| Parent File | Name | Number | Package |
|---|---|---|---|
| 9002071.01 | OTHER PROVIDER (ON-FILE) | 9002071.02 | Contract Health Management Information System |
| Field # | Name | Loc | Type | Details |
|---|---|---|---|---|
| .01 | OTHER PROVIDER (ON-FILE) | 0;1 | POINTER TO VENDOR FILE (#9999999.11) | VENDOR(#9999999.11)
|
| 2 | EST. CHARGES (THIS PROVIDER) | 0;2 | NUMBER |
|
| 3 | ACTUAL CHARGES (THIS PROVIDER) | 0;3 | NUMBER |
|