Parent File | Name | Number | Package |
---|---|---|---|
CHS DEFERRED SERVICE DATA(#9002066) | CHS UNMET NEED NUMBER | 9002066.01 | Contract Health Management Information System |
Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | CHS UNMET NEED NUMBER | 0;1 | FREE TEXT | ************************REQUIRED FIELD************************
|
2 | UNMET NEED DATE ISSUED | 0;2 | DATE |
|
3 | ISSUED BY | 0;3 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
4 | DATE REQUEST RECEIVED | 0;4 | DATE |
|
5 | IS PATIENT REGISTERED? | 0;5 | SET |
|
6 | REGISTERED PATIENT | 0;6 | POINTER TO PATIENT FILE (#9000001) | PATIENT(#9000001)
|
7 | PATIENT NAME | 0;7 | FREE TEXT |
|
8 | MAILING ADDRESS-STREET | 0;8 | FREE TEXT |
|
9 | MAILING ADDRESS-CITY | 0;9 | FREE TEXT |
|
10 | MAILING ADDRESS-STATE | 0;10 | POINTER TO STATE FILE (#5) | STATE(#5)
|
11 | MAILING ADDRESS-ZIP | 0;11 | FREE TEXT |
|
12 | CHART# (OTHER FACILITY) | 0;12 | NUMBER |
|
13 | PATIENT TELEPHONE | 0;13 | FREE TEXT |
|
14 | UNMET NEED CANCELLED | 0;14 | SET |
|
100 | UNMET NEED CATEGORY | 100;1 | POINTER TO CHS DEFERRED SERVICES CATEGORY FILE (#9002066.5) | ************************REQUIRED FIELD************************ CHS DEFERRED SERVICES CATEGORY(#9002066.5)
|
105 | UNMET NEED SUBCATEGORY | 100;4 | NUMBER | ************************REQUIRED FIELD************************
|
110 | UNMET NEED TYPE | 100;2 | SET |
|
120 | NUMBER OF UNITS | 100;3 | NUMBER |
|
130 | ESTIMATED COST | 100;5 | NUMBER | ************************REQUIRED FIELD************************
|
200 | UNMET NEED DIAG (ICD) | 200;0 | POINTER Multiple #9002066.02 | 9002066.02
|
300 | UNMET NEED PROC (CPT) | 300;0 | POINTER Multiple #9002066.03 | 9002066.03
|
400 | UNMET NEED COMMENT | 400;0 | WORD-PROCESSING #9002066.04 |
|
500 | DOCUMENT CONTROL | 500;1 | SET |
|
501 | RECEIPT TYPE | 500;2 | SET |
|
502 | DATE LETTER RECEIVED | 500;3 | DATE |
|
503 | PERSON RECEIVING LETTER | 500;4 | FREE TEXT |
|
504 | DATE DENIAL ISSUED | 500;5 | DATE |
|
505 | DENIAL NUMBER | 500;6 | FREE TEXT |
|
506 | DATE SERVICE PROVIDED | 500;7 | DATE |
|
507 | PURCHASE ORDER NUMBER | 500;8 | FREE TEXT |
|