| Parent File | Name | Number | Package |
|---|---|---|---|
| PRIVATE INSURANCE ELIGIBLE(#9000006) | INSURER | 9000006.11 | IHS Patient |
| Field # | Name | Loc | Type | Details |
|---|---|---|---|---|
| .01 | INSURER | 0;1 | POINTER TO INSURER FILE (#9999999.18) | ************************REQUIRED FIELD************************ INSURER(#9999999.18)
|
| .02 | *POLICY NUMBER | 0;2 | FREE TEXT |
|
| .03 | *COVERAGE | 0;3 | POINTER TO COVERAGE TYPE FILE (#9999999.65) | COVERAGE TYPE(#9999999.65)
|
| .04 | *NAME OF INSURED | 0;4 | FREE TEXT |
|
| .05 | RELATIONSHIP | 0;5 | POINTER TO RELATIONSHIP FILE (#9999999.36) | RELATIONSHIP(#9999999.36)
|
| .06 | ELIG. DATE | 0;6 | DATE |
|
| .07 | ELIG. END DATE | 0;7 | DATE |
|
| .08 | POLICY HOLDER | 0;8 | POINTER TO POLICY HOLDER FILE (#9000003.1) | POLICY HOLDER(#9000003.1)
|
| .09 | VERIFIED COVERAGE DATE | 0;9 | DATE |
|
| .11 | VERIFIED BY | 0;11 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
| .12 | PERSON CODE | 0;12 | FREE TEXT |
|
| .14 | PRIMARY CARE PROVIDER | 0;14 | FREE TEXT |
|
| .15 | PI CARD COPY ON FILE | 0;15 | SET |
|
| .16 | DATE PI CC WAS OBTAINED | 0;16 | DATE |
|
| 21 | MEMBER NUMBER | 2;1 | FREE TEXT |
|