| Parent File | Name | Number | Package |
|---|---|---|---|
| 9002313.0301 | Other Amt Paid Repeating Flds | 9002313.1401 | Pharmacy Point of Sale |
| Field # | Name | Loc | Type | Details |
|---|---|---|---|---|
| .01 | Other Amt Paid Counter | 0;1 | FREE TEXT |
|
| 564 | Other Amount Paid Qualifier | 1;1 | FREE TEXT |
|
| 565 | Other Amount Paid | 1;2 | FREE TEXT |
|