCMODS"",Z)),"","",2) I Z0'="""" S IBXDATA(Z)=Z0"
^IBA(364.7,925,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,925,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,925,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,925,3,3,0)="any service line data is found, the data is output."
^IBA(364.7,926,0)="860^N^5^^^^N"
^IBA(364.7,926,1)="K IBXDATA N Z,Z0 S Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  S Z0=$P($G(IBXSAVE(""PROCMODS"",Z)),"","",3) I Z0'="""" S IBXDATA(Z)=Z0"
^IBA(364.7,926,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,926,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,926,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,926,3,3,0)="any service line data is found, the data is output."
^IBA(364.7,927,0)="861^N^5^^^^N"
^IBA(364.7,927,1)="K IBXDATA N Z,Z0 S Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  S Z0=$P($G(IBXSAVE(""PROCMODS"",Z)),"","",4) K IBXSAVE(""PROCMODS"",Z) I Z0'="""" S IBXDATA(Z)=Z0"
^IBA(364.7,927,3,0)="^^3^3^3000120^^^^"
^IBA(364.7,927,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,927,3,2,0)="possible for the data element in the previously extract IBXSAVE array.  If"
^IBA(364.7,927,3,3,0)="any service line data is found, the data is output."
^IBA(364.7,928,0)="953^N^230^^^^ZL"
^IBA(364.7,928,1)="S IBXDATA=$E($P(IBXDATA,U,3),4,7) I $TR(IBXDATA,0)="""" K IBXDATA"
^IBA(364.7,928,3,0)="^^2^2^2991006^^^^"
^IBA(364.7,928,3,1,0)="Always 0-fill data to the left.  If primary site, don't output.  If not"
^IBA(364.7,928,3,2,0)="primary site, this is the site suffix (up to 4 digits)"
^IBA(364.7,929,0)="954^N^246^^^^N"
^IBA(364.7,929,1)="I $G(IBXDATA)'="""" S:$G(^TMP(""IBXSAVE"",$J,""RM"")) IBXDATA="" ""_IBXDATA"
^IBA(364.7,929,3,0)="^^1^1^2990609^^^"
^IBA(364.7,929,3,1,0)="If the right margin is 81 instead of 80, move the output over 1 space."
^IBA(364.7,930,0)="955^N^247^^^^N"
^IBA(364.7,930,1)="I $G(IBXDATA)'="""" S:$G(^TMP(""IBXSAVE"",$J,""RM"")) IBXDATA="" ""_IBXDATA"
^IBA(364.7,930,3,0)="^^1^1^2990609^^^"
^IBA(364.7,930,3,1,0)="If the right margin is 81 instead of 80, move the output over 1 space."
^IBA(364.7,931,0)="956^N^266^^^^N"
^IBA(364.7,931,1)="N Z,IBZ M IBZ=IBXDATA K IBXDATA F Z=1,2 I $G(IBZ(Z))'="""" S IBXDATA(Z)=IBZ(Z)"
^IBA(364.7,931,3,0)="^^3^3^2990722^^^"
^IBA(364.7,931,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,931,3,2,0)="possible for the data element in the IBXDATA array.  If any other insurance"
^IBA(364.7,931,3,3,0)="company data is found, these authorization codes are output."
^IBA(364.7,932,0)="957^N^262^^^^N"
^IBA(364.7,933,0)="958^N^5^^^^N"
^IBA(364.7,933,1)="N Z S Z=0 F  S Z=$O(IBXSAVE(""INPT"",Z)) Q:'Z  S:$P(IBXSAVE(""INPT"",Z),U,7)'="""" IBXDATA(Z)=$P(IBXSAVE(""INPT"",Z),U,7)"
^IBA(364.7,933,3,0)="^364.73^1^1^3001005^^^^"
^IBA(364.7,933,3,1,0)="If data element's value is null, do not output."
^IBA(364.7,934,0)="960^N^5^^^^N"
^IBA(364.7,934,1)="K IBXDATA S IBXDATA=""Y"""
^IBA(364.7,934,3,0)="^364.73^1^1^3030905^^^^"
^IBA(364.7,934,3,1,0)="Explanation of benefits indicator should always be set to ""y"""
^IBA(364.7,935,0)="959^N^5^^^^N"
^IBA(364.7,936,0)="965^N^293^^^^N"
^IBA(364.7,936,1)="S IBXDATA=$$DT^IBCEFG1(IBXDATA,"""",""D8"")"
^IBA(364.7,936,3,0)="^^2^2^3000302^^"
^IBA(364.7,936,3,1,0)="Format data element in CCYYMMDD date format.  If data element's value is"
^IBA(364.7,936,3,2,0)="null, do not output."
^IBA(364.7,937,0)="967^N^71^^^^N"
^IBA(364.7,937,1)="S IBXDATA=$$FMTE^XLFDT(IBXDATA,""5D"")"
^IBA(364.7,937,3,0)="^^1^1^2991209^^^^"
^IBA(364.7,937,3,1,0)="Format data element in MM/DD/CCYY date format."
^IBA(364.7,938,0)="795^N^292^^^^N"
^IBA(364.7,938,1)="S:IBXDATA IBXDATA=$$DT^IBCEFG1(IBXDATA,"""",""D8"")"
^IBA(364.7,939,0)="977^N^5^^^^N"
^IBA(364.7,939,1)="K IBXDATA N Z S Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  I $P($G(IBXSAVE(""OUTPT"",Z,""AUX"")),U,2)'="""",$$BILLSPEC^IBCEU3(IBXIEN)=35 S IBXDATA(Z)=$$DT^IBCEFG1($P(IBXSAVE(""OUTPT"",Z,""AUX""),U,2),"""",""D8"")"
^IBA(364.7,939,3,0)="^^4^4^2991115^^^^"
^IBA(364.7,939,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,939,3,2,0)="possible for the data element in the previously extracted IBXSAVE array."
^IBA(364.7,939,3,3,0)="Only output the data for service lines that have data. Format of the data"
^IBA(364.7,939,3,4,0)="element is CCYYMMDD."
^IBA(364.7,940,0)="978^N^5^^^^N"
^IBA(364.7,940,1)="K IBXDATA N Z S Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  S:$P($G(IBXSAVE(""OUTPT"",Z,""AUX"")),U,3)'="""" IBXDATA(Z)=$P(""N^Y"",U,$P(IBXSAVE(""OUTPT"",Z,""AUX""),U,3)+1)"
^IBA(364.7,940,3,0)="^^3^3^2990901^^^"
^IBA(364.7,940,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,940,3,2,0)="possible for the data element in the previously extracted IBXSAVE array."
^IBA(364.7,940,3,3,0)="Only output the data for service lines that have data."
^IBA(364.7,941,0)="979^N^5^^^^N"
^IBA(364.7,941,1)="K IBXDATA N Z S Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  S:$P($P($G(IBXSAVE(""OUTPT"",Z,""AUX"")),U,4),""-"",2)'="""" IBXDATA(Z)=$P($P(IBXSAVE(""OUTPT"",Z,""AUX""),U,4),""-"",2)"
^IBA(364.7,941,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,941,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,941,3,2,0)="possible for the data element in the previously extracted IBXSAVE array."
^IBA(364.7,941,3,3,0)="Only output the data for service lines that have data."
^IBA(364.7,942,0)="980^N^5^^^^N"
^IBA(364.7,942,1)="K IBXDATA N Z S Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  S:$P($G(IBXSAVE(""OUTPT"",Z,""AUX"")),U,6)'="""" IBXDATA(Z)=$P(IBXSAVE(""OUTPT"",Z,""AUX""),U,6)"
^IBA(364.7,942,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,942,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,942,3,2,0)="possible for the data element in the previously extracted IBXSAVE array."
^IBA(364.7,942,3,3,0)="Only output the data for service lines that have data."
^IBA(364.7,943,0)="981^N^5^^^^N"
^IBA(364.7,943,1)="K IBXDATA N Z S Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  S:$P($G(IBXSAVE(""OUTPT"",Z,""AUX"")),U,5)'="""" IBXDATA(Z)=$P(IBXSAVE(""OUTPT"",Z,""AUX""),U,5)"
^IBA(364.7,943,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,943,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,943,3,2,0)="possible for the data element in the previously extracted IBXSAVE array."
^IBA(364.7,943,3,3,0)="Only output the data for service lines that have data."
^IBA(364.7,944,0)="982^N^5^^^^N"
^IBA(364.7,944,1)="K IBXDATA N Z S Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  S:$P($G(IBXSAVE(""OUTPT"",Z,""AUX"")),U,7)'="""" IBXDATA(Z)=$P(""N^Y"",U,$P(IBXSAVE(""OUTPT"",Z,""AUX""),U,7)+1)"
^IBA(364.7,944,3,0)="0^^3^3^2990901^^^^"
^IBA(364.7,944,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,944,3,2,0)="possible for the data element in the previously extracted IBXSAVE array."
^IBA(364.7,944,3,3,0)="Only output the data for service lines that have data."
^IBA(364.7,945,0)="177^N^296^^^^N"
^IBA(364.7,945,3,0)="^364.73^3^3^3031105^^^^"
^IBA(364.7,945,3,1,0)="If header data has already been extracted, array ^TMP(""IBHDR"",$J) will"
^IBA(364.7,945,3,2,0)="already exist.  Don't want to extract this field again, so kill data"
^IBA(364.7,945,3,3,0)="element so there is no output."
^IBA(364.7,946,0)="796^N^270^^^^N"
^IBA(364.7,946,1)="S IBXDATA=$$DT^IBCEFG1(IBXDATA,"""",""D8"")"
^IBA(364.7,946,3,0)="^^2^2^2991115^^^^"
^IBA(364.7,946,3,1,0)="Format data element in CCYYMMDD date format.  If data element's value is "
^IBA(364.7,946,3,2,0)="null do not output."
^IBA(364.7,947,0)="970^N^112^^^^N"
^IBA(364.7,947,1)="I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA)"
^IBA(364.7,947,3,0)="^^1^1^3060111^"
^IBA(364.7,947,3,1,0)="Format code for the CLIA# in SUB-8.  Just remove any punctuation."
^IBA(364.7,948,0)="971^N^113^^^^N"
^IBA(364.7,948,1)="I $D(IBXDATA) N IBZ D VAMCFD^IBCEF75(IBXIEN,.IBZ) K:$D(IBZ)&'$G(IBZ(""C"",1)) IBXDATA I $D(IBXDATA) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA)"
^IBA(364.7,948,3,0)="^^1^1^3060111^"
^IBA(364.7,948,3,1,0)="Remove punctuation from the returned tax ID number."
^IBA(364.7,949,0)="972^N^273^^^^N"
^IBA(364.7,949,1)="N A,B,Z S A=IBXIEN,B=IBXDATA D F^IBCEF(""N-RENDERING INSTITUTION"") S Z=IBXDATA K IBXDATA S B=$S($P(Z,U,4):0,$$FT^IBCEF(A)=3&$$WNRBILL^IBEFUNC(A)&'B:"""",$P(Z,U,2)=""""&'$P(Z,U,3):"""",'$P(Z,U,2):0,1:B) S:B'="""" IBXDATA=B,IBXSAVE(""PSVC"")=B"
^IBA(364.7,949,3,0)="^^6^6^3060908^"
^IBA(364.7,949,3,1,0)="Extract the code for the non VA care type or 0 for a VA remote site"
^IBA(364.7,949,3,2,0)="rendering facility.  If the bill is a MEDICARE WNR bill and the form type"
^IBA(364.7,949,3,3,0)="is UB-92 (3) and the bill is not a NON-VA claim, output nothing.  Also, if"
^IBA(364.7,949,3,4,0)="the bill is a 1500 MEDICARE WNR bill and it is not a bill for a"
^IBA(364.7,949,3,5,0)="NON-VA claim, output 0.  If the facility is not remote or NON-VA but the"
^IBA(364.7,949,3,6,0)="flag for another VA does the site's billing is set, output 0."
^IBA(364.7,951,0)="891^N^5^^^^N"
^IBA(364.7,951,1)="N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F  S IBZ=$O(IBXSAVE(""CCOB"",IBZ)) Q:'IBZ  S Z0=Z0+1,Z=0 F  S Z=$O(IBXSAVE(""CCOB"",IBZ,Z)) Q:'Z  I $P($G(IBXSAVE(""CCOB"",IBZ,Z,0)),U,6) S IBXDATA(Z0)=$$DT^IBCEFG1($P(IBXSAVE(""CCOB"",IBZ,Z,0),U,6),"""",""D8"") Q"
^IBA(364.7,951,3,0)="^^4^4^2991115^^^^"
^IBA(364.7,951,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,951,3,2,0)="insurance into the IBXSAVE(""CCOB"",COB,n,0) array.  Extract the sixth piece"
^IBA(364.7,951,3,3,0)="for this data.  Extract only the first date paid for each COB sequence into"
^IBA(364.7,951,3,4,0)="IBXDATA(n)."
^IBA(364.7,952,0)="974^N^5^^^^N"
^IBA(364.7,952,1)="K IBXDATA N Z S Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  S:$P(IBXSAVE(""OUTPT"",Z),U,11)'="""" IBXDATA(Z)=$$DOLLAR^IBCEFG1($P(IBXSAVE(""OUTPT"",Z),U,11))"
^IBA(364.7,952,3,0)="^^3^3^2991128^^^^"
^IBA(364.7,952,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,952,3,2,0)="possible for the data element in the previously extracted IBXSAVE array."
^IBA(364.7,952,3,3,0)="Only output the data for service lines that have data."
^IBA(364.7,953,0)="975^N^5^^^^N"
^IBA(364.7,953,1)="K IBXDATA"
^IBA(364.7,953,3,0)="^^4^4^3060818^"
^IBA(364.7,953,3,1,0)="esg - 8/18/06 - IB patch 348 - New CMS-1500 claim form project"
^IBA(364.7,953,3,2,0)=" "
^IBA(364.7,953,3,3,0)="Box 24K no longer exists on the 1500 form.  Austin FSC was not mapping "
^IBA(364.7,953,3,4,0)="this field to anything anyway."
^IBA(364.7,954,0)="968^N^5^^^^N"
^IBA(364.7,954,1)="S IBXDATA="""""
^IBA(364.7,954,3,0)="^364.73^1^1^3060125^^"
^IBA(364.7,954,3,1,0)="IB patch 320.  Move the data in this field to CI1A-3."
^IBA(364.7,955,0)="961^N^5^^^^N"
^IBA(364.7,955,1)="N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F  S IBZ=$O(IBXSAVE(""CCOB"",IBZ)) Q:'IBZ  S Z0=Z0+1,Z=0 F  S Z=$O(IBXSAVE(""CCOB"",IBZ,Z)) Q:'Z  I $P($G(IBXSAVE(""CCOB"",IBZ,Z,2)),U,3) S IBXDATA(Z0)=$G(IBXDATA(Z0))+$P(IBXSAVE(""CCOB"",IBZ,Z,2),U,3)"
^IBA(364.7,955,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,955,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,955,3,2,0)="insurance into the IBXSAVE(""CCOB"",COB,n,2) array.  Extract the third piece"
^IBA(364.7,955,3,3,0)="for this data.  Output the sum of each COB sequence as 1 IBXDATA(n) entry."
^IBA(364.7,956,0)="964^N^5^^^^N"
^IBA(364.7,956,1)="N Z,ZO,IBZ K IBXDATA S (IBZ,Z0)=0 F  S IBZ=$O(IBXSAVE(""CCOB"",IBZ)) Q:'IBZ  S Z0=Z0+1,Z=0 F  S Z=$O(IBXSAVE(""CCOB"",IBZ,Z)) Q:'Z  I $P($G(IBXSAVE(""CCOB"",IBZ,Z,4)),U) S IBXDATA(Z0)=$P(IBXSAVE(""CCOB"",IBZ,Z,4),U)"
^IBA(364.7,956,3,0)="^364.73^3^3^3031002^^^^"
^IBA(364.7,956,3,1,0)="This data element relies on the previous extract of COB data for"
^IBA(364.7,956,3,2,0)="other insurance into the IBXSAVE(""CCOB"",COB,n,4) array.  Extract the first"
^IBA(364.7,956,3,3,0)="piece for this data.  Output each COB sequence as 1 IBXDATA(n) entry."
^IBA(364.7,957,0)="868^N^5^^^^N"
^IBA(364.7,957,1)="N S,N K IBXDATA S S=4 D COBOUT^IBCEU1(.IBXSAVE,.IBXDATA,S) S N=0 F  S N=$O(IBXDATA(N)) Q:'N  S:$G(IBXDATA(N)) IBXDATA(N)=$$DOLLAR^IBCEFG1(IBXDATA(N))"
^IBA(364.7,957,3,0)="^^4^4^3030428^"
^IBA(364.7,957,3,1,0)="This data element assumes the existence of the IBXSAVE array for each "
^IBA(364.7,957,3,2,0)="line item (LCOB) that was previously extracted.  If the line has COB data "
^IBA(364.7,957,3,3,0)="associated with it, output the amount paid for each COB sequence found for"
^IBA(364.7,957,3,4,0)="the line."
^IBA(364.7,958,0)="869^N^5^^^^N"
^IBA(364.7,958,1)="N S K IBXDATA S S=5 D COBOUT^IBCEU1(.IBXSAVE,.IBXDATA,S)"
^IBA(364.7,958,3,0)="^^4^4^2990902^^^"
^IBA(364.7,958,3,1,0)="This data element assumes the existence of the IBXSAVE array for each line"
^IBA(364.7,958,3,2,0)="item (LCOB) that was previously extracted.  If the line has COB data"
^IBA(364.7,958,3,3,0)="associated with it, output the procedure for each COB sequence found for the"
^IBA(364.7,958,3,4,0)="line."
^IBA(364.7,959,0)="870^N^5^^^^N"
^IBA(364.7,959,1)="N S K IBXDATA S S=11 D COBOUT^IBCEU1(.IBXSAVE,.IBXDATA,S)"
^IBA(364.7,959,3,0)="^^4^4^2990902^^^"
^IBA(364.7,959,3,1,0)="This data element assumes the existence of the IBXSAVE array for each line"
^IBA(364.7,959,3,2,0)="item (LCOB) that was previously extracted.  If the line has COB data"
^IBA(364.7,959,3,3,0)="associated with it, output the revenue code for each COB sequence found for"
^IBA(364.7,959,3,4,0)="the line."
^IBA(364.7,960,0)="871^N^5^^^^N"
^IBA(364.7,960,1)="D COBMOD^IBCEU0(.IBXSAVE,.IBXDATA,1)"
^IBA(364.7,960,3,0)="^^4^4^2990902^^^"
^IBA(364.7,960,3,1,0)="This data element assumes the existence of the IBXSAVE array for each line"
^IBA(364.7,960,3,2,0)="item (LCOB) that was previously extracted.  If the line has COB data"
^IBA(364.7,960,3,3,0)="associated with it, output the modifier 1 for each COB sequence found for"
^IBA(364.7,960,3,4,0)="the line."
^IBA(364.7,961,0)="872^N^5^^^^N"
^IBA(364.7,961,1)="D COBMOD^IBCEU0(.IBXSAVE,.IBXDATA,2)"
^IBA(364.7,961,3,0)="^^4^4^2990902^^"
^IBA(364.7,961,3,1,0)="This data element assumes the existence of the IBXSAVE array for each line"
^IBA(364.7,961,3,2,0)="item (LCOB) that was previously extracted.  If the line has COB data"
^IBA(364.7,961,3,3,0)="associated with it, output the modifier 2 for each COB sequence found for"
^IBA(364.7,961,3,4,0)="the line."
^IBA(364.7,962,0)="873^N^5^^^^N"
^IBA(364.7,962,1)="D COBMOD^IBCEU0(.IBXSAVE,.IBXDATA,3)"
^IBA(364.7,962,3,0)="^^4^4^2990902^^"
^IBA(364.7,962,3,1,0)="This data element assumes the existence of the IBXSAVE array for each line"
^IBA(364.7,962,3,2,0)="item (LCOB) that was previously extracted.  If the line has COB data"
^IBA(364.7,962,3,3,0)="associated with it, output the modifier 3 for each COB sequence found for"
^IBA(364.7,962,3,4,0)="the line."
^IBA(364.7,963,0)="874^N^5^^^^N"
^IBA(364.7,963,1)="D COBMOD^IBCEU0(.IBXSAVE,.IBXDATA,4)"
^IBA(364.7,963,3,0)="^^4^4^2990902^^"
^IBA(364.7,963,3,1,0)="This data element assumes the existence of the IBXSAVE array for each line"
^IBA(364.7,963,3,2,0)="item (LCOB) that was previously extracted.  If the line has COB data"
^IBA(364.7,963,3,3,0)="associated with it, output the modifier 4 for each COB sequence found for"
^IBA(364.7,963,3,4,0)="the line."
^IBA(364.7,964,0)="875^N^5^^^^N"
^IBA(364.7,964,1)="K IBXDATA D COBOUT^IBCEU1(.IBXSAVE,.IBXDATA,10)"
^IBA(364.7,964,3,0)="^^4^4^2990902^^"
^IBA(364.7,964,3,1,0)="This data element assumes the existence of the IBXSAVE array for each line"
^IBA(364.7,964,3,2,0)="item (LCOB) that was previously extracted.  If the line has COB data"
^IBA(364.7,964,3,3,0)="associated with it, output the description for each COB sequence found for"
^IBA(364.7,964,3,4,0)="the line."
^IBA(364.7,965,0)="876^N^5^^^^N"
^IBA(364.7,965,1)="N S,N K IBXDATA S S=12 D COBOUT^IBCEU1(.IBXSAVE,.IBXDATA,S) S N=0 F  S N=$O(IBXDATA(N)) Q:'N  S:$G(IBXDATA(N)) IBXDATA(N)=$FN(IBXDATA(N),"""",0)"
^IBA(364.7,965,3,0)="^^4^4^2990902^^"
^IBA(364.7,965,3,1,0)="This data element assumes the existence of the IBXSAVE array for each line"
^IBA(364.7,965,3,2,0)="item (LCOB) that was previously extracted.  If the line has COB data"
^IBA(364.7,965,3,3,0)="associated with it, output the paid units for each COB sequence found for"
^IBA(364.7,965,3,4,0)="the line."
^IBA(364.7,966,0)="877^N^5^^^^N"
^IBA(364.7,966,1)="N S K IBXDATA S S=13 D COBOUT^IBCEU1(.IBXSAVE,.IBXDATA,S) K:'$G(IBXTRA) IBXDATA"
^IBA(364.7,966,3,0)="^^4^4^2990902^^"
^IBA(364.7,966,3,1,0)="This data element assumes the existence of the IBXSAVE array for each line"
^IBA(364.7,966,3,2,0)="item (LCOB) that was previously extracted.  If the line has COB data"
^IBA(364.7,966,3,3,0)="associated with it, output the assigned line # for each COB sequence found"
^IBA(364.7,966,3,4,0)="for the line."
^IBA(364.7,967,0)="976^N^5^^^^N"
^IBA(364.7,967,1)="N S,N K IBXDATA S S=20 D COBOUT^IBCEU1(.IBXSAVE,.IBXDATA,S) S N=0 F  S N=$O(IBXDATA(N)) Q:'N  S:$G(IBXDATA(N)) IBXDATA(N)=$$DT^IBCEFG1(IBXDATA(N),"""",""D8"")"
^IBA(364.7,967,3,0)="^^5^5^2991115^^^^"
^IBA(364.7,967,3,1,0)="This data element assumes the existence of the IBXSAVE array for each line"
^IBA(364.7,967,3,2,0)="item (LCOB) that was previously extracted.  If the line has COB data"
^IBA(364.7,967,3,3,0)="associated with it, output the date paid for each COB sequence found for"
^IBA(364.7,967,3,4,0)="the line.  This data is only stored at the claim level, not the line level,"
^IBA(364.7,967,3,5,0)="so it is assumed it applies to every line item on the EOB."
^IBA(364.7,968,0)="883^N^5^^^^N"
^IBA(364.7,968,1)="D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,6)"
^IBA(364.7,968,3,0)="^^4^4^2990902^^^"
^IBA(364.7,968,3,1,0)="This data element assumes the existence of the IBXSAVE(""LCOB"") array that"
^IBA(364.7,968,3,2,0)="was previously extracted with COB data for specific line items.  Up to 6"
^IBA(364.7,968,3,3,0)="adj quantity can be output on a single record for the same line and group"
^IBA(364.7,968,3,4,0)="code.  This extracts the first, seventh, etc onto separate records."
^IBA(364.7,969,0)="912^N^5^^^^N"
^IBA(364.7,969,1)="N Z D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,8) I $D(IBXDATA) S Z=0 F  S Z=$O(IBXDATA(Z)) Q:'Z  S IBXDATA(Z)=$$DOLLAR^IBCEFG1(IBXDATA(Z))"
^IBA(364.7,969,3,0)="^^4^4^2990902^^^^"
^IBA(364.7,969,3,1,0)="This data element assumes the existence of the IBXSAVE(""LCOB"") array that"
^IBA(364.7,969,3,2,0)="was previously extracted with COB data for specific line items.  Up to 6"
^IBA(364.7,969,3,3,0)="adj amts can be output on a single record for the same line and group"
^IBA(364.7,969,3,4,0)="code.  This extracts the second, eighth, etc onto separate records."
^IBA(364.7,970,0)="908^N^5^^^^N"
^IBA(364.7,970,1)="D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,10)"
^IBA(364.7,970,3,0)="^^4^4^2990902^^^^"
^IBA(364.7,970,3,1,0)="This data element assumes the existence of the IBXSAVE(""LCOB"") array that"
^IBA(364.7,970,3,2,0)="was previously extracted with COB data for specific line items.  Up to 6"
^IBA(364.7,970,3,3,0)="reason codes can be output on a single record for the same line and group"
^IBA(364.7,970,3,4,0)="code.  This extracts the third, ninth, etc onto separate records."
^IBA(364.7,971,0)="909^N^5^^^^N"
^IBA(364.7,971,1)="D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,13)"
^IBA(364.7,971,3,0)="^^4^4^2990902^^^^"
^IBA(364.7,971,3,1,0)="This data element assumes the existence of the IBXSAVE(""LCOB"") array that"
^IBA(364.7,971,3,2,0)="was previously extracted with COB data for specific line items.  Up to 6"
^IBA(364.7,971,3,3,0)="reason codes can be output on a single record for the same line and group"
^IBA(364.7,971,3,4,0)="code.  This extracts the fourth, tenth, etc onto separate records."
^IBA(364.7,972,0)="910^N^5^^^^N"
^IBA(364.7,972,1)="D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,16)"
^IBA(364.7,972,3,0)="^^4^4^2990902^^^^"
^IBA(364.7,972,3,1,0)="This data element assumes the existence of the IBXSAVE(""LCOB"") array that"
^IBA(364.7,972,3,2,0)="was previously extracted with COB data for specific line items.  Up to 6"
^IBA(364.7,972,3,3,0)="reason codes can be output on a single record for the same line and group"
^IBA(364.7,972,3,4,0)="code.  This extracts the fifth, eleventh, etc onto separate records."
^IBA(364.7,973,0)="921^N^5^^^^N"
^IBA(364.7,973,1)="D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,21)"
^IBA(364.7,973,3,0)="^^4^4^2990902^^^"
^IBA(364.7,973,3,1,0)="This data element assumes the existence of the IBXSAVE(""LCOB"") array that"
^IBA(364.7,973,3,2,0)="was previously extracted with COB data for specific line items.  Up to 6"
^IBA(364.7,973,3,3,0)="adj quantity can be output on a single record for the same line and group"
^IBA(364.7,973,3,4,0)="code.  This extracts the sixth, twelveth, etc onto separate records."
^IBA(364.7,974,0)="911^N^5^^^^N"
^IBA(364.7,974,1)="D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,19)"
^IBA(364.7,974,3,0)="^^4^4^2990902^^^^"
^IBA(364.7,974,3,1,0)="This data element assumes the existence of the IBXSAVE(""LCOB"") array that"
^IBA(364.7,974,3,2,0)="was previously extracted with COB data for specific line items.  Up to 6"
^IBA(364.7,974,3,3,0)="reason codes can be output on a single record for the same line and group"
^IBA(364.7,974,3,4,0)="code.  This extracts the sixth, twelveth, etc onto separate records."
^IBA(364.7,975,0)="914^N^5^^^^N"
^IBA(364.7,975,1)="N Z D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,14) I $D(IBXDATA) S Z=0 F  S Z=$O(IBXDATA(Z)) Q:'Z  S IBXDATA(Z)=$$DOLLAR^IBCEFG1(IBXDATA(Z))"
^IBA(364.7,975,3,0)="^^4^4^2990902^^^"
^IBA(364.7,975,3,1,0)="This data element assumes the existence of the IBXSAVE(""LCOB"") array that"
^IBA(364.7,975,3,2,0)="was previously extracted with COB data for specific line items.  Up to 6"
^IBA(364.7,975,3,3,0)="adj amts can be output on a single record for the same line and group"
^IBA(364.7,975,3,4,0)="code.  This extracts the fourth, tenth, etc onto separate records."
^IBA(364.7,976,0)="918^N^5^^^^N"
^IBA(364.7,976,1)="D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,12)"
^IBA(364.7,976,3,0)="^^4^4^2990902^^^"
^IBA(364.7,976,3,1,0)="This data element assumes the existence of the IBXSAVE(""LCOB"") array that"
^IBA(364.7,976,3,2,0)="was previously extracted with COB data for specific line items.  Up to 6"
^IBA(364.7,976,3,3,0)="adj quantity can be output on a single record for the same line and group"
^IBA(364.7,976,3,4,0)="code.  This extracts the third, ninth, etc onto separate records."
^IBA(364.7,977,0)="920^N^5^^^^N"
^IBA(364.7,977,1)="D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,18)"
^IBA(364.7,977,3,0)="^^4^4^2990902^^^"
^IBA(364.7,977,3,1,0)="This data element assumes the existence of the IBXSAVE(""LCOB"") array that"
^IBA(364.7,977,3,2,0)="was previously extracted with COB data for specific line items.  Up to 6"
^IBA(364.7,977,3,3,0)="adj quantity can be output on a single record for the same line and group"
^IBA(364.7,977,3,4,0)="code.  This extracts the fifth, eleventh, etc onto separate records."
^IBA(364.7,978,0)="913^N^5^^^^N"
^IBA(364.7,978,1)="N Z D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,11) I $D(IBXDATA) S Z=0 F  S Z=$O(IBXDATA(Z)) Q:'Z  S IBXDATA(Z)=$$DOLLAR^IBCEFG1(IBXDATA(Z))"
^IBA(364.7,978,3,0)="^^4^4^2990902^^^^"
^IBA(364.7,978,3,1,0)="This data element assumes the existence of the IBXSAVE(""LCOB"") array that"
^IBA(364.7,978,3,2,0)="was previously extracted with COB data for specific line items.  Up to 6"
^IBA(364.7,978,3,3,0)="adj amts can be output on a single record for the same line and group"
^IBA(364.7,978,3,4,0)="code.  This extracts the third, ninth, etc onto separate records."
^IBA(364.7,979,0)="919^N^5^^^^N"
^IBA(364.7,979,1)="D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,15)"
^IBA(364.7,979,3,0)="^^4^4^2990902^^^"
^IBA(364.7,979,3,1,0)="This data element assumes the existence of the IBXSAVE(""LCOB"") array that"
^IBA(364.7,979,3,2,0)="was previously extracted with COB data for specific line items.  Up to 6"
^IBA(364.7,979,3,3,0)="adj quantity can be output on a single record for the same line and group"
^IBA(364.7,979,3,4,0)="code.  This extracts the fourth, tenth, etc onto separate records."
^IBA(364.7,980,0)="915^N^5^^^^N"
^IBA(364.7,980,1)="N Z D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,17) I $D(IBXDATA) S Z=0 F  S Z=$O(IBXDATA(Z)) Q:'Z  S IBXDATA(Z)=$$DOLLAR^IBCEFG1(IBXDATA(Z))"
^IBA(364.7,980,3,0)="^^4^4^2990902^^^"
^IBA(364.7,980,3,1,0)="This data element assumes the existence of the IBXSAVE(""LCOB"") array that"
^IBA(364.7,980,3,2,0)="was previously extracted with COB data for specific line items.  Up to 6"
^IBA(364.7,980,3,3,0)="adj amts can be output on a single record for the same line and group"
^IBA(364.7,980,3,4,0)="code.  This extracts the fifth, eleventh, etc onto separate records."
