ABMDF11X ; IHS/ASDST/DMJ - PRINT UB92 ;
Source file <AZXDF11X.m>
| Name | Comments | DBIA/ICR reference |
|---|---|---|
| 11 | ;
|
|
| 10 | ;
|
|
| 12 | ;
; If private insurance and relationship of policy holder to patient ; is not self, write name of policy holder |
|
| OTHER | ;DO OTHER ROUTINES & QUIT
|
|
| 1 | ; EP
; Provider name -- form locator #1 |
|
| 3 | ;
; Provider city, state, zip -- form locator #1 |
|
| 2 | ;
; Provider address, Patient control number, Bill type |
|
| 4 | ;
|
|
| 6 | ;
; Patient's name and mailing address |
|
| TEST | ;
; EP;Test forms allignment |
|
| 8 | ;
|
| Name | Field # of Occurrence |
|---|---|
| TEST^ABMDF11W | TEST+2 |
| WRT^ABMDF11W | 1+6, 2+6, 2+8, 2+11, 3+10, 4+11, 4+13, 4+15, 4+17, 4+20 , 4+22, 4+24, 4+26, 6+15, 6+17, 8+13, 8+15, 8+17, 8+19, 8+21 , 8+23, 8+25, 8+27, 8+29, 8+31, 8+33, 8+35, 8+37, 8+39, 8+41 , 8+43, 8+45, 10+10, 10+12, 10+14, 10+16, 10+18, 10+20, 10+22, 10+24 , 10+26, 10+28, 10+30, 11+10, 11+12, 11+14, 11+16, 11+18, 11+20, 11+22 , 11+24, 11+26, 11+28, 11+30, 12+18, 12+40 |
| ^ABMDF11Y | OTHER+1 |
| ^ABMDF11Z | OTHER+1 |
| 110^ABMER10 | 4+2 |
| 120^ABMER10 | 1+4 |
| 130^ABMER10 | 2+3 |
| 140^ABMER10 | 3+3 |
| 150^ABMER10 | 3+4 |
| 160^ABMER10 | 3+5 |
| 40^ABMER10 | 4+3 |
| 190^ABMER20 | 4+4 |
| 200^ABMER20 | 4+5 |
| 30^ABMER20 | 2+4 |
| 200^ABMER30 | 4+6 |
| 210^ABMER30 | 4+7 |
| 220^ABMER30 | 4+8 |
| 230^ABMER30 | 4+9 |
| PRVT^ABMERINS | 12+15 |
| $$EN^ABMVDF | OTHER+2 |
| Name | Line Occurrences |
|---|---|
| Function Call: WRITE |
|
| Function Call: WRITE |
|
| Function Call: WRITE |
|
| Function Call: WRITE |
|
| Function Call: WRITE |
|
| Function Call: WRITE |
|
| Function Call: WRITE |
|
| Function Call: WRITE |
|
| Function Call: WRITE |
|
| Function Call: WRITE |
|
| Name | Line Occurrences (* Changed, ! Killed) |
|---|---|
| ^ABMDBILL( | 12+9, 12+11, 12+12 |
| ^ABMDEXP(11 | ABMDF11X+18 |
| ^ABMDPARM( | 12+4 |
| ^AUTNINS - [#9999999.18] | 12+24, 12+25, 12+27, 12+29, 12+30, 12+32, 12+36, 12+37, 12+38 |
| Name | Line Occurrences |
|---|---|
| @( | 6+6, 6+9, 8+5, 8+8, 8+11, 10+5, 10+8, 11+5, 11+8 |
| >> | Not killed explicitly |
| * | Changed |
| ! | Killed |
