Parent File | Name | Number | Package |
---|---|---|---|
9002313.0201 | COB/Other Payments | 9002313.0401 | Pharmacy Point of Sale |
Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | COB/Other Paymnt Cntr | 0;1 | FREE TEXT |
|
338 | Other Payer Coverage Type | 0;2 | FREE TEXT |
|
339 | Other Payer ID Qualifier | 0;3 | FREE TEXT |
|
340 | Other Payer ID | 0;4 | FREE TEXT |
|
341 | Other Payer Amt Paid Cnt | 0;6 | FREE TEXT |
|
342 | Other Payer Amt Paid Qual | 1;0 | Multiple #9002313.401342 | 9002313.401342 |
443 | Other Payer Date | 0;5 | FREE TEXT |
|
471 | Other Payer Reject Count | 0;7 | FREE TEXT |
|
472 | Other Payer Reject Code | 2;0 | Multiple #9002313.401472 | 9002313.401472 |