^IBA(364.7,981,0)="917^N^5^^^^N"
^IBA(364.7,981,1)="D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,9)"
^IBA(364.7,981,3,0)="^^4^4^2990902^^^"
^IBA(364.7,981,3,1,0)="This data element assumes the existence of the IBXSAVE(""LCOB"") array that"
^IBA(364.7,981,3,2,0)="was previously extracted with COB data for specific line items.  Up to 6"
^IBA(364.7,981,3,3,0)="adj quantity can be output on a single record for the same line and group"
^IBA(364.7,981,3,4,0)="code.  This extracts the second, eighth, etc onto separate records."
^IBA(364.7,982,0)="916^N^5^^^^N"
^IBA(364.7,982,1)="N Z D LCOBOUT^IBCEU1(.IBXSAVE,.IBXDATA,20) I $D(IBXDATA) S Z=0 F  S Z=$O(IBXDATA(Z)) Q:'Z  S IBXDATA(Z)=$$DOLLAR^IBCEFG1(IBXDATA(Z))"
^IBA(364.7,982,3,0)="^^4^4^2990902^^^^"
^IBA(364.7,982,3,1,0)="This data element assumes the existence of the IBXSAVE(""LCOB"") array that"
^IBA(364.7,982,3,2,0)="was previously extracted with COB data for specific line items.  Up to 6"
^IBA(364.7,982,3,3,0)="adj amts can be output on a single record for the same line and group"
^IBA(364.7,982,3,4,0)="code.  This extracts the sixth, twelveth, etc onto separate records."
^IBA(364.7,983,0)="962^N^5^^^^N"
^IBA(364.7,983,1)="N Z,Z0,IBZ K IBXDATA S (IBZ,Z0)=0 F  S IBZ=$O(IBXSAVE(""CCOB"",IBZ)) Q:'IBZ  S Z0=Z0+1,Z=0 F  S Z=$O(IBXSAVE(""CCOB"",IBZ,Z)) Q:'Z  I $P($G(IBXSAVE(""CCOB"",IBZ,Z,0)),U,21)'="""" S IBXDATA(Z0)=$P(IBXSAVE(""CCOB"",IBZ,Z,0),U,21)"
^IBA(364.7,983,3,0)="^^4^4^2990901^^^^"
^IBA(364.7,983,3,1,0)="This data element relies on the previous extract of COB data for other"
^IBA(364.7,983,3,2,0)="insurance into the IBXSAVE(""CCOB"",COB,n,0) array.  Extract the thirteenth"
^IBA(364.7,983,3,3,0)="piece for this data.  Output only the last claim status found for each COB"
^IBA(364.7,983,3,4,0)="sequence."
^IBA(364.7,984,0)="884^N^100^^^^N"
^IBA(364.7,984,1)="K IBXSAVE"
^IBA(364.7,984,3,0)="^^1^1^2990901^"
^IBA(364.7,984,3,1,0)="Cleans up the IBXSAVE array.  No output."
^IBA(364.7,985,0)="983^N^5^^^^N"
^IBA(364.7,985,1)="N Z,Z0 K IBXDATA I $$COBN^IBCEF(IBXIEN)>1 F Z0=""INPT"",""OUTPT"",""RX"" S Z=0 F  S Z=$O(IBXSAVE(Z0,Z)) K:'Z IBXSAVE(Z0) Q:'Z  I $D(IBXSAVE(Z0,Z,""COB"")),$$EOBCNT^IBCEU1(IBXIEN) M IBXSAVE(""LCOB"",Z)=IBXSAVE(Z0,Z)"
^IBA(364.7,985,3,0)="^364.73^4^4^3050511^^^^"
^IBA(364.7,985,3,1,0)="The arrays IBXSAVE(""INPT""), IBXSAVE(""OUTPT"") and IBXSAVE(""RX"") are created"
^IBA(364.7,985,3,2,0)="when the line items on the bill are produced.  This field takes the data"
^IBA(364.7,985,3,3,0)="from these arrays and creates a new IBXSAVE(""LCOB"") array with just the COB"
^IBA(364.7,985,3,4,0)="data and deletes the original IBXSAVE arrays."
^IBA(364.7,987,0)="985^N^318^^^^N"
^IBA(364.7,987,1)="S IBXDATA=$S($P(IBXSAVE(""ID""),U,3):$P(IBXSAVE(""ID""),U,3),1:$P(IBXSAVE(""ID""),U,4))"
^IBA(364.7,987,3,0)="^364.73^2^2^3040527^^^^"
^IBA(364.7,987,3,1,0)="Finds the operating provider id for all insurance companies, saves data in"
^IBA(364.7,987,3,2,0)="IBXSAVE array and resets IBXDATA to primary id number, if defined."
^IBA(364.7,988,0)="986^N^318^^^^N"
^IBA(364.7,988,1)="S IBXDATA=$S($P(IBXDATA,U,3):$P(IBXDATA,U,3),1:$P(IBXDATA,U,4))"
^IBA(364.7,988,3,0)="^364.73^2^2^3040527^^^^"
^IBA(364.7,988,3,1,0)="Finds the referring provider id for all insurance companies, saves data in"
^IBA(364.7,988,3,2,0)="IBXSAVE array and resets IBXDATA to primary id number, if defined."
^IBA(364.7,989,0)="988^N^5^^^^N"
^IBA(364.7,989,1)="K IBXDATA N Z,Z0 F Z=1,2 K:$P($G(IBXSAVE(""OIEMP"",Z)),U,5)="""" IBXSAVE(""OIEMP"",Z) I $D(IBXSAVE(""OIEMP"",Z)) S IBXDATA(Z)=$P(IBXSAVE(""OIEMP"",Z),U,5)"
^IBA(364.7,989,3,0)="^^1^1^2991006^^^"
^IBA(364.7,989,3,1,0)="If there is no street address, don't use the rest of the address either."
^IBA(364.7,990,0)="987^N^5^^^^N"
^IBA(364.7,990,1)="S IBXDATA=$P($G(IBXSAVE(""EMP"")),U,5)"
^IBA(364.7,990,3,0)="^^1^1^3000107^"
^IBA(364.7,990,3,1,0)="Retrieves insured employment info from IBXSAVE array previously extracted."
^IBA(364.7,992,0)="993^N^318^^^^N"
^IBA(364.7,992,1)="S IBXDATA=$P(IBXSAVE(""ID""),U,2)"
^IBA(364.7,992,3,0)="^364.73^3^3^3031014^^^^"
^IBA(364.7,992,3,1,0)="Field relies on the existence of the IBXSAVE(""OP-ID"",n) array previously"
^IBA(364.7,992,3,2,0)="extracted for the primary operating provider id.  The tertiary id, if it"
^IBA(364.7,992,3,3,0)="exists, will be in IBXSAVE(""OP-ID"",3)."
^IBA(364.7,993,0)="991^N^318^^^^N"
^IBA(364.7,993,1)="S IBXDATA=$P(IBXSAVE(""ID""),U,9)"
^IBA(364.7,993,3,0)="^364.73^3^3^3031029^^^^"
^IBA(364.7,993,3,1,0)="Field relies on the existence of the IBXSAVE(""OP-ID"",n) array previously"
^IBA(364.7,993,3,2,0)="extracted for the primary operating provider id.  The secondary id, if it"
^IBA(364.7,993,3,3,0)="exists, will be in IBXSAVE(""OP-ID"",2)."
^IBA(364.7,994,0)="992^N^318^^^^N"
^IBA(364.7,994,1)="S IBXDATA=$P(IBXDATA,U,9)"
^IBA(364.7,994,3,0)="^364.73^3^3^3031029^^^^"
^IBA(364.7,994,3,1,0)="Field relies on the existence of the IBXSAVE(""REF-ID"",n) array previously"
^IBA(364.7,994,3,2,0)="extracted for the primary referring provider id.  The secondary id, if it"
^IBA(364.7,994,3,3,0)="exists, will be in IBXSAVE(""REF-ID"",2)."
^IBA(364.7,995,0)="994^N^318^^^^N"
^IBA(364.7,995,1)="S IBXDATA=$P(IBXDATA,U,2)"
^IBA(364.7,995,3,0)="^364.73^3^3^3031016^^^^"
^IBA(364.7,995,3,1,0)="Field relies on the existence of the IBXSAVE(""REF-ID"",n) array previously"
^IBA(364.7,995,3,2,0)="extracted for the primary referring provider id.  The tertiary id, if it"
^IBA(364.7,995,3,3,0)="exists, will be in IBXSAVE(""REF-ID"",3)."
^IBA(364.7,997,0)="996^N^146^^^^N"
^IBA(364.7,997,1)="S IBXDATA=$J("""",6)_IBXDATA"
^IBA(364.7,998,0)="995^N^145^^^^N"
^IBA(364.7,998,1)="N IBZ D F^IBCEF(""N-ROI INDICATOR"",""IBZ"") I IBZ S IBXDATA=""MODIFIED/RESTRICTED RELEASE ""_IBXDATA"
^IBA(364.7,1000,0)="999^N^55^^^^N"
^IBA(364.7,1001,0)="1000^N^277^^^^N"
^IBA(364.7,1001,1)="N COB,IBZ S COB=+$$COBN^IBCEF(IBXIEN),IBZ=IBXDATA K IBXDATA I +IBZ=4,$P(IBZ,U,COB+1)'="""" S IBXDATA=$P(IBZ,U,COB+1)"
^IBA(364.7,1001,3,0)="^364.73^1^1^3000526^^^^"
^IBA(364.7,1001,3,1,0)="Retrieves the current insurance co's attending provider ID for UB92 billS"
^IBA(364.7,1002,0)="1001^N^282^^^^SR"
^IBA(364.7,1002,1)="S IBXDATA=$S('IBXDATA:"""",1:$TR($J(IBXDATA,10,2),"" ""))"
^IBA(364.7,1002,3,0)="^364.73^1^1^3000919^^^^"
^IBA(364.7,1002,3,1,0)="Format data in 10 characters with 2 decimals."
^IBA(364.7,1003,0)="1002^N^148^^^^N"
^IBA(364.7,1003,1)="S:$L(IBXDATA)>80 IBXDATA=$E(IBXDATA,1,80)"
^IBA(364.7,1003,3,0)="^^1^1^3000831^"
^IBA(364.7,1003,3,1,0)="Only the first 80 characters output for transmission"
^IBA(364.7,1005,0)="1004^N^290^^^^N"
^IBA(364.7,1005,1)="S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA)"
^IBA(364.7,1006,0)="1005^N^234^^^^N"
^IBA(364.7,1006,1)="N A,Q,Z S Q=$G(IBXDATA) K IBXDATA I $$FT^IBCEF(IBXIEN)=2 F Z=1,2 S A=$P(Q,U,Z) I $D(^DGCR(399,IBXIEN,""I""_(Z+1))) S IBXDATA(Z)=$S(A=1:""HM"",A=2:""C1"",A=3:""MB"",A=4:""MC"",A=5:""GP"",1:""OT"")"
^IBA(364.7,1006,3,0)="^^12^12^3050629^"
^IBA(364.7,1006,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,1006,3,2,0)="possible for the data element in the IBXDATA array.  If any 'other'"
^IBA(364.7,1006,3,3,0)="insurance company data is found, the data is formatted as the insurance type"
^IBA(364.7,1006,3,4,0)="of the insurance company in X12 format (see codes below or refer to the"
^IBA(364.7,1006,3,5,0)="837 V4010 field 2320/SBR/05 - professional guide)"
^IBA(364.7,1006,3,6,0)=" "
^IBA(364.7,1006,3,7,0)="     Type codes: = 1:HMO  (HM)"
^IBA(364.7,1006,3,8,0)="                   2:COMMERCIAL  (C1)"
^IBA(364.7,1006,3,9,0)="                   3:MEDICARE  (MB)"
^IBA(364.7,1006,3,10,0)="                   4:MEDICAID  (MC)"
^IBA(364.7,1006,3,11,0)="                   5:GROUP POLICY  (GP)"
^IBA(364.7,1006,3,12,0)="                   9:OTHER  (OT)"
^IBA(364.7,1007,0)="1006^N^5^^^^N"
^IBA(364.7,1007,1)="K IBXDATA N Z,IBZ S Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  I $P($G(IBXSAVE(""OUTPT"",Z,""AUX"")),U,8)'="""" S IBXDATA(Z)=$P(IBXSAVE(""OUTPT"",Z,""AUX""),U,8),IBZ=$P(IBXSAVE(""OUTPT"",Z,""AUX""),U,9) S:IBZ="""" IBZ=""  "" S IBXDATA(Z)=IBZ_IBXDATA(Z)"
^IBA(364.7,1007,3,0)="^^11^11^3060818^"
^IBA(364.7,1007,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,1007,3,2,0)="possible for the data element in the previously extracted IBXSAVE array."
^IBA(364.7,1007,3,3,0)="Only output the data for service lines that have data."
^IBA(364.7,1007,3,4,0)=" "
^IBA(364.7,1007,3,5,0)="esg - 8/18/06 - IB patch 348 - new CMS 1500 claim form"
^IBA(364.7,1007,3,6,0)="If the service line comment qualifier doesn't exist, then add 2 blank "
^IBA(364.7,1007,3,7,0)="spaces in front of the service line comment.  If it does exist, then add "
^IBA(364.7,1007,3,8,0)="it to the front of the comment."
^IBA(364.7,1007,3,9,0)=" "
^IBA(364.7,1007,3,10,0)="Length was also reduced from 80 chars to 61 chars in the field since that "
^IBA(364.7,1007,3,11,0)="is all the Box 24 shaded area allows for the comment per line item."
^IBA(364.7,1008,0)="1007^N^5^^^^N"
^IBA(364.7,1008,1)="N IBZ S IBXDATA=$P($G(IBXSAVE(""ATTP"")),U,4) I IBXDATA="""",$G(IBXSAVE(""ATTP""))="""" D F^IBCEF(""N-ATT/REND PHYSICIAN NAME"",""IBZ"") S $P(IBZ,U,3,4)=IBXIEN_U_$O(^DGCR(399,IBXIEN,""PRV"",""B"",4,0)),IBXDATA=$P($$NAME^IBCEFG1(IBZ,1),U,4)"
^IBA(364.7,1008,3,0)="^364.73^1^1^3040527^^"
^IBA(364.7,1008,3,1,0)="Credentials should be in the 4th piece of the IBXSAVE(""ATTP"") array."
^IBA(364.7,1009,0)="1008^N^113^^^^N"
^IBA(364.7,1009,1)="D BOX324^IBCEP8A(IBXIEN,.IBXSAVE,.IBXDATA)"
^IBA(364.7,1009,3,0)="^^3^3^3060116^"
^IBA(364.7,1009,3,1,0)="HCFA-1500 form, Box 32, Line 4."
^IBA(364.7,1009,3,2,0)="Display mammography certification number if it exists."
^IBA(364.7,1009,3,3,0)="Otherwise, display the facility tax ID for remote VA site or non-VA site."
^IBA(364.7,1010,0)="1009^N^233^^^^N"
^IBA(364.7,1010,1)="I $D(IBXDATA) K IBXSAVE(""DEFID"") S IBXDATA=$P(""HM^C1^MB^MC^GP^^^^OT"",U,+IBXDATA) S:IBXDATA=""C1"" IBXSAVE(""DEFID"")=1 S IBXDATA="""" S IBXDATA="""""
^IBA(364.7,1010,3,0)="^364.73^2^2^3030911^^^^"
^IBA(364.7,1010,3,1,0)="Translate to X12 code, default to Group Policy (GP) if data is missing."
^IBA(364.7,1010,3,2,0)="Refer to Professional 837 V4010 2000B/SBR/05 for codes. REMOVED DEFAULT ""GP"""
^IBA(364.7,1011,0)="1010^N^5^^^^N"
^IBA(364.7,1011,1)="K IBXDATA N Z S Z=0 F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  S:$P($G(IBXSAVE(""OUTPT"",Z,""AUX"")),U,4)'="""" IBXDATA(Z)=$P($P(IBXSAVE(""OUTPT"",Z,""AUX""),U,4),""-"",1)"
^IBA(364.7,1011,3,0)="^^3^3^2990901^^^^"
^IBA(364.7,1011,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,1011,3,2,0)="possible for the data element in the previously extracted IBXSAVE array."
^IBA(364.7,1011,3,3,0)="Only output the data for service lines that have data."
^IBA(364.7,1012,0)="1011^N^5^^^^N"
^IBA(364.7,1012,1)="K IBXDATA N Z S Z="""" F  S Z=$O(IBXSAVE(""OUTPT"",Z)) Q:'Z  I $D(IBXSAVE(""OUTPT"",Z,""RX"")),$P(IBXSAVE(""OUTPT"",Z,""RX""),U,3)'="""" S IBXDATA(Z)=""N4"""
^IBA(364.7,1012,3,0)="^364.73^3^3^3040309^^^^"
^IBA(364.7,1012,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,1012,3,2,0)="possible for the data element in the previously extract IBXSAVE array."
^IBA(364.7,1012,3,3,0)="Changes the internal code into a valid X12 837 code (N1,N2,N3,N4)."
^IBA(364.7,1013,0)="1012^N^5"
^IBA(364.7,1013,1)="N S K IBXDATA S S=19 D COBOUT^IBCEU1(.IBXSAVE,.IBXDATA,S)"
^IBA(364.7,1013,3,0)="^^4^4^3030331^"
^IBA(364.7,1013,3,1,0)="This data element assumes the existence of the IBXSAVE array for each line"
^IBA(364.7,1013,3,2,0)="item (LCOB) that was previously extracted.  If the line has COB data"
^IBA(364.7,1013,3,3,0)="associated with it, output the procedure type code for each COB sequence"
^IBA(364.7,1013,3,4,0)="found for the line."
^IBA(364.7,1015,0)="1014^N^5"
^IBA(364.7,1015,1)="S IBXDATA=""343.0      """
^IBA(364.7,1015,3,0)="^364.73^1^1^3060807^^^^"
^IBA(364.7,1015,3,1,0)=" "
^IBA(364.7,1018,0)="1301^N^312^^^^N"
^IBA(364.7,1018,1)="K IBXSAVE(""OSQ"") N Q,OK M Q=IBXSAVE(""PROVINF"",IBXIEN,""O"") S (C,Z)=0 F  S Z=$O(Q(Z)) Q:'Z  S OK=0 X ""N A F A=1:1 Q:'$D(Q(Z,5,A))  I $P(Q(Z,5,A),U,4)'="""""""" S OK=1 Q"" I OK S C=C+1,IBXDATA(C)=$G(Q(Z)),IBXSAVE(""OSQ"",Z)=C D:C>1 ID^IBCEF2(C,""OP8 "")"
^IBA(364.7,1018,3,0)="^^9^9^3030902^^^^"
^IBA(364.7,1018,3,1,0)="Output if an ID exists for the 'other insurance'.  If more than 1 ins,"
^IBA(364.7,1018,3,2,0)="must output the record id.  Must kill the IBXSAVE(""OSQ"") array as this is"
^IBA(364.7,1018,3,3,0)="used to determine the current bill's sequence of other providers and which"
^IBA(364.7,1018,3,4,0)="IBXDATA array entry needs to be set for each.  IBXSAVE(""OSQ"") must be killed"
^IBA(364.7,1018,3,5,0)="at the last field for this record."
^IBA(364.7,1018,3,6,0)="IBXSAVE(""OSQ"",n)=m where n = the sequence for the other insurance (if bill"
^IBA(364.7,1018,3,7,0)="is primary, 1=secondary, 2=tertiary; if bill is secondary, 1=primary,"
^IBA(364.7,1018,3,8,0)="2=tertiary; if bill is tertiary, 1=primary, 2=secondary).  And where"
^IBA(364.7,1018,3,9,0)="m = the IBXDATA(m) entry to set for the 'n' COB sequence."
^IBA(364.7,1019,0)="1303^N^312^^^^N"
^IBA(364.7,1019,1)="K IBXDATA D PROVSEQ^IBCEF72(IBXIEN,.IBXSAVE,.IBXDATA,3,""OP1 "")"
^IBA(364.7,1019,3,0)="^364.73^9^9^3030916^^^^"
^IBA(364.7,1019,3,1,0)="Output if an ID exists for the 'other insurance'.  If more than 1"
^IBA(364.7,1019,3,2,0)="insurance, must output the record id.  The IBXSAVE(""OSQ"") array is "
^IBA(364.7,1019,3,3,0)="used to determine the current bill's sequence of other providers and"
^IBA(364.7,1019,3,4,0)="which IBXDATA array entry needs to be set for each.  This variable must"
^IBA(364.7,1019,3,5,0)="be killed at the last field for this record.  IBXSAVE(""OSQ"",n)=m where"
^IBA(364.7,1019,3,6,0)="n = the sequence for the other insurance (if bill is primary, 1=secondary,"
^IBA(364.7,1019,3,7,0)="2=tertiary; if bill is secondary, 1=primary, 2=tertiary; if bill is"
^IBA(364.7,1019,3,8,0)="tertiary, 1=primary, 2=secondary.  And where m=the IBXDATA(m) entry to"
^IBA(364.7,1019,3,9,0)="set for the 'n' COB sequence."
^IBA(364.7,1020,0)="1305^N^5^^^^N"
^IBA(364.7,1020,1)="D OTH^IBCEF76(IBXIEN,.IBXSAVE,.IBXDATA,($$FT^IBCEF(IBXIEN)=3),""OP3 "")"
^IBA(364.7,1020,3,0)="^^3^3^3060314^"
^IBA(364.7,1020,3,1,0)="OP3-2"
^IBA(364.7,1020,3,2,0)="Call the provider ID function only if the claim is a UB claim."
^IBA(364.7,1020,3,3,0)="Output the other payer sequence."
^IBA(364.7,1021,0)="1306^N^312^^^^N"
^IBA(364.7,1021,1)="K IBXSAVE(""OSQ"") N C,Z,Q,OK M Q=IBXSAVE(""PROVINF"",IBXIEN,""O"") S (C,Z)=0 F  S Z=$O(Q(Z)) Q:'Z  S OK=0 X ""N A F A=1:1 Q:'$D(Q(Z,1,A))  I $P(Q(Z,1,A),U,4)'="""""""" S OK=1 Q"" I OK S C=C+1,IBXDATA(C)=$G(Q(Z)),IBXSAVE(""OSQ"",Z)=C D:C>1 ID^IBCEF2(C,""OP4 "")"
^IBA(364.7,1021,3,0)="^^9^9^3030821^^^^"
^IBA(364.7,1021,3,1,0)="Output if an ID exists for the 'other insurance'.  If more than 1 insurance"
^IBA(364.7,1021,3,2,0)="must output the record id.  Must kill the IBXSAVE(""OSQ"") array as this"
^IBA(364.7,1021,3,3,0)="is used to determine the current bill's sequence of other providers and"
^IBA(364.7,1021,3,4,0)="which IBXDATA array entry needs to be set for each.  This variable must"
^IBA(364.7,1021,3,5,0)="be killed at the last field for this record.  IBXSAVE(""OSQ"",n)=m where"
^IBA(364.7,1021,3,6,0)="n = the sequence for the other insurance (if bill is primary, 1=secondary,"
^IBA(364.7,1021,3,7,0)="2=tertiary; if bill is secondary, 1=primary, 2=tertiary; if bill is"
^IBA(364.7,1021,3,8,0)="tertiary, 1=primary, 2=secondary.  And where m=the IBXDATA(m) entry to"
^IBA(364.7,1021,3,9,0)="set for the 'n' COB sequence."
^IBA(364.7,1022,0)="1308^N^5^^^^N"
^IBA(364.7,1022,1)="D OTH^IBCEF76(IBXIEN,.IBXSAVE,.IBXDATA,$$SUB1OK^IBCEP8A(IBXIEN),""OP6 "")"
^IBA(364.7,1022,3,0)="^^4^4^3060314^"
^IBA(364.7,1022,3,1,0)="OP6-2"
^IBA(364.7,1022,3,2,0)="Call provider ID function only if claim is for professional purchased "
^IBA(364.7,1022,3,3,0)="services.  Loop through all other insurances and output the corresponding "
^IBA(364.7,1022,3,4,0)="payer sequence of that other insurance."
^IBA(364.7,1023,0)="1309^N^5^^^^N"
^IBA(364.7,1023,1)="D OTH^IBCEF76(IBXIEN,.IBXSAVE,.IBXDATA,($$FT^IBCEF(IBXIEN)=2),""OP7 "")"
^IBA(364.7,1023,3,0)="^^3^3^3060314^"
^IBA(364.7,1023,3,1,0)="OP7-2"
^IBA(364.7,1023,3,2,0)="other payer sequence.  Call provider ID function only when claim is a "
^IBA(364.7,1023,3,3,0)="1500 claim."
^IBA(364.7,1024,0)="1310^N^312^^^^N"
^IBA(364.7,1024,1)="K IBXSAVE(""OSQ"") N C,Z,Q,OK M Q=IBXSAVE(""PROVINF"",IBXIEN,""O"") S (C,Z)=0 F  S Z=$O(Q(Z)) Q:'Z  S OK=0 X ""N A F A=1:1 Q:'$D(Q(Z,9,A))  I $P(Q(Z,9,A),U,4)'="""""""" S OK=1 Q"" I OK S C=C+1,IBXDATA(C)=$G(Q(Z)),IBXSAVE(""OSQ"",Z)=C D:C>1 ID^IBCEF2(C,""OP9 "")"
^IBA(364.7,1024,3,0)="^^9^9^3030821^^^^"
^IBA(364.7,1024,3,1,0)="Output if an ID exists for the 'other insurance'.  If more than 1 insurance"
^IBA(364.7,1024,3,2,0)="must output the record id.  Must kill the IBXSAVE(""OSQ"") array as this"
^IBA(364.7,1024,3,3,0)="is used to determine the current bill's sequence of other providers and"
^IBA(364.7,1024,3,4,0)="which IBXDATA array entry needs to be set for each.  This variable must"
^IBA(364.7,1024,3,5,0)="be killed at the last field for this record.  IBXSAVE(""OSQ"",n)=m where"
^IBA(364.7,1024,3,6,0)="n = the sequence for the other insurance (if bill is primary, 1=secondary,"
^IBA(364.7,1024,3,7,0)="2=tertiary; if bill is secondary, 1=primary, 2=tertiary; if bill is"
^IBA(364.7,1024,3,8,0)="tertiary, 1=primary, 2=secondary.  And where m=the IBXDATA(m) entry to"
^IBA(364.7,1024,3,9,0)="set for the 'n' COB sequence."
^IBA(364.7,1025,0)="1304^N^312^^^^N"
^IBA(364.7,1025,1)="K IBXSAVE(""OSQ"") N C,Z,Q,OK M Q=IBXSAVE(""PROVINF"",IBXIEN,""O"") S (C,Z)=0 F  S Z=$O(Q(Z)) Q:'Z  S OK=0 X ""N A F A=1:1 Q:'$D(Q(Z,2,A))  I $P(Q(Z,2,A),U,4)'="""""""" S OK=1 Q"" I OK S C=C+1,IBXDATA(C)=$G(Q(Z)),IBXSAVE(""OSQ"",Z)=C D:C>1 ID^IBCEF2(C,""OP2 "")"
^IBA(364.7,1025,3,0)="^^9^9^3030826^^^^"
^IBA(364.7,1025,3,1,0)="Output if an ID exists for the 'other insurance'.  If more than 1 insurance"
^IBA(364.7,1025,3,2,0)="must output the record id.  Must kill the IBXSAVE(""OSQ"") array as this"
^IBA(364.7,1025,3,3,0)="is used to determine the current bill's sequence of other providers and"
^IBA(364.7,1025,3,4,0)="which IBXDATA array entry needs to be set for each.  This variable must"
^IBA(364.7,1025,3,5,0)="be killed at the last field for this record.  IBXSAVE(""OSQ"",n)=m where"
^IBA(364.7,1025,3,6,0)="n = the sequence for the other insurance (if bill is primary, 1=secondary,"
^IBA(364.7,1025,3,7,0)="2=tertiary; if bill is secondary, 1=primary, 2=tertiary; if bill is"
^IBA(364.7,1025,3,8,0)="tertiary, 1=primary, 2=secondary.  And where m=the IBXDATA(m) entry to"
^IBA(364.7,1025,3,9,0)="set for the 'n' COB sequence."
^IBA(364.7,1026,0)="1084^N^5^^^^N"
^IBA(364.7,1026,1)="N Z,Z1 S (Z,Z1)=0 F  S Z=$O(IBXSAVE(1,Z)) Q:'Z  S Z1=Z1+1,IBXDATA(Z1)=""MI"""
^IBA(364.7,1027,0)="1311^N^101^^^^N"
^IBA(364.7,1027,1)="N IBZ,Z,Z0 M IBZ=IBXDATA K IBXDATA I $O(IBXSAVE(1,0)) S (Z,Z0)=0 F  S Z=$O(IBXSAVE(1,Z)) Q:'Z  S Z0=Z0+1,IBXDATA(Z0)=IBXSAVE(1,Z) I Z0>1 D ID^IBCEF2(Z0,""OI3 "")"
^IBA(364.7,1027,3,0)="^364.73^7^7^3030916^^^^"
^IBA(364.7,1027,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,1027,3,2,0)="possible for the data element in the IBXDATA array.  The IBXSAVE(1) variable"
^IBA(364.7,1027,3,3,0)="holds the indicator of which insurance [(P)rimary/(S)econdary/(T)ertiary] is"
^IBA(364.7,1027,3,4,0)="currently responsible for the bill.  Using this data as a guide, the next"
^IBA(364.7,1027,3,5,0)="insurance for the primary is secondary, then tertiary.  For secondary, it's"
^IBA(364.7,1027,3,6,0)="primary then tertiary, and for tertiary, it's primary, then secondary. For"
^IBA(364.7,1027,3,7,0)="other than the first occurrence, the RECORD ID 'OI3 ' must be output."
^IBA(364.7,1028,0)="1312^N^101^^^^N"
^IBA(364.7,1028,1)="N IBZ,Z,Z0 M IBZ=IBXDATA K IBXDATA I $O(IBXSAVE(1,0)) D ELMADDR^IBCEF7(IBXIEN,0,.Z) S (Z,Z0)=0 F  S Z=$O(IBXSAVE(1,Z)) Q:'Z  S Z0=Z0+1,IBXDATA(Z0)=$S($G(Z(Z0))'="""":IBXSAVE(1,Z),1:"""") D:Z0>1&(IBXDATA(Z0)'="""") ID^IBCEF2(Z0,""OI4 "")"
^IBA(364.7,1028,3,0)="^364.73^7^7^3030929^^^^"
^IBA(364.7,1028,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,1028,3,2,0)="possible for the data element in the IBXDATA array.  The IBXSAVE(1) variable"
^IBA(364.7,1028,3,3,0)="holds the indicator of which insurance [(P)rimary/(S)econdary/(T)ertiary] is"
^IBA(364.7,1028,3,4,0)="currently responsible for the bill.  Using this data as a guide, the next"
^IBA(364.7,1028,3,5,0)="insurance for the primary is secondary, then tertiary.  For secondary, it's"
^IBA(364.7,1028,3,6,0)="primary then tertiary, and for tertiary, it's primary, then secondary. For"
^IBA(364.7,1028,3,7,0)="other than the first occurrence, the RECORD ID 'OI4 ' must be output."