| ~ | Newed |
| Name | Field # of Occurrence |
|---|---|
| ABM | ABMDF11X+17!, OTHER+3! |
| ABM( | 12+17 |
| >> ABM38FLG | 12+4*, 12+5, 12+21, 12+42 |
| >> ABMDE | 1+5*, 2+5*, 2+7*, 2+10*, 3+9*, 4+10*, 4+12*, 4+14*, 4+16*, 4+18* , 4+21*, 4+23*, 4+25*, 6+14*, 6+16*, 8+12*, 8+14*, 8+16*, 8+18*, 8+20* , 8+22*, 8+24*, 8+26*, 8+28*, 8+30*, 8+32*, 8+34*, 8+36*, 8+38*, 8+40* , 8+42*, 8+44*, 10+9*, 10+11*, 10+13*, 10+15*, 10+17*, 10+19*, 10+21*, 10+23* , 10+25*, 10+27*, 10+29*, 11+9*, 11+11*, 11+13*, 11+15*, 11+17*, 11+19*, 11+21* , 11+23*, 11+25*, 11+27*, 11+29*, 12+17*, 12+39* |
| ABME | OTHER+3! |
| ABME("INS" | 12+12* |
| ABME("INSIEN" | 12+13*, 12+14 |
| ABME("PH" | 12+17 |
| >> ABMI | 12+34*, 12+35*, 12+36, 12+37, 12+38 |
| ABMICTY | 12+36*, OTHER+4! |
| ABMINM | 12+25*, 12+27*, 12+39, OTHER+4! |
| >> ABMINMF | 12+22*, 12+26*, 12+29, 12+34 |
| ABMIST | 12+37*, OTHER+4! |
| ABMISTR | 12+30*, 12+32*, OTHER+4! |
| >> ABMISTRF | 12+22*, 12+31*, 12+34 |
| ABMIZIP | 12+38*, OTHER+4! |
| >> ABMORE | 6+20 |
| >> ABMP("BDFN" | 12+9, 12+11, 12+12 |
| >> ABMP("BTYP" | 2+10 |
| >> ABMP("CDAYS" | 4+19* |
| >> ABMP("INS" | 12+24, 12+25, 12+27, 12+29, 12+30, 12+32, 12+36, 12+37, 12+38 |
| >> ABMP("ITYPE" | 12+6 |
| >> ABMP("LM" | ABMDF11X+18* |
| >> ABMP("NOFMT" | 1+3*, 6+18* |
| >> ABMP("PNAME" | 6+3!, 6+13*, 6+14 |
| ABMR | 8+2!, 10+2!, 11+2!, OTHER+3! |
| ABMR(10 | 1+5, 2+5, 3+6, 3+7*, 3+9, 4+10, 4+12 |
| ABMR(20 | 2+7, 4+14, 4+16, 6+10, 6+11*, 6+13, 6+16, 8+12, 8+14, 8+16 , 8+18, 8+20, 8+22, 8+24, 8+26, 8+28, 8+30 |
| ABMR(30 | 4+18, 4+19, 4+20, 4+21, 4+22, 4+23, 4+25 |
| ABMR(40 | 10+9, 10+11, 10+13, 10+15, 10+17, 10+19, 10+21, 10+23, 10+25, 10+27 , 10+29, 11+9, 11+11, 11+13, 11+15, 11+17, 11+19, 11+21, 11+23, 11+25 , 11+27, 11+29 |
| ABMR(41 | 8+32, 8+34, 8+36, 8+38, 8+40, 8+42, 8+44 |
| ABMREC | OTHER+3! |
| DUZ(2 | 12+4, 12+9, 12+11, 12+12 |
| I | 6+4~, 6+5*, 6+6, 6+7~, 6+8*, 6+9, 8+3~, 8+4*, 8+5, 8+6~ , 8+7*, 8+8, 8+9~, 8+10*, 8+11, 10+3~, 10+4*, 10+5, 10+6~, 10+7* , 10+8, 11+3~, 11+4*, 11+5, 11+6~, 11+7*, 11+8, 12+7~, 12+8*, 12+9* , 12+11, 12+12, 12+13 |
| U | 12+4, 12+24, 12+25, 12+27, 12+29, 12+30, 12+32, 12+36, 12+37, 12+38 |