ACHSRP3D ; IHS/ITSC/PMF - PRINT CHS (57 - DENTAL) FORMS ;
Source file <ACHSRP3D.m>
Package | Total | Call Graph |
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Contract Health Management Information System | 3 | $$PARM^ACHS (CSUPLA,KILLNULS)^ACHSRP3 $$SSV^ACHSTX3 |
IHS Patient | 1 | $$GETMBI^AUPNMBI |
Package | Total | Caller Graph |
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Contract Health Management Information System | 2 | ACHSRP1 ACHSRP2 |
Name | Comments | DBIA/ICR reference |
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TESTPRNT | ;EP.
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REFTYPE | ;
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MCD | ;
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AGESEX | ;
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OBLGAMT | ;
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PADRS | ;
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SIG | ;
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FROMTO | ;
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END | ;
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DT | ;
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EIN | ;
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CONTNO | ;
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PVT | ;*******LOOP THRU PRIVATE INSURANCE ELIGIBLE FILE
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RRE | ;
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PTYPE | ;
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E | ;;SPECIFIC REFERRAL, TYPE E: Emergency examination and;treatment not to exceed above obligation. Services;limited to Levels I-III of the IHS Schedule of Oral;Health Services.
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SSN | ;
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NO3 | ;
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DCR | ;
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B | ;;SPECIFIC REFERRAL, TYPE B: Examination and treatment;limited to Levels I-III of the IHS Schedule of Oral;Health Services. Treatment plans exceeding $300 must;be returned for predetermination.
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PTADRS | ;
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G | ;;GENERAL REFERRAL: Before providing services other than;examination, radiographs, or emergency services, this;claim form must be returned for predetermination.
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DEST | ;
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L | ;;REFERRAL TYPE L: Authorization for dental laboratory;services for fabrication of _________________________.
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S | ;;SPECIFIC REFERRAL, TYPE S: Specialty Services: Services;limited to *_____________, not to exceed above obligation.;;*In the above blank, give a brief description of the;services ordered, including ADA code(s), if possible.
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SUCODE | ;
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DESC | ;
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ORDADRS | ;
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CANOBJ | ;
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NAME | ;
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DOBSEX | ;
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FACHRN | ;
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PROV | ;
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SSV | ;
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PONUM | ;
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COMCODE | ;
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MCR | ;
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ORDOFF | ;
