- IBDEI00Y ; ; 18-MAR-1994
- ;;Version 2.0 ; INTEGRATED BILLING ;; 21-MAR-94
- Q:'DIFQR(358.5) F I=1:2 S X=$T(Q+I) Q:X="" S Y=$E($T(Q+I+1),4,999),X=$E(X,4,999) S:$A(Y)=126 I=I+1,Y=$E(Y,2,999)_$E($T(Q+I+1),5,99) S:$A(Y)=61 Y=$E(Y,2,999) X NO E S @X=Y
- Q Q
- ;;^UTILITY(U,$J,358.5,47,0)
- ;;=ADDRESS LINE 1^11^9^0^1
- ;;^UTILITY(U,$J,358.5,47,2,0)
- ;;=^357.52I^1^1
- ;;^UTILITY(U,$J,358.5,47,2,1,0)
- ;;=LINE1^^I^^^0^39^45^1
- ;;^UTILITY(U,$J,358.5,48,0)
- ;;=ADDRESS LINE 2^11^9^0^2
- ;;^UTILITY(U,$J,358.5,48,2,0)
- ;;=^357.52I^1^1
- ;;^UTILITY(U,$J,358.5,48,2,1,0)
- ;;=LINE2^^I^^^1^39^45^1
- ;;^UTILITY(U,$J,358.5,49,0)
- ;;=DATE^11^10
- ;;^UTILITY(U,$J,358.5,49,2,0)
- ;;=^357.52I^1^1
- ;;^UTILITY(U,$J,358.5,49,2,1,0)
- ;;=Date Printed:^^^90^1^1^104^12^1
- ;;^UTILITY(U,$J,358.5,50,0)
- ;;=CHECK IF SC^11^3
- ;;^UTILITY(U,$J,358.5,50,2,0)
- ;;=^357.52I^2^2
- ;;^UTILITY(U,$J,358.5,50,2,1,0)
- ;;=*** NOTE: IF THE PATIENT'S TREATMENT WAS FOR ANY CONDITION RELATED TO THE FOLLOWING SERVICE-CONNECTED^^^7^4
- ;;^UTILITY(U,$J,358.5,50,2,2,0)
- ;;=DISABILITIES, CHECK BELOW TO THE LEFT OF THE LISTED CONDITON(S). ***^^^11^5
- ;;^UTILITY(U,$J,358.5,51,0)
- ;;=SC DISABILITY 1^11^11^0^1
- ;;^UTILITY(U,$J,358.5,51,2,0)
- ;;=^357.52I^3^3
- ;;^UTILITY(U,$J,358.5,51,2,1,0)
- ;;=Disabilities:^^^8^7
- ;;^UTILITY(U,$J,358.5,51,2,2,0)
- ;;=(__)^^^0^8^8^5^45^1
- ;;^UTILITY(U,$J,358.5,51,2,3,0)
- ;;=% - SERVICE CONNECTED^^I^^^8^51^24^5
- ;;^UTILITY(U,$J,358.5,52,0)
- ;;=SC DISABILITY 2^11^11^0^2
- ;;^UTILITY(U,$J,358.5,52,2,0)
- ;;=^357.52I^2^2
- ;;^UTILITY(U,$J,358.5,52,2,1,0)
- ;;=(__)^^^0^9^9^5^45^1
- ;;^UTILITY(U,$J,358.5,52,2,2,0)
- ;;=% - SERVICE CONNECTED^^I^^^9^51^24^5
- ;;^UTILITY(U,$J,358.5,53,0)
- ;;=SC DISABILITY 3^11^11^1^3
- ;;^UTILITY(U,$J,358.5,53,2,0)
- ;;=^357.52I^2^2
- ;;^UTILITY(U,$J,358.5,53,2,1,0)
- ;;=(__)^^^0^10^10^5^45^1
- ;;^UTILITY(U,$J,358.5,53,2,2,0)
- ;;=% - SERVICE CONNECTED^^I^^^10^51^24^5
- ;;^UTILITY(U,$J,358.5,54,0)
- ;;=INSURED?^11^12
- ;;^UTILITY(U,$J,358.5,54,2,0)
- ;;=^357.52I^1^1
- ;;^UTILITY(U,$J,358.5,54,2,1,0)
- ;;=Health Insurance:^^^3^12^12^21^7^1
- ;;^UTILITY(U,$J,358.5,55,0)