^IBA(364.7,1029,0)="1313^N^101^^^^N"
^IBA(364.7,1029,1)="N IBZ,Z,Z0 M IBZ=IBXDATA K IBXDATA I $O(IBXSAVE(1,0)) S (Z,Z0)=0 F  S Z=$O(IBXSAVE(1,Z)) Q:'Z  S Z0=Z0+1,IBXDATA(Z0)=IBXSAVE(1,Z) I Z0>1 D ID^IBCEF2(Z0,""OI5 "")"
^IBA(364.7,1029,3,0)="^364.73^7^7^3040728^^^^"
^IBA(364.7,1029,3,1,0)="This is a group data element so more than 1 occurrence of a value is"
^IBA(364.7,1029,3,2,0)="possible for the data element in the IBXDATA array.  The IBXSAVE(1) variable"
^IBA(364.7,1029,3,3,0)="holds the indicator of which insurance [(P)rimary/(S)econdary/(T)ertiary] is"
^IBA(364.7,1029,3,4,0)="currently responsible for the bill.  Using this data as a guide, the next"
^IBA(364.7,1029,3,5,0)="insurance for the primary is secondary, then tertiary.  For secondary, it's"
^IBA(364.7,1029,3,6,0)="primary then tertiary, and for tertiary, it's primary, then secondary. For"
^IBA(364.7,1029,3,7,0)="other than the first occurrence, the RECORD ID 'OI5 ' must be output."
^IBA(364.7,1030,0)="1314^N^101^^^^N"
^IBA(364.7,1030,1)="N IBZ,Z,Z0,Z1 M IBZ=IBXDATA K IBXDATA I $O(IBXSAVE(1,0)) S Z1=0 F Z0=1:1:3 I $D(IBXSAVE(1,Z0)) S Z1=Z1+1,IBXDATA(Z1)=""QC"""
^IBA(364.7,1030,3,0)="^364.73^2^2^3030916^^^^"
^IBA(364.7,1030,3,1,0)="If the previous extract returned a value for ibxdata then the"
^IBA(364.7,1030,3,2,0)="QC modifier is needed here."
^IBA(364.7,1031,0)="1315^N^5"
^IBA(364.7,1031,1)="S IBXDATA=$P($G(IBZSAVE(""BILLING PRV"",IBXIEN,""C"",1,2,""PTQ"")),U,1) K IBZSAVE"
^IBA(364.7,1031,3,0)="^364.73^2^2^3060420^^"
^IBA(364.7,1031,3,1,0)="CI1-9.  This is the billing provider ID qualifier (#2).  It is found on "
^IBA(364.7,1031,3,2,0)="screen 3 for the current insurance company qualifier.  Same as CI1A-4."
^IBA(364.7,1032,0)="1316^N^5^^^^N"
^IBA(364.7,1032,1)="K IBZSAVE D ALLIDS^IBCEF75(IBXIEN,.IBZSAVE,1) S IBXDATA=$P($G(IBZSAVE(""BILLING PRV"",IBXIEN,""C"",1,2)),U,2)"
^IBA(364.7,1032,3,0)="^^2^2^3060227^"
^IBA(364.7,1032,3,1,0)="CI1-7:  This is the billing provider secondary ID (#2).  It is found on "
^IBA(364.7,1032,3,2,0)="billing screen 3 for the current insurance company.  Same as CI1A-5."
^IBA(364.7,1033,0)="1317^N^5"
^IBA(364.7,1033,1)="S IBXDATA="""""
^IBA(364.7,1033,3,0)="^^3^3^3060222^"
^IBA(364.7,1033,3,1,0)="Prior to IB patch 320, this was the current insurance billing provider ID "
^IBA(364.7,1033,3,2,0)="qualifier (one of them).  All billing provider ID's and qualifiers are "
^IBA(364.7,1033,3,3,0)="now in the CI1A segment so this field has been removed."
^IBA(364.7,1034,0)="973^N^5^^^^N"
^IBA(364.7,1034,1)="N IBT,IBZ,IBN S IBT=$S($$FT^IBCEF(IBXIEN)=2:3,1:4) D GETPRV^IBCEU(IBXIEN,IBT,.IBZ) I $G(IBZ(IBT,1))'="""" S IBN=$P($G(IBZ(IBT,1)),U,3),IBXDATA=$S(IBN'[""355.93,"":1,$P($G(^IBA(355.93,+IBN,0)),U,2)=2:1,1:2)"
^IBA(364.7,1034,3,0)="^364.73^2^2^3040505^^^"
^IBA(364.7,1034,3,1,0)="Get the rendering/attending provider id info.  If facility provider,"
^IBA(364.7,1034,3,2,0)="output 2 for non-person or 1 for person."
^IBA(364.7,1035,0)="1318^N^5"
^IBA(364.7,1035,1)="N IBZ,IBN D GETPRV^IBCEU(IBXIEN,1,.IBZ) I $G(IBZ(1,1))'="""" S IBN=$P($G(IBZ(1,1)),U,3),IBXDATA=$S(IBN'[""355.93,"":1,$P($G(^IBA(355.93,+IBN,0)),U,2)=2:1,1:2)"
^IBA(364.7,1035,3,0)="^^2^2^3040505^"
^IBA(364.7,1035,3,1,0)="Get the referring provider id info.  If facility provider, output 2 for"
^IBA(364.7,1035,3,2,0)="non-person or 1 for person."
^IBA(364.7,1036,0)="1319^N^5"
^IBA(364.7,1036,1)="N IBZ,IBN D GETPRV^IBCEU(IBXIEN,2,.IBZ) I $G(IBZ(2,1))'="""" S IBN=$P($G(IBZ(2,1)),U,3),IBXDATA=$S(IBN'[""355.93,"":1,$P($G(^IBA(355.93,+IBN,0)),U,2)=2:1,1:2)"
^IBA(364.7,1036,3,0)="^364.73^2^2^3040505^^"
^IBA(364.7,1036,3,1,0)="Get the operating provider id info.  If facility provider, output 2 for"
^IBA(364.7,1036,3,2,0)="non-person or 1 for person."
^IBA(364.7,1037,0)="990^N^5^^^^N"
^IBA(364.7,1037,1)="N IBZ,IBN D GETPRV^IBCEU(IBXIEN,9,.IBZ) I $G(IBZ(9,1))'="""" S IBN=$P($G(IBZ(9,1)),U,3),IBXDATA=$S(IBN'[""355.93,"":1,$P($G(^IBA(355.93,+IBN,0)),U,2)=2:1,1:2)"
^IBA(364.7,1037,3,0)="^364.73^2^2^3040505^^"
^IBA(364.7,1037,3,1,0)="Get the other provider id info.  If facility provider, output 2 for"
^IBA(364.7,1037,3,2,0)="non-person or 1 for person."
^IBA(364.7,1038,0)="1320^N^5"
^IBA(364.7,1038,1)="N A,L,Z S L=0 F  S L=$O(^TMP(""IBXDATA"",$J,IBXREC,IBXPG,L)) Q:'L  S A=0 X ""S Z=2 F  S Z=$O(^TMP(""""IBXDATA"""",$J,IBXREC,IBXPG,L,Z)) Q:'Z  I $G(^(Z))'="""""""" S A=1 Q"" I 'A K ^TMP(""IBXDATA"",$J,IBXREC,IBXPG,L)"
^IBA(364.7,1038,3,0)="^364.73^2^2^3040706^^"
^IBA(364.7,1038,3,1,0)="Check all the data elements on the record.  If all but the 1st and second"
^IBA(364.7,1038,3,2,0)="are null, force a null into the second element so no output occurs."
^IBA(364.7,1039,0)="1321^N^101^^^^N^0"
^IBA(364.7,1039,1)="K IBXDATA S IBXDATA=$S($G(IBXSAVE(1))=""P"":""P"",1:""S"")"
^IBA(364.7,1039,3,0)="^^2^2^3050110^"
^IBA(364.7,1039,3,1,0)="Get the current payer sequence from the claim. "
^IBA(364.7,1039,3,2,0)="Output ""P"" if primary, ""S"" if secondary or tertiary. "
^IBA(364.7,1040,0)="1322^N^5^^^^N^0"
^IBA(364.7,1040,1)="S IBXDATA=$S($$COBN^IBCEF(IBXIEN)=1:"""",+$$MRASEC^IBCEF4(IBXIEN):""M"",1:""N"")"
^IBA(364.7,1040,3,0)="^^3^3^3050110^"
^IBA(364.7,1040,3,1,0)="If the bill payer is secondary to MEDICARE WNR with an MRA on file"
^IBA(364.7,1040,3,2,0)="output 'M'. For non-secondaries, output nothing. "
^IBA(364.7,1040,3,3,0)="For non-MRA secondaries, output 'N'. "
^IBA(364.7,1041,0)="1323^N^131^^^^N"
^IBA(364.7,1041,1)="S IBXDATA=""NPI """
^IBA(364.7,1042,0)="1324^N^323^^^^N"
^IBA(364.7,1042,1)="S IBXDATA=$S($P($G(IBXSAVE(""NPI"")),U,3):$P($G(IBXSAVE(""NPI"")),U,3),1:$P($G(IBXSAVE(""NPI"")),U,4))"
^IBA(364.7,1043,0)="1325^N^320^^^^N"
^IBA(364.7,1043,1)="S IBXDATA=$S($P($G(IBXSAVE(""TAX"")),U,3):$P($G(IBXSAVE(""TAX"")),U,3),1:$P($G(IBXSAVE(""TAX"")),U,4))"
^IBA(364.7,1044,0)="1326^N^5^^^^N"
^IBA(364.7,1044,1)="S IBXDATA=$P($G(IBXSAVE(""NPI"")),U,9)"
^IBA(364.7,1045,0)="1327^N^5^^^^N"
^IBA(364.7,1045,1)="S IBXDATA=$P($G(IBXSAVE(""TAX"")),U,9)"
^IBA(364.7,1046,0)="1328^N^5^^^^N"
^IBA(364.7,1046,1)="S IBXDATA=$P($G(IBXSAVE(""NPI"")),U,2)"
^IBA(364.7,1047,0)="1329^N^5^^^^N"
^IBA(364.7,1047,1)="S IBXDATA=$P($G(IBXSAVE(""TAX"")),U,2)"
^IBA(364.7,1048,0)="1330^N^5^^^^N"
^IBA(364.7,1048,1)="S IBXDATA=$P($G(IBXSAVE(""NPI"")),U,5)"
^IBA(364.7,1049,0)="1331^N^5^^^^N"
^IBA(364.7,1049,1)="S IBXDATA=$P($G(IBXSAVE(""TAX"")),U,5)"
^IBA(364.7,1050,0)="1332^N^5^^^^N"
^IBA(364.7,1050,1)="S IBXDATA=$P($G(IBXSAVE(""NPI"")),U,1) K IBXSAVE(""NPI"")"
^IBA(364.7,1051,0)="1333^N^5^^^^N"
^IBA(364.7,1051,1)="S IBXDATA=$P($G(IBXSAVE(""TAX"")),U,1) K IBXSAVE(""TAX"")"
^IBA(364.7,1052,0)="1334^N^321^^^^N"
^IBA(364.7,1052,1)="S IBXDATA=$P($G(IBXSAVE(""ORGNPI"")),U,3)"
^IBA(364.7,1053,0)="1335^N^322^^^^N"
^IBA(364.7,1053,1)="S IBXDATA=$P($G(IBXSAVE(""ORGTAX"")),U,3)"
^IBA(364.7,1054,0)="1336^N^5^^^^N"
^IBA(364.7,1054,1)="I $$SUB1OK^IBCEP8A(IBXIEN) S IBXDATA=$P($G(IBXSAVE(""ORGNPI"")),U,2)"
^IBA(364.7,1055,0)="1337^N^5^^^^N"
^IBA(364.7,1055,1)="I $$SUB1OK^IBCEP8A(IBXIEN) S IBXDATA=$P($G(IBXSAVE(""ORGTAX"")),U,2)"
^IBA(364.7,1056,0)="1338^N^5^^^^N"
^IBA(364.7,1056,1)="N IBZ,Z,ZSVC S Z=IBXIEN D F^IBCEF(""N-RENDERING INSTITUTION"",""IBZ"",,Z) S ZSVC=$P($G(IBZ),U,2) S IBXDATA=$S(ZSVC=1:$P($G(IBXSAVE(""ORGNPI"")),U,2),ZSVC=0:$P($G(IBXSAVE(""ORGNPI"")),U,1),1:$P($G(IBXSAVE(""ORGNPI"")),U,3))"
^IBA(364.7,1057,0)="1339^N^5^^^^N"
^IBA(364.7,1057,1)="N IBZ,Z,ZSVC S Z=IBXIEN D F^IBCEF(""N-RENDERING INSTITUTION"",""IBZ"",,Z) S ZSVC=$P($G(IBZ),U,2) S IBXDATA=$S(ZSVC=1:$P($G(IBXSAVE(""ORGTAX"")),U,2),ZSVC=0:$P($G(IBXSAVE(""ORGTAX"")),U,1),1:$P($G(IBXSAVE(""ORGTAX"")),U,3))"
^IBA(364.7,1100,0)="1400^N^142^^^^N"
^IBA(364.7,1100,1)="N Z S Z=$J("""",+$P($G(^IBE(350.9,1,1)),U,27)),IBXDATA=Z_IBXDATA K ^UTILITY(""VADM"",$J),^UTILITY(""VAPA"",$J),^TMP(""IBXSAVE"",$J),IBXSAVE"
^IBA(364.7,1100,3,0)="^364.73^3^3^3060807^^^"
^IBA(364.7,1100,3,1,0)="Move the text over to the column specified in the 1500 ADDRESS COLUMN"
^IBA(364.7,1100,3,2,0)="parameter (file 350.9, field 1.27).  Also initialize utility globals"
^IBA(364.7,1100,3,3,0)="and variables used in this form."
^IBA(364.7,1101,0)="1401^N^280^^^^N"
^IBA(364.7,1101,1)="N Z S:$$WNRBILL^IBEFUNC(IBXIEN) IBXDATA=""MEDICARE"" S Z="""",$P(Z,"" "",+$P($G(^IBE(350.9,1,1)),U,27)+1)="""" S IBXSAVE(""INDENT"")=Z S:IBXDATA'="""" IBXDATA=Z_IBXDATA"
^IBA(364.7,1101,3,0)="^^4^4^3060713^"
^IBA(364.7,1101,3,1,0)="If the 1500 ADDRESS COLUMN parameter exists, move the text over to"
^IBA(364.7,1101,3,2,0)="this column by adding spaces at the start of it.  Save the indent parameter"
^IBA(364.7,1101,3,3,0)="in IBXSAVE(""INDENT"") for future use.  If the current insurance is MEDICARE"
^IBA(364.7,1101,3,4,0)="WNR, output 'MEDICARE'."
^IBA(364.7,1102,0)="1402^N^192^^^^N"
^IBA(364.7,1102,1)="N Y,Z K IBXSAVE(""CADR"") I $O(IBXDATA(0)) S Y=$G(IBXDATA(6)) D ZIPOUT^VAFADDR S:Y'="""" $P(IBXSAVE(""CADR""),U,6)=Y F Z=1:1:5,7 S:$D(IBXDATA(Z)) $P(IBXSAVE(""CADR""),U,Z)=IBXDATA(Z) I Z=7 D CIADDR^IBCEF1(.IBXDATA,.IBXSAVE,,1)"
^IBA(364.7,1102,3,0)="^^5^5^3060713^"
^IBA(364.7,1102,3,1,0)="If the 1500 ADDRESS COLUMN parameter exists, move the text over to this"
^IBA(364.7,1102,3,2,0)="column by adding spaces at the start of it.  Format the address so each"
^IBA(364.7,1102,3,3,0)="street address occupies one line, then a line containing city followed by"
^IBA(364.7,1102,3,4,0)="a comma and space, the state abbreviation, a space and the zip code,"
^IBA(364.7,1102,3,5,0)="formatted for zip plus 4 if appropriate."
^IBA(364.7,1103,0)="1403^N^235^^^^N"
^IBA(364.7,1103,1)="N Z S Z=IBXDATA D F^IBCEF(""N-CURRENT INSURANCE CO TYPE"") S IBXDATA=$J("""",$S(Z=16!(Z=""MB"")!(Z=""MA""):0,Z=""TV""!(Z=""MC""):7,Z=""CH"":14,$$CHAMPVA^IBCEU3(IBXIEN)&($P($G(^DIC(36,+$$CURR^IBCEF2(IBXIEN),0)),U,2)=""Y""):23,IBXDATA=5:30,1:44))_""X"""
^IBA(364.7,1103,3,0)="^^7^7^3060721^"
^IBA(364.7,1103,3,1,0)="Check appropriate box for type of insurance. "
^IBA(364.7,1103,3,2,0)="CMS-1500, Box 1.  Possibility of checking one box.  FECA BLK LUNG is not "
^IBA(364.7,1103,3,3,0)="an available selection.  Choices are mainly extracted from the ELECTRONIC "
^IBA(364.7,1103,3,4,0)="PLAN TYPE field (#.15) in FILE# 355.3.  Also used for the Group Health "
^IBA(364.7,1103,3,5,0)="Plan box is the 3.09 field in file 36 (if the value is 5)."
^IBA(364.7,1103,3,6,0)=" "
^IBA(364.7,1103,3,7,0)="Code is basically setting IBXDATA=$J("""",[some offset amount])_""X""."
^IBA(364.7,1104,0)="1404^N^3^^^^N"
^IBA(364.7,1104,3,0)="^^1^1^3060714^"
^IBA(364.7,1104,3,1,0)="1500 form, Box 1a.  Current insurance insured's ID number."
^IBA(364.7,1105,0)="1405^N^65^^^^N"
^IBA(364.7,1105,3,0)="^^1^1^3060714^"
^IBA(364.7,1105,3,1,0)="1500 form, Box 2.  Patient Name"
^IBA(364.7,1106,0)="1406^N^66^^^^N"
^IBA(364.7,1106,1)="S IBXDATA=$$DATE^IBCF2(+IBXDATA,1)"
^IBA(364.7,1106,3,0)="^364.73^1^1^3060714^^^^"
^IBA(364.7,1106,3,1,0)="Format the date as MM DD YYYY."
^IBA(364.7,1107,0)="1407^N^67^^^^N"
^IBA(364.7,1107,1)="S IBXSAVE(""SEX"")=IBXDATA,IBXDATA=$S($G(IBXSAVE(""SEX""))=""M"":""X"",1:"""")"
^IBA(364.7,1107,3,0)="^364.73^2^2^3060714^^"
^IBA(364.7,1107,3,1,0)="Save the value of patient sex in IBXSAVE variable for later use.  If the"
^IBA(364.7,1107,3,2,0)="value is 'M', this field's value is 'X'."
^IBA(364.7,1108,0)="1408^N^5^^^^N"
^IBA(364.7,1108,1)="S:$G(IBXSAVE(""SEX""))'=""M"" IBXDATA=""X"" K IBXSAVE(""SEX"")"
^IBA(364.7,1108,3,0)="^364.73^3^3^3060714^^"
^IBA(364.7,1108,3,1,0)="This field relies on the existence of variable IBXSAVE(""SEX"") previously"
^IBA(364.7,1108,3,2,0)="extracted.  If its value is not 'M', assume the sex is female and this"
^IBA(364.7,1108,3,3,0)="field's value will be 'X'."
^IBA(364.7,1109,0)="1409^N^6^^^^N"
^IBA(364.7,1109,1)="S IBXSAVE(""IDEM"")=IBXDATA"
^IBA(364.7,1109,3,0)="^364.73^1^1^3060714^^"
^IBA(364.7,1109,3,1,0)="Save the insured's demographic data in IBXSAVE(""IDEM"")."
^IBA(364.7,1110,0)="1410^N^2^^^^N"
^IBA(364.7,1110,3,0)="^^6^6^3060823^"
^IBA(364.7,1110,3,1,0)="If the current insured is the patient, the word 'SAME' is printed instead"
^IBA(364.7,1110,3,2,0)="of repeating the name."
^IBA(364.7,1110,3,3,0)=" "
^IBA(364.7,1110,3,4,0)="esg - 8/23/06 - IB*2*348 - Requirement 3.2.1.12 - No longer print the "
^IBA(364.7,1110,3,5,0)="word ""SAME"" in Box 4 ever.  We have to print the name of the insured in "
^IBA(364.7,1110,3,6,0)="all cases."
^IBA(364.7,1111,0)="1411^N^157^^^^N"
^IBA(364.7,1111,1)="N Z F Z=1:1:3 S IBXDATA=IBXDATA_$S(Z>1:"" "",1:"""")_$G(^UTILITY(""VAPA"",$J,Z))"
^IBA(364.7,1111,3,0)="^364.73^1^1^3060714^^"
^IBA(364.7,1111,3,1,0)="Concatenate all 3 lines of the address together, separated by a space."
^IBA(364.7,1112,0)="1412^N^25^^^^N"
^IBA(364.7,1112,1)="S IBXSAVE(""PREL"")=+IBXDATA,IBXDATA=$S(IBXSAVE(""PREL"")=1:""X"",1:"""")"
^IBA(364.7,1112,3,0)="^364.73^2^2^3060714^^"
^IBA(364.7,1112,3,1,0)="Save the value of patient sex in IBXSAVE variable for later use.  If"
^IBA(364.7,1112,3,2,0)="the value is '1' (patient), this field's value is 'X'."
^IBA(364.7,1113,0)="1413^N^5^^^^N"
^IBA(364.7,1113,1)="I $G(IBXSAVE(""PREL""))=2 S IBXDATA=""X"""
^IBA(364.7,1113,3,0)="^364.73^3^3^3060714^^"
^IBA(364.7,1113,3,1,0)="This field relies on the existence of variable IBXSAVE(""PREL"")"
^IBA(364.7,1113,3,2,0)="previously extracted.  If its value is '2' (spouse), this field's value"
^IBA(364.7,1113,3,3,0)="will be 'X'."
^IBA(364.7,1114,0)="1414^N^5^^^^N"
^IBA(364.7,1114,1)="I $G(IBXSAVE(""PREL""))=3 S IBXDATA=""X"""
^IBA(364.7,1114,3,0)="^364.73^2^2^3060714^^"
^IBA(364.7,1114,3,1,0)="This field relies on the existence of variable IBXSAVE(""PREL"") previously"
^IBA(364.7,1114,3,2,0)="extracted.  If its value is '3' (child), this field's value will be 'X'."
^IBA(364.7,1115,0)="1415^N^5^^^^N"
^IBA(364.7,1115,1)="S:$G(IBXSAVE(""PREL""))=""""!(""123""'[$G(IBXSAVE(""PREL""))) IBXDATA=""X"" K IBXSAVE(""PREL"")"
^IBA(364.7,1115,3,0)="^364.73^3^3^3060714^^^"
^IBA(364.7,1115,3,1,0)="This field relies on the existence of variable IBXSAVE(""PREL"") previously"
^IBA(364.7,1115,3,2,0)="extracted.  If its value is not a '1', '2', or '3', assume it is other and"
^IBA(364.7,1115,3,3,0)="this field's value will be 'X'."
^IBA(364.7,1116,0)="1416^N^4^^^^N"
^IBA(364.7,1116,1)="S IBXSAVE(""IADR"")=IBXDATA"
^IBA(364.7,1116,3,0)="^^5^5^3060823^"
^IBA(364.7,1116,3,1,0)="If patient is different than the insured, then save the address "
^IBA(364.7,1116,3,2,0)="information."
^IBA(364.7,1116,3,3,0)=" "
^IBA(364.7,1116,3,4,0)="esg - 8/23/06 - IB*2*348 - Requirement 3.2.1.8 - Save the address "
^IBA(364.7,1116,3,5,0)="information in all cases.  Remove printing of the word ""SAME"" in Box 7."
^IBA(364.7,1117,0)="1417^N^5^^^^N"
^IBA(364.7,1117,1)="S IBXDATA=$P($G(IBXSAVE(""IADR"")),U)"
^IBA(364.7,1117,3,0)="^^1^1^3060714^"
^IBA(364.7,1117,3,1,0)="1500 form, Box 7 - Insured's address"
^IBA(364.7,1118,0)="1418^N^61^^^^N"
^IBA(364.7,1119,0)="1419^N^62^^^^N"
^IBA(364.7,1119,1)="S IBXDATA=$$STATE^IBCEFG1(IBXDATA)"
^IBA(364.7,1119,3,0)="^364.73^1^1^3060714^^^"
^IBA(364.7,1119,3,1,0)="Output the state abbreviation."
^IBA(364.7,1120,0)="1420^N^68^^^^N"
^IBA(364.7,1120,1)="S IBXSAVE(""MSTAT"")=$$MARITAL^IBCEFG1(+IBXDATA),IBXDATA=$S(IBXSAVE(""MSTAT"")=""I"":""X"",1:"""")"
^IBA(364.7,1120,3,0)="^364.73^2^2^3060714^^^^"
^IBA(364.7,1120,3,1,0)="Save the value of marital status in IBXSAVE variable for later use.  If"
^IBA(364.7,1120,3,2,0)="the value is 'I' (NEVER MARRIED), this field's value is 'X'."
^IBA(364.7,1121,0)="1421^N^5^^^^N"
^IBA(364.7,1121,1)="I $G(IBXSAVE(""MSTAT""))'="""",""M""[IBXSAVE(""MSTAT"") S IBXDATA=""X"""
^IBA(364.7,1121,3,0)="^364.73^3^3^3060714^^^"
^IBA(364.7,1121,3,1,0)="This field relies on the existence of variable IBXSAVE(""MSTAT"")"
^IBA(364.7,1121,3,2,0)="previously extracted. If its value is 'M' (MARRIED), this field's value"
^IBA(364.7,1121,3,3,0)="will be 'X'."
^IBA(364.7,1122,0)="1422^N^5^^^^N"
^IBA(364.7,1122,1)="S IBXDATA=$S($G(IBXSAVE(""MSTAT""))="""":"""",""MI""'[IBXSAVE(""MSTAT""):""X"",1:"""") K IBXSAVE(""MSTAT"")"
^IBA(364.7,1122,3,0)="^364.73^3^3^3060714^^^^"
^IBA(364.7,1122,3,1,0)="This field relies on the existence of variable IBXSAVE(""MSTAT"") previously"
^IBA(364.7,1122,3,2,0)="extracted.  If its value is not a 'M', or 'I', assume it must be other and"
^IBA(364.7,1122,3,3,0)="this field's value will be 'X'."
^IBA(364.7,1123,0)="1423^N^5^^^^N"
^IBA(364.7,1123,1)="S IBXDATA=$P($G(IBXSAVE(""IADR"")),U,2)"
^IBA(364.7,1123,3,0)="^364.73^2^2^3060714^^"
^IBA(364.7,1123,3,1,0)="This field relies on the existence of variable IBXSAVE(""IADR"") previously"
^IBA(364.7,1123,3,2,0)="extracted."
^IBA(364.7,1124,0)="1424^N^5^^^^N"
^IBA(364.7,1124,1)="S IBXDATA=$P($G(IBXSAVE(""IADR"")),U,3)"
^IBA(364.7,1124,3,0)="^364.73^2^2^3060714^^^"
^IBA(364.7,1124,3,1,0)="This field relies on the existence of variable IBXSAVE(""IADR"") previously"
^IBA(364.7,1124,3,2,0)="extracted.  Output the state abbreviation."
^IBA(364.7,1125,0)="1425^N^63"
^IBA(364.7,1125,1)="N Y S Y=IBXDATA D ZIPOUT^VAFADDR S IBXDATA=Y"
^IBA(364.7,1125,3,0)="^364.73^1^1^3060714^^"
^IBA(364.7,1125,3,1,0)="Format zip code as zip plus 4 if needed."
^IBA(364.7,1126,0)="1426^N^64^^^^N"
^IBA(364.7,1126,1)="N IBZ S IBZ=$$NOPUNCT^IBCEF(IBXDATA,1) S IBXDATA=$S(IBZ?10N:($E(IBZ,1,3)_"" ""_$E(IBZ,4,6)_""-""_$E(IBZ,7,10)),1:$J(IBXDATA,14))"
^IBA(364.7,1126,3,0)="^^6^6^3060721^"
^IBA(364.7,1126,3,1,0)="CMS-1500, Box 5 patient telephone with area code."
^IBA(364.7,1126,3,2,0)="Strip out all punctuation.  If you have exactly 10 numbers left, then "
^IBA(364.7,1126,3,3,0)="format as nnn nnn-nnnn because the form already has the area code "
^IBA(364.7,1126,3,4,0)="parenthesis pre-printed."
^IBA(364.7,1126,3,5,0)="If you have something other than 10 numbers, then just display the raw "
^IBA(364.7,1126,3,6,0)="data right justified so as to not overwrite those pre-printed parenthesis."
^IBA(364.7,1127,0)="1427^N^99^^^^N"
^IBA(364.7,1127,1)="S IBXDATA=$S("",1,2,4,6,""[("",""_+IBXDATA_"",""):""X"",1:"""")"
^IBA(364.7,1127,3,0)="^364.73^3^3^3060714^^^^"
^IBA(364.7,1127,3,1,0)="If the value of this field is '1' (EMPLOYED FULL TIME), '2' (EMPLOYED"
^IBA(364.7,1127,3,2,0)="PART TIME), '4' (SELF EMPLOYED), or '6' (FULL TIME MILITARY), assume"
^IBA(364.7,1127,3,3,0)="employed and output this field as 'X'."
^IBA(364.7,1128,0)="1428^N^5^^^^N"
^IBA(364.7,1128,1)="S IBXDATA=$P($G(IBXSAVE(""IADR"")),U,4)"
^IBA(364.7,1128,3,0)="^364.73^2^2^3060714^^"
^IBA(364.7,1128,3,1,0)="This field relies on the existence of variable IBXSAVE(""IADR"") previously"
^IBA(364.7,1128,3,2,0)="extracted.  Output the insured's zip code."
^IBA(364.7,1129,0)="1429^N^5^^^^N"
^IBA(364.7,1129,1)="S IBXDATA=$P($G(IBXSAVE(""IDEM"")),U,3) I IBXDATA'="""" N IBZ S IBZ=$$NOPUNCT^IBCEF(IBXDATA,1),IBXDATA=$S(IBZ?10N:($E(IBZ,1,3)_"" ""_$E(IBZ,4,6)_""-""_$E(IBZ,7,10)),1:$J(IBXDATA,14))"
^IBA(364.7,1129,3,0)="^^2^2^3060823^"
^IBA(364.7,1129,3,1,0)="This field relies on the existence of the variable IBXSAVE(""IDEM"")"
^IBA(364.7,1129,3,2,0)="previously extracted."
^IBA(364.7,1130,0)="1430^N^32^^^^N"
^IBA(364.7,1130,1)="N IBZ M IBZ=IBXDATA K IBXDATA S IBXDATA=$G(IBZ(1))"
^IBA(364.7,1131,0)="1431^N^27^^^^N"
^IBA(364.7,1131,1)="N Z S Z=$$WNRBILL^IBEFUNC(IBXIEN,+$$COBN^IBCEF(IBXIEN)) S:Z IBXDATA=""NONE"" Q:Z  I $$POLICY^IBCEF(IBXIEN,2,$P($G(^DGCR(399,IBXIEN,0)),U,21))="""" S IBXDATA="""""
^IBA(364.7,1131,3,0)="^364.73^1^1^3060714^^^^"
^IBA(364.7,1131,3,1,0)="Only output the group number if the SUBSCRIBER ID field is non-null."
^IBA(364.7,1132,0)="1432^N^33^^^^N"
^IBA(364.7,1132,1)="N IBZ M IBZ=IBXDATA K IBXDATA,IBXSAVE(""OINUM"") D:$G(IBZ(1))="""" F^IBCEF(""N-OTH INSURED ID"",""IBZ"") S:$E($$OTHINS1^IBCEF2(IBXIEN)) (IBXDATA,IBXSAVE(""OINUM""))=$G(IBZ(1))"
^IBA(364.7,1132,3,0)="^364.73^6^6^3060714^^^^"
^IBA(364.7,1132,3,1,0)="Save the value of other insured group number in IBXSAVE variable for later"
^IBA(364.7,1132,3,2,0)="use.  Use the first occurrence of other insured group number for this"
^IBA(364.7,1132,3,3,0)="field's value.  If the other insurance is a medigap (MEDICARE WNR is"
^IBA(364.7,1132,3,4,0)="before this insurance on the bill), the group # is preceeded by 'MG'"
^IBA(364.7,1132,3,5,0)="on output.  If no other insured group number is found, use the other"
^IBA(364.7,1132,3,6,0)="insured's policy id number instead."
