| Parent File | Name | Number | Package |
|---|---|---|---|
| 3P INSURER(#9002274.09) | SPLIT PAGE(S) | 9002274.096 | Third Party Billing |
| Field # | Name | Loc | Type | Details |
|---|---|---|---|---|
| .01 | SPLIT PAGE(S) | 0;1 | SET |
|
| .02 | START DATE | 0;2 | DATE |
|
| .03 | SPLIT CLAIM HOW | 0;3 | SET |
|
| .04 | END DATE | 0;4 | DATE |
|
| .05 | ENTRY CREATED DATE | 0;5 | DATE |
|
| .06 | ENTRY CREATED BY | 0;6 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
| .07 | ENTRY END DATE ENTERED DATE | 0;7 | DATE |
|
| .08 | ENTRY END DATE ENTERED BY | 0;8 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|