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 |
|
2 | SERVICE UNIT | 0;3 | POINTER TO SERVICE UNIT FILE (#9999999.22) | SERVICE UNIT(#9999999.22)
|
3 | CLAIM NUMBER | 0;4 | NUMBER |
|
4 | CLAIM SEQUENCE COUNT | 0;5 | NUMBER |
|
5 | CHECK NUMBER | 0;6 | NUMBER |
|
6 | REMITTANCE NUMBER | 0;7 | NUMBER |
|
7 | PAID DATE | 0;8 | DATE |
|
8 | CERTIFICATE NUMBER | 0;9 | NUMBER |
|
9 | FACILITY CODE | 0;10 | NUMBER |
|
10 | DOCUMENTATION TYPE | 0;11 | NUMBER |
|
11 | PATIENT NAME | 1;1 | FREE TEXT |
|
12 | HEALTH RECORD NUMBER | 1;2 | NUMBER |
|
13 | AUTHORIZATION DATE | 1;3 | DATE |
|
14 | ACTUAL DAYS | 1;4 | NUMBER |
|
15 | DRG | 1;5 | FREE TEXT |
|
16 | COMMON ACCOUNTING NUMBER | 1;6 | FREE TEXT |
|
17 | OBJECT CLASS CODE | 1;7 | FREE TEXT |
|
18 | SERVICES BILLED | 1;8 | FREE TEXT |
|
19 | BLANKET INDICATOR | 1;9 | SET |
|
20 | CONTRACT NUMBER | 1;10 | FREE TEXT |
|
20.5 | INTERIM/FINAL IND | 1;14 | SET |
|
21 | SERVICE START DATE | 1;11 | DATE |
|
22 | SERVICE END DATE | 1;12 | DATE |
|
23 | VENDOR NUMBER | 1;13 | FREE TEXT |
|
24 | VENDOR NAME | 2;1 | POINTER TO VENDOR FILE (#9999999.11) | VENDOR(#9999999.11)
|
25 | BILLED BY PROVIDER | 2;2 | FREE TEXT |
|
26 | ALLOWABLE AMOUNT | 2;3 | FREE TEXT |
|
27 | PAID BY 3RD PARTY | 2;4 | NUMBER |
|
28 | IHS COST | 2;5 | NUMBER |
|
29 | OBLIGATION INDICATOR | 2;6 | NUMBER |
|
30 | OBLIGATION AMOUNT | 2;7 | FREE TEXT |
|
31 | ADJUSTMENT AMOUNT | 2;8 | FREE TEXT |
|
32 | DIAGNOSIS CODE 1 | 2;9 | FREE TEXT |
|
33 | DIAGNOSIS CODE 2 | 2;10 | FREE TEXT |
|
34 | DIAGNOSIS CODE 3 | 2;11 | FREE TEXT |
|
35 | DIAGNOSIS CODE 4 | 2;12 | FREE TEXT |
|
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 |
|
39 | PROCEDURE CODE 2 | 4;2 | FREE TEXT |
|
40 | PROCEDURE CODE 3 | 4;3 | FREE TEXT |
|
44 | PROCEDURE CODE 4 | 4;4 | FREE TEXT |
|
45 | PROCEDURE CODE 5 | 4;5 | FREE TEXT |
|
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 |