^IBA(364.7,1133,0)="1433^N^87^^^^N"
^IBA(364.7,1133,1)="S IBXSAVE(""CONDE"")=IBXDATA,IBXDATA=$S(IBXDATA:""X"",1:"""")"
^IBA(364.7,1133,3,0)="^364.73^2^2^3060714^^"
^IBA(364.7,1133,3,1,0)="Save the value of condition related to employment in IBXSAVE variable for"
^IBA(364.7,1133,3,2,0)="later use.  If this value is 1 (yes), this field's value is 'X'."
^IBA(364.7,1134,0)="1434^N^5^^^^N"
^IBA(364.7,1134,1)="S:'$G(IBXSAVE(""CONDE"")) IBXDATA=""X"" K IBXSAVE(""CONDE"")"
^IBA(364.7,1134,3,0)="^364.73^3^3^3060714^^"
^IBA(364.7,1134,3,1,0)="This field relies on the existence of the IBXSAVE(""CONDE"") variable"
^IBA(364.7,1134,3,2,0)="previously extracted.  If this variable's value is 0 or null, this assumes"
^IBA(364.7,1134,3,3,0)="condition is not related and this field's value is 'X'."
^IBA(364.7,1135,0)="1435^N^5^^^^N"
^IBA(364.7,1135,1)="S IBXDATA=$$DATE^IBCF2($P($G(IBXSAVE(""IDEM"")),U),1)"
^IBA(364.7,1135,3,0)="^364.73^2^2^3060714^^^^"
^IBA(364.7,1135,3,1,0)="This field relies on the existence of the variable IBXSAVE(""IDEM"")"
^IBA(364.7,1135,3,2,0)="previously extracted.  Format the birthdate as MM DD YYYY."
^IBA(364.7,1136,0)="1436^N^5^^^^N"
^IBA(364.7,1136,1)="S:$P($G(IBXSAVE(""IDEM"")),U,2)=""M"" IBXDATA=""X"""
^IBA(364.7,1136,3,0)="^364.73^3^3^3060714^^^"
^IBA(364.7,1136,3,1,0)="This field relies on the existence of the IBXSAVE(""IDEM"") variable"
^IBA(364.7,1136,3,2,0)="previously extracted.  The second '^' piece contains the sex and if this"
^IBA(364.7,1136,3,3,0)="is an 'M', this field's value is 'X'."
^IBA(364.7,1137,0)="1437^N^5^^^^N"
^IBA(364.7,1137,1)="S:""M""'[$P($G(IBXSAVE(""IDEM"")),U,2) IBXDATA=""X"""
^IBA(364.7,1137,3,0)="^364.73^3^3^3060714^^"
^IBA(364.7,1137,3,1,0)="This field relies on the existence of the IBXSAVE(""IDEM"") variable"
^IBA(364.7,1137,3,2,0)="previously extracted.  The second '^' piece contains the sex and if this"
^IBA(364.7,1137,3,3,0)="is not an 'M', this field's value is 'X'."
^IBA(364.7,1138,0)="1438^N^28^^^^N"
^IBA(364.7,1138,1)="S IBXDATA="""" I $O(IBXDATA("""")) N Z S Z=$G(IBXDATA(1)) K IBXDATA S IBXSAVE(""OIDEM"")=Z,IBXDATA=$$DATE^IBCF2($P(Z,U),1)"
^IBA(364.7,1138,3,0)="^364.73^2^2^3060714^^^^"
^IBA(364.7,1138,3,1,0)="Save the other insured's demographic data in IBXSAVE for later use. Format"
^IBA(364.7,1138,3,2,0)="the birthdate as MM DD YYYY."
^IBA(364.7,1139,0)="1439^N^5^^^^N"
^IBA(364.7,1139,1)="I $P($G(IBXSAVE(""OIDEM"")),U,2)=""M"" S IBXDATA=""X"""
^IBA(364.7,1139,3,0)="^364.73^3^3^3060714^^"
^IBA(364.7,1139,3,1,0)="This field relies on the existence of the IBXSAVE(""OIDEM"") variable"
^IBA(364.7,1139,3,2,0)="previously extracted.  The second '^' piece contains the sex and if this"
^IBA(364.7,1139,3,3,0)="is an 'M', this field's value is 'X'."
^IBA(364.7,1140,0)="1440^N^5^^^^N"
^IBA(364.7,1140,1)="N Z S Z=$P($G(IBXSAVE(""OIDEM"")),U,2) S:Z'=""M""&(Z'="""") IBXDATA=""X"" K IBXSAVE(""OIDEM"")"
^IBA(364.7,1140,3,0)="^364.73^3^3^3060714^^"
^IBA(364.7,1140,3,1,0)="This field relies on the existence of the IBXSAVE(""OIDEM"") variable"
^IBA(364.7,1140,3,2,0)="previously extracted.  The second '^' piece contains the sex and if this"
^IBA(364.7,1140,3,3,0)="is not a null and is not an 'M', this field's value is 'X'."
^IBA(364.7,1141,0)="1441^N^88^^^^N"
^IBA(364.7,1141,1)="S IBXSAVE(""CONDA"")=IBXDATA,IBXDATA=$S(IBXDATA:""X"",1:"""")"
^IBA(364.7,1141,3,0)="^364.73^2^2^3060714^^"
^IBA(364.7,1141,3,1,0)="Save the value of condition related to auto accident in IBXSAVE variable"
^IBA(364.7,1141,3,2,0)="for later use.  If this value is 1 (yes), this field's value is 'X'."
^IBA(364.7,1142,0)="1442^N^5^^^^N"
^IBA(364.7,1142,1)="S:'$G(IBXSAVE(""CONDA"")) IBXDATA=""X"""
^IBA(364.7,1142,3,0)="^364.73^3^3^3060714^^"
^IBA(364.7,1142,3,1,0)="This field relies on the existence of the IBXSAVE(""CONDA"") variable"
^IBA(364.7,1142,3,2,0)="previously extracted.  If this variable's value is 0 or null, this assumes"
^IBA(364.7,1142,3,3,0)="condition is not related and this field's value is 'X'."
^IBA(364.7,1143,0)="1443^N^159^^^^N"
^IBA(364.7,1143,1)="S IBXDATA=$$STATE^IBCEFG1(IBXDATA) K IBXSAVE(""CONDA"")"
^IBA(364.7,1143,3,0)="^364.73^1^1^3060714^^^^"
^IBA(364.7,1143,3,1,0)="Output state abbreviation."
^IBA(364.7,1144,0)="1444^N^7^^^^N"
^IBA(364.7,1144,1)="S IBXDATA=$P(IBXDATA,U)"
^IBA(364.7,1144,3,0)="^364.73^1^1^3060714^^^^"
^IBA(364.7,1144,3,1,0)="Employer name is the first '^' piece of field's value."
^IBA(364.7,1145,0)="1445^N^30^^^^N"
^IBA(364.7,1145,1)="S IBXDATA="""" I $O(IBXDATA("""")) N Z S Z=$G(IBXDATA(1)) K IBXDATA S IBXDATA=$P(Z,U)"
^IBA(364.7,1145,3,0)="^364.73^2^2^3060714^^^^"
^IBA(364.7,1145,3,1,0)="Use the first occurrence of other insured employer information.  The first"
^IBA(364.7,1145,3,2,0)="'^' piece is the employer's name."
^IBA(364.7,1146,0)="1446^N^89^^^^N"
^IBA(364.7,1146,1)="S IBXSAVE(""CONDOA"")=IBXDATA,IBXDATA=$S(IBXDATA:""X"",1:"""")"
^IBA(364.7,1146,3,0)="^364.73^2^2^3060714^^"
^IBA(364.7,1146,3,1,0)="Save the value of condition related to other accident in IBXSAVE variable"
^IBA(364.7,1146,3,2,0)="for later use.  If this value is 1 (yes), this field's value is 'X'."
^IBA(364.7,1147,0)="1447^N^5^^^^N"
^IBA(364.7,1147,1)="S:'$G(IBXSAVE(""CONDOA"")) IBXDATA=""X"" K IBXSAVE(""CONDOA"")"
^IBA(364.7,1147,3,0)="^364.73^3^3^3060714^^"
^IBA(364.7,1147,3,1,0)="This field relies on the existence of the IBXSAVE(""CONDOA"") variable"
^IBA(364.7,1147,3,2,0)="previously extracted.  If this variable's value is 0 or null, this assumes"
^IBA(364.7,1147,3,3,0)="condition is not related and this field's value is 'X'."
^IBA(364.7,1148,0)="1448^N^26^^^^N"
^IBA(364.7,1149,0)="1449^N^31^^^^N"
^IBA(364.7,1149,1)="K IBXSAVE(""OINUM"") S IBXDATA="""" I $O(IBXDATA("""")) N C,Z,Z0 S C=$$OTHINS1^IBCEF2(IBXIEN),Z=$G(IBXDATA(1)) K IBXDATA I $E(C) S IBXDATA=$S($$MCRWNR^IBEFUNC(+$G(^DGCR(399,IBXIEN,""I""_$E(C)))):""MEDICARE"",$P(Z,U,2):$P($G(^DIC(36,+Z,0)),U),1:$P(Z,U))"
^IBA(364.7,1149,3,0)="^364.73^6^6^3060714^^^^"
^IBA(364.7,1149,3,1,0)="Use the first occurrence of other insured group name.  The first '^' piece"
^IBA(364.7,1149,3,2,0)="of this value has either the group name or the insurance company pointer."
^IBA(364.7,1149,3,3,0)="If the second '^' piece is a 1, the insurance company name is extracted"
^IBA(364.7,1149,3,4,0)="using the insurance company pointer in the first '^' piece, otherwise, the"
^IBA(364.7,1149,3,5,0)="name in the first '^' piece is output."
^IBA(364.7,1149,3,6,0)="MEDICARE WNR always outputs MEDICARE."
^IBA(364.7,1150,0)="1450^N^5^^^^N"
^IBA(364.7,1150,3,0)="^^3^3^3060721^"
^IBA(364.7,1150,3,1,0)="CMS-1500, BOX 10d.  RESERVED FOR LOCAL USE."
^IBA(364.7,1150,3,2,0)=" "
^IBA(364.7,1150,3,3,0)="Not currently used."
^IBA(364.7,1151,0)="1451^N^144^^^^N"
^IBA(364.7,1151,1)="S IBXSAVE(""OI"")=IBXDATA,IBXDATA=$S(IBXDATA:""X"",1:"""")"
^IBA(364.7,1151,3,0)="^364.73^2^2^3060714^^"
^IBA(364.7,1151,3,1,0)="Save the other insurance exists data in the IBXSAVE variable for later"
^IBA(364.7,1151,3,2,0)="use.  If the value is 1, output an 'X'."
^IBA(364.7,1152,0)="1452^N^5^^^^N"
^IBA(364.7,1152,1)="S:'$G(IBXSAVE(""OI"")) IBXDATA=""X"" K IBXSAVE(""OI"")"
^IBA(364.7,1152,3,0)="^364.73^3^3^3060714^^"
^IBA(364.7,1152,3,1,0)="This field relies on the existence of the IBXSAVE(""OI"") variable"
^IBA(364.7,1152,3,2,0)="previously extracted.  If the value of this data element is null or 0,"
^IBA(364.7,1152,3,3,0)="output an 'X' in this field"
^IBA(364.7,1153,0)="1453^N^145^^^^N"
^IBA(364.7,1153,1)="N IBZ D F^IBCEF(""N-ROI INDICATOR"",""IBZ"") S:IBZ IBXDATA=""MODIFIED/RESTRICTED RELEASE ""_IBXDATA S:$L(IBXDATA)<35 IBXDATA=$J("""",3)_IBXDATA"
^IBA(364.7,1154,0)="1454^N^146^^^^N"
^IBA(364.7,1154,1)="S IBXDATA=$J("""",3)_IBXDATA"
^IBA(364.7,1155,0)="1455^N^65^^^^N"
^IBA(364.7,1155,1)="N Z S Z=$$NAME^IBCEFG1(IBXDATA),IBXDATA=$P(Z,U,2)_"" ""_$S($P(Z,U,3)'="""":$E($P(Z,U,3))_"" "",1:"""")_$P(Z,U)"
^IBA(364.7,1155,3,0)="^364.73^1^1^3060717^^"
^IBA(364.7,1155,3,1,0)="Output the patient's name as the signature first middle last name."
^IBA(364.7,1156,0)="1456^N^71^^^^N"
^IBA(364.7,1156,1)="S IBXDATA=$$FMTE^XLFDT(IBXDATA,""5D"")"
^IBA(364.7,1156,3,0)="^364.73^1^1^3060717^^^^"
^IBA(364.7,1156,3,1,0)="Format data element in MM/DD/CCYY date format."
^IBA(364.7,1157,0)="1457^N^2^^^^N"
^IBA(364.7,1157,1)="N Z S Z=$$NAME^IBCEFG1(IBXDATA),IBXDATA=$P(Z,U,2)_"" ""_$S($P(Z,U,3)'="""":$E($P(Z,U,3))_"" "",1:"""")_$P(Z,U)"
^IBA(364.7,1157,3,0)="^364.73^2^2^3060717^^^"
^IBA(364.7,1157,3,1,0)="Output the current insured's name as the signature first name, middle name"
^IBA(364.7,1157,3,2,0)="last name"
^IBA(364.7,1158,0)="1458^N^232^^^^N"
^IBA(364.7,1158,1)="S IBXDATA=$$DATE^IBCF2(IBXDATA,1)"
^IBA(364.7,1158,3,0)="^364.73^1^1^3060717^^^^"
^IBA(364.7,1158,3,1,0)="Format date as MM DD YYYY."
^IBA(364.7,1159,0)="1459^N^90^^^^N"
^IBA(364.7,1159,1)="S IBXDATA=$$DATE^IBCF2(IBXDATA,1)"
^IBA(364.7,1159,3,0)="^364.73^1^1^3060717^^^^"
^IBA(364.7,1159,3,1,0)="Format date as MM DD YYYY."
^IBA(364.7,1160,0)="1460^N^93^^^^N"
^IBA(364.7,1160,1)="S IBXDATA=$$DATE^IBCF2(IBXDATA,1)"
^IBA(364.7,1160,3,0)="^364.73^1^1^3060717^^^^"
^IBA(364.7,1160,3,1,0)="Format date as MM DD YYYY."
^IBA(364.7,1161,0)="1461^N^94^^^^N"
^IBA(364.7,1161,1)="S IBXDATA=$$DATE^IBCF2(IBXDATA,1)"
^IBA(364.7,1161,3,0)="^364.73^1^1^3060717^^^^"
^IBA(364.7,1161,3,1,0)="Format date as MM DD YYYY."
^IBA(364.7,1162,0)="1462^N^5^^^^N"
^IBA(364.7,1162,1)="S IBXSAVE(""BOX 17"")=$$CFIDS^IBCEF77(IBXIEN,1),IBXDATA=$P(IBXSAVE(""BOX 17""),U,1)"
^IBA(364.7,1162,3,0)="^^8^8^3060825^"
^IBA(364.7,1162,3,1,0)="cms-1500, box 17a/1, 2 character qualifier for the Referring provider "
^IBA(364.7,1162,3,2,0)="other ID (non-NPI ID)."
^IBA(364.7,1162,3,3,0)=" "
^IBA(364.7,1162,3,4,0)="IBXSAVE(""BOX 17"") is a 3 piece string which will be used for all of Box "
^IBA(364.7,1162,3,5,0)="17."
^IBA(364.7,1162,3,6,0)="[1] default secondary ID qualifier"
^IBA(364.7,1162,3,7,0)="[2] default secondary ID"
^IBA(364.7,1162,3,8,0)="[3] referring provider npi"
^IBA(364.7,1163,0)="1463^N^5^^^^N"
^IBA(364.7,1163,1)="S IBXDATA=$P($G(IBXSAVE(""BOX 17"")),U,2)"
^IBA(364.7,1163,3,0)="^364.73^8^8^3060825^^"
^IBA(364.7,1163,3,1,0)="CMS-1500, Box 17a/2, Referring Provider other ID number (non NPI ID "
^IBA(364.7,1163,3,2,0)="number).  "
^IBA(364.7,1163,3,3,0)=" "
^IBA(364.7,1163,3,4,0)="IBXSAVE(""BOX 17"") is a 3 piece string which will be used for all of Box"
^IBA(364.7,1163,3,5,0)="17."
^IBA(364.7,1163,3,6,0)="[1] default secondary ID qualifier"
^IBA(364.7,1163,3,7,0)="[2] default secondary ID"
^IBA(364.7,1163,3,8,0)="[3] referring provider npi"
^IBA(364.7,1164,0)="1464^N^240^^^^N"
^IBA(364.7,1165,0)="1465^N^5^^^^N"
^IBA(364.7,1165,1)="S IBXDATA=$P($G(IBXSAVE(""BOX 17"")),U,3) KILL IBXSAVE(""BOX 17"")"
^IBA(364.7,1165,3,0)="^^9^9^3060825^"
^IBA(364.7,1165,3,1,0)="NPI# of Referring Physician"
^IBA(364.7,1165,3,2,0)=" "
^IBA(364.7,1165,3,3,0)="IBXSAVE(""BOX 17"") is a 3 piece string which will be used for all of Box"
^IBA(364.7,1165,3,4,0)="17."
^IBA(364.7,1165,3,5,0)="[1] default secondary ID qualifier"
^IBA(364.7,1165,3,6,0)="[2] default secondary ID"
^IBA(364.7,1165,3,7,0)="[3] referring provider npi"
^IBA(364.7,1165,3,8,0)=" "
^IBA(364.7,1165,3,9,0)="Since this is the last field in box 17, kill this variable."
^IBA(364.7,1166,0)="1466^N^147^^^^N"
^IBA(364.7,1166,1)="S IBXDATA=$$DATE^IBCF2(IBXDATA,1)"
^IBA(364.7,1166,3,0)="^364.73^1^1^3060717^^^^"
^IBA(364.7,1166,3,1,0)="'From' date is the first '^' piece of this data.  Format date as MM DD YYYY."
^IBA(364.7,1167,0)="1467^N^160^^^^N"
^IBA(364.7,1167,1)="D:'IBXDATA&'$$INPAT^IBCEF(IBXIEN,1) F^IBCEF(""N-STATEMENT COVERS TO DATE"",,,IBXIEN) S IBXDATA=$$DATE^IBCF2(IBXDATA,1)"
^IBA(364.7,1167,3,0)="^364.73^2^2^3060717^^^^"
^IBA(364.7,1167,3,1,0)="If there is no date in IBXDATA, set it to Statement Covers To Date then "
^IBA(364.7,1167,3,2,0)="format the resulted date."
^IBA(364.7,1168,0)="1468^N^148"
^IBA(364.7,1168,1)="S IBXSAVE(""BOX19"")=$S($L(IBXDATA)<49:$J("""",48),$L(IBXDATA)<84:$J("""",13),1:"""")_IBXDATA,IBXDATA=$E(IBXSAVE(""BOX19""),1,48)"
^IBA(364.7,1168,3,0)="^364.73^1^1^3060717^^^^"
^IBA(364.7,1168,3,1,0)="This field holds the 1st through 48th characters of the box's data."
^IBA(364.7,1169,0)="1469^N^5^^^^N"
^IBA(364.7,1169,1)="D:'$D(IBXSAVE(""BOX19"")) F^IBCEF(""N-HCFA 1500 BOX 19"",,,IBXIEN) S IBXDATA=$E($G(IBXSAVE(""BOX19"")),49,96) K IBXSAVE(""BOX19"")"
^IBA(364.7,1169,3,0)="^364.73^2^2^3060717^^^^"
^IBA(364.7,1169,3,1,0)="If the array that holds the entire box 19 data is not defined, extract it."
^IBA(364.7,1169,3,2,0)="This field will hold the 49th through 96th characters of the box's data."
^IBA(364.7,1170,0)="1470^N^150^^^^N"
^IBA(364.7,1170,1)="S IBXDATA=$S(IBXDATA:""X"",1:"""")"
^IBA(364.7,1170,3,0)="^^4^4^3060719^"
^IBA(364.7,1170,3,1,0)="cms-1500, box 20 Outside Lab=YES"
^IBA(364.7,1170,3,2,0)="If the value of the data element is true, then it is an outside lab, so "
^IBA(364.7,1170,3,3,0)="an ""X"" should display.  Otherwise, it is not an outside lab so nothing "
^IBA(364.7,1170,3,4,0)="should display in the Yes box."
^IBA(364.7,1171,0)="1471^N^283^^^^N"
^IBA(364.7,1171,1)="K IBXDATA S:$G(IBXSAVE(""OLAB"")) IBXDATA=$$DOL^IBCEF77($G(IBXSAVE(""OLAB"")),9) K IBXSAVE(""OLAB"")"
^IBA(364.7,1171,3,0)="^^1^1^3060915^"
^IBA(364.7,1171,3,1,0)="Format the amount in 9 characters with 2 decimals."
^IBA(364.7,1172,0)="1472^N^282^^^^N"
^IBA(364.7,1172,1)="S IBXDATA=$S('IBXDATA:"""",1:$$DOL^IBCEF77(IBXDATA,9)) K IBXDATA"
^IBA(364.7,1172,3,0)="^^6^6^3060915^"
^IBA(364.7,1172,3,1,0)="Format data in 9 characters with 2 decimals."
^IBA(364.7,1172,3,2,0)=" "
^IBA(364.7,1172,3,3,0)="The 1500 instruction manual says that this area should always be left "
^IBA(364.7,1172,3,4,0)="blank, but there was existing code here for some reason.  For now, the "
^IBA(364.7,1172,3,5,0)="field usage is being discontinued, but the software is not being removed "
^IBA(364.7,1172,3,6,0)="in case it is needed in the future."
^IBA(364.7,1173,0)="1473^N^86^^^^N"
^IBA(364.7,1173,1)="N IB,IBCT M IB=IBXDATA K IBXDATA X ""N Z S (Z,IBCT)=0 F  S Z=$O(IB(Z)) Q:'Z  I $G(IB(Z)) S IBCT=IBCT+1 M IBXSAVE(""""DX"""",IBCT)=IB(Z)"" S IBXDATA=$P($G(^ICD9(+$G(IBXSAVE(""DX"",1)),0)),U) D PGDX^IBCEF31(1,IBX0,IBXDA,IBXLN,IBXCOL,.IBXSIZE,.IBXSAVE)"
^IBA(364.7,1173,3,0)="^364.73^4^4^3060717^^^^"
^IBA(364.7,1173,3,1,0)="Save the diagnoses in the IBXSAVE array for later use. Output the"
^IBA(364.7,1173,3,2,0)="diagnosis code for the first diagnosis. Check for any diagnosis codes"
^IBA(364.7,1173,3,3,0)="that should display in the first position on pages subsequent to page 1"
^IBA(364.7,1173,3,4,0)="and output them."
^IBA(364.7,1174,0)="1474^N^163^^^^N"
^IBA(364.7,1174,1)="S IBXDATA=$P($G(^ICD9(+IBXDATA,0)),U) D PGDX^IBCEF31(3,IBX0,IBXDA,IBXLN,IBXCOL,.IBXSIZE,.IBXSAVE)"
^IBA(364.7,1174,3,0)="^364.73^3^3^3060717^^^^"
^IBA(364.7,1174,3,1,0)="Output the third diagnosis code. Check for any diagnosis codes that should"
^IBA(364.7,1174,3,2,0)="display in the third position on pages subsequent to page 1 and output"
^IBA(364.7,1174,3,3,0)="them."
^IBA(364.7,1175,0)="1475^N^5^^^^N"
^IBA(364.7,1176,0)="1476^N^5^^^^N"
^IBA(364.7,1177,0)="1477^N^162^^^^N"
^IBA(364.7,1177,1)="S IBXDATA=$P($G(^ICD9(+IBXDATA,0)),U) D PGDX^IBCEF31(2,IBX0,IBXDA,IBXLN,IBXCOL,.IBXSIZE,.IBXSAVE)"
^IBA(364.7,1177,3,0)="^364.73^3^3^3060717^^^^"
^IBA(364.7,1177,3,1,0)="Output the second diagnosis code.  Check for any diagnosis codes that should"
^IBA(364.7,1177,3,2,0)="display in the second position on pages subsequent to page 1 and output"
^IBA(364.7,1177,3,3,0)="them."
^IBA(364.7,1178,0)="1478^N^164^^^^N"
^IBA(364.7,1178,1)="S IBXDATA=$P($G(^ICD9(+IBXDATA,0)),U) D PGDX^IBCEF31(4,IBX0,IBXDA,IBXLN,IBXCOL,.IBXSIZE,.IBXSAVE) K IBXSAVE(""DX"")"
^IBA(364.7,1178,3,0)="^364.73^3^3^3060717^^^^"
^IBA(364.7,1178,3,1,0)="Output the forth diagnosis code. Check for any diagnosis codes that should"
^IBA(364.7,1178,3,2,0)="display in the forth position on pages subsequent to page 1 and output"
^IBA(364.7,1178,3,3,0)="them."
^IBA(364.7,1179,0)="1479^N^262^^^^N"
^IBA(364.7,1179,1)="I $$OLAB^IBCEU(IBXIEN) N IBZ S IBZ=IBXDATA D F^IBCEF(""N-LAB CLIA #"",,,IBXIEN) I IBXDATA="""",IBZ'="""" S IBXDATA=IBZ"
^IBA(364.7,1179,3,0)="^364.73^2^2^3060717^^^^"
^IBA(364.7,1179,3,1,0)="If the bill is for services rendered at an outside lab, get the CLIA number."
^IBA(364.7,1179,3,2,0)="If this # is not available, use the prior authorization #."
^IBA(364.7,1180,0)="1480^N^5^^^^N"
^IBA(364.7,1180,1)="I '$O(IBXSAVE(""BOX24"",0)) D B24^IBCEF3(.IBXSAVE,IBXIEN,1)"
^IBA(364.7,1180,3,0)="^364.73^1^1^3060717^^^^"
^IBA(364.7,1180,3,1,0)="If array doesn't already exist, extract it"
^IBA(364.7,1181,0)="1481^N^165^^^^N"
^IBA(364.7,1181,1)="N Z S Z=12 F  S Z=$O(IBXDATA(Z)) Q:'Z  D PG^IBCEF3(IBXDATA(Z),Z)"
^IBA(364.7,1181,3,0)="^364.73^2^2^3060717^^^^"
^IBA(364.7,1181,3,1,0)="If more than 6 service dates (12 lines) exist"
^IBA(364.7,1181,3,2,0)="for the bill, this outputs the rest on additional bill pages."
^IBA(364.7,1182,0)="1482^N^166^^^^N"
^IBA(364.7,1182,1)="N Z S Z=12 F  S Z=$O(IBXDATA(Z)) Q:'Z  D PG^IBCEF3(IBXDATA(Z),Z)"
^IBA(364.7,1182,3,0)="^364.73^2^2^3060717^^^^"
^IBA(364.7,1182,3,1,0)="If more than 6 service dates (12 lines) exists for the bill, this outputs"
^IBA(364.7,1182,3,2,0)="the rest on additional bill pages."
^IBA(364.7,1183,0)="1483^N^167^^^^N"
^IBA(364.7,1183,1)="N Z S Z=12 F  S Z=$O(IBXDATA(Z)) Q:'Z  D PG^IBCEF3(IBXDATA(Z),Z)"
^IBA(364.7,1183,3,0)="^364.73^2^2^3060717^^^^"
^IBA(364.7,1183,3,1,0)="If more than 6 service dates (12 lines) exists for the bill, this outputs"
^IBA(364.7,1183,3,2,0)="the rest on additional bill pages."
^IBA(364.7,1184,0)="1484^N^229^^^^N"
^IBA(364.7,1184,1)="N Z S Z=12 F  S Z=$O(IBXDATA(Z)) Q:'Z  D PG^IBCEF3(IBXDATA(Z),Z)"
^IBA(364.7,1184,3,0)="^^2^2^3060816^"
^IBA(364.7,1184,3,1,0)="If more than 6 service dates (12 lines) exists for the bill, this outputs"
^IBA(364.7,1184,3,2,0)="the rest on additional bill pages."
^IBA(364.7,1185,0)="1485^N^169^^^^N"
^IBA(364.7,1185,1)="N Z S Z=12 F  S Z=$O(IBXDATA(Z)) Q:'Z  D PG^IBCEF3(IBXDATA(Z),Z)"
^IBA(364.7,1185,3,0)="^364.73^2^2^3060816^^^^"
^IBA(364.7,1185,3,1,0)="If more than 6 service dates (12 lines) exists for the bill, this outputs"
^IBA(364.7,1185,3,2,0)="the rest on additional bill pages."
^IBA(364.7,1186,0)="1486^N^170^^^^N"
^IBA(364.7,1186,1)="N Z S Z=12 F  S Z=$O(IBXDATA(Z)) Q:'Z  D PG^IBCEF3(IBXDATA(Z),Z)"
^IBA(364.7,1186,3,0)="^364.73^2^2^3060717^^^"
^IBA(364.7,1186,3,1,0)="If more than 6 service dates (12 lines) exist for the bill, this outputs"
^IBA(364.7,1186,3,2,0)="the rest on additional bill pages."
^IBA(364.7,1187,0)="1487^N^171^^^^N"
^IBA(364.7,1187,1)="N Z S Z=12 F  S Z=$O(IBXDATA(Z)) Q:'Z  D PG^IBCEF3(IBXDATA(Z),Z)"
^IBA(364.7,1187,3,0)="^^2^2^3060816^"
^IBA(364.7,1187,3,1,0)="If more than 6 service dates (12 lines) exist for the bill, this outputs"
^IBA(364.7,1187,3,2,0)="the rest on additional bill pages."
^IBA(364.7,1188,0)="1488^N^172^^^^N"
^IBA(364.7,1188,1)="N Z S Z=12 F  S Z=$O(IBXDATA(Z)) Q:'Z  D PG^IBCEF3(IBXDATA(Z),Z)"
^IBA(364.7,1188,3,0)="^^2^2^3060816^"
^IBA(364.7,1188,3,1,0)="If more than 6 service dates (12 lines) exist for the bill, this outputs"
^IBA(364.7,1188,3,2,0)="the rest on additional bill pages."
^IBA(364.7,1189,0)="1489^N^174^^^^N"
^IBA(364.7,1189,1)="N Z S Z=12 F  S Z=$O(IBXDATA(Z)) Q:'Z  D PG^IBCEF3(IBXDATA(Z),Z)"
^IBA(364.7,1189,3,0)="^364.73^2^2^3060717^^^^"
^IBA(364.7,1189,3,1,0)="If more than 6 service dates (12 lines) exists for the bill, this outputs"
^IBA(364.7,1189,3,2,0)="the rest on additional bill pages."
^IBA(364.7,1190,0)="1490^N^188^^^^N"
^IBA(364.7,1190,1)="N Z S Z=12 F  S Z=$O(IBXDATA(Z)) Q:'Z  D PG^IBCEF3(IBXDATA(Z),Z)"
^IBA(364.7,1190,3,0)="^364.73^2^2^3060816^^^^"
^IBA(364.7,1190,3,1,0)="If more than 6 service dates (12 lines) exists for the bill, this outputs"
^IBA(364.7,1190,3,2,0)="the rest on additional bill pages."
^IBA(364.7,1191,0)="1491^N^189^^^^N"
^IBA(364.7,1191,1)="N Z S Z=12 F  S Z=$O(IBXDATA(Z)) Q:'Z  D PG^IBCEF3(IBXDATA(Z),Z)"
^IBA(364.7,1191,3,0)="^364.73^2^2^3060816^^^^"
^IBA(364.7,1191,3,1,0)="If more than 6 service dates (12 lines) exists for the bill, this outputs"
^IBA(364.7,1191,3,2,0)="the rest on additional bill pages."
^IBA(364.7,1192,0)="1492^N^5^^^^N"
^IBA(364.7,1192,1)="K IBXSAVE(""DX""),IBXSAVE(""BOX24""),IBXSAVE(""OCC""),IBXSAVE(""OCCS""),IBXSAVE(""IDEM""),IBXSAVE(""IADR"")"
^IBA(364.7,1192,3,0)="^364.73^1^1^3060718^^^^"
^IBA(364.7,1192,3,1,0)="Clean up IBXSAVE array."