- ;;=INSURANCE 1^11^13^0^1
- ;;^UTILITY(U,$J,358.5,55,2,0)
- ;;=^357.52I^4^4
- ;;^UTILITY(U,$J,358.5,55,2,1,0)
- ;;=Insurance^^U^3^13^14^3^30^1
- ;;^UTILITY(U,$J,358.5,55,2,2,0)
- ;;=Policy #^^U^35^13^14^35^20^3
- ;;^UTILITY(U,$J,358.5,55,2,3,0)
- ;;=Group #^^U^58^13^14^58^17^4
- ;;^UTILITY(U,$J,358.5,55,2,4,0)
- ;;=Holder^^U^77^13^14^77^9^7
- ;;^UTILITY(U,$J,358.5,56,0)
- ;;=INSURANCE 2^11^13^0^2
- ;;^UTILITY(U,$J,358.5,56,2,0)
- ;;=^357.52I^4^4
- ;;^UTILITY(U,$J,358.5,56,2,1,0)
- ;;=COMPANY^^I^^^15^3^30^1
- ;;^UTILITY(U,$J,358.5,56,2,2,0)
- ;;=POLICY #^^I^^^15^35^20^3
- ;;^UTILITY(U,$J,358.5,56,2,3,0)
- ;;=GROUP #^^I^^^15^58^17^4
- ;;^UTILITY(U,$J,358.5,56,2,4,0)
- ;;=HOLDER^^I^^^15^77^9^7
- ;;^UTILITY(U,$J,358.5,57,0)
- ;;=INSURANCE 3^11^13^1^3
- ;;^UTILITY(U,$J,358.5,57,2,0)
- ;;=^357.52I^4^4
- ;;^UTILITY(U,$J,358.5,57,2,1,0)
- ;;=COMPANY^^I^^^16^3^30^1
- ;;^UTILITY(U,$J,358.5,57,2,2,0)
- ;;=POLICY #^^I^^^16^35^20^3
- ;;^UTILITY(U,$J,358.5,57,2,3,0)
- ;;=GROUP #^^I^^^16^58^17^4
- ;;^UTILITY(U,$J,358.5,57,2,4,0)
- ;;=HOLDER^^I^^^16^77^9^7
- ;;^UTILITY(U,$J,358.5,58,0)
- ;;=FACILITY^11^14
- ;;^UTILITY(U,$J,358.5,58,2,0)
- ;;=^357.52I^1^1
- ;;^UTILITY(U,$J,358.5,58,2,1,0)
- ;;=FACILITY:^^^90^0^0^100^30^1
- ;;^UTILITY(U,$J,358.5,59,0)
- ;;=ADDRESS LINE 3^11^9^1^3
- ;;^UTILITY(U,$J,358.5,59,2,0)
- ;;=^357.52I^1^1
- ;;^UTILITY(U,$J,358.5,59,2,1,0)
- ;;=LINE 3^^I^^^2^39^45^1
- ;;^UTILITY(U,$J,358.5,60,0)
- ;;=CLINIC^12^5
- ;;^UTILITY(U,$J,358.5,60,2,0)
- ;;=^357.52I^1^1
- ;;^UTILITY(U,$J,358.5,60,2,1,0)
- ;;=Clinic:^^^0^0^0^8^30^1
- ;;^UTILITY(U,$J,358.5,61,0)
- ;;=APPT. DT/TIME^12^4
- ;;^UTILITY(U,$J,358.5,61,2,0)
- ;;=^357.52I^1^1
- ;;^UTILITY(U,$J,358.5,61,2,1,0)
- ;;=Appt. DT/Time:^^^0^2^2^15^23^1
- ;;^UTILITY(U,$J,358.5,62,0)
- ;;=OTHER ALLERGIES^13^3
- ;;^UTILITY(U,$J,358.5,62,2,0)
- ;;=^357.52I^1^1
- IBDEI00Y ; ; 18-MAR-1994
- +1 ;;Version 2.0 ; INTEGRATED BILLING ;; 21-MAR-94
- +2 IF 'DIFQR(358.5)
- QUIT
- FOR I=1:2
- SET X=$TEXT(Q+I)
- IF X=""
- QUIT
- SET Y=$EXTRACT($TEXT(Q+I+1),4,999)
- SET X=$EXTRACT(X,4,999)
- IF $ASCII(Y)=126
- SET I=I+1
- SET Y=$EXTRACT(Y,2,999)_$EXTRACT($TEXT(Q+I+1),5,99)
- IF $ASCII(Y)=61
