| Parent File | Name | Number | Package |
|---|---|---|---|
| 3P CLAIM DATA(#9002274.3) | Special Program Code | 9002274.3059 | Third Party Billing |
| Field # | Name | Loc | Type | Details |
|---|---|---|---|---|
| .01 | SPECIAL PROGRAM CODE | 0;1 | POINTER TO 3P CODES FILE (#9002274.03) | 3P CODES(#9002274.03)
|
| .02 | EPSDT REFERRAL? | 0;2 | SET |
|
| .03 | REFERRAL REASON | 1;0 | SET Multiple #9002274.305901 | 9002274.305901 |