^IBA(364.7,1193,0)="1493^N^109^^^^N"
^IBA(364.7,1194,0)="1494^N^151^^^^N"
^IBA(364.7,1195,0)="1495^N^210^^^^N"
^IBA(364.7,1196,0)="1496^N^24^^^^N"
^IBA(364.7,1196,1)="N Z S Z=$S(IBXDATA=""""!(""Nn0""'[IBXDATA):1,1:6) S IBXDATA=$J(""X"",Z)"
^IBA(364.7,1196,3,0)="^364.73^2^2^3060718^^^^"
^IBA(364.7,1196,3,1,0)="Print indicator of ASSIGNMENT OF BENEFITS.  Check Yes if data element value"
^IBA(364.7,1196,3,2,0)="returned is null or is not 0,'n', or 'N', otherwise check No."
^IBA(364.7,1197,0)="1497^N^95^^^^N"
^IBA(364.7,1197,1)="S IBXSAVE(""TOT"")=IBXDATA K IBXDATA I $O(^TMP(""IBXDATA"",$J,IBXREC,""""),-1)'>1 S IBXDATA=$$DOL^IBCEF77(IBXSAVE(""TOT""),9)"
^IBA(364.7,1197,3,0)="^364.73^3^3^3060825^^"
^IBA(364.7,1197,3,1,0)="Save the total charges in IBXSAVE array for later use.  If"
^IBA(364.7,1197,3,2,0)="total is not null, output as numeric with 2 decimal places."
^IBA(364.7,1197,3,3,0)="Only output totals on last page of form."
^IBA(364.7,1198,0)="1498^N^5^^^^N"
^IBA(364.7,1198,1)="S IBXSAVE(""PAID"")=0 K IBXDATA I $O(^TMP(""IBXDATA"",$J,IBXREC,""""),-1)'>1 S IBXDATA=$$DOL^IBCEF77(IBXSAVE(""PAID""),8) K IBXSAVE(""PAID"")"
^IBA(364.7,1198,3,0)="^364.73^2^2^3060825^^^^"
^IBA(364.7,1198,3,1,0)="This field is the prior amounts the patient has paid.  This will always"
^IBA(364.7,1198,3,2,0)="be 0 unless VA changes policy."
^IBA(364.7,1199,0)="1499^N^173^^^^N"
^IBA(364.7,1199,1)="S IBXSAVE(""BDUE"")=IBXDATA K IBXDATA I $O(^TMP(""IBXDATA"",$J,IBXREC,""""),-1)'>1 S IBXDATA=$$DOL^IBCEF77(IBXSAVE(""BDUE""),8) K IBXSAVE(""BDUE""),IBXSAVE(""PTOT""),IBXSAVE(""TOT"")"
^IBA(364.7,1199,3,0)="^^2^2^3060825^"
^IBA(364.7,1199,3,1,0)="If not 0, output as numeric with 2 decimals."
^IBA(364.7,1199,3,2,0)="Only output total on last page of form."
^IBA(364.7,1200,0)="1500^N^5^^^^N"
^IBA(364.7,1200,1)="N Z,IBZ S Z=$G(^IBE(350.9,1,2)),IBXDATA=$P(Z,U,11) S:IBXDATA="""" IBXDATA=$P(Z,U,6) S IBZ=$$NOPUNCT^IBCEF(IBXDATA,1),IBXDATA=$S(IBZ?10N:($E(IBZ,1,3)_"" ""_$E(IBZ,4,6)_""-""_$E(IBZ,7,10)),1:$J(IBXDATA,13))"
^IBA(364.7,1200,3,0)="^^6^6^3060825^"
^IBA(364.7,1200,3,1,0)="Billing provider phone number."
^IBA(364.7,1200,3,2,0)="Check first for the 2.11 field in file 350.9:  SITE CONTACT PHONE NUMBER"
^IBA(364.7,1200,3,3,0)="If 2.11 is blank, then check the 2.06 field in file 350.9:  AGENT CASHIER "
^IBA(364.7,1200,3,4,0)="PHONE NUMBER"
^IBA(364.7,1200,3,5,0)=" "
^IBA(364.7,1200,3,6,0)="Format the phone# for printing in Box33, upper right hand corner."
^IBA(364.7,1201,0)="1501^N^275^^^^N"
^IBA(364.7,1201,1)="N A,Z K IBXSAVE(""OFAC"") S A=IBXDATA,Z=$P(A,U,2),IBXSAVE(""IBFAC"")=+A,IBXDATA=$$GETFAC^IBCEP8(+A,+Z,0) S:Z IBXSAVE(""OFAC"")=1"
^IBA(364.7,1201,3,0)="^^6^6^3060825^"
^IBA(364.7,1201,3,1,0)="This returns the name of the INSTITUTION file entry for the non-VA or"
^IBA(364.7,1201,3,2,0)="remote site where care was rendered.  Save the ien in IBXSAVE(""IBFAC"") for"
^IBA(364.7,1201,3,3,0)="later use."
^IBA(364.7,1201,3,4,0)=" "
^IBA(364.7,1201,3,5,0)="esg - 8/25/06 - IB*2*348 - Always print the name/address of the service "
^IBA(364.7,1201,3,6,0)="facility.  Never print 'SAME'."
^IBA(364.7,1202,0)="1502^N^296^^^^N"
^IBA(364.7,1202,3,0)="^364.73^1^1^3060825^^^"
^IBA(364.7,1202,3,1,0)="This is the constant we will use as the name of the billing entity."
^IBA(364.7,1203,0)="1503^N^83^^^^N"
^IBA(364.7,1203,1)="S IBXSAVE(""BOX31"")=IBXDATA,IBXDATA=$$NAME31^IBCF2(IBXIEN,IBXDATA)"
^IBA(364.7,1203,3,0)="^^2^2^3060908^"
^IBA(364.7,1203,3,1,0)="Formats the name in 21 spaces for block 31 of the 1500."
^IBA(364.7,1203,3,2,0)="IBXSAVE(""BOX31"") is the name in format Last,first mi^ien in file 200"
^IBA(364.7,1206,0)="1506^N^5^^^^N"
^IBA(364.7,1206,1)="S IBXDATA=$$GETFAC^IBCEP8(+$G(IBXSAVE(""IBFAC"")),+$G(IBXSAVE(""OFAC"")),12)"
^IBA(364.7,1206,3,0)="^364.73^3^3^3060825^^^^"
^IBA(364.7,1206,3,1,0)="Extract the street address for the rendering facility.  Relies on the"
^IBA(364.7,1206,3,2,0)="existence of the array IBXSAVE(""IBFAC"") extracted previously by the"
^IBA(364.7,1206,3,3,0)="rendering facility name field."
^IBA(364.7,1207,0)="1507^N^104^^^^N"
^IBA(364.7,1207,1)="N IBZ D F^IBCEF(""N-AGENT CASHIER MAIL SYMBOL"",""IBZ"",,IBXIEN) I $G(IBZ)'="""" S IBXDATA=IBXDATA_"" ""_IBZ"
^IBA(364.7,1207,3,0)="^364.73^2^2^3060718^^^^"
^IBA(364.7,1207,3,1,0)="Concatenate Agent Cashier Mail Symbol to the end of Agent Cashier Street"
^IBA(364.7,1207,3,2,0)="Address."
^IBA(364.7,1208,0)="1508^N^209^^^^N"
^IBA(364.7,1208,1)="N A,P,Q,Z S Q=IBXIEN,Z=$$DATE31^IBCF2(IBXDATA,Q),A=$G(IBXSAVE(""BOX31"")) D GETPRV^IBCEU(Q,3,.P) S P=$G(P(3,1)),A=$S($P(P,U,4)'="""":$P(P,U,4),'$D(^DGCR(399,Q,""PRV"",0)):$E($P(P,U),22,42),1:$$CRED^IBCEU($P(P,U,3),Q,,3)),IBXDATA=A_$J("""",11-$L(A))_Z"
^IBA(364.7,1208,3,0)="^364.73^2^2^3060718^^^^"
^IBA(364.7,1208,3,1,0)="Print credentials left justified and date right justified. Format date as"
^IBA(364.7,1208,3,2,0)="MM/DD/YYYY."
^IBA(364.7,1209,0)="1509^N^5^^^^N"
^IBA(364.7,1209,1)="S IBXDATA=$$GETFAC^IBCEP8(+$G(IBXSAVE(""IBFAC"")),+$G(IBXSAVE(""OFAC"")),3)"
^IBA(364.7,1209,3,0)="^364.73^3^3^3060825^^^^"
^IBA(364.7,1209,3,1,0)="Extract the city, state abbreviation and zip code for the rendering"
^IBA(364.7,1209,3,2,0)="facility.  Relies on the existence of the array IBXSAVE(""IBFAC"") extracted"
^IBA(364.7,1209,3,3,0)="previously by the rendering facility name field."
^IBA(364.7,1210,0)="1510^N^105^^^^N"
^IBA(364.7,1210,1)="S IBXSAVE(""ACCITY"")=IBXDATA"
^IBA(364.7,1210,3,0)="^364.73^1^1^3060718^^"
^IBA(364.7,1210,3,1,0)="Save the data in the IBXSAVE array for later use."
^IBA(364.7,1211,0)="1511^N^106^^^^N"
^IBA(364.7,1211,1)="S IBXSAVE(""ACSTATE"")=IBXDATA"
^IBA(364.7,1211,3,0)="^364.73^1^1^3060718^^"
^IBA(364.7,1211,3,1,0)="Save the data in the IBXSAVE array for later use."
^IBA(364.7,1212,0)="1512^N^107^^^^N"
^IBA(364.7,1212,1)="S IBXSAVE(""ACZIP"")=$E(IBXDATA,1,5)_$S($E(IBXDATA,6,9)'="""":""-""_$E(IBXDATA,6,9),1:"""")"
^IBA(364.7,1212,3,0)="^364.73^1^1^3060718^^"
^IBA(364.7,1212,3,1,0)="Save the data in the IBXSAVE array for later use."
^IBA(364.7,1213,0)="1513^N^5^^^^N"
^IBA(364.7,1213,1)="N Z S Z=$$STATE^IBCEFG1($G(IBXSAVE(""ACSTATE"")))_"" ""_$G(IBXSAVE(""ACZIP"")),IBXDATA=$E($G(IBXSAVE(""ACCITY"")),1,29-2-$L(Z))_"", ""_Z F Z=""ACCITY"",""ACSTATE"",""ACZIP"" K IBXSAVE(Z)"
^IBA(364.7,1213,3,0)="^364.73^5^5^3060825^^^^"
^IBA(364.7,1213,3,1,0)="This data relies on the existence of the IBXSAVE(""ACCITY""),"
^IBA(364.7,1213,3,2,0)="IBXSAVE(""ACSTATE"") and IBXSAVE(""ACZIP"") variables previously extracted."
^IBA(364.7,1213,3,3,0)="The data consists of the city concatenated with a , and space, the state"
^IBA(364.7,1213,3,4,0)="abbreviation, a space and the zip code.  The city name is shortened to fit"
^IBA(364.7,1213,3,5,0)="in the whole state and zip in the space allowed."
^IBA(364.7,1214,0)="1514^N^5^^^^N"
^IBA(364.7,1214,1)="I '$D(^DGCR(399,IBXIEN,""PRV"",0)) S IBXDATA=$E($P($G(IBXSAVE(""BOX31"")),U),43,63)"
^IBA(364.7,1214,3,0)="^^1^1^3060908^"
^IBA(364.7,1214,3,1,0)="This line is no longer printed on the standard 1500."
^IBA(364.7,1215,0)="1515^N^275^^^^N"
^IBA(364.7,1215,1)="N IBZ,IBZ1 S IBZ=$P(IBXDATA,U,2),IBZ1="""" D:$D(^IBA(364.5,""B"",""N-ORGANIZATION NPI CODES"")) F^IBCEF(""N-ORGANIZATION NPI CODES"",""IBZ1"",,IBXIEN) S IBXDATA=$S(IBZ=1:$P(IBZ1,U,2),IBZ=0:$P(IBZ1,U,1),1:$P(IBZ1,U,3)),IBXSAVE(""NPISVC"")=IBXDATA"
^IBA(364.7,1215,3,0)="^^11^11^3060823^"
^IBA(364.7,1215,3,1,0)="CMS-1500 form, Box 32a."
^IBA(364.7,1215,3,2,0)="Service Facility NPI#"
^IBA(364.7,1215,3,3,0)=" "
^IBA(364.7,1215,3,4,0)="Determine the Rendering Institution Flag [2] of IBXDATA."
^IBA(364.7,1215,3,5,0)=" "
^IBA(364.7,1215,3,6,0)="1 means the service facility is the non-VA facilty"
^IBA(364.7,1215,3,7,0)="0 means the service facility is the CBOC/Division"
^IBA(364.7,1215,3,8,0)=""""" means the service facility is the main VAMC facility"
^IBA(364.7,1215,3,9,0)=" "
^IBA(364.7,1215,3,10,0)="Set IBXDATA equal to the appropriate piece of the organizational NPI "
^IBA(364.7,1215,3,11,0)="string."
^IBA(364.7,1216,0)="1516^N^5^^^^N"
^IBA(364.7,1216,1)="N IBX,IBY,IBZ S IBY=$$PRTLID^IBCEF77(IBXIEN,$G(IBXSAVE(""NPISVC""))) K IBXSAVE(""NPISVC""),IBXDATA I IBY D ALLIDS^IBCEF75(IBXIEN,.IBZ,1) S IBX=$G(IBZ(""LAB/FAC"",IBXIEN,""C"",1,1)),IBXDATA=$P(IBX,U,1)_$P(IBX,U,2)"
^IBA(364.7,1216,3,0)="^^2^2^3060830^"
^IBA(364.7,1216,3,1,0)="1500, Box 32b.  Accommodate the reporting of other ID numbers."
^IBA(364.7,1216,3,2,0)="Enter the 2 digit qualifier followed by the secondary ID number."
^IBA(364.7,1217,0)="1517^N^5^^^^N"
^IBA(364.7,1217,1)="N IBZ S (IBZ,IBXDATA)="""" D:$D(^IBA(364.5,""B"",""N-ORGANIZATION NPI CODES"")) F^IBCEF(""N-ORGANIZATION NPI CODES"",""IBZ"",,IBXIEN) S IBXDATA=$P(IBZ,U,3),IBXSAVE(""NPIBILL"")=IBXDATA"
^IBA(364.7,1217,3,0)="^^1^1^3060823^"
^IBA(364.7,1217,3,1,0)="cms-1500 form, Box 33a.  Billing provider NPI."
^IBA(364.7,1218,0)="1518^N^5^^^^N"
^IBA(364.7,1218,1)="N IBX,IBY,IBZ S IBY=$$PRTLID^IBCEF77(IBXIEN,$G(IBXSAVE(""NPIBILL""))) K IBXSAVE(""NPIBILL""),IBXDATA I IBY D ALLIDS^IBCEF75(IBXIEN,.IBZ,1) S IBX=$G(IBZ(""BILLING PRV"",IBXIEN,""C"",1,2)),IBXDATA=$P(IBX,U,1)_$P(IBX,U,2)"
^IBA(364.7,1218,3,0)="^364.73^2^2^3060830^^^"
^IBA(364.7,1218,3,1,0)="1500 form.  Box 33b.  Billing provider Other ID number."
^IBA(364.7,1218,3,2,0)="Enter the 2 digit qualifier followed by the secondary ID#."
^IBA(364.7,1219,0)="1519^N^5^^^^N"
^IBA(364.7,1219,1)="I $O(^TMP(""IBXDATA"",$J,IBXREC,1)) N Z,FLDS X ""F Z=1:1:+$O(^IBA(364.6,""""ASEQ"""",2,1,""""""""),-1) S:(Z'>43!(Z'<57))&(Z'=6)&(Z'=39)&(Z'=41) FLDS(Z)="""""""""" F Z=2:1:+$O(^TMP(""IBXDATA"",$J,IBXREC,Z),-1) D MPG^IBCEF3(Z,.FLDS,2)"
^IBA(364.7,1219,3,0)="^364.73^4^4^3061005^^^"
^IBA(364.7,1219,3,1,0)="If there is more than 1 page of bill extracted, the variable"
^IBA(364.7,1219,3,2,0)="FLDS(line,column) holds the lines and columns that should be duplicated on"
^IBA(364.7,1219,3,3,0)="pages after the first.  This takes care of the population of these static"
^IBA(364.7,1219,3,4,0)="fields on these subsequent pages."
^IBA(364.7,1220,0)="1520^N^150^^^^N"
^IBA(364.7,1220,1)="S IBXDATA=$S(IBXDATA:"""",1:""X"")"
^IBA(364.7,1220,3,0)="^^4^4^3060719^"
^IBA(364.7,1220,3,1,0)="CMS-1500, box 20 Outside Lab=NO."
^IBA(364.7,1220,3,2,0)="If the value of the data element is true, then it is an outside lab so "
^IBA(364.7,1220,3,3,0)="this box should be blank.  If the data element is false, then it is not "
^IBA(364.7,1220,3,4,0)="an outside lab, so this box should have an ""X"" in it."
^IBA(364.7,1250,0)="1550^N^5^^^^N"
^IBA(364.7,1250,1)="K ^UTILITY(""VADM"",$J),^UTILITY(""VAPA"",$J),^TMP(""IBXSAVE"",$J),IBXSAVE"
^IBA(364.7,1250,3,0)="^364.73^1^1^3061103^^^^"
^IBA(364.7,1250,3,1,0)="Kills off globals,other variables to be used, sets right margin variable."
^IBA(364.7,1251,0)="1551^N^142^^^^N"
^IBA(364.7,1252,0)="1552^N^5^^^^N"
^IBA(364.7,1252,1)="S IBXDATA=$$GETFAC^IBCEP8(+$$SITE^VASITE,0,0)"
^IBA(364.7,1252,3,0)="^^1^1^3061106^"
^IBA(364.7,1252,3,1,0)="Facility name from file 4."
^IBA(364.7,1253,0)="1553^N^5^^^^N"
^IBA(364.7,1253,1)="S IBXDATA=$$GETFAC^IBCEP8(+$$SITE^VASITE,0,12)"
^IBA(364.7,1253,3,0)="^^2^2^3061106^"
^IBA(364.7,1253,3,1,0)="Retrieve the billing provider address from the Institution file "
^IBA(364.7,1253,3,2,0)="(file#4).  Grab both address line 1 and address line 2."
^IBA(364.7,1254,0)="1554^N^5^^^^N"
^IBA(364.7,1254,1)="S IBXDATA=$$GETFAC^IBCEP8(+$$SITE^VASITE,0,""3C"")"
^IBA(364.7,1254,3,0)="^364.73^1^1^3061120^^"
^IBA(364.7,1254,3,1,0)="Get the billing provider city from file 4."
^IBA(364.7,1255,0)="1555^N^5^^^^N"
^IBA(364.7,1255,1)="S IBXDATA=$$GETFAC^IBCEP8(+$$SITE^VASITE,0,""3S"")"
^IBA(364.7,1255,3,0)="^364.73^1^1^3061120^^"
^IBA(364.7,1255,3,1,0)="Get the billing provider state from file 4."
^IBA(364.7,1256,0)="1556^N^5^^^^N"
^IBA(364.7,1256,1)="S IBXDATA=$TR($$GETFAC^IBCEP8(+$$SITE^VASITE,0,""3Z""),""-"")"
^IBA(364.7,1256,3,0)="^^2^2^3061120^"
^IBA(364.7,1256,3,1,0)="Get the billing provider zip code from file 4.  Form Locator 1"
^IBA(364.7,1256,3,2,0)="accommodates a 9-digit zip code so strip out the hyphen."
^IBA(364.7,1257,0)="1557^N^255^^^^N"
^IBA(364.7,1257,1)="D:IBXDATA="""" F^IBCEF(""N-AGENT CASHIER PHONE"","""","""",IBXIEN) S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,1257,3,0)="^364.73^2^2^3061103^^^^"
^IBA(364.7,1257,3,1,0)="Print the site contact phone or if no site contact phone #, use agent"
^IBA(364.7,1257,3,2,0)="cashier's phone #."
^IBA(364.7,1258,0)="1558^N^5^^^^N"
^IBA(364.7,1259,0)="1559^N^5^^^^N"
^IBA(364.7,1260,0)="1560^N^296^^^^N"
^IBA(364.7,1260,3,0)="^^2^2^3061106^"
^IBA(364.7,1260,3,1,0)="Pay-to facility name is retrieved from the IB site parameter field 2.1 - "
^IBA(364.7,1260,3,2,0)="facility name for billing."
^IBA(364.7,1261,0)="1561^N^104^^^^N"
^IBA(364.7,1261,1)="N IBZ D F^IBCEF(""N-AGENT CASHIER MAIL SYMBOL"",""IBZ"",,IBXIEN) I $G(IBZ)'="""" S IBXDATA=IBXDATA_"" ""_IBZ"
^IBA(364.7,1261,3,0)="^364.73^2^2^3061106^^^"
^IBA(364.7,1261,3,1,0)="Concatenate Agent Cashier Mail Symbol to the end of Agent Cashier Street "
^IBA(364.7,1261,3,2,0)="Address."
^IBA(364.7,1262,0)="1562^N^105^^^^N"
^IBA(364.7,1263,0)="1563^N^106^^^^N"
^IBA(364.7,1263,1)="I IBXDATA'="""" S IBXDATA=$$STATE^IBCEFG1(IBXDATA)"
^IBA(364.7,1264,0)="1564^N^107^^^^N"
^IBA(364.7,1264,1)="I IBXDATA'="""" S IBXDATA=$E(IBXDATA,1,5)"
^IBA(364.7,1264,3,0)="^^2^2^3061106^"
^IBA(364.7,1264,3,1,0)="Pay-to facility address zip code field only allows for 5 character zip "
^IBA(364.7,1264,3,2,0)="codes."
^IBA(364.7,1265,0)="1565^N^5^^^^N"
^IBA(364.7,1265,1)="K IBXDATA I $D(IBXSAVE(""PROC"",1)) S IBXDATA=$P(IBXSAVE(""PROC"",1),U),IBXDATA=$S(IBXDATA[""ICPT""!(IBXDATA[""ICD0""):$P($$PRCD^IBCEF1(IBXDATA),U),1:IBXDATA)"
^IBA(364.7,1265,3,0)="^364.73^3^3^3061120^^^^"
^IBA(364.7,1265,3,1,0)="This data element relies on the existence of the IBXSAVE(""PROC"") array"
^IBA(364.7,1265,3,2,0)="previously extracted.  If the first occurrence exists, output the code"
^IBA(364.7,1265,3,3,0)="referenced by its first '^' piece."
^IBA(364.7,1266,0)="1566^N^5^^^^N"
^IBA(364.7,1266,1)="K IBXDATA"
^IBA(364.7,1266,3,0)="^364.73^1^1^3061120^^"
^IBA(364.7,1266,3,1,0)="NOT USED.  Reserved for Assignment by the NUBC."
^IBA(364.7,1267,0)="1567^N^210^^^^N"
^IBA(364.7,1268,0)="1568^N^10^^^^N"
^IBA(364.7,1268,1)="S IBXDATA=$$NOPUNCT^IBCEF(IBXDATA,1)"
^IBA(364.7,1269,0)="1569^N^5^^^^N"
^IBA(364.7,1269,1)="K IBXDATA S IBXDATA=0_$$TOB^IBCEF1(IBXIEN)"
^IBA(364.7,1269,3,0)="^^2^2^3061106^"
^IBA(364.7,1269,3,1,0)="Type of bill is 4 characters long with the first digit being a leading "
^IBA(364.7,1269,3,2,0)="zero."
^IBA(364.7,1270,0)="1570^N^230^^^^ZL"
^IBA(364.7,1270,1)="S IBXDATA=$E($P(IBXDATA,U,3),4,7) I $TR(IBXDATA,0)="""" K IBXDATA"
^IBA(364.7,1270,3,0)="^364.73^2^2^3061106^^^^"
^IBA(364.7,1270,3,1,0)="Always 0-fill data to the left.  If primary site, don't output.  If not"
^IBA(364.7,1270,3,2,0)="primary site, this is the site suffix (up to 4 digits)"
^IBA(364.7,1271,0)="1571^N^109^^^^N"
^IBA(364.7,1272,0)="1572^N^71^^^^N"
^IBA(364.7,1272,1)="S IBXDATA=$$DATE^IBCF2(IBXDATA,,1)"
^IBA(364.7,1272,3,0)="^364.73^1^1^3061106^^^^"
^IBA(364.7,1272,3,1,0)="Format date in MMDDYY format."
^IBA(364.7,1273,0)="1573^N^133^^^^N"
^IBA(364.7,1273,1)="S IBXDATA=$$DATE^IBCF2(IBXDATA,,1)"
^IBA(364.7,1273,3,0)="^364.73^1^1^3061106^^^^"
^IBA(364.7,1273,3,1,0)="Format date in MMDDYY format."
^IBA(364.7,1274,0)="1574^N^5^^^^N"
^IBA(364.7,1274,1)="K IBXDATA"
^IBA(364.7,1274,3,0)="^^1^1^3061106^"
^IBA(364.7,1274,3,1,0)="Reserved for Assignment by the NUBC."
^IBA(364.7,1275,0)="1575^N^5^^^^N"
^IBA(364.7,1275,1)="K IBXDATA"
^IBA(364.7,1275,3,0)="^^1^1^3061106^"
^IBA(364.7,1275,3,1,0)="Reserved for Assignment by the NUBC."
^IBA(364.7,1276,0)="1576^N^5^^^^N"
^IBA(364.7,1276,1)="K IBXDATA"
^IBA(364.7,1276,3,0)="^^5^5^3070215^"
^IBA(364.7,1276,3,1,0)="This is the patient identification number as assigned by the current "
^IBA(364.7,1276,3,2,0)="payer for this patient."
^IBA(364.7,1276,3,3,0)=" "
^IBA(364.7,1276,3,4,0)="As of the release of IB patch 349 (April 2007), there is no corresponding "
^IBA(364.7,1276,3,5,0)="field in the VistA patient insurance file (2.312) for this data."
^IBA(364.7,1277,0)="1577^N^65^^^^N"
^IBA(364.7,1278,0)="1578^N^157^^^^N"
^IBA(364.7,1278,1)="S IBXDATA=$G(^UTILITY(""VAPA"",$J,1))_"" ""_$G(^UTILITY(""VAPA"",$J,2))_"" ""_$G(^UTILITY(""VAPA"",$J,3))"
^IBA(364.7,1278,3,0)="^^1^1^3061107^"
^IBA(364.7,1278,3,1,0)="Patient address - street address"
^IBA(364.7,1279,0)="1579^N^61^^^^N"
^IBA(364.7,1279,3,0)="^^1^1^3061107^"
^IBA(364.7,1279,3,1,0)="Patient address - city"
^IBA(364.7,1280,0)="1580^N^62^^^^N"
^IBA(364.7,1280,1)="S IBXDATA=$$GET1^DIQ(5,$S(+$$PTADDR^IBCEF(IBXIEN,25)>1:+$$PTADDR^IBCEF(IBXIEN,23),1:+IBXDATA),1)"
^IBA(364.7,1280,3,0)="^^1^1^3061107^"
^IBA(364.7,1280,3,1,0)="Patient address - state/province (2-char code)"
^IBA(364.7,1281,0)="1581^N^63^^^^N"
^IBA(364.7,1281,1)="S:+$$PTADDR^IBCEF(IBXIEN,25)>1 IBXDATA=$$PTADDR^IBCEF(IBXIEN,24)"
^IBA(364.7,1281,3,0)="^^1^1^3061107^"
^IBA(364.7,1281,3,1,0)="Patient address - zip code/postal code"
^IBA(364.7,1282,0)="1582^N^190^^^^N"
^IBA(364.7,1282,1)="N Z,Z0 K IBXDATA S Z0=0 F Z=1,5 S Z0=Z0+1 S:$G(IBXSAVE(""OCC"",Z))'="""" IBXDATA(Z0)=$P(IBXSAVE(""OCC"",Z),U)"
^IBA(364.7,1282,3,0)="^364.73^3^3^3061108^^^^"
^IBA(364.7,1282,3,1,0)="The data element extracts multiply-occurring data for the occurrence codes"
^IBA(364.7,1282,3,2,0)="and occurrence span codes and outputs the first occurrence code here."
^IBA(364.7,1282,3,3,0)="Overflow codes are printed on a separate page."
^IBA(364.7,1283,0)="1583^N^5^^^^N"
^IBA(364.7,1283,1)="N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=1:4 Q:$G(IBXSAVE(""OCC"",Z))=""""  S Z0=Z0+1,Z1=$$DATE^IBCF2($P(IBXSAVE(""OCC"",Z),U,2),,1) S:Z'>5 IBXDATA(Z0)=Z1 D:Z>5 XOCC^IBCEF3($P(IBXSAVE(""OCC"",Z),U)_U_Z1,Z0,31) K IBXSAVE(""OCC"",Z)"
^IBA(364.7,1283,3,0)="^364.73^6^6^3061108^^^^"
^IBA(364.7,1283,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,1283,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,1283,3,3,0)="IBXSAVE(""OCC"") extracted previously.  This field outputs the 1st and 5th"
^IBA(364.7,1283,3,4,0)="occurrences of occurrence code 'from date' formatted as MMDDYY found in the"
^IBA(364.7,1283,3,5,0)="second '^' piece of the IBXSAVE(""OCC"",n) array data element."
^IBA(364.7,1283,3,6,0)="Overflow codes (9,13,...) are printed on a separate page."
^IBA(364.7,1284,0)="1584^N^5^^^^N"
^IBA(364.7,1284,1)="N Z,Z0 K IBXDATA S Z0=0 F Z=2,6 S Z0=Z0+1 S:$G(IBXSAVE(""OCC"",Z))'="""" IBXDATA(Z0)=$P(IBXSAVE(""OCC"",Z),U)"
^IBA(364.7,1284,3,0)="^364.73^5^5^3061108^^^^"
^IBA(364.7,1284,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,1284,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,1284,3,3,0)="IBXSAVE(""OCC"") extracted previously.  This field outputs the 2nd and 6th"
^IBA(364.7,1284,3,4,0)="occurrences of occurrence codes found in the IBXSAVE(""OCC"",n) array data"
^IBA(364.7,1284,3,5,0)="element.  Overflow codes are printed on a separate page."
^IBA(364.7,1285,0)="1585^N^5^^^^N"
^IBA(364.7,1285,1)="N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=2:4 Q:$G(IBXSAVE(""OCC"",Z))=""""  S Z0=Z0+1,Z1=$$DATE^IBCF2($P(IBXSAVE(""OCC"",Z),U,2),,1) S:Z'>6 IBXDATA(Z0)=Z1 D:Z>6 XOCC^IBCEF3($P(IBXSAVE(""OCC"",Z),U)_U_Z1,Z0,32) K IBXSAVE(""OCC"",Z)"
^IBA(364.7,1285,3,0)="^364.73^6^6^3061108^^^^"
^IBA(364.7,1285,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,1285,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,1285,3,3,0)="IBXSAVE(""OCC"") extracted previously.  This field outputs the 2nd and 6th"
^IBA(364.7,1285,3,4,0)="occurrences of occurrence code 'from date' formatted as MMDDYY found in the"
^IBA(364.7,1285,3,5,0)="second '^' piece of the IBXSAVE(""OCC"",n) array data element."
^IBA(364.7,1285,3,6,0)="Overflow codes (10,14,...) are printed on a separate page."
^IBA(364.7,1286,0)="1586^N^5^^^^N"
^IBA(364.7,1286,1)="N Z,Z0 K IBXDATA S Z0=0 F Z=3,7 S Z0=Z0+1 S:$G(IBXSAVE(""OCC"",Z))'="""" IBXDATA(Z0)=$P(IBXSAVE(""OCC"",Z),U)"
^IBA(364.7,1286,3,0)="^364.73^5^5^3061108^^^^"
^IBA(364.7,1286,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,1286,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,1286,3,3,0)="IBXSAVE(""OCC"") extracted previously.  This field outputs the 3rd and 7th"
^IBA(364.7,1286,3,4,0)="occurrences of occurrence codes found in the IBXSAVE(""OCC"",n) array data"
^IBA(364.7,1286,3,5,0)="element.  Overflow codes are printed on a separate page."