- SET Y=$EXTRACT(Y,2,999)
- XECUTE NO
- IF '$TEST
- SET @X=Y
- Q QUIT
- +1 ;;^UTILITY(U,$J,358.5,47,0)
- +2 ;;=ADDRESS LINE 1^11^9^0^1
- +3 ;;^UTILITY(U,$J,358.5,47,2,0)
- +4 ;;=^357.52I^1^1
- +5 ;;^UTILITY(U,$J,358.5,47,2,1,0)
- +6 ;;=LINE1^^I^^^0^39^45^1
- +7 ;;^UTILITY(U,$J,358.5,48,0)
- +8 ;;=ADDRESS LINE 2^11^9^0^2
- +9 ;;^UTILITY(U,$J,358.5,48,2,0)
- +10 ;;=^357.52I^1^1
- +11 ;;^UTILITY(U,$J,358.5,48,2,1,0)
- +12 ;;=LINE2^^I^^^1^39^45^1
- +13 ;;^UTILITY(U,$J,358.5,49,0)
- +14 ;;=DATE^11^10
- +15 ;;^UTILITY(U,$J,358.5,49,2,0)
- +16 ;;=^357.52I^1^1
- +17 ;;^UTILITY(U,$J,358.5,49,2,1,0)
- +18 ;;=Date Printed:^^^90^1^1^104^12^1
- +19 ;;^UTILITY(U,$J,358.5,50,0)
- +20 ;;=CHECK IF SC^11^3
- +21 ;;^UTILITY(U,$J,358.5,50,2,0)
- +22 ;;=^357.52I^2^2
- +23 ;;^UTILITY(U,$J,358.5,50,2,1,0)
- +24 ;;=*** NOTE: IF THE PATIENT'S TREATMENT WAS FOR ANY CONDITION RELATED TO THE FOLLOWING SERVICE-CONNECTED^^^7^4
- +25 ;;^UTILITY(U,$J,358.5,50,2,2,0)
- +26 ;;=DISABILITIES, CHECK BELOW TO THE LEFT OF THE LISTED CONDITON(S). ***^^^11^5
- +27 ;;^UTILITY(U,$J,358.5,51,0)
- +28 ;;=SC DISABILITY 1^11^11^0^1
- +29 ;;^UTILITY(U,$J,358.5,51,2,0)
- +30 ;;=^357.52I^3^3
- +31 ;;^UTILITY(U,$J,358.5,51,2,1,0)
- +32 ;;=Disabilities:^^^8^7
- +33 ;;^UTILITY(U,$J,358.5,51,2,2,0)
- +34 ;;=(__)^^^0^8^8^5^45^1
- +35 ;;^UTILITY(U,$J,358.5,51,2,3,0)
- +36 ;;=% - SERVICE CONNECTED^^I^^^8^51^24^5
- +37 ;;^UTILITY(U,$J,358.5,52,0)
- +38 ;;=SC DISABILITY 2^11^11^0^2
- +39 ;;^UTILITY(U,$J,358.5,52,2,0)
- +40 ;;=^357.52I^2^2
- +41 ;;^UTILITY(U,$J,358.5,52,2,1,0)
- +42 ;;=(__)^^^0^9^9^5^45^1
- +43 ;;^UTILITY(U,$J,358.5,52,2,2,0)
- +44 ;;=% - SERVICE CONNECTED^^I^^^9^51^24^5
- +45 ;;^UTILITY(U,$J,358.5,53,0)
- +46 ;;=SC DISABILITY 3^11^11^1^3
- +47 ;;^UTILITY(U,$J,358.5,53,2,0)
- +48 ;;=^357.52I^2^2
- +49 ;;^UTILITY(U,$J,358.5,53,2,1,0)
- +50 ;;=(__)^^^0^10^10^5^45^1
- +51 ;;^UTILITY(U,$J,358.5,53,2,2,0)
- +52 ;;=% - SERVICE CONNECTED^^I^^^10^51^24^5
- +53 ;;^UTILITY(U,$J,358.5,54,0)
- +54 ;;=INSURED?^11^12
- +55 ;;^UTILITY(U,$J,358.5,54,2,0)
- +56 ;;=^357.52I^1^1
- +57 ;;^UTILITY(U,$J,358.5,54,2,1,0)
- +58 ;;=Health Insurance:^^^3^12^12^21^7^1
