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Sub-Field: 9002274.4023

Package: Third Party Billing

3P BILL(#9002274.4)-->9002274.4023

Sub-Field: 9002274.4023


Information

Parent File Name Number Package
3P BILL(#9002274.4) Pharmacy 9002274.4023 Third Party Billing

Details

Field # Name Loc Type Details
.01 MEDICATION 0;1 POINTER TO DRUG FILE (#50) DRUG(#50)

  • LAST EDITED:  APR 21, 1995
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
.02 REVENUE CODE 0;2 POINTER TO REVENUE CODES FILE (#9999999.72) REVENUE CODES(#9999999.72)

  • LAST EDITED:  MAY 06, 1998
.03 UNITS 0;3 NUMBER
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:+X'=X!(X>99999)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  MAY 28, 1993
  • HELP-PROMPT:  Type a Number between 1 and 99999, 0 Decimal Digits
.04 UNIT COST 0;4 NUMBER
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:+X'=X!(X>9999)!(X<0)!(X?.E1"."6N.N) X
  • LAST EDITED:  FEB 22, 1999
  • HELP-PROMPT:  Type a Number between 0 and 9999, 5 Decimal Digits
.05 DISPENSE FEE 0;5 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>200)!(X<0) X
  • LAST EDITED:  MAY 03, 1995
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 200, 2 Decimal Digits
.06 PRESCRIPTION 0;6 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>9!($L(X)<1) X
  • LAST EDITED:  APR 20, 1992
  • HELP-PROMPT:  Answer must be 1-9 characters in length.
.07 IV ADDITIVE 0;7 POINTER TO IV ADDITIVES FILE (#52.6) IV ADDITIVES(#52.6)

  • LAST EDITED:  JUN 18, 1992
.08 IV SOLUTION 0;8 POINTER TO IV SOLUTIONS FILE (#52.7) IV SOLUTIONS(#52.7)

  • LAST EDITED:  JUN 18, 1992
.09 IV NARRATIVE 0;9 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<1) X
  • LAST EDITED:  JUN 18, 1992
  • HELP-PROMPT:  Answer must be 1-10 characters in length.
.1 NON-RX PROVIDER 0;10 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  JAN 12, 2006
.11 NON-RX DAYS SUPPLY 0;11 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  MAR 21, 1995
  • HELP-PROMPT:  Type a Number between 1 and 999, 0 Decimal Digits
.12 NON-RX REFILL NUMBER 0;12 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  MAR 21, 1995
  • HELP-PROMPT:  Type a Number between 0 and 99, 0 Decimal Digits
.13 CORRESPONDING DIAGNOSIS 0;13 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>7!($L(X)<1) X
  • LAST EDITED:  APR 06, 1995
  • HELP-PROMPT:  Answer must be 1-7 characters in length.
.14 SERVICE FROM DATE/TIME 0;14 DATE

  • INPUT TRANSFORM:  S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUL 03, 2006
.15 IV TYPE 0;15 SET
  • 'A' FOR ADMIXTURE;
  • 'P' FOR PIGGYBACK;
  • 'H' FOR HYPERAL;
  • 'S' FOR SYRINGE;
  • 'C' FOR CHEMOTHERAPY;

  • LAST EDITED:  JUN 22, 1995
.16 TIMES DISPENSED 0;16 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  JUN 22, 1995
  • HELP-PROMPT:  Type a Number between 1 and 999, 0 Decimal Digits
.17 DATA SOURCE 0;17 FREE TEXT

  • INPUT TRANSFORM:  K:X[""""!($A(X)=45) X I $D(X) K:$L(X)>12!($L(X)<1) X
  • LAST EDITED:  DEC 13, 2005
  • HELP-PROMPT:  Answer must be 1-12 characters in length.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
.18 SERVICE LINE PROVIDER P;0 POINTER Multiple #9002274.402318 9002274.402318
.19 NEW/REFILL CODE 0;19 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  OCT 14, 1997
  • HELP-PROMPT:  Type a Number between 0 and 99, 0 Decimal Digits
.2 DAYS SUPPLY 0;20 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  OCT 14, 1997
  • HELP-PROMPT:  Type a Number between 1 and 999, 0 Decimal Digits
.21 NON-RX PHARMACIST 0;21 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  SEP 03, 1998
.22 RX FILE POINTER 0;22 POINTER TO PRESCRIPTION FILE (#52) PRESCRIPTION(#52)

  • LAST EDITED:  JUL 25, 2007
.24 NDC 0;24 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>15!($L(X)<1) X
  • LAST EDITED:  JUN 27, 2006
  • HELP-PROMPT:  Answer must be 1-15 characters in length.
.25 DATE WRITTEN 0;25 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUN 27, 2006
.26 DATE DISCONTINUED 0;26 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUN 27, 2006
.27 RETURNED TO STOCK 0;27 DATE

  • INPUT TRANSFORM:  S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUN 27, 2006
.28 SERVICE TO DATE/TIME 0;28 DATE

  • INPUT TRANSFORM:  S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUL 03, 2006
.29 CPT CODE 0;29 POINTER TO CPT FILE (#81) CPT(#81)

  • LAST EDITED:  APR 14, 2011
.3 PRINT ORDER 0;30 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99999)!(X<1)!(X?.E1"."1.N) X
  • LAST EDITED:  SEP 05, 2017
  • HELP-PROMPT:  Type a number between 1 and 99999, 0 decimal digits.
.31 MODIFIER 2;3 FREE TEXT

  • INPUT TRANSFORM:  D EN^ABMMODIT
  • LAST EDITED:  MAR 16, 2016
  • HELP-PROMPT:  Answer must be 2 characters in length.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
.32 SECOND MODIFIER 2;4 FREE TEXT

  • INPUT TRANSFORM:  D EN^ABMMODIT
  • LAST EDITED:  MAR 16, 2016
  • HELP-PROMPT:  Answer must be 2 characters in length.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
.33 THIRD MODIFIER 2;5 FREE TEXT

  • INPUT TRANSFORM:  D EN^ABMMODIT
  • LAST EDITED:  MAR 16, 2016
  • HELP-PROMPT:  Answer must be 2 characters in length.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
21 LINE ITEM CONTROL NUMBER 2;1 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>18!($L(X)<18) X
  • LAST EDITED:  FEB 01, 2011
  • HELP-PROMPT:  Answer must be 18 characters in length
  • TECHNICAL DESCR:  This field will be unique for each line item on every bill. The format being used is:
    Characters 1-12  = Bill IEN
    Characters 13-14 = Multiple #
    Characters 15-18 = Line item counter
22 CPT NARRATIVE 3;2 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>80!($L(X)<3) X
  • LAST EDITED:  DEC 03, 2015
  • HELP-PROMPT:  Answer must be 3-80 characters in length.
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