^IBA(364.7,1287,0)="1587^N^5^^^^N"
^IBA(364.7,1287,1)="N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=3:4 Q:$G(IBXSAVE(""OCC"",Z))=""""  S Z0=Z0+1,Z1=$$DATE^IBCF2($P(IBXSAVE(""OCC"",Z),U,2),,1) S:Z'>7 IBXDATA(Z0)=Z1 D:Z>7 XOCC^IBCEF3($P(IBXSAVE(""OCC"",Z),U)_U_Z1,Z0,33) K IBXSAVE(""OCC"",Z)"
^IBA(364.7,1287,3,0)="^364.73^6^6^3061108^^^^"
^IBA(364.7,1287,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,1287,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,1287,3,3,0)="IBXSAVE(""OCC"") extracted previously.  This field outputs the 3rd and 7th"
^IBA(364.7,1287,3,4,0)="occurrences of occurrence code 'from date' formatted as MMDDYY found in the"
^IBA(364.7,1287,3,5,0)="second '^' piece of the IBXSAVE(""OCC"",n) array data element."
^IBA(364.7,1287,3,6,0)="Any overflow codes (11,15,...) are output on a separate page."
^IBA(364.7,1288,0)="1588^N^5^^^^N"
^IBA(364.7,1288,1)="N Z,Z0 K IBXDATA S Z0=0 F Z=4,8 S Z0=Z0+1 S:$G(IBXSAVE(""OCC"",Z))'="""" IBXDATA(Z0)=$P(IBXSAVE(""OCC"",Z),U)"
^IBA(364.7,1288,3,0)="^364.73^5^5^3061108^^^^"
^IBA(364.7,1288,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,1288,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,1288,3,3,0)="IBXSAVE(""OCC"") extracted previously.  This field outputs the 4th and 8th"
^IBA(364.7,1288,3,4,0)="occurrences of occurrence codes found in the IBXSAVE(""OCC"",n) array data"
^IBA(364.7,1288,3,5,0)="element.  Overflow codes are printed on a separate page."
^IBA(364.7,1289,0)="1589^N^5^^^^N"
^IBA(364.7,1289,1)="N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=4:4 Q:$G(IBXSAVE(""OCC"",Z))=""""  S Z0=Z0+1,Z1=$$DATE^IBCF2($P(IBXSAVE(""OCC"",Z),U,2),,1) S:Z'>8 IBXDATA(Z0)=Z1 D:Z>8 XOCC^IBCEF3($P(IBXSAVE(""OCC"",Z),U)_U_Z1,Z0,34) K IBXSAVE(""OCC"",Z)"
^IBA(364.7,1289,3,0)="^364.73^6^6^3061108^^^^"
^IBA(364.7,1289,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,1289,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,1289,3,3,0)="IBXSAVE(""OCC"") extracted previously.  This field outputs the 4th and 8th"
^IBA(364.7,1289,3,4,0)="occurrences of occurrence code 'from date' formatted as MMDDYY found in the"
^IBA(364.7,1289,3,5,0)="second '^' piece of the IBXSAVE(""OCC"",n) array data element."
^IBA(364.7,1289,3,6,0)="Any overflow codes (12,16,...) are output on a separate page."
^IBA(364.7,1290,0)="1590^N^5^^^^N"
^IBA(364.7,1290,1)="N Z,Z0 K IBXDATA S Z0=0 F Z=1,3 S Z0=Z0+1 S:$G(IBXSAVE(""OCCS"",Z))'="""" IBXDATA(Z0)=$P(IBXSAVE(""OCCS"",Z),U)"
^IBA(364.7,1290,3,0)="^^5^5^3061108^"
^IBA(364.7,1290,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,1290,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,1290,3,3,0)="IBXSAVE(""OCCS"") extracted previously.  This field outputs the 1st and 3rd"
^IBA(364.7,1290,3,4,0)="occurrences of occurrence span codes found in the IBXSAVE(""OCCS"",n) array"
^IBA(364.7,1290,3,5,0)="data element.  Overflow codes are printed on a separate page."
^IBA(364.7,1291,0)="1591^N^5^^^^N"
^IBA(364.7,1291,1)="N Z,Z0 K IBXDATA S Z0=0 F Z=1,3 S Z0=Z0+1 S:$G(IBXSAVE(""OCCS"",Z))'="""" IBXDATA(Z0)=$$DATE^IBCF2($P(IBXSAVE(""OCCS"",Z),U,2),,1)"
^IBA(364.7,1291,3,0)="^^5^5^3061108^"
^IBA(364.7,1291,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,1291,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,1291,3,3,0)="IBXSAVE(""OCCS"") extracted previously.  This field outputs the 1st and 3rd"
^IBA(364.7,1291,3,4,0)="occurrences of occurrence span code 'from date' formatted as MMDDYY found"
^IBA(364.7,1291,3,5,0)="in the second '^' piece of the IBXSAVE(""OCCS"",n) array data element."
^IBA(364.7,1292,0)="1592^N^5^^^^N"
^IBA(364.7,1292,1)="N Z,Q,Z0 K IBXDATA S Z0=0 F Z=1:2 Q:$G(IBXSAVE(""OCCS"",Z))=""""  S Z0=Z0+1,Q=$$DATE^IBCF2($P(IBXSAVE(""OCCS"",Z),U,3),,1) S:Z'>3 IBXDATA(Z0)=Q D:Z>3 XOCCS^IBCEF3($P(IBXSAVE(""OCCS"",Z),U)_U_$$DATE^IBCF2($P(IBXSAVE(""OCCS"",Z),U,2),,1)_U_Q,Z0,35)"
^IBA(364.7,1292,3,0)="^364.73^5^5^3061208^^^^"
^IBA(364.7,1292,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,1292,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,1292,3,3,0)="IBXSAVE(""OCCS"") extracted previously.  This field outputs the 1st and 3rd"
^IBA(364.7,1292,3,4,0)="occurrences of occurrence span code 'to date' formatted as MMDDYY found"
^IBA(364.7,1292,3,5,0)="in the third '^' piece of the IBXSAVE(""OCCS"",n) array data element."
^IBA(364.7,1293,0)="1593^N^5^^^^N"
^IBA(364.7,1293,1)="N CIEN S CIEN=+$$PTADDR^IBCEF(IBXIEN,25),IBXDATA=$S(CIEN>1:$$GET1^DIQ(779.004,CIEN,1.2),1:"""")"
^IBA(364.7,1293,3,0)="^^2^2^3061108^"
^IBA(364.7,1293,3,1,0)="Patient address - country code."
^IBA(364.7,1293,3,2,0)="Printed if country is not USA, blank otherwise."
^IBA(364.7,1294,0)="1594^N^5^^^^N"
^IBA(364.7,1294,1)="N Z,Z0 K IBXDATA S Z0=0 F Z=2,4 S Z0=Z0+1 S:$G(IBXSAVE(""OCCS"",Z))'="""" IBXDATA(Z0)=$P(IBXSAVE(""OCCS"",Z),U)"
^IBA(364.7,1294,3,0)="^^5^5^3061108^"
^IBA(364.7,1294,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,1294,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,1294,3,3,0)="IBXSAVE(""OCCS"") extracted previously.  This field outputs the 2nd and 4th"
^IBA(364.7,1294,3,4,0)="occurrences of occurrence span codes found in the IBXSAVE(""OCCS"",n) array"
^IBA(364.7,1294,3,5,0)="data element.  Overflow codes are printed on a separate page."
^IBA(364.7,1295,0)="1595^N^5^^^^N"
^IBA(364.7,1295,1)="N Z,Z0 K IBXDATA S Z0=0 F Z=2,4 S Z0=Z0+1 S:$G(IBXSAVE(""OCCS"",Z))'="""" IBXDATA(Z0)=$$DATE^IBCF2($P(IBXSAVE(""OCCS"",Z),U,2),,1)"
^IBA(364.7,1295,3,0)="^^5^5^3061108^"
^IBA(364.7,1295,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,1295,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,1295,3,3,0)="IBXSAVE(""OCCS"") extracted previously.  This field outputs the 2nd and 4th"
^IBA(364.7,1295,3,4,0)="occurrences of occurrence span code 'from date' formatted as MMDDYY found"
^IBA(364.7,1295,3,5,0)="in the second '^' piece of the IBXSAVE(""OCCS"",n) array data element."
^IBA(364.7,1296,0)="1596^N^5^^^^N"
^IBA(364.7,1296,1)="N Z,Q,Z0 K IBXDATA S Z0=0 F Z=2:2 Q:$G(IBXSAVE(""OCCS"",Z))=""""  S Z0=Z0+1,Q=$$DATE^IBCF2($P(IBXSAVE(""OCCS"",Z),U,3),,1) S:Z'>4 IBXDATA(Z0)=Q D:Z>4 XOCCS^IBCEF3($P(IBXSAVE(""OCCS"",Z),U)_U_$$DATE^IBCF2($P(IBXSAVE(""OCCS"",Z),U,2),,1)_U_Q,Z0,36)"
^IBA(364.7,1296,3,0)="^364.73^5^5^3061208^^"
^IBA(364.7,1296,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,1296,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,1296,3,3,0)="IBXSAVE(""OCCS"") extracted previously.  This field outputs the 2nd and 4th"
^IBA(364.7,1296,3,4,0)="occurrences of occurrence span code 'to date' formatted as MMDDYY found"
^IBA(364.7,1296,3,5,0)="in the third '^' piece of the IBXSAVE(""OCCS"",n) array data element."
^IBA(364.7,1297,0)="1597^N^5"
^IBA(364.7,1297,1)="S IBXDATA=""9"""
^IBA(364.7,1297,3,0)="^364.73^1^1^3061113^^"
^IBA(364.7,1297,3,1,0)="Hardcoded to 9 for ICD 9 codes"
^IBA(364.7,1298,0)="1598^N^86^^^^N"
^IBA(364.7,1298,1)="N C,Z,Z0,IBZ M IBZ=IBXDATA K IBXDATA S (C,Z)=0 F  S Z=$O(IBZ(Z)) Q:'Z  I '$$ECODE^IBCEU4(+IBZ(Z)) S C=C+1 S:C=1 IBXDATA=$P($G(^ICD9(+IBZ(Z),0)),U) S IBXSAVE(""DX"",C)=+IBZ(Z)"
^IBA(364.7,1298,3,0)="^^3^3^3061121^"
^IBA(364.7,1298,3,1,0)="The principal dx is found in the first occurrence of the data element's"
^IBA(364.7,1298,3,2,0)="values.  The diagnoses are saved off in the IBXSAVE(""DX"") array for later"
^IBA(364.7,1298,3,3,0)="use.  Only allow 1 E-code."
^IBA(364.7,1299,0)="1599^N^5^^^^N"
^IBA(364.7,1299,1)="D CKPGUB^IBCEF3"
^IBA(364.7,1299,3,0)="^364.73^1^1^3061109^^^^"
^IBA(364.7,1299,3,1,0)="Checks for multi-page output, adds the static fields to subsequent pages."
^IBA(364.7,1300,0)="1600^N^5^^^^N"
^IBA(364.7,1300,1)="K IBXDATA"
^IBA(364.7,1300,3,0)="^^1^1^3061109^"
^IBA(364.7,1300,3,1,0)="Reserved for Assignment by the NUBC.  Not used."
^IBA(364.7,1301,0)="1601^N^5^^^^N"
^IBA(364.7,1301,1)="K IBXDATA"
^IBA(364.7,1301,3,0)="^^1^1^3061109^"
^IBA(364.7,1301,3,1,0)="Reserved for Assignment by the NUBC.  Box 37 line 2.  Not used."
^IBA(364.7,1302,0)="1602^N^5^^^^N"
^IBA(364.7,1302,1)="I $D(IBXSAVE(""DX"",11)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(""DX"",11),0)),U)"
^IBA(364.7,1302,3,0)="^^1^1^3061117^"
^IBA(364.7,1302,3,1,0)="If there is a eleventh diagnosis, print its name."
^IBA(364.7,1303,0)="1603^N^66^^^^N"
^IBA(364.7,1303,1)="S IBXDATA=$$DATE^IBCF2(IBXDATA,1,1) S:IBXDATA="""" IBXDATA=""00000000"""
^IBA(364.7,1303,3,0)="^364.73^2^2^3061109^^^^"
^IBA(364.7,1303,3,1,0)="If BIRTHDATE exists, format it MMDDYYYY.  If it doesn't exist, output"
^IBA(364.7,1303,3,2,0)="00000000."
^IBA(364.7,1304,0)="1604^N^67^^^^N"
^IBA(364.7,1304,1)="S:IBXDATA="""" IBXDATA=""U"""
^IBA(364.7,1304,3,0)="^364.73^1^1^3061109^^^^"
^IBA(364.7,1304,3,1,0)="If the data element's value is null, set it equal to 'U'."
^IBA(364.7,1305,0)="1605^N^78^^^^N"
^IBA(364.7,1305,1)="S IBXSAVE(""ADTM"")=$$TIME^IBCF3(IBXDATA),IBXDATA=$$DATE^IBCF2($P(IBXDATA,"".""),,1)"
^IBA(364.7,1305,3,0)="^364.73^2^2^3061109^^^^"
^IBA(364.7,1305,3,1,0)="Save the admission time in IBXSAVE array for later use.  Format date"
^IBA(364.7,1305,3,2,0)="without the time as MMDDYY."
^IBA(364.7,1306,0)="1606^N^5^^^^N"
^IBA(364.7,1306,1)="S IBXDATA=$S('$$INPAT^IBCEF(IBXIEN,1):"""",$G(IBXSAVE(""ADTM""))'="""":$E(IBXSAVE(""ADTM""),1,2),1:""00"")"
^IBA(364.7,1306,3,0)="^364.73^1^1^3070328^^"
^IBA(364.7,1306,3,1,0)="Admission time"
^IBA(364.7,1307,0)="1607^N^79^^^^N"
^IBA(364.7,1307,3,0)="^^8^8^3061109^"
^IBA(364.7,1307,3,1,0)="Admission type:"
^IBA(364.7,1307,3,2,0)="1 - Emergency"
^IBA(364.7,1307,3,3,0)="2 - Urgent"
^IBA(364.7,1307,3,4,0)="3 - Elective"
^IBA(364.7,1307,3,5,0)="4 - Newborn"
^IBA(364.7,1307,3,6,0)="5 - Trauma"
^IBA(364.7,1307,3,7,0)="6-8 - Reserved"
^IBA(364.7,1307,3,8,0)="9 - Information not available"
^IBA(364.7,1308,0)="1608^N^80^^^^N"
^IBA(364.7,1308,3,0)="^^21^21^3061109^"
^IBA(364.7,1308,3,1,0)="Source of admission:"
^IBA(364.7,1308,3,2,0)="1 - Physician referral"
^IBA(364.7,1308,3,3,0)="2 - Clinic referral"
^IBA(364.7,1308,3,4,0)="3 - HMO referral"
^IBA(364.7,1308,3,5,0)="4 - Transfer from a hospital"
^IBA(364.7,1308,3,6,0)="5 - Transfer from a skilled nursing facility"
^IBA(364.7,1308,3,7,0)="6 - Transfer from another health care facility"
^IBA(364.7,1308,3,8,0)="7 - Emergency room"
^IBA(364.7,1308,3,9,0)="8 - Court / Law enforcement"
^IBA(364.7,1308,3,10,0)="9 - Information not available"
^IBA(364.7,1308,3,11,0)="A - Transfer from a critical access hospital"
^IBA(364.7,1308,3,12,0)="B - Transfer from another home health agency"
^IBA(364.7,1308,3,13,0)="C - Readmission to same home health agency"
^IBA(364.7,1308,3,14,0)="D - Transfer from hospital inpatient in the same facility,"
^IBA(364.7,1308,3,15,0)="    resulting in a separate claim to the payer"
^IBA(364.7,1308,3,16,0)="Codes for Newborn admission type:"
^IBA(364.7,1308,3,17,0)="1 - Normal delivery"
^IBA(364.7,1308,3,18,0)="2 - Premature delivery"
^IBA(364.7,1308,3,19,0)="3 - Sick baby"
^IBA(364.7,1308,3,20,0)="4 - Extramural birth"
^IBA(364.7,1308,3,21,0)="5-9 - Reserved"
^IBA(364.7,1309,0)="1609^N^81^^^^N"
^IBA(364.7,1309,1)="K:'$$INPAT^IBCEF(IBXIEN,1) IBXDATA I $D(IBXDATA) S IBXDATA=$S($P(IBXDATA,""."",2)'="""":$$TIME^IBCF3(IBXDATA),1:"""")"
^IBA(364.7,1309,3,0)="^364.73^2^2^3061109^^^^"
^IBA(364.7,1309,3,1,0)="If this is an outpatient bill, no output.  For inpatient bills, output the"
^IBA(364.7,1309,3,2,0)="time portion of the discharge date/time or 99 if no time found."
^IBA(364.7,1310,0)="1610^N^9^^^^N"
^IBA(364.7,1311,0)="1611^N^280^^^^N"
^IBA(364.7,1311,1)="S:$$WNRBILL^IBEFUNC(IBXIEN) IBXDATA=""MEDICARE"" S IBXSAVE(""CADR_NAME"")=$G(IBXDATA)"
^IBA(364.7,1311,3,0)="^^1^1^3061117^"
^IBA(364.7,1311,3,1,0)="Extract the current payer name and save it in IBXSAVE."
^IBA(364.7,1312,0)="1612^N^192^^^^N"
^IBA(364.7,1312,1)="N Y,Z K IBXSAVE(""CADR"") I $O(IBXDATA(0)) S Y=$G(IBXDATA(6)) D ZIPOUT^VAFADDR S:Y'="""" $P(IBXSAVE(""CADR""),U,6)=Y F Z=1:1:5,7 S:$D(IBXDATA(Z)) $P(IBXSAVE(""CADR""),U,Z)=IBXDATA(Z)"
^IBA(364.7,1312,3,0)="^^10^10^3061117^"
^IBA(364.7,1312,3,1,0)="Extract the current payer address and store the address components in the "
^IBA(364.7,1312,3,2,0)="IBXSAVE(""CADR"") pieced string variable with the following pieces:"
^IBA(364.7,1312,3,3,0)=" "
^IBA(364.7,1312,3,4,0)="[1] address line 1"
^IBA(364.7,1312,3,5,0)="[2] address line 2"
^IBA(364.7,1312,3,6,0)="[3] address line 3"
^IBA(364.7,1312,3,7,0)="[4] city"
^IBA(364.7,1312,3,8,0)="[5] pointer to the state file"
^IBA(364.7,1312,3,9,0)="[6] external zip code with dashes"
^IBA(364.7,1312,3,10,0)="[7] claim office ID (not used)"
^IBA(364.7,1313,0)="1613^N^5^^^^N"
^IBA(364.7,1313,1)="D CIADDR^IBCEF1(.IBXDATA,.IBXSAVE,,2)"
^IBA(364.7,1313,3,0)="^^2^2^3061117^"
^IBA(364.7,1313,3,1,0)="Calls CIADDR^IBCEF1 where the IBXDATA formatted array is returned.  The "
^IBA(364.7,1313,3,2,0)="IBXSAVE array elements for the current payer name and address are killed."
^IBA(364.7,1314,0)="1614^N^5^^^^N"
^IBA(364.7,1314,1)="I $D(IBXSAVE(""DX"",12)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(""DX"",12),0)),U)"
^IBA(364.7,1314,3,0)="^^1^1^3061117^"
^IBA(364.7,1314,3,1,0)="If there is a twelth diagnosis, print its name."
^IBA(364.7,1315,0)="1615^N^5^^^^N"
^IBA(364.7,1315,1)="I $D(IBXSAVE(""DX"",13)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(""DX"",13),0)),U)"
^IBA(364.7,1315,3,0)="^^1^1^3061117^"
^IBA(364.7,1315,3,1,0)="If there is a thirteenth diagnosis, print its name."
^IBA(364.7,1316,0)="1616^N^12^^^^N"
^IBA(364.7,1316,1)="N Z,Z0,Z1 S Z=0 F  S Z=$O(IBFL(39,Z)) K:'Z IBFL(39) Q:'Z  S Z0=$P(IBFL(39,Z),U,2),Z1=$P(IBFL(39,Z),U,3),IBXSAVE(""VC"",Z)=$P(IBFL(39,Z),U,1)_U_$S(Z1:$$DOL^IBCEF77(Z0,10),1:$J(Z0,8))"
^IBA(364.7,1316,3,0)="^^11^11^3061110^"
^IBA(364.7,1316,3,1,0)="Save all value codes extracted into IBXSAVE(""VC"") array for later use.  "
^IBA(364.7,1316,3,2,0)="Format the value as we loop through them."
^IBA(364.7,1316,3,3,0)=" "
^IBA(364.7,1316,3,4,0)="IBXSAVE(""VC"",z) = [1] VALUE CODE"
^IBA(364.7,1316,3,5,0)="                  [2] FORMATTED VALUE AMOUNT"
^IBA(364.7,1316,3,6,0)=" "
^IBA(364.7,1316,3,7,0)="Dollar amounts are formatted using all 10 characters with the decimal "
^IBA(364.7,1316,3,8,0)="point implied by the dollars/cents delimiter on the pre-printed UB form."
^IBA(364.7,1316,3,9,0)=" "
^IBA(364.7,1316,3,10,0)="Non-dollar amounts are formatted right-justified to the left of the "
^IBA(364.7,1316,3,11,0)="dollars/cents delimiter on the pre-printed UB form (thus 8 characters)."
^IBA(364.7,1317,0)="1617^N^5^^^^N"
^IBA(364.7,1317,1)="N Z,DATA,CODE I $D(IBXSAVE(""VC"")) K IBXSAVE(""VCS"") S Z=0 F  S Z=$O(IBXSAVE(""VC"",Z)) Q:'Z  S DATA=$G(IBXSAVE(""VC"",Z)),CODE=$P(DATA,U,1) I CODE'="""" S IBXSAVE(""VCS"","" ""_CODE,Z)=DATA"
^IBA(364.7,1317,3,0)="^^2^2^3061110^"
^IBA(364.7,1317,3,1,0)="If the ""VC"" value code array exists, then sort it by value code in the "
^IBA(364.7,1317,3,2,0)="IBXSAVE(""VCS"") array."
^IBA(364.7,1318,0)="1618^N^5^^^^N"
^IBA(364.7,1318,1)="N CODE,CT,Z I $D(IBXSAVE(""VCS"")) K IBXSAVE(""VC"") S CODE="""",CT=0 F  S CODE=$O(IBXSAVE(""VCS"",CODE)) Q:CODE=""""  S Z=0 F  S Z=$O(IBXSAVE(""VCS"",CODE,Z)) Q:'Z  S CT=CT+1,IBXSAVE(""VC"",CT)=IBXSAVE(""VCS"",CODE,Z) K IBXSAVE(""VCS"",CODE,Z)"
^IBA(364.7,1318,3,0)="^^2^2^3061110^"
^IBA(364.7,1318,3,1,0)="If the value codes exist and have been sorted into the IBXSAVE(""VCS"") "
^IBA(364.7,1318,3,2,0)="array, then loop thru that array and re-build the IBXSAVE(""VC"") array."
^IBA(364.7,1319,0)="1619^N^5^^^^N"
^IBA(364.7,1319,1)="N Z,Z0 S Z0=0 F Z=1:3:10 Q:'$D(IBXSAVE(""VC"",Z))  S Z0=Z0+1,IBXDATA(Z0)=$P(IBXSAVE(""VC"",Z),U)"
^IBA(364.7,1319,3,0)="^364.73^3^3^3061110^^^^"
^IBA(364.7,1319,3,1,0)="This data element relies on the array IBXSAVE(""VC"") previously extracted."
^IBA(364.7,1319,3,2,0)="This is a group data element and can have multiple occurrences.  Output is"
^IBA(364.7,1319,3,3,0)="the first piece of each occurrence found."
^IBA(364.7,1320,0)="1620^N^5^^^^N"
^IBA(364.7,1320,1)="N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=1:3 Q:$G(IBXSAVE(""VC"",Z))=""""  S Z0=Z0+1,Z1=$P(IBXSAVE(""VC"",Z),U,2) S:Z'>10 IBXDATA(Z0)=Z1 D:Z>10 XVAL^IBCEF3(IBXSAVE(""VC"",Z),Z) K IBXSAVE(""VC"",Z)"
^IBA(364.7,1320,3,0)="^364.73^3^3^3061110^^^^"
^IBA(364.7,1320,3,1,0)="This data element relies on the array IBXSAVE(""VC"") previously extracted."
^IBA(364.7,1320,3,2,0)="This is a group data element and can have multiple occurrences.  Output is"
^IBA(364.7,1320,3,3,0)="the second piece of each occurrence found."
^IBA(364.7,1321,0)="1621^N^5^^^^N"
^IBA(364.7,1321,1)="N Z,Z0 S Z0=0 F Z=2:3:11 Q:'$D(IBXSAVE(""VC"",Z))  S Z0=Z0+1,IBXDATA(Z0)=$P(IBXSAVE(""VC"",Z),U)"
^IBA(364.7,1321,3,0)="^364.73^3^3^3061110^^^^"
^IBA(364.7,1321,3,1,0)="This data element relies on the array IBXSAVE(""VC"") previously extracted."
^IBA(364.7,1321,3,2,0)="This is a group data element and can have multiple occurrences.  Output is"
^IBA(364.7,1321,3,3,0)="the first piece of each occurrence found."
^IBA(364.7,1322,0)="1622^N^5^^^^N"
^IBA(364.7,1322,1)="N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=2:3 Q:$G(IBXSAVE(""VC"",Z))=""""  S Z0=Z0+1,Z1=$P(IBXSAVE(""VC"",Z),U,2) S:Z'>11 IBXDATA(Z0)=Z1 D:Z>11 XVAL^IBCEF3(IBXSAVE(""VC"",Z),Z) K IBXSAVE(""VC"",Z)"
^IBA(364.7,1322,3,0)="^364.73^3^3^3061110^^^^"
^IBA(364.7,1322,3,1,0)="This data element relies on the array IBXSAVE(""VC"") previously extracted."
^IBA(364.7,1322,3,2,0)="This is a group data element and can have multiple occurrences.  Output is"
^IBA(364.7,1322,3,3,0)="the second piece of each occurrence found."
^IBA(364.7,1323,0)="1623^N^5^^^^N"
^IBA(364.7,1323,1)="N Z,Z0 S Z0=0 F Z=3:3:12 Q:'$D(IBXSAVE(""VC"",Z))  S Z0=Z0+1,IBXDATA(Z0)=$P(IBXSAVE(""VC"",Z),U)"
^IBA(364.7,1323,3,0)="^364.73^4^4^3061110^^^^"
^IBA(364.7,1323,3,1,0)="This data element relies on the array IBXSAVE(""VC"") previously extracted."
^IBA(364.7,1323,3,2,0)="This is a group data element and can have multiple occurrences.  Output is"
^IBA(364.7,1323,3,3,0)="the first piece of each occurrence found.  If there are more than 12"
^IBA(364.7,1323,3,4,0)="value codes, they are stored in the overflow array."
^IBA(364.7,1324,0)="1624^N^5^^^^N"
^IBA(364.7,1324,1)="N Z,Z0,Z1 K IBXDATA S Z0=0 F Z=3:3 Q:$G(IBXSAVE(""VC"",Z))=""""  S Z0=Z0+1,Z1=$P(IBXSAVE(""VC"",Z),U,2) S:Z'>12 IBXDATA(Z0)=Z1 D:Z>12 XVAL^IBCEF3(IBXSAVE(""VC"",Z),Z) K IBXSAVE(""VC"",Z)"
^IBA(364.7,1324,3,0)="^364.73^3^3^3061110^^^^"
^IBA(364.7,1324,3,1,0)="This data element relies on the array IBXSAVE(""VC"") previously extracted."
^IBA(364.7,1324,3,2,0)="This is a group data element and can have multiple occurrences.  Output is"
^IBA(364.7,1324,3,3,0)="the second piece of each occurrence found."
^IBA(364.7,1325,0)="1625^N^5^^^^N"
^IBA(364.7,1325,1)="K IBXDATA I $G(IBXSAVE(""CC"",1))'="""" S IBXDATA=IBXSAVE(""CC"",1) K IBXSAVE(""CC"",1)"
^IBA(364.7,1325,3,0)="^364.73^7^7^3061113^^^^"
^IBA(364.7,1325,3,1,0)="Data element's array reference is IBFL(24), not default of IBXDATA.  This is"
^IBA(364.7,1325,3,2,0)="a group data element so more than 1 occurrence of a value is possible for"
^IBA(364.7,1325,3,3,0)="the data element in the IBFL(24) array.  All occurrences of the data element"
^IBA(364.7,1325,3,4,0)="are saved in the IBXSAVE(""CC"",n) array and only IBXSAVE(""CC"",1) is output"
^IBA(364.7,1325,3,5,0)="in this field. Note: hard code is used to output the"
^IBA(364.7,1325,3,6,0)="codes that exceed the # that will fit on one page if multiple pages of bill"
^IBA(364.7,1325,3,7,0)="are printed."
^IBA(364.7,1326,0)="1626^N^11^^^^N"
^IBA(364.7,1326,1)="N Z S Z=0 F  S Z=$O(IBFL(24,Z)) Q:Z=""""  S IBXSAVE(""CCU"","" ""_$G(IBFL(24,Z)))="""""
^IBA(364.7,1327,0)="1627^N^5^^^^N"
^IBA(364.7,1327,1)="K IBXDATA I $G(IBXSAVE(""CC"",2))'="""" S IBXDATA=IBXSAVE(""CC"",2) K IBXSAVE(""CC"",2)"
^IBA(364.7,1327,3,0)="^364.73^2^2^3061113^^^^"
^IBA(364.7,1327,3,1,0)="Data element relies on the data in array IBXSAVE(""CC"") extracted previously."
^IBA(364.7,1327,3,2,0)="This field reports the data in the second occurrence of the array."
^IBA(364.7,1328,0)="1628^N^5^^^^N"
^IBA(364.7,1328,1)="K IBXDATA I $G(IBXSAVE(""CC"",3))'="""" S IBXDATA=IBXSAVE(""CC"",3) K IBXSAVE(""CC"",3)"
^IBA(364.7,1328,3,0)="^364.73^2^2^3061113^^^^"
^IBA(364.7,1328,3,1,0)="Data element relies on the data in array IBXSAVE(""CC"") extracted previously."
^IBA(364.7,1328,3,2,0)="This field reports the data in the third occurrence of the array."
^IBA(364.7,1329,0)="1629^N^5^^^^N"
^IBA(364.7,1329,1)="K IBXDATA I $G(IBXSAVE(""CC"",4))'="""" S IBXDATA=IBXSAVE(""CC"",4) K IBXSAVE(""CC"",4)"
^IBA(364.7,1329,3,0)="^364.73^2^2^3061113^^^^"
^IBA(364.7,1329,3,1,0)="Data element relies on the data in array IBXSAVE(""CC"") extracted previously."
^IBA(364.7,1329,3,2,0)="This field reports the data in the fourth occurrence of the array."
^IBA(364.7,1330,0)="1630^N^5^^^^N"
^IBA(364.7,1330,1)="K IBXDATA I $G(IBXSAVE(""CC"",5))'="""" S IBXDATA=IBXSAVE(""CC"",5) K IBXSAVE(""CC"",5)"
^IBA(364.7,1330,3,0)="^364.73^2^2^3061113^^^^"
^IBA(364.7,1330,3,1,0)="Data element relies on the data in array IBXSAVE(""CC"") extracted previously."
^IBA(364.7,1330,3,2,0)="This field reports the data in the fifth occurrence of the array."
^IBA(364.7,1331,0)="1631^N^5^^^^N"
^IBA(364.7,1331,1)="K IBXDATA I $G(IBXSAVE(""CC"",6))'="""" S IBXDATA=IBXSAVE(""CC"",6) K IBXSAVE(""CC"",6)"
^IBA(364.7,1331,3,0)="^364.73^2^2^3061113^^^^"
^IBA(364.7,1331,3,1,0)="Data element relies on the data in array IBXSAVE(""CC"") extracted previously."
^IBA(364.7,1331,3,2,0)="This field reports the data in the sixth occurrence of the array."
