| FileMan FileNo | FileMan Filename | Package | 
|---|---|---|
| 9002065 | CHS NON-PROCESSED EOBRS | Contract Health Management Information System | 
| Package | Total | Routines | 
|---|---|---|
| Contract Health Management Information System | 4 | ACHSEDOC ACHSEOBD ACHSEOBE CPT PROCEDURES | 
| Package | Total | Routines | 
|---|---|---|
| Contract Health Management Information System | 1 | ACHSEOBD | 
| Package | Total | FileMan Files | 
|---|---|---|
| Utility Tables | 2 | SERVICE UNIT(#9999999.22)[2] VENDOR(#9999999.11)[24] | 
| Field # | Name | Loc | Type | Details | 
|---|---|---|---|---|
| .01 | NAME | 0;1 | FREE TEXT | ************************REQUIRED FIELD************************ 
 | 
| 1 | AREA OFFICE | 0;2 | NUMBER | 
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| 2 | SERVICE UNIT | 0;3 | POINTER TO SERVICE UNIT FILE (#9999999.22) | SERVICE UNIT(#9999999.22) 
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| 3 | CLAIM NUMBER | 0;4 | NUMBER | 
 | 
| 4 | CLAIM SEQUENCE COUNT | 0;5 | NUMBER | 
 | 
| 5 | CHECK NUMBER | 0;6 | NUMBER | 
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| 6 | REMITTANCE NUMBER | 0;7 | NUMBER | 
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| 7 | PAID DATE | 0;8 | DATE | 
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| 8 | CERTIFICATE NUMBER | 0;9 | NUMBER | 
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| 9 | FACILITY CODE | 0;10 | NUMBER | 
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| 10 | DOCUMENTATION TYPE | 0;11 | NUMBER | 
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| 11 | PATIENT NAME | 1;1 | FREE TEXT | 
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| 12 | HEALTH RECORD NUMBER | 1;2 | NUMBER | 
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| 13 | AUTHORIZATION DATE | 1;3 | DATE | 
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| 14 | ACTUAL DAYS | 1;4 | NUMBER | 
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| 15 | DRG | 1;5 | FREE TEXT | 
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| 16 | COMMON ACCOUNTING NUMBER | 1;6 | FREE TEXT | 
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| 17 | OBJECT CLASS CODE | 1;7 | FREE TEXT | 
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| 18 | SERVICES BILLED | 1;8 | FREE TEXT | 
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| 19 | BLANKET INDICATOR | 1;9 | SET | 
 
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| 20 | CONTRACT NUMBER | 1;10 | FREE TEXT | 
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| 20.5 | INTERIM/FINAL IND | 1;14 | SET | 
 
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| 21 | SERVICE START DATE | 1;11 | DATE | 
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| 22 | SERVICE END DATE | 1;12 | DATE | 
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| 23 | VENDOR NUMBER | 1;13 | FREE TEXT | 
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| 24 | VENDOR NAME | 2;1 | POINTER TO VENDOR FILE (#9999999.11) | VENDOR(#9999999.11) 
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| 25 | BILLED BY PROVIDER | 2;2 | FREE TEXT | 
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| 26 | ALLOWABLE AMOUNT | 2;3 | FREE TEXT | 
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| 27 | PAID BY 3RD PARTY | 2;4 | NUMBER | 
 | 
| 28 | IHS COST | 2;5 | NUMBER | 
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| 29 | OBLIGATION INDICATOR | 2;6 | NUMBER | 
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| 30 | OBLIGATION AMOUNT | 2;7 | FREE TEXT | 
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| 31 | ADJUSTMENT AMOUNT | 2;8 | FREE TEXT | 
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| 32 | DIAGNOSIS CODE 1 | 2;9 | FREE TEXT | 
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| 33 | DIAGNOSIS CODE 2 | 2;10 | FREE TEXT | 
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| 34 | DIAGNOSIS CODE 3 | 2;11 | FREE TEXT | 
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| 35 | DIAGNOSIS CODE 4 | 2;12 | FREE TEXT | 
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| 36 | DIAGNOSIS CODE 5 | 2;13 | FREE TEXT | 
 | 
| 37 | CPT PROCEDURES | 3;0 | Multiple #9002065.037 | 9002065.037 
 | 
| 38 | PROCEDURE CODE 1 | 4;1 | FREE TEXT | 
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| 39 | PROCEDURE CODE 2 | 4;2 | FREE TEXT | 
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| 40 | PROCEDURE CODE 3 | 4;3 | FREE TEXT | 
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| 44 | PROCEDURE CODE 4 | 4;4 | FREE TEXT | 
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| 45 | PROCEDURE CODE 5 | 4;5 | FREE TEXT | 
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| Name | Field # of Occurrence | 
|---|---|
| ^%DT | 7+1, 13+1, 21+1, 22+1 | 
| Name | Line Occurrences (* Changed, ! Killed) | 
|---|---|
| ^ACHSEOBE("B" | .01(XREF 1S), .01(XREF 1K) | 
| ^ACHSEOBE("EOBD" | 7(XREF 1S), 7(XREF 1K) | 
| ^ACHSEOBE("EOBP" | 11(XREF 1S), 11(XREF 1K) | 
| ^ACHSEOBE("EOBV" | 24(XREF 1S), 24(XREF 1K) | 
| >> | Not killed explicitly | 
| * | Changed | 
| ! | Killed | 
| ~ | Newed | 
| Name | Field # of Occurrence | 
|---|---|
| >> %DT | 7+1*, 13+1*, 21+1*, 22+1* | 
| >> DA | .01(XREF 1S), .01(XREF 1K), 7(XREF 1S), 7(XREF 1K), 11(XREF 1S), 11(XREF 1K), 24(XREF 1S), 24(XREF 1K) | 
| X | .01+1!, .01(XREF 1S), .01(XREF 1K), 1+1!, 3+1!, 4+1!, 5+1!, 6+1!, 7+1*!, 7(XREF 1S) , 7(XREF 1K), 8+1!, 9+1!, 10+1!, 11+1!, 11(XREF 1S), 11(XREF 1K), 12+1!, 13+1*!, 14+1! , 15+1!, 16+1!, 17+1!, 18+1!, 20+1!, 21+1*!, 22+1*!, 23+1!, 24(XREF 1S), 24(XREF 1K) , 25+1!, 26+1!, 27+1*!, 28+1*!, 29+1!, 30+1!, 31+1!, 32+1!, 33+1!, 34+1! , 35+1!, 36+1!, 38+1!, 39+1!, 40+1!, 44+1!, 45+1! | 
| >> Y | 7+1, 13+1, 21+1, 22+1 |