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Name | Line Occurrences (* Changed, ! Killed) |
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^ACHSF - [#9002080] | ACHSRP3D+5, ACHSRP3D+8, REFTYPE+2 |
^AUPN3PPH - [#9000003.1] | PVT+10, PVT+11, PVT+12 |
^AUPNMCD - [#9000004] | MCD+5, MCD+6, MCD+7, MCD+8, MCD+11, MCD+12 |
^AUPNMCD("B" | MCD+2, MCD+3 |
^AUPNMCR - [#9000003] | MCR+2, MCR+5, MCR+8, MCR+9, MCR+10, MCR+13, MCR+15, MCR+16, MCR+17 |
^AUPNPRVT - [#9000006] | PVT+1, PVT+5, PVT+6 |
^AUPNRRE - [#9000005] | RRE+2, RRE+4, RRE+5, RRE+6, RRE+7, RRE+15, RRE+16, RRE+19, RRE+20 |
^AUTNINS - [#9999999.18] | PVT+9 |
^AUTTMCS - [#9999999.32] | MCR+5 |
^AUTTPIC - [#9999999.65] | PVT+12 |
^AUTTRRP - [#9999999.33] | RRE+15 |
^DIC(5 - [#5] | MCD+11 |
Name | Line Occurrences |
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END | OBLGAMT+2, REFTYPE+4 |
MCD | MCR+2 |
NO3 | MCR+2, PVT+1 |
PVT | RRE+2, RRE+9 |
RRE | MCD+2 |
Name | Field # of Occurrence |
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^(0 | ACHSRP3D+5, MCR+5, MCD+11, MCD+12, RRE+20 |
^(11 | PVT+1 |
>> | Not killed explicitly |
* | Changed |
! | Killed |
~ | Newed |
Name | Field # of Occurrence |
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>> A(1 | FACHRN+2 |
>> A(11 | SSN+2 |
>> A(2 | NAME+2 |
>> A(3 | PTADRS+2 |
>> A(4 | DOBSEX+2, AGESEX+2 |
>> A(5 | COMCODE+1 |
>> A(7 | DESC+2 |
>> A(9 | MCR+2 |
>> ACHSDCR | DCR+1 |
>> ACHSDIEN | ACHSRP3D+5, ACHSRP3D+8, REFTYPE+2 |
>> ACHSEDOS | MCR+9, MCR+10, MCD+6, MCD+8, RRE+5, RRE+7, PVT+7, PVT+8 |
>> ACHSLCA | ACHSRP3D+5*, ACHSRP3D+7 |
ACHSLREF | REFTYPE+2*, REFTYPE+3, END+2! |
>> ACHSMBI | MCR+4*, MCR+5*, MCR+14, RRE+12*, RRE+13, RRE+14*, RRE+15*, RRE+16*, RRE+17 |
>> ACHSORDN | PONUM+1 |
>> ACHSSF | ACHSRP3D+5*, ACHSRP3D+6*, ACHSRP3D+7*, PONUM+1 |
>> ACHSSIG | SIG+1 |
>> ACHSTAB | FACHRN+2, FROMTO+1, PONUM+1, NAME+2, DCR+1, PTADRS+2, SIG+1, DT+1, DOBSEX+1, ORDOFF+1 , SUCODE+1, AGESEX+1, AGESEX+2, ORDADRS+1, DEST+1, SSV+2, SSN+1, PROV+1, EIN+1, PADRS+1 , PADRS+2, DESC+2, OBLGAMT+1, REFTYPE+3, MCR+12, MCD+11, RRE+17, PVT+9, NO3+1 |
>> ACHSTIEN | ACHSRP3D+5, ACHSRP3D+8, REFTYPE+2 |
>> ACHSTOPM | TESTPRNT+1 |
>> ACHSTPRT | CANOBJ+1, OBLGAMT+2 |
>> ACHSTYPE | ACHSRP3D+5*, ACHSRP3D+8, REFTYPE+4 |
>> ACHSTYPV | PONUM+1 |
>> B(1 | ORDOFF+1 |
>> B(3 | ORDADRS+1 |
>> B(4 | SUCODE+1 |
>> C(4 | FROMTO+1 |
>> D(1 | PROV+1 |
>> D(2 | PADRS+1 |
>> D(3 | PADRS+2 |
>> D(4 | EIN+1* |
>> D(5 | DEST+1 |
>> D(7 | PTYPE+1 |
>> DFN | SSV+2, MCR+2, MCR+4, MCR+5, MCR+8, MCR+9, MCR+10, MCR+13, MCR+15, MCR+16 , MCR+17, MCD+2, MCD+3, RRE+2, RRE+4, RRE+5, RRE+6, RRE+7, RRE+12, RRE+15 , RRE+16, RRE+19, RRE+20, PVT+1, PVT+5, PVT+6 |
DT | MCR+4, RRE+12 |
DUZ(2 | ACHSRP3D+5, ACHSRP3D+8, REFTYPE+2 |
>> E(11 | ACHSRP3D+8* |
>> E(7 | ACHSRP3D+8*, DT+1 |
>> E(9 | OBLGAMT+1 |
>> F(6 | CONTNO+2 |
>> F(7 | CANOBJ+1 |
>> F(8 | CANOBJ+1 |
>> F(9 | CANOBJ+1 |
>> I | TESTPRNT+1*, REFTYPE+3*, MCR+7*, MCR+8*, MCR+9, MCR+10, MCR+13, MCR+15, MCR+16, MCR+17 , MCD+5*, MCD+6, MCD+7, MCD+8, MCD+12, RRE+4*, RRE+5, RRE+6, RRE+7, PVT+3* , PVT+5*, PVT+6 |
>> I2 | PVT+6*, PVT+7, PVT+8, PVT+9, PVT+10, PVT+11, PVT+12, PVT+13 |
IOF | END+1 |
>> JJ | MCR+7*, MCR+8, MCR+11*, MCD+4*, MCD+5, MCD+7*, MCD+9*, MCD+10, RRE+3*, RRE+4 , RRE+6*, RRE+8*, RRE+9, RRE+18*, RRE+19*, RRE+20 |
>> LS | ACHSRP3D+5*, ACHSRP3D+6 |
>> R | MCD+3* |
U | ACHSRP3D+5, ACHSRP3D+8, REFTYPE+2, MCR+5, MCR+9, MCR+10, MCR+13, MCR+15, MCR+16, MCR+17 , MCD+6, MCD+7, MCD+8, MCD+11, MCD+12, RRE+5, RRE+6, RRE+7, RRE+15, RRE+16 , RRE+20, PVT+7, PVT+8, PVT+9, PVT+10, PVT+11, PVT+12, PVT+13 |
>> X | ACHSRP3D+8*, SSV+2*, MCD+3*, MCD+5, MCD+6, MCD+7, MCD+8, MCD+11, MCD+12 |
Name | Field # of Occurrence |
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$T(@ACHSLREF | REFTYPE+3 |