- +59 ;;^UTILITY(U,$J,358.5,55,0)
- +60 ;;=INSURANCE 1^11^13^0^1
- +61 ;;^UTILITY(U,$J,358.5,55,2,0)
- +62 ;;=^357.52I^4^4
- +63 ;;^UTILITY(U,$J,358.5,55,2,1,0)
- +64 ;;=Insurance^^U^3^13^14^3^30^1
- +65 ;;^UTILITY(U,$J,358.5,55,2,2,0)
- +66 ;;=Policy #^^U^35^13^14^35^20^3
- +67 ;;^UTILITY(U,$J,358.5,55,2,3,0)
- +68 ;;=Group #^^U^58^13^14^58^17^4
- +69 ;;^UTILITY(U,$J,358.5,55,2,4,0)
- +70 ;;=Holder^^U^77^13^14^77^9^7
- +71 ;;^UTILITY(U,$J,358.5,56,0)
- +72 ;;=INSURANCE 2^11^13^0^2
- +73 ;;^UTILITY(U,$J,358.5,56,2,0)
- +74 ;;=^357.52I^4^4
- +75 ;;^UTILITY(U,$J,358.5,56,2,1,0)
- +76 ;;=COMPANY^^I^^^15^3^30^1
- +77 ;;^UTILITY(U,$J,358.5,56,2,2,0)
- +78 ;;=POLICY #^^I^^^15^35^20^3
- +79 ;;^UTILITY(U,$J,358.5,56,2,3,0)
- +80 ;;=GROUP #^^I^^^15^58^17^4
- +81 ;;^UTILITY(U,$J,358.5,56,2,4,0)
- +82 ;;=HOLDER^^I^^^15^77^9^7
- +83 ;;^UTILITY(U,$J,358.5,57,0)
- +84 ;;=INSURANCE 3^11^13^1^3
- +85 ;;^UTILITY(U,$J,358.5,57,2,0)
- +86 ;;=^357.52I^4^4
- +87 ;;^UTILITY(U,$J,358.5,57,2,1,0)
- +88 ;;=COMPANY^^I^^^16^3^30^1
- +89 ;;^UTILITY(U,$J,358.5,57,2,2,0)
- +90 ;;=POLICY #^^I^^^16^35^20^3
- +91 ;;^UTILITY(U,$J,358.5,57,2,3,0)
- +92 ;;=GROUP #^^I^^^16^58^17^4
- +93 ;;^UTILITY(U,$J,358.5,57,2,4,0)
- +94 ;;=HOLDER^^I^^^16^77^9^7
- +95 ;;^UTILITY(U,$J,358.5,58,0)
- +96 ;;=FACILITY^11^14
- +97 ;;^UTILITY(U,$J,358.5,58,2,0)
- +98 ;;=^357.52I^1^1
- +99 ;;^UTILITY(U,$J,358.5,58,2,1,0)
- +100 ;;=FACILITY:^^^90^0^0^100^30^1
- +101 ;;^UTILITY(U,$J,358.5,59,0)
- +102 ;;=ADDRESS LINE 3^11^9^1^3
- +103 ;;^UTILITY(U,$J,358.5,59,2,0)
- +104 ;;=^357.52I^1^1
- +105 ;;^UTILITY(U,$J,358.5,59,2,1,0)
- +106 ;;=LINE 3^^I^^^2^39^45^1
- +107 ;;^UTILITY(U,$J,358.5,60,0)
- +108 ;;=CLINIC^12^5
- +109 ;;^UTILITY(U,$J,358.5,60,2,0)
- +110 ;;=^357.52I^1^1
- +111 ;;^UTILITY(U,$J,358.5,60,2,1,0)
- +112 ;;=Clinic:^^^0^0^0^8^30^1
- +113 ;;^UTILITY(U,$J,358.5,61,0)
- +114 ;;=APPT. DT/TIME^12^4
- +115 ;;^UTILITY(U,$J,358.5,61,2,0)
- +116 ;;=^357.52I^1^1
- +117 ;;^UTILITY(U,$J,358.5,61,2,1,0)
- +118 ;;=Appt. DT/Time:^^^0^2^2^15^23^1
- +119 ;;^UTILITY(U,$J,358.5,62,0)
- +120 ;;=OTHER ALLERGIES^13^3
- +121 ;;^UTILITY(U,$J,358.5,62,2,0)
- +122 ;;=^357.52I^1^1