^IBA(364.7,1332,0)="1632^N^5^^^^N"
^IBA(364.7,1332,1)="K IBXDATA I $G(IBXSAVE(""CC"",7))'="""" S IBXDATA=IBXSAVE(""CC"",7) K IBXSAVE(""CC"",7)"
^IBA(364.7,1332,3,0)="^^2^2^3061113^"
^IBA(364.7,1332,3,1,0)="Data element relies on the data in array IBXSAVE(""CC"") extracted previously."
^IBA(364.7,1332,3,2,0)="This field reports the data in the seventh occurrence of the array."
^IBA(364.7,1333,0)="1633^N^5^^^^N"
^IBA(364.7,1333,1)="K IBXDATA I $G(IBXSAVE(""CC"",8))'="""" S IBXDATA=IBXSAVE(""CC"",8) K IBXSAVE(""CC"",8)"
^IBA(364.7,1333,3,0)="^^2^2^3061113^"
^IBA(364.7,1333,3,1,0)="Data element relies on the data in array IBXSAVE(""CC"") extracted previously."
^IBA(364.7,1333,3,2,0)="This field reports the data in the eighth occurrence of the array."
^IBA(364.7,1334,0)="1634^N^5^^^^N"
^IBA(364.7,1334,1)="K IBXDATA I $G(IBXSAVE(""CC"",9))'="""" S IBXDATA=IBXSAVE(""CC"",9) K IBXSAVE(""CC"",9)"
^IBA(364.7,1334,3,0)="^^2^2^3061113^"
^IBA(364.7,1334,3,1,0)="Data element relies on the data in array IBXSAVE(""CC"") extracted previously."
^IBA(364.7,1334,3,2,0)="This field reports the data in the ninth occurance of the array."
^IBA(364.7,1335,0)="1635^N^5^^^^N"
^IBA(364.7,1335,1)="K IBXDATA I $G(IBXSAVE(""CC"",10))'="""" S IBXDATA=IBXSAVE(""CC"",10) K IBXSAVE(""CC"",10)"
^IBA(364.7,1335,3,0)="^^2^2^3061113^"
^IBA(364.7,1335,3,1,0)="Data element relies on the data in array IBXSAVE(""CC"") extracted previously."
^IBA(364.7,1335,3,2,0)="This field reports the data in the tenth occurance of the array."
^IBA(364.7,1336,0)="1636^N^5^^^^N"
^IBA(364.7,1336,1)="S:$G(IBXSAVE(""CC"",11))'="""" IBXDATA=IBXSAVE(""CC"",11) K IBXSAVE(""CC"",11) S Z=0 F  S Z=$O(IBXSAVE(""CC"",Z)) Q:'Z  D XCC^IBCEF3(IBXSAVE(""CC"",Z),Z)"
^IBA(364.7,1336,3,0)="^364.73^4^4^3061113^^^^"
^IBA(364.7,1336,3,1,0)="Data element relies on the data in array IBXSAVE(""CC"") extracted previously."
^IBA(364.7,1336,3,2,0)="This field reports the data in the eleventh occurrence of the array."
^IBA(364.7,1336,3,3,0)="If there are more than 11 condition codes present, save them in the global"
^IBA(364.7,1336,3,4,0)="overflow array."
^IBA(364.7,1337,0)="1637^N^88^^^^N"
^IBA(364.7,1337,1)="S:$G(IBXDATA)'="""" IBXDATA=$$STATE^IBCEFG1($P(IBXDATA,U,2))"
^IBA(364.7,1337,3,0)="^^1^1^3061113^"
^IBA(364.7,1337,3,1,0)="2 char state abbreviation where the accident occured."
^IBA(364.7,1338,0)="1638^N^5^^^^N"
^IBA(364.7,1338,1)="K IBXDATA"
^IBA(364.7,1338,3,0)="^^3^3^3061120^"
^IBA(364.7,1338,3,1,0)="FL-30"
^IBA(364.7,1338,3,2,0)="Reserved for assignment by the NUBC.  Not used.  11 positions upper "
^IBA(364.7,1338,3,3,0)="line.  13 positions lower line."
^IBA(364.7,1339,0)="1639^N^5^^^^N"
^IBA(364.7,1339,1)="N IBZ S (IBZ,IBXDATA)="""" D F^IBCEF(""N-ORGANIZATION NPI CODES"",""IBZ"",,IBXIEN) S IBXDATA=$P(IBZ,U,3),IBXSAVE(""NPIBILL"")=IBXDATA"
^IBA(364.7,1339,3,0)="^^1^1^3061116^"
^IBA(364.7,1339,3,1,0)="NPI - Billing Provider."
^IBA(364.7,1340,0)="1640^N^194^^^^N"
^IBA(364.7,1340,1)="N Z,Z0 M Z0=IBXDATA K IBXDATA S Z="""" F  S Z=$O(Z0(Z)) Q:'Z  I $D(^DGCR(399,IBXIEN,""I""_Z)) S IBXDATA(Z)=$S(Z<3&$$WNRBILL^IBEFUNC(IBXIEN,Z):""MEDICARE"",1:$P(Z0(Z),U))"
^IBA(364.7,1340,3,0)="^364.73^4^4^3061116^^^^"
^IBA(364.7,1340,3,1,0)="The first 15 characters of the name of the primary, secondary, and tertiary"
^IBA(364.7,1340,3,2,0)="insurance companies along with the claim office number and payer id, if"
^IBA(364.7,1340,3,3,0)="known.  If the primary or secondary insurance is MEDICARE WNR, output"
^IBA(364.7,1340,3,4,0)="'MEDICARE'."
^IBA(364.7,1341,0)="1641^N^5^^^^N"
^IBA(364.7,1341,1)="K IBXDATA"
^IBA(364.7,1341,3,0)="^364.73^1^1^3061128^^^^"
^IBA(364.7,1341,3,1,0)="Field reserved to contain National Plan ID. Currently blank."
^IBA(364.7,1342,0)="1642^N^23^^^^N"
^IBA(364.7,1342,1)="N Z,Z0 S Z0=$S(IBXDATA&'$P($G(^DGCR(399,IBXIEN,""U"")),U,7):""I"",1:""Y"") F Z=1:1:3 I $S(Z=1:1,1:$D(^DGCR(399,IBXIEN,""I""_Z))) S IBXDATA(Z)=Z0"
^IBA(364.7,1342,3,0)="^364.73^2^2^3061116^^^^"
^IBA(364.7,1342,3,1,0)="For each insurance on file in the bill, print the ROI indicator = 'I' if"
^IBA(364.7,1342,3,2,0)="the record is sensitive and there's no ROI on file, or 'Y' otherwise."
^IBA(364.7,1343,0)="1643^N^24^^^^N"
^IBA(364.7,1343,1)="N Z,Z0 S Z0=$S(IBXDATA=""""!(""Nn0""'[IBXDATA):""Y"",1:""N"") F Z=1:1:3 I $S(Z=1:1,1:$D(^DGCR(399,IBXIEN,""I""_Z))) S IBXDATA(Z)=Z0"
^IBA(364.7,1343,3,0)="^364.73^3^3^3061116^^^^"
^IBA(364.7,1343,3,1,0)="For each insurance on file in the bill, print the ASSIGNMENT OF BENEFITS"
^IBA(364.7,1343,3,2,0)="indicator = 'Y' if the data element value returned is null or is not 0,'n'"
^IBA(364.7,1343,3,3,0)="or 'N', otherwise print 'N'."
^IBA(364.7,1344,0)="1644^N^156^^^^N"
^IBA(364.7,1344,1)="N Z F Z=1:1:3 K:'$D(^DGCR(399,IBXIEN,""I""_Z)) IBXDATA(Z) I $D(IBXDATA(Z)) S IBXDATA(Z)=$$DOL^IBCEF77(IBXDATA(Z),10)"
^IBA(364.7,1344,3,0)="^364.73^2^2^3061116^^^^"
^IBA(364.7,1344,3,1,0)="If the insurance company for the prior payment does not exist for the bill,"
^IBA(364.7,1344,3,2,0)="don't output the prior payment information."
^IBA(364.7,1345,0)="1645^N^152^^^^N"
^IBA(364.7,1345,1)="N Z,Z0,IBZ S IBZ=$G(IBXDATA) K IBXDATA S Z0=$$COBN^IBCEF(IBXIEN),IBXDATA(Z0)=$$DOL^IBCEF77(+IBZ,11) F Z=1:1:3 I Z'=Z0,$D(^DGCR(399,IBXIEN,""I""_Z)) S IBXDATA(Z)=$$DOL^IBCEF77(0,11)"
^IBA(364.7,1345,3,0)="^364.73^2^2^3061116^^^^"
^IBA(364.7,1345,3,1,0)="Set the estimated amt for the current insurance equal to the balance on the"
^IBA(364.7,1345,3,2,0)="bill."
^IBA(364.7,1346,0)="1646^N^5^^^^N"
^IBA(364.7,1346,1)="I $D(IBXSAVE(""DX"",2)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(""DX"",2),0)),U)"
^IBA(364.7,1346,3,0)="^364.73^1^1^3061121^^^^"
^IBA(364.7,1346,3,1,0)="If there is a second diagnosis, print its name."
^IBA(364.7,1347,0)="1647^N^5^^^^N"
^IBA(364.7,1347,1)="I $D(IBXSAVE(""DX"",3)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(""DX"",3),0)),U)"
^IBA(364.7,1347,3,0)="^364.73^1^1^3061121^^^^"
^IBA(364.7,1347,3,1,0)="If there is a third diagnosis, print its name."
^IBA(364.7,1348,0)="1648^N^5^^^^N"
^IBA(364.7,1348,1)="I $D(IBXSAVE(""DX"",4)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(""DX"",4),0)),U)"
^IBA(364.7,1348,3,0)="^364.73^1^1^3061121^^^^"
^IBA(364.7,1348,3,1,0)="If there is a fourth diagnosis, print its name."
^IBA(364.7,1349,0)="1649^N^5^^^^N"
^IBA(364.7,1349,1)="I $D(IBXSAVE(""DX"",5)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(""DX"",5),0)),U)"
^IBA(364.7,1349,3,0)="^364.73^1^1^3061121^^^^"
^IBA(364.7,1349,3,1,0)="If there is a fifth diagnosis, print its name."
^IBA(364.7,1350,0)="1650^N^5^^^^N"
^IBA(364.7,1350,1)="I $D(IBXSAVE(""DX"",6)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(""DX"",6),0)),U)"
^IBA(364.7,1350,3,0)="^364.73^1^1^3061121^^^^"
^IBA(364.7,1350,3,1,0)="If there is a sixth diagnosis, print its name."
^IBA(364.7,1351,0)="1651^N^5^^^^N"
^IBA(364.7,1351,1)="I $D(IBXSAVE(""DX"",7)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(""DX"",7),0)),U)"
^IBA(364.7,1351,3,0)="^364.73^1^1^3061121^^^^"
^IBA(364.7,1351,3,1,0)="If there is a seventh diagnosis, print its name."
^IBA(364.7,1352,0)="1652^N^5^^^^N"
^IBA(364.7,1352,1)="I $D(IBXSAVE(""DX"",8)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(""DX"",8),0)),U)"
^IBA(364.7,1352,3,0)="^364.73^1^1^3061121^^^^"
^IBA(364.7,1352,3,1,0)="If there is an eighth diagnosis, print its name."
^IBA(364.7,1353,0)="1653^N^5^^^^N"
^IBA(364.7,1353,1)="I $D(IBXSAVE(""DX"",9)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(""DX"",9),0)),U)"
^IBA(364.7,1353,3,0)="^364.73^1^1^3061121^^"
^IBA(364.7,1353,3,1,0)="If there is a ninth diagnosis, print its name."
^IBA(364.7,1354,0)="1654^N^5^^^^N"
^IBA(364.7,1354,1)="I $D(IBXSAVE(""DX"",10)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(""DX"",10),0)),U)"
^IBA(364.7,1354,3,0)="^364.73^1^1^3061121^^"
^IBA(364.7,1354,3,1,0)="If there is a tenth diagnosis, print its name."
^IBA(364.7,1355,0)="1655^N^5^^^^N"
^IBA(364.7,1355,1)="I $D(IBXSAVE(""DX"",14)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(""DX"",14),0)),U)"
^IBA(364.7,1355,3,0)="^^1^1^3061117^"
^IBA(364.7,1355,3,1,0)="If there is a fourteenth diagnosis, print its name."
^IBA(364.7,1356,0)="1656^N^5^^^^N"
^IBA(364.7,1356,1)="I $D(IBXSAVE(""DX"",15)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(""DX"",15),0)),U)"
^IBA(364.7,1356,3,0)="^^1^1^3061117^"
^IBA(364.7,1356,3,1,0)="If there is a fifteenth diagnosis, print its name."
^IBA(364.7,1357,0)="1657^N^5^^^^N"
^IBA(364.7,1357,1)="I $D(IBXSAVE(""DX"",16)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(""DX"",16),0)),U)"
^IBA(364.7,1357,3,0)="^364.73^1^1^3061126^^"
^IBA(364.7,1357,3,1,0)="If there is a sixteenth diagnosis, print its name."
^IBA(364.7,1358,0)="1658^N^5^^^^N"
^IBA(364.7,1358,1)="I $D(IBXSAVE(""DX"",17)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(""DX"",17),0)),U)"
^IBA(364.7,1358,3,0)="^^1^1^3061117^"
^IBA(364.7,1358,3,1,0)="If there is a seventeenth diagnosis, print its name."
^IBA(364.7,1359,0)="1659^N^5^^^^N"
^IBA(364.7,1359,1)="I $D(IBXSAVE(""DX"",18)) S IBXDATA=$P($G(^ICD9(+IBXSAVE(""DX"",18),0)),U)"
^IBA(364.7,1359,3,0)="^364.73^2^2^3061117^^^"
^IBA(364.7,1359,3,1,0)="If there is a eighteenth diagnosis, print its name.  Check for more than "
^IBA(364.7,1359,3,2,0)="17 other diagnoses on file. If there is, output on new pg."
^IBA(364.7,1360,0)="1660^N^195^^^^N"
^IBA(364.7,1360,1)="K:'$$PRTLID^IBCEF77(IBXIEN,$G(IBXSAVE(""NPIBILL""))) IBXDATA K IBXSAVE(""NPIBILL"")"
^IBA(364.7,1361,0)="1661^N^196^^^^N"
^IBA(364.7,1361,1)="N Z F Z=1:1:3 I $G(IBXDATA(Z))'="""",IBXDATA(Z)'["","" S Q=$$NAME^IBCEFG1(IBXDATA(Z),1),IBXDATA(Z)=$P(Q,U)_$S($P(Q,U,2)'="""":"",""_$P(Q,U,2),1:"""")"
^IBA(364.7,1362,0)="1662^N^197^^^^N"
^IBA(364.7,1363,0)="1663^N^198^^^^N"
^IBA(364.7,1364,0)="1664^N^199^^^^N"
^IBA(364.7,1364,1)="N Z,Z0 S Z0=$$COBN^IBCEF(IBXIEN) F Z=1:1:3 S IBXDATA(Z)=$G(IBXDATA(Z))_"" "" I $D(^DGCR(399,IBXIEN,""I""_Z)),$$WNRBILL^IBEFUNC(IBXIEN,Z) S IBXDATA(Z)="""""
^IBA(364.7,1364,3,0)="^364.73^3^3^3061117^^^^"
^IBA(364.7,1364,3,1,0)="If the insurance is MEDICARE WNR, do not output the group name."
^IBA(364.7,1364,3,2,0)="Add a space to the end of the Group Name to separate it from"
^IBA(364.7,1364,3,3,0)="the next field , Group Number."
^IBA(364.7,1365,0)="1665^N^200^^^^N"
^IBA(364.7,1365,1)="N Z,Z0 S Z0=$$COBN^IBCEF(IBXIEN) F Z=1:1:3 I $D(^DGCR(399,IBXIEN,""I""_Z)),Z0=Z,$$WNRBILL^IBEFUNC(IBXIEN,Z) S IBXDATA(Z)="""""
^IBA(364.7,1365,3,0)="^364.73^1^1^3061117^^^^"
^IBA(364.7,1365,3,1,0)="If the insurance is MEDICARE WNR, do not output the group number."
^IBA(364.7,1366,0)="1666^N^265^^^^N"
^IBA(364.7,1367,0)="1667^N^5^^^^N"
^IBA(364.7,1367,1)="N Z,Z0 S Z0=$P($G(^DGCR(399,IBXIEN,""UF3"")),U,4,6) K IBXDATA F Z=1,2,3 S IBXDATA(Z)=$P(Z0,U,Z)"
^IBA(364.7,1367,3,0)="^^1^1^3061117^"
^IBA(364.7,1367,3,1,0)="Document control numbers from file 399/fields 453-455."
^IBA(364.7,1368,0)="1668^N^5^^^^N"
^IBA(364.7,1368,1)="N Z,IBZ D:'$D(IBXSAVE(""OIEMP"")) F^IBCEF(""N-ALL INSURED EMPLOYER INFO"",""IBZ"",,IBXIEN) K IBXDATA M:$O(IBZ("""")) IBXSAVE(""OIEMP"")=IBZ F Z=1:1:3 I $D(IBXSAVE(""OIEMP"",Z)) S IBXDATA(Z)=$P(IBXSAVE(""OIEMP"",Z),U)"
^IBA(364.7,1368,3,0)="^364.73^3^3^3061117^^^^"
^IBA(364.7,1368,3,1,0)="If the array IBXSAVE(""OIEMP"") doesn't already exist, extract it.  For each"
^IBA(364.7,1368,3,2,0)="insured on the bill, extract the first piece of the data element for output"
^IBA(364.7,1368,3,3,0)="in this field."
^IBA(364.7,1369,0)="1669^N^5^^^^N"
^IBA(364.7,1369,1)="K IBXDATA"
^IBA(364.7,1369,3,0)="^^3^3^3061120^"
^IBA(364.7,1369,3,1,0)="FL-30"
^IBA(364.7,1369,3,2,0)="Reserved for assignment by the NUBC.  Not used.  11 positions upper "
^IBA(364.7,1369,3,3,0)="line.  13 positions lower line."
^IBA(364.7,1370,0)="1670^N^85^^^^N"
^IBA(364.7,1371,0)="1671^N^253^^^^N"
^IBA(364.7,1371,3,0)="^364.73^3^3^3061125^^^^"
^IBA(364.7,1371,3,1,0)="This data element relies on the existence of the array containing the"
^IBA(364.7,1371,3,2,0)="diagnoses for the bill, previously extracted.  This data will be output if"
^IBA(364.7,1371,3,3,0)="it is the first 'E-code' dx found."
^IBA(364.7,1372,0)="1672^N^5^^^^N"
^IBA(364.7,1372,1)="K IBXDATA I $D(IBXSAVE(""PROC"",1)) S IBXDATA=$P(IBXSAVE(""PROC"",1),U,2) K IBXSAVE(""PROC"",1)"
^IBA(364.7,1372,3,0)="^364.73^3^3^3061120^^^^"
^IBA(364.7,1372,3,1,0)="This data element relies on the existence of the IBXSAVE(""PROC"") array"
^IBA(364.7,1372,3,2,0)="previously extracted.  If the first occurrence exists, output the date"
^IBA(364.7,1372,3,3,0)="found in its second '^' piece."
^IBA(364.7,1373,0)="1673^N^5^^^^N"
^IBA(364.7,1373,1)="K IBXDATA I $D(IBXSAVE(""PROC"",2)) S IBXDATA=$P(IBXSAVE(""PROC"",2),U),IBXDATA=$S(IBXDATA[""ICD0""!(IBXDATA[""ICPT""):$P($$PRCD^IBCEF1(IBXDATA),U),1:IBXDATA)"
^IBA(364.7,1373,3,0)="^364.73^3^3^3061120^^^^"
^IBA(364.7,1373,3,1,0)="This data element relies on the existence of the IBXSAVE(""PROC"") array"
^IBA(364.7,1373,3,2,0)="previously extracted.  If the second occurrence exists, output the code"
^IBA(364.7,1373,3,3,0)="referenced by its first '^' piece."
^IBA(364.7,1374,0)="1674^N^5^^^^N"
^IBA(364.7,1374,1)="K IBXDATA I $D(IBXSAVE(""PROC"",2)) S IBXDATA=$P(IBXSAVE(""PROC"",2),U,2) K IBXSAVE(""PROC"",2)"
^IBA(364.7,1374,3,0)="^364.73^3^3^3061120^^^^"
^IBA(364.7,1374,3,1,0)="This data element relies on the existence of the IBXSAVE(""PROC"") array"
^IBA(364.7,1374,3,2,0)="previously extracted.  If the second occurrence exists, output the date"
^IBA(364.7,1374,3,3,0)="found in its second '^' piece."
^IBA(364.7,1375,0)="1675^N^5^^^^N"
^IBA(364.7,1375,1)="K IBXDATA I $D(IBXSAVE(""PROC"",3)) S IBXDATA=$P(IBXSAVE(""PROC"",3),U),IBXDATA=$S(IBXDATA[""ICD0""!(IBXDATA[""ICPT""):$P($$PRCD^IBCEF1(IBXDATA),U),1:IBXDATA)"
^IBA(364.7,1375,3,0)="^364.73^3^3^3061120^^^^"
^IBA(364.7,1375,3,1,0)="This data element relies on the existence of the IBXSAVE(""PROC"") array"
^IBA(364.7,1375,3,2,0)="previously extracted.  If the third occurrence exists, output the code"
^IBA(364.7,1375,3,3,0)="referenced by its first '^' piece."
^IBA(364.7,1376,0)="1676^N^5^^^^N"
^IBA(364.7,1376,1)="K IBXDATA I $D(IBXSAVE(""PROC"",3)) S IBXDATA=$P(IBXSAVE(""PROC"",3),U,2) K IBXSAVE(""PROC"",3)"
^IBA(364.7,1376,3,0)="^364.73^3^3^3061120^^^^"
^IBA(364.7,1376,3,1,0)="This data element relies on the existence of the IBXSAVE(""PROC"") array"
^IBA(364.7,1376,3,2,0)="previously extracted.  If the third occurrence exists, output the date"
^IBA(364.7,1376,3,3,0)="found in its second '^' piece."
^IBA(364.7,1377,0)="1677^N^5^^^^N"
^IBA(364.7,1377,1)="K IBXDATA I $D(IBXSAVE(""PROC"",4)) S IBXDATA=$P(IBXSAVE(""PROC"",4),U),IBXDATA=$S(IBXDATA[""ICD0""!(IBXDATA[""ICPT""):$P($$PRCD^IBCEF1(IBXDATA),U),1:IBXDATA)"
^IBA(364.7,1377,3,0)="^364.73^3^3^3061120^^^^"
^IBA(364.7,1377,3,1,0)="This data element relies on the existence of the IBXSAVE(""PROC"") array"
^IBA(364.7,1377,3,2,0)="previously extracted.  If the fourth occurrence exists, output the code"
^IBA(364.7,1377,3,3,0)="referenced by its first '^' piece."
^IBA(364.7,1378,0)="1678^N^5^^^^N"
^IBA(364.7,1378,1)="K IBXDATA I $D(IBXSAVE(""PROC"",4)) S IBXDATA=$P(IBXSAVE(""PROC"",4),U,2) K IBXSAVE(""PROC"",4)"
^IBA(364.7,1378,3,0)="^364.73^3^3^3061120^^^^"
^IBA(364.7,1378,3,1,0)="This data element relies on the existence of the IBXSAVE(""PROC"") array"
^IBA(364.7,1378,3,2,0)="previously extracted.  If the fourth occurrence exists, output the date"
^IBA(364.7,1378,3,3,0)="found in its second '^' piece."
^IBA(364.7,1379,0)="1679^N^5^^^^N"
^IBA(364.7,1379,1)="K IBXDATA I $D(IBXSAVE(""PROC"",5)) S IBXDATA=$P(IBXSAVE(""PROC"",5),U),IBXDATA=$S(IBXDATA[""ICD0""!(IBXDATA[""ICPT""):$P($$PRCD^IBCEF1(IBXDATA),U),1:IBXDATA)"
^IBA(364.7,1379,3,0)="^364.73^3^3^3061120^^^^"
^IBA(364.7,1379,3,1,0)="This data element relies on the existence of the IBXSAVE(""PROC"") array"
^IBA(364.7,1379,3,2,0)="previously extracted.  If the fifth occurrence exists, output the code"
^IBA(364.7,1379,3,3,0)="referenced by its first '^' piece."
^IBA(364.7,1380,0)="1680^N^5^^^^N"
^IBA(364.7,1380,1)="K IBXDATA I $D(IBXSAVE(""PROC"",5)) S IBXDATA=$P(IBXSAVE(""PROC"",5),U,2) K IBXSAVE(""PROC"",5)"
^IBA(364.7,1380,3,0)="^364.73^3^3^3061120^^^^"
^IBA(364.7,1380,3,1,0)="This data element relies on the existence of the IBXSAVE(""PROC"") array"
^IBA(364.7,1380,3,2,0)="previously extracted.  If the fifth occurrence exists, output the date"
^IBA(364.7,1380,3,3,0)="found in its second '^' piece."
^IBA(364.7,1381,0)="1681^N^5^^^^N"
^IBA(364.7,1381,1)="K IBXDATA I $D(IBXSAVE(""PROC"",6)) S IBXDATA=$P(IBXSAVE(""PROC"",6),U),IBXDATA=$S(IBXDATA[""ICD0""!(IBXDATA[""ICPT""):$P($$PRCD^IBCEF1(IBXDATA),U),1:IBXDATA)"
^IBA(364.7,1381,3,0)="^364.73^3^3^3061120^^^^"
^IBA(364.7,1381,3,1,0)="This data element relies on the existence of the IBXSAVE(""PROC"") array"
^IBA(364.7,1381,3,2,0)="previously extracted.  If the sixth occurrence exists, output the code"
^IBA(364.7,1381,3,3,0)="referenced by its first '^' piece."
^IBA(364.7,1382,0)="1682^N^5^^^^N"
^IBA(364.7,1382,1)="N Z,Q,R S:$D(IBXSAVE(""PROC"",6)) IBXDATA=$P(IBXSAVE(""PROC"",6),U,2) S Z=6 F  S Z=$O(IBXSAVE(""PROC"",Z)) Q:'Z  S R=IBXSAVE(""PROC"",Z),Q=$P(R,U,2) D XPROC^IBCEF3($S(R[""ICPT""!(R[""ICD0""):$P($$PRCD^IBCEF1(R),U),1:$P(R,U))_U_Q,Z)"
^IBA(364.7,1382,3,0)="^364.73^3^3^3061120^^^^"
^IBA(364.7,1382,3,1,0)="This data element relies on the existence of the IBXSAVE(""PROC"") array"
^IBA(364.7,1382,3,2,0)="previously extracted.  If the sixth occurrence exists, output the date"
^IBA(364.7,1382,3,3,0)="found in its second '^' piece."
^IBA(364.7,1383,0)="1683^N^5^^^^N"
^IBA(364.7,1383,1)="I $D(IBXSAVE(""DX"",1)) K IBXSAVE(""DX"",1) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):""U"",1:"" "")"
^IBA(364.7,1383,3,0)="^^3^3^3061121^"
^IBA(364.7,1383,3,1,0)="This is the present on admissions indicator.  Since this information is "
^IBA(364.7,1383,3,2,0)="not currently captured, the value ""U"" (No Information in the Record) is "
^IBA(364.7,1383,3,3,0)="sent for INPATIENT claims."
^IBA(364.7,1384,0)="1684^N^5^^^^N"
^IBA(364.7,1384,1)="I $D(IBXSAVE(""DX"",2)) K IBXSAVE(""DX"",2) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):""U"",1:"" "")"
^IBA(364.7,1384,3,0)="^^3^3^3061121^"
^IBA(364.7,1384,3,1,0)="This is the present on admissions indicator.  Since this information is"
^IBA(364.7,1384,3,2,0)="not currently captured, the value ""U"" (No Information in the Record) is"
^IBA(364.7,1384,3,3,0)="sent for INPATIENT claims."
^IBA(364.7,1385,0)="1685^N^5^^^^N"
^IBA(364.7,1385,1)="I $D(IBXSAVE(""DX"",3)) K IBXSAVE(""DX"",3) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):""U"",1:"" "")"
^IBA(364.7,1385,3,0)="^^3^3^3061121^"
^IBA(364.7,1385,3,1,0)="This is the present on admissions indicator.  Since this information is"
^IBA(364.7,1385,3,2,0)="not currently captured, the value ""U"" (No Information in the Record) is"
^IBA(364.7,1385,3,3,0)="sent for INPATIENT claims."
^IBA(364.7,1386,0)="1686^N^5^^^^N"
^IBA(364.7,1386,1)="I $D(IBXSAVE(""DX"",4)) K IBXSAVE(""DX"",4) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):""U"",1:"" "")"
^IBA(364.7,1386,3,0)="^^3^3^3061121^"
^IBA(364.7,1386,3,1,0)="This is the present on admissions indicator.  Since this information is"
^IBA(364.7,1386,3,2,0)="not currently captured, the value ""U"" (No Information in the Record) is"
^IBA(364.7,1386,3,3,0)="sent for INPATIENT claims."
^IBA(364.7,1387,0)="1687^N^5^^^^N"
^IBA(364.7,1387,1)="I $D(IBXSAVE(""DX"",5)) K IBXSAVE(""DX"",5) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):""U"",1:"" "")"
^IBA(364.7,1387,3,0)="^^3^3^3061121^"
^IBA(364.7,1387,3,1,0)="This is the present on admissions indicator.  Since this information is"
^IBA(364.7,1387,3,2,0)="not currently captured, the value ""U"" (No Information in the Record) is"
^IBA(364.7,1387,3,3,0)="sent for INPATIENT claims."
^IBA(364.7,1388,0)="1688^N^5^^^^N"
^IBA(364.7,1388,1)="I $D(IBXSAVE(""DX"",6)) K IBXSAVE(""DX"",6) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):""U"",1:"" "")"
^IBA(364.7,1388,3,0)="^^3^3^3061121^"
^IBA(364.7,1388,3,1,0)="This is the present on admissions indicator.  Since this information is"
^IBA(364.7,1388,3,2,0)="not currently captured, the value ""U"" (No Information in the Record) is"
^IBA(364.7,1388,3,3,0)="sent for INPATIENT claims."
^IBA(364.7,1389,0)="1689^N^5^^^^N"
^IBA(364.7,1389,1)="I $D(IBXSAVE(""DX"",7)) K IBXSAVE(""DX"",7) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):""U"",1:"" "")"
^IBA(364.7,1389,3,0)="^^3^3^3061121^"
^IBA(364.7,1389,3,1,0)="This is the present on admissions indicator.  Since this information is"
^IBA(364.7,1389,3,2,0)="not currently captured, the value ""U"" (No Information in the Record) is"
^IBA(364.7,1389,3,3,0)="sent for INPATIENT claims."
^IBA(364.7,1390,0)="1690^N^5^^^^N"
^IBA(364.7,1390,1)="I $D(IBXSAVE(""DX"",8)) K IBXSAVE(""DX"",8) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):""U"",1:"" "")"
^IBA(364.7,1390,3,0)="^^3^3^3061121^"
^IBA(364.7,1390,3,1,0)="This is the present on admissions indicator.  Since this information is"
^IBA(364.7,1390,3,2,0)="not currently captured, the value ""U"" (No Information in the Record) is"
^IBA(364.7,1390,3,3,0)="sent for INPATIENT claims."
^IBA(364.7,1391,0)="1691^N^5^^^^N"
^IBA(364.7,1391,1)="I $D(IBXSAVE(""DX"",9)) K IBXSAVE(""DX"",9) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):""U"",1:"" "")"
^IBA(364.7,1391,3,0)="^^3^3^3061121^"
^IBA(364.7,1391,3,1,0)="This is the present on admissions indicator.  Since this information is"
^IBA(364.7,1391,3,2,0)="not currently captured, the value ""U"" (No Information in the Record) is"
^IBA(364.7,1391,3,3,0)="sent for INPATIENT claims."
^IBA(364.7,1392,0)="1692^N^5^^^^N"
^IBA(364.7,1392,1)="I $D(IBXSAVE(""DX"",10)) K IBXSAVE(""DX"",10) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):""U"",1:"" "")"
^IBA(364.7,1392,3,0)="^^3^3^3061121^"
^IBA(364.7,1392,3,1,0)="This is the present on admissions indicator.  Since this information is"
^IBA(364.7,1392,3,2,0)="not currently captured, the value ""U"" (No Information in the Record) is"
^IBA(364.7,1392,3,3,0)="sent for INPATIENT claims."
^IBA(364.7,1393,0)="1693^N^5^^^^N"
^IBA(364.7,1393,1)="I $D(IBXSAVE(""DX"",11)) K IBXSAVE(""DX"",11) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):""U"",1:"" "")"
^IBA(364.7,1393,3,0)="^^3^3^3061121^"
^IBA(364.7,1393,3,1,0)="This is the present on admissions indicator.  Since this information is"
^IBA(364.7,1393,3,2,0)="not currently captured, the value ""U"" (No Information in the Record) is"
^IBA(364.7,1393,3,3,0)="sent for INPATIENT claims."
^IBA(364.7,1394,0)="1694^N^5^^^^N"
^IBA(364.7,1394,1)="I $D(IBXSAVE(""DX"",12)) K IBXSAVE(""DX"",12) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):""U"",1:"" "")"
^IBA(364.7,1394,3,0)="^^3^3^3061121^"
^IBA(364.7,1394,3,1,0)="This is the present on admissions indicator.  Since this information is"
^IBA(364.7,1394,3,2,0)="not currently captured, the value ""U"" (No Information in the Record) is"
^IBA(364.7,1394,3,3,0)="sent for INPATIENT claims."
^IBA(364.7,1395,0)="1695^N^5^^^^N"
^IBA(364.7,1395,1)="I $D(IBXSAVE(""DX"",13)) K IBXSAVE(""DX"",13) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):""U"",1:"" "")"
^IBA(364.7,1395,3,0)="^^3^3^3061121^"
^IBA(364.7,1395,3,1,0)="This is the present on admissions indicator.  Since this information is"
^IBA(364.7,1395,3,2,0)="not currently captured, the value ""U"" (No Information in the Record) is"
^IBA(364.7,1395,3,3,0)="sent for INPATIENT claims."
^IBA(364.7,1396,0)="1696^N^5^^^^N"
^IBA(364.7,1396,1)="I $D(IBXSAVE(""DX"",14)) K IBXSAVE(""DX"",14) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):""U"",1:"" "")"
^IBA(364.7,1396,3,0)="^^3^3^3061121^"
^IBA(364.7,1396,3,1,0)="This is the present on admissions indicator.  Since this information is"
^IBA(364.7,1396,3,2,0)="not currently captured, the value ""U"" (No Information in the Record) is"
^IBA(364.7,1396,3,3,0)="sent for INPATIENT claims."
^IBA(364.7,1397,0)="1697^N^5^^^^N"
^IBA(364.7,1397,1)="I $D(IBXSAVE(""DX"",15)) K IBXSAVE(""DX"",15) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):""U"",1:"" "")"
^IBA(364.7,1397,3,0)="^^3^3^3061121^"
^IBA(364.7,1397,3,1,0)="This is the present on admissions indicator.  Since this information is"
^IBA(364.7,1397,3,2,0)="not currently captured, the value ""U"" (No Information in the Record) is"
^IBA(364.7,1397,3,3,0)="sent for INPATIENT claims."
^IBA(364.7,1398,0)="1698^N^5^^^^N"
^IBA(364.7,1398,1)="I $D(IBXSAVE(""DX"",16)) K IBXSAVE(""DX"",16) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):""U"",1:"" "")"
^IBA(364.7,1398,3,0)="^^3^3^3061121^"
^IBA(364.7,1398,3,1,0)="This is the present on admissions indicator.  Since this information is"
^IBA(364.7,1398,3,2,0)="not currently captured, the value ""U"" (No Information in the Record) is"
^IBA(364.7,1398,3,3,0)="sent for INPATIENT claims."
^IBA(364.7,1399,0)="1699^N^5^^^^N"
^IBA(364.7,1399,1)="I $D(IBXSAVE(""DX"",17)) K IBXSAVE(""DX"",17) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):""U"",1:"" "")"
^IBA(364.7,1399,3,0)="^^3^3^3061121^"
^IBA(364.7,1399,3,1,0)="This is the present on admissions indicator.  Since this information is"
^IBA(364.7,1399,3,2,0)="not currently captured, the value ""U"" (No Information in the Record) is"
^IBA(364.7,1399,3,3,0)="sent for INPATIENT claims."
^IBA(364.7,1400,0)="1700^N^5^^^^N"
^IBA(364.7,1400,1)="I $D(IBXSAVE(""DX"",18)) K IBXSAVE(""DX"",18) S IBXDATA=$S($$INPAT^IBCEF(IBXIEN):""U"",1:"" "")"
^IBA(364.7,1400,3,0)="^^3^3^3061121^"
^IBA(364.7,1400,3,1,0)="This is the present on admissions indicator.  Since this information is"
^IBA(364.7,1400,3,2,0)="not currently captured, the value ""U"" (No Information in the Record) is"
^IBA(364.7,1400,3,3,0)="sent for INPATIENT claims."
^IBA(364.7,1401,0)="1701^N^5^^^^N"
^IBA(364.7,1401,1)="K IBXDATA"
^IBA(364.7,1402,0)="1702^N^5^^^^N"
^IBA(364.7,1402,1)="K IBXDATA"
^IBA(364.7,1403,0)="1703^N^16^^^^N"
^IBA(364.7,1403,1)="N Z S Z="""" F  S Z=$O(IBXDATA(Z)) Q:'Z  S $P(IBXDATA(Z),U,2)=$$DATE^IBCF3($P(IBXDATA(Z),U,2)),IBXSAVE(""PROC"",Z)=IBXDATA(Z) K IBXDATA(Z)"
^IBA(364.7,1403,3,0)="^364.73^5^5^3061124^^^^"
^IBA(364.7,1403,3,1,0)="This is a group data element so more than one occurrence of IBXDATA(n) is"
^IBA(364.7,1403,3,2,0)="possible.  Save off the procedures in the IBXSAVE array.  Six procedures"
^IBA(364.7,1403,3,3,0)="will fit on a single page of a bill.  If more than 6 procedure codes are"
^IBA(364.7,1403,3,4,0)="on the bill, multiple pages are used.  The format of the IBXSAVE array is:"
^IBA(364.7,1403,3,5,0)="   the actual code for the ICD9 or ICD0 code^proc date formatted as MMDDYY"
^IBA(364.7,1404,0)="1704^N^193^^^^N"
^IBA(364.7,1405,0)="1705^N^5^^^^N"
^IBA(364.7,1405,1)="N Z,Q,R F Z=1:1 Q:'$D(^TMP($J,""IBC-RC"",Z))  S R=^(Z),Q=$S(+R=1:$$FO^IBCNEUT1($P(R,U,2),4,""R"",0),+R=2:$E($P(R,U,2),1,5),1:"""") S:Z'>22 IBXDATA(Z)=Q D:Z>22 CKREV^IBCEF3(Z,Q)"
^IBA(364.7,1405,3,0)="^^11^11^3070125^"
^IBA(364.7,1405,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,1405,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,1405,3,3,0)="IBXSAVE(""REV"",n) extracted previously.  The first '^' piece of the array"
^IBA(364.7,1405,3,4,0)="indicates whether this is a 'normal' service data line (=1) or a text line"
^IBA(364.7,1405,3,5,0)="(=2 or =3).  For a normal service line, the data is found in the second '^'"
^IBA(364.7,1405,3,6,0)="piece of the array.  For text line where the first piece = 2, the text is"
^IBA(364.7,1405,3,7,0)="assumed to start in column 1, so the data is extracted from positions 1-5."
^IBA(364.7,1405,3,8,0)="For text line where the first piece = 3, the text is assumed to start in"
^IBA(364.7,1405,3,9,0)="column 6, so there is no data extracted for this field. Since only 22"
^IBA(364.7,1405,3,10,0)="lines of service line can appear on one form, if there are more than 22"
^IBA(364.7,1405,3,11,0)="lines, subsequent pages are forced for the remaining data lines after 22."
^IBA(364.7,1406,0)="1706^N^5^^^^N"
^IBA(364.7,1406,1)="N Z,Z0,Z1 F Z=1:1 Q:'$D(^TMP($J,""IBC-RC"",Z))  S Z1=^(Z),Z0=$S(+Z1=1:$E($P(Z1,U,3),1,24),+Z1=2:$E($P(Z1,U,2),6,30),1:$E($P(Z1,U,2),1,25)) S:Z'>22 IBXDATA(Z)=Z0 D:Z>22 CKREV^IBCEF3(Z,Z0)"
^IBA(364.7,1406,3,0)="^^12^12^3070125^"
^IBA(364.7,1406,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,1406,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,1406,3,3,0)="IBXSAVE(""REV"",n) extracted previously.  The first '^' piece of the array"
^IBA(364.7,1406,3,4,0)="indicates whether this is a 'normal' service data line (=1) or a text line"
^IBA(364.7,1406,3,5,0)="(=2 or =3).  For a normal service line, the data is found in the third '^'"
^IBA(364.7,1406,3,6,0)="piece of the array.  For text line where the first piece = 2, the text is"
^IBA(364.7,1406,3,7,0)="assumed TO start in column 1, so the data is extracted from positions "
^IBA(364.7,1406,3,8,0)="6-30. For text line where the first piece = 3, the text is assumed to"
^IBA(364.7,1406,3,9,0)="start in column 6, so the data for this field is extracted from positions"
^IBA(364.7,1406,3,10,0)="1-25. Since only 22 lines of service line can appear on one form, if there"
^IBA(364.7,1406,3,11,0)="are more than 22 lines, subsequent pages are forced for the remaining data"
^IBA(364.7,1406,3,12,0)="lines after 22."
^IBA(364.7,1407,0)="1707^N^5^^^^N"
^IBA(364.7,1407,1)="K IBXDATA"
^IBA(364.7,1407,3,0)="^^1^1^3061124^"
^IBA(364.7,1407,3,1,0)="This information is not captured"
^IBA(364.7,1408,0)="1708^N^5^^^^N"
^IBA(364.7,1408,1)="K IBXDATA"
^IBA(364.7,1408,3,0)="^^1^1^3061124^"
^IBA(364.7,1408,3,1,0)="This information is not captured"
^IBA(364.7,1409,0)="1709^N^5^^^^N"
^IBA(364.7,1409,1)="K IBXDATA"
^IBA(364.7,1409,3,0)="^^1^1^3061124^"
^IBA(364.7,1409,3,1,0)="This information is not captured"
^IBA(364.7,1410,0)="1710^N^5^^^^N"
^IBA(364.7,1410,1)="K IBXDATA"
^IBA(364.7,1410,3,0)="^^1^1^3061124^"
^IBA(364.7,1410,3,1,0)="VistA will not retrieve or print the PPS code at this time"
^IBA(364.7,1411,0)="1711^N^5^^^^N"
^IBA(364.7,1411,1)="S IBXDATA=$S('$$INPAT^IBCEF(IBXIEN):"" "",$D(IBXSAVE(""DX-E"")):""U"",1:"""") K IBXSAVE(""DX-E"")"
^IBA(364.7,1411,3,0)="^364.73^3^3^3070523^^^^"
^IBA(364.7,1411,3,1,0)="This is the present on admissions indicator.  Since this information is"
^IBA(364.7,1411,3,2,0)="not currently captured, the value ""U"" (No Information in the Record) is"
^IBA(364.7,1411,3,3,0)="sent for INPATIENT claims."
^IBA(364.7,1412,0)="1712^N^5^^^^N"
^IBA(364.7,1412,1)="K IBXDATA"
^IBA(364.7,1412,3,0)="^364.73^1^1^3061213^^^^"
^IBA(364.7,1412,3,1,0)="Only one per claim"
^IBA(364.7,1413,0)="1713^N^5^^^^N"
^IBA(364.7,1413,1)="K IBXDATA"
^IBA(364.7,1413,3,0)="^^1^1^3061125^"
^IBA(364.7,1413,3,1,0)="Only one per claim"
^IBA(364.7,1414,0)="1714^N^5^^^^N"
^IBA(364.7,1414,1)="K IBXDATA"
^IBA(364.7,1414,3,0)="^^1^1^3061125^"
^IBA(364.7,1414,3,1,0)="Only one per claim"
^IBA(364.7,1415,0)="1715^N^5^^^^N"
^IBA(364.7,1415,1)="K IBXDATA"
^IBA(364.7,1415,3,0)="^^1^1^3061125^"
^IBA(364.7,1415,3,1,0)="Only one per claim"
^IBA(364.7,1416,0)="1716^N^5^^^^N"
^IBA(364.7,1416,1)="K IBXDATA"
^IBA(364.7,1417,0)="1717^N^5^^^^N"
^IBA(364.7,1417,1)="N Z,Z0,D,T,T4,T5 F Z=1:1 Q:'$G(^TMP($J,""IBC-RC"",Z))  S D=^(Z),T=$P(D,U,2),T5=$P(D,U,5),T4=$P(D,U,4),Z0=$S(+D=2:$E(T,31,45),+D=3:$E(T,26,40),T4'=""""&(T>219):T4,T5'=""""&(T<220)&(T>1):$J(T5,7,2),1:"""") S:Z'>22 IBXDATA(Z)=Z0 D:Z>22 CKREV^IBCEF3(Z,Z0)"
^IBA(364.7,1417,3,0)="^364.73^12^12^3070125^^^"
^IBA(364.7,1417,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,1417,3,2,0)="might be expected.  It relies on the presence of data in global"
^IBA(364.7,1417,3,3,0)="^TMP($J,""IBC-RC"",n) extracted previously.  The first '^' piece of the array"
^IBA(364.7,1417,3,4,0)="indicates whether this is a 'normal' service data line (=1) or a text line"
^IBA(364.7,1417,3,5,0)="(=2 or =3).  For a normal service line, the data is found in the fourth"
^IBA(364.7,1417,3,6,0)="(procedure code and modifiers) or fifth (unit charge) '^' pieces of the"
^IBA(364.7,1417,3,7,0)="array. If there is a procedure and a unit charge, only the procedure code"
^IBA(364.7,1417,3,8,0)="and its modifiers will print. If there is a unit charge and this is an"
^IBA(364.7,1417,3,9,0)="inpatient bill and the revenue code is 100-219, it is printed and"
^IBA(364.7,1417,3,10,0)="formatted with 2 decimal places. Since only 22 lines of service can appear"
^IBA(364.7,1417,3,11,0)="on one form, if there are more than 22 lines, subsequent pages are forced"
^IBA(364.7,1417,3,12,0)="for the remaining data lines after 22."
^IBA(364.7,1418,0)="1718^N^5^^^^N"
^IBA(364.7,1418,1)="K IBXDATA D DATE45^IBCF33(IBXIEN,.IBXDATA,$G(IBXSAVE(""DATE"")))"
^IBA(364.7,1418,3,0)="^^12^12^3070125^"
^IBA(364.7,1418,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,1418,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,1418,3,3,0)="IBXSAVE(""REV"",n) extracted previously.  The first '^' piece of the array"
^IBA(364.7,1418,3,4,0)="indicates whether this is a 'normal' service data line (=1) or a text line"
^IBA(364.7,1418,3,5,0)="(=2 or =3).   For a normal service line, output the OUTPATIENT from date "
^IBA(364.7,1418,3,6,0)="that was previously extracted into IBXSAVE(""DATE""). For text line where"
^IBA(364.7,1418,3,7,0)="the first piece = 2, the text is assumed to start in column 1, so the data"
^IBA(364.7,1418,3,8,0)="is extracted from positions 46-52. For text line where the first piece ="
^IBA(364.7,1418,3,9,0)="3, the text is assumed to start in column 6, so the data for this field is"
^IBA(364.7,1418,3,10,0)="extracted from positions 41-47. Since only 22 lines of service line can"
^IBA(364.7,1418,3,11,0)="appear on one form, if there are more than 22 lines, subsequent pages are"
^IBA(364.7,1418,3,12,0)="forced for the remaining data lines after 22."
^IBA(364.7,1419,0)="1719^N^5^^^^N"
^IBA(364.7,1419,1)="K IBXDATA"
^IBA(364.7,1420,0)="1720^N^5^^^^N"
^IBA(364.7,1420,1)="K IBXDATA"
^IBA(364.7,1421,0)="1721^N^5^^^^N"
^IBA(364.7,1421,1)="K IBXDATA"
^IBA(364.7,1422,0)="1722^N^5^^^^N"
^IBA(364.7,1422,1)="K IBXDATA"
^IBA(364.7,1423,0)="1723^N^5^^^^N"
^IBA(364.7,1423,1)="D REMARK^IBCEF77(IBXIEN,.IBXDATA,1)"
^IBA(364.7,1423,3,0)="^^4^4^3070209^"
^IBA(364.7,1423,3,1,0)="Remarks in FL-80 on the UB-04.  All data is retrieved and formatted by "
^IBA(364.7,1423,3,2,0)="REMARK^IBCEF77.  Line 1 of this box has a mandatory 5 leading spaces and "
^IBA(364.7,1423,3,3,0)="therefore only 19 printed characters can be in line 1.  Lines 2-4 have a "
^IBA(364.7,1423,3,4,0)="max length of 24 characters."
^IBA(364.7,1427,0)="1727^N^5^^^^N"
^IBA(364.7,1427,1)="S IBXDATA(1)="""",IBXDATA(2)="""",IBXDATA(3)="""",IBXDATA(4)="""""
^IBA(364.7,1427,3,0)="^364.73^2^2^3061127^^"
^IBA(364.7,1427,3,1,0)="Not currently used.  This field is for overflow codes or externally "
^IBA(364.7,1427,3,2,0)="maintained codes."
^IBA(364.7,1428,0)="1728^N^5^^^^N"
^IBA(364.7,1428,1)="S IBXDATA(1)="""",IBXDATA(2)="""",IBXDATA(3)="""",IBXDATA(4)="""""
^IBA(364.7,1428,3,0)="^^2^2^3061127^"
^IBA(364.7,1428,3,1,0)="Not currently used.  This field is for overflow codes or externally"
^IBA(364.7,1428,3,2,0)="maintained codes."
^IBA(364.7,1429,0)="1729^N^5^^^^N"
^IBA(364.7,1429,1)="S IBXDATA(1)="""",IBXDATA(2)="""",IBXDATA(3)="""",IBXDATA(4)="""""
^IBA(364.7,1429,3,0)="^^2^2^3061127^"
^IBA(364.7,1429,3,1,0)="Not currently used.  This field is for overflow codes or externally"
^IBA(364.7,1429,3,2,0)="maintained codes."
^IBA(364.7,1430,0)="1730^N^5^^^^N"
^IBA(364.7,1430,1)="N IBZ D GETPRV^IBCEU(IBXIEN,4,.IBZ) S IBXSAVE(""NAME"")=$P($G(IBZ(4,1)),U),IBXDATA=$P(IBXSAVE(""NAME""),"","")"
^IBA(364.7,1430,3,0)="^^1^1^3061128^"
^IBA(364.7,1430,3,1,0)="Attending Providers last name"
^IBA(364.7,1431,0)="1731^N^5^^^^N"
^IBA(364.7,1431,1)="S IBXDATA=$P($G(IBXSAVE(""NAME"")),"","",2) K IBXSAVE(""NAME"")"
^IBA(364.7,1431,3,0)="^^1^1^3061128^"
^IBA(364.7,1431,3,1,0)="Attending Providers first name"
^IBA(364.7,1432,0)="1732^N^5^^^^N"
^IBA(364.7,1432,1)="N IBZ D GETPRV^IBCEU(IBXIEN,2,.IBZ) S IBXSAVE(""NAME"")=$P($G(IBZ(2,1)),U),IBXDATA=$P(IBXSAVE(""NAME""),"","")"
^IBA(364.7,1432,3,0)="^^1^1^3061128^"
^IBA(364.7,1432,3,1,0)="Operating Provider last name"
^IBA(364.7,1433,0)="1733^N^5^^^^N"
^IBA(364.7,1433,1)="S IBXDATA=$P($G(IBXSAVE(""NAME"")),"","",2) K IBXSAVE(""NAME"")"
^IBA(364.7,1433,3,0)="^^1^1^3061128^"
^IBA(364.7,1433,3,1,0)="Operating Provider first name"
^IBA(364.7,1434,0)="1734^N^5^^^^N"
^IBA(364.7,1434,1)="N Z,Z0,Z1 F Z=1:1 Q:'$D(^TMP($J,""IBC-RC"",Z))  S Z1=^(Z),Z0=$S(+Z1=1:$J($P(Z1,U,6),7),+Z1=2:$E($P(Z1,U,2),53,59),1:$E($P(Z1,U,2),48,54)) S:Z'>22 IBXDATA(Z)=Z0 D:Z>22 CKREV^IBCEF3(Z,Z0)"
^IBA(364.7,1434,3,0)="^^13^13^3070125^"
^IBA(364.7,1434,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,1434,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,1434,3,3,0)="IBXSAVE(""REV"",n) extracted previously.  The first '^' piece of the array"
^IBA(364.7,1434,3,4,0)="indicates whether this is a 'normal' service data line (=1) or a text line"
^IBA(364.7,1434,3,5,0)="(=2 or =3).  For a normal service line, the data is found in the sixth '^'"
^IBA(364.7,1434,3,6,0)="piece of the array.  For text line"
^IBA(364.7,1434,3,7,0)="where the first piece = 2, the text is assumed to start in column 1, so the"
^IBA(364.7,1434,3,8,0)="data is extracted from positions 53-59.  For text line where the first"
^IBA(364.7,1434,3,9,0)="piece = 3, the text is assumed to start in column 6, so the data for this"
^IBA(364.7,1434,3,10,0)="field is extracted from positions 48-54."
^IBA(364.7,1434,3,11,0)="Since only 22 lines of service line can appear on one form, if there"
^IBA(364.7,1434,3,12,0)="are more than 22 lines, subsequent pages are forced for the remaining data"
^IBA(364.7,1434,3,13,0)="lines after 22."
^IBA(364.7,1435,0)="1735^N^5^^^^N"
^IBA(364.7,1435,1)="N Z,Z0,Z1 F Z=1:1 Q:'$D(^TMP($J,""IBC-RC"",Z))  S Z1=^(Z),Z0=$S(+Z1=1:$$DOL^IBCEF77($P(Z1,U,7),10),+Z1=2:$E($P(Z1,U,2),60,69),1:$E($P(Z1,U,2),55,64)) S:Z'>22 IBXDATA(Z)=Z0 D:Z>22 CKREV^IBCEF3(Z,Z0)"
^IBA(364.7,1435,3,0)="^^12^12^3070125^"
^IBA(364.7,1435,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,1435,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,1435,3,3,0)="IBXSAVE(""REV"",n) extracted previously.  The first '^' piece of the array"
^IBA(364.7,1435,3,4,0)="indicates whether this is a 'normal' service data line (=1) or a text line"
^IBA(364.7,1435,3,5,0)="(=2 or =3).  For a normal service line, the data is found in the seventh "
^IBA(364.7,1435,3,6,0)="'^' piece of the array.  For text line where the first piece = 2, the text"
^IBA(364.7,1435,3,7,0)="is assumed to start in column 1, so the data is extracted from positions"
^IBA(364.7,1435,3,8,0)="60-69.  For text line where the first piece = 3, the text is assumed to"
^IBA(364.7,1435,3,9,0)="start in column 6, so the data for this field is extracted from positions"
^IBA(364.7,1435,3,10,0)="55-64. Since only 22 lines of service line can appear on one form, if"
^IBA(364.7,1435,3,11,0)="there are more than 22 lines, subsequent pages are forced for the"
^IBA(364.7,1435,3,12,0)="remaining data lines after 22."
^IBA(364.7,1436,0)="1736^N^5^^^^N"
^IBA(364.7,1436,1)="N IBZ D GETPRV^IBCEU(IBXIEN,9,.IBZ) S IBXSAVE(""NAME"")=$P($G(IBZ(9,1)),U),IBXDATA=$P(IBXSAVE(""NAME""),"","")"
^IBA(364.7,1436,3,0)="^^1^1^3061128^"
^IBA(364.7,1436,3,1,0)="Other Provider last name"
^IBA(364.7,1437,0)="1737^N^5^^^^N"
^IBA(364.7,1437,1)="S IBXDATA=$P($G(IBXSAVE(""NAME"")),"","",2) K IBXSAVE(""NAME"")"
^IBA(364.7,1437,3,0)="^^1^1^3061128^"
^IBA(364.7,1437,3,1,0)="Other Provider first name"
^IBA(364.7,1438,0)="1738^N^5^^^^N"
^IBA(364.7,1438,1)="K IBXDATA"
^IBA(364.7,1438,3,0)="^^1^1^3061128^"
^IBA(364.7,1438,3,1,0)="This is the second other provider and it is not currently used."
^IBA(364.7,1439,0)="1739^N^5^^^^N"
^IBA(364.7,1439,1)="K IBXDATA"
^IBA(364.7,1439,3,0)="^^1^1^3061128^"
^IBA(364.7,1439,3,1,0)="This is the second other provider and it is not currently used."
^IBA(364.7,1440,0)="1740^N^5^^^^N"
^IBA(364.7,1440,1)="S IBXSAVE(""BOX 76"")=$$CFIDS^IBCEF77(IBXIEN,4,""^1A^1B^1C^1H^G2^LU^N5^""),IBXDATA=$P(IBXSAVE(""BOX 76""),U,3)"
^IBA(364.7,1440,3,0)="^^1^1^3061129^"
^IBA(364.7,1440,3,1,0)="Attending Provider NPI if available"
^IBA(364.7,1441,0)="1741^N^5^^^^N"
^IBA(364.7,1441,1)="S IBXDATA=$P($G(IBXSAVE(""BOX 76"")),U,1)"
^IBA(364.7,1441,3,0)="^364.73^1^1^3061129^^"
^IBA(364.7,1441,3,1,0)="Legacy ID quailifer"
^IBA(364.7,1442,0)="1742^N^5^^^^N"
^IBA(364.7,1442,1)="S IBXDATA=$P($G(IBXSAVE(""BOX 76"")),U,2) K IBXSAVE(""BOX 76"")"
^IBA(364.7,1442,3,0)="^^1^1^3061129^"
^IBA(364.7,1442,3,1,0)="Attending legacy ID"
^IBA(364.7,1443,0)="1743^N^5^^^^N"
^IBA(364.7,1443,1)="S IBXSAVE(""BOX 77"")=$$CFIDS^IBCEF77(IBXIEN,2,""^1A^1B^1C^1H^G2^LU^N5^""),IBXDATA=$P(IBXSAVE(""BOX 77""),U,3)"
^IBA(364.7,1443,3,0)="^^1^1^3061129^"
^IBA(364.7,1443,3,1,0)="Operating Provider NPI if available"
^IBA(364.7,1444,0)="1744^N^5^^^^N"
^IBA(364.7,1444,1)="S IBXDATA=$P($G(IBXSAVE(""BOX 77"")),U,1)"
^IBA(364.7,1444,3,0)="^^1^1^3061129^"
^IBA(364.7,1444,3,1,0)="Operating provider legacy ID if needed"
^IBA(364.7,1445,0)="1745^N^5^^^^N"
^IBA(364.7,1445,1)="S IBXDATA=$P($G(IBXSAVE(""BOX 77"")),U,2) K IBXSAVE(""BOX 77"")"
^IBA(364.7,1445,3,0)="^^1^1^3061129^"
^IBA(364.7,1445,3,1,0)="Operating legacy ID if needed"
^IBA(364.7,1446,0)="1746^N^5^^^^N"
^IBA(364.7,1446,1)="S IBXSAVE(""BOX 78"")=$$CFIDS^IBCEF77(IBXIEN,9,""^1A^1B^1C^1H^G2^LU^N5^""),IBXDATA=$P(IBXSAVE(""BOX 78""),U,3)"
^IBA(364.7,1446,3,0)="^^1^1^3061129^"
^IBA(364.7,1446,3,1,0)="Other provider NPI if available"
^IBA(364.7,1447,0)="1747^N^5^^^^N"
^IBA(364.7,1447,1)="S IBXDATA=$P($G(IBXSAVE(""BOX 78"")),U,1)"
^IBA(364.7,1447,3,0)="^^1^1^3061129^"
^IBA(364.7,1447,3,1,0)="Other provider legacy ID qualifier if needed"
^IBA(364.7,1448,0)="1748^N^5^^^^N"
^IBA(364.7,1448,1)="S IBXDATA=$P($G(IBXSAVE(""BOX 78"")),U,2) K IBXSAVE(""BOX 78"")"
^IBA(364.7,1448,3,0)="^^1^1^3061129^"
^IBA(364.7,1448,3,1,0)="Other provider legacy ID if needed"
^IBA(364.7,1449,0)="1749^N^5^^^^N"
^IBA(364.7,1449,1)="N Z,Z0,Z1 F Z=1:1 Q:'$D(^TMP($J,""IBC-RC"",Z))  S Z1=^(Z),Z0=$S(+Z1=1:$$DOL^IBCEF77($P(Z1,U,8),10),+Z1=2:$E($P(Z1,U,2),70,79),1:$E($P(Z1,U,2),65,74)) S:Z'>22 IBXDATA(Z)=Z0 D:Z>22 CKREV^IBCEF3(Z,Z0)"
^IBA(364.7,1449,3,0)="^^12^12^3070125^"
^IBA(364.7,1449,3,1,0)="This data element is a group data element where more than one occurrence"
^IBA(364.7,1449,3,2,0)="might be expected.  It relies on the presence of data in array"
^IBA(364.7,1449,3,3,0)="IBXSAVE(""REV"",n) extracted previously.  The first '^' piece of the array"
^IBA(364.7,1449,3,4,0)="indicates whether this is a 'normal' service data line (=1) or a text line"
^IBA(364.7,1449,3,5,0)="(=2 or =3).  For a normal service line, the data is found in the eighth "
^IBA(364.7,1449,3,6,0)="'^' piece of the array.  For text line where the first piece = 2, the text"
^IBA(364.7,1449,3,7,0)="is assumed to start in column 1, so the data is extracted from positions"
^IBA(364.7,1449,3,8,0)="70-79.  For text line where the first piece = 3, the text is assumed to"
^IBA(364.7,1449,3,9,0)="start in column 6, so the data for this field is extracted from positions"
^IBA(364.7,1449,3,10,0)="65-74. Since only 22 lines of service line can appear on one form, if"
^IBA(364.7,1449,3,11,0)="there are more than 22 lines, subsequent pages are forced for the"
^IBA(364.7,1449,3,12,0)="remaining data lines after 22."
^IBA(364.7,1450,0)="1750^N^5^^^^N"
^IBA(364.7,1450,1)="K IBXDATA"
^IBA(364.7,1450,3,0)="^364.73^1^1^3070125^^"
^IBA(364.7,1450,3,1,0)="Reserved by the NUBC. This field is always blank."
^IBA(364.7,1451,0)="1751^N^5^^^^N"
^IBA(364.7,1451,1)="K IBXDATA"
^IBA(364.7,1451,3,0)="^^1^1^3061129^"
^IBA(364.7,1451,3,1,0)="Not currently used"
^IBA(364.7,1452,0)="1752^N^5^^^^N"
^IBA(364.7,1452,1)="K IBXDATA"
^IBA(364.7,1452,3,0)="^^1^1^3061129^"
^IBA(364.7,1452,3,1,0)="Not currently used"
^IBA(364.7,1453,0)="1753^N^5^^^^N"
^IBA(364.7,1453,1)="K IBXDATA"
^IBA(364.7,1453,3,0)="^^1^1^3061129^"
^IBA(364.7,1453,3,1,0)="Not currently used"
^IBA(364.7,1454,0)="1754^N^5^^^^N"
^IBA(364.7,1454,1)="K IBXDATA"
^IBA(364.7,1454,3,0)="^^1^1^3061129^"
^IBA(364.7,1454,3,1,0)="Not currently used"
^IBA(364.7,1455,0)="1755^N^5^^^^N"
^IBA(364.7,1455,1)="K IBXDATA"
^IBA(364.7,1455,3,0)="^^1^1^3061129^"
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