| Name |
Label |
Category |
| ADFROMER
| QA2b ADMITTED FROM EMERGENCY ROOM |
|
| AIDPAYM
| QC4c SOURCE OF PAYMENT - MEDICAID |
|
| ALLEVNTS
| QA4c COVERED ALL EVENTS FOR 2000 |
|
| ANCILL
| QC2b ANCILLARY CHARGES INCLUDED OR NOT |
|
| ANYCOPAY
| QC7b ANY CO-PAYMENT |
|
| ANYSBDS
| QA3 ANY SEPARATELY BILLING DOCTORS |
|
| ANYSURG
| QA9 ANY SURGICAL PROCEDURES |
|
| BADDEB
| QC6r BAD DEBT |
|
| BETOS1
| BETOS CODE 1 (CPT4 OR CODED BETOS) |
|
| BETOS10
| BETOS CODE 10 (CPT4 OR CODED BETOS) |
|
| BETOS11
| BETOS CODE 11 (CPT4 OR CODED BETOS) |
|
| BETOS12
| BETOS CODE 12 (CPT4 OR CODED BETOS) |
|
| BETOS13
| BETOS CODE 13 (CPT4 OR CODED BETOS) |
|
| BETOS14
| BETOS CODE 14 (CPT4 OR CODED BETOS) |
|
| BETOS15
| BETOS CODE 15 (CPT4 OR CODED BETOS) |
|
| BETOS16
| BETOS CODE 16 (CPT4 OR CODED BETOS) |
|
| BETOS17
| BETOS CODE 17 (CPT4 OR CODED BETOS) |
|
| BETOS18
| BETOS CODE 18 (CPT4 OR CODED BETOS) |
|
| BETOS19
| BETOS CODE 19 (CPT4 OR CODED BETOS) |
|
| BETOS2
| BETOS CODE 2 (CPT4 OR CODED BETOS) |
|
| BETOS20
| BETOS CODE 20 (CPT4 OR CODED BETOS) |
|
| BETOS21
| BETOS CODE 21 (CPT4 OR CODED BETOS) |
|
| BETOS22
| BETOS CODE 22 (CPT4 OR CODED BETOS) |
|
| BETOS23
| BETOS CODE 23 (CPT4 OR CODED BETOS) |
|
| BETOS24
| BETOS CODE 24 (CPT4 OR CODED BETOS) |
|
| BETOS25
| BETOS CODE 25 (CPT4 OR CODED BETOS) |
|
| BETOS26
| BETOS CODE 26 (CPT4 OR CODED BETOS) |
|
| BETOS27
| BETOS CODE 27 (CPT4 OR CODED BETOS) |
|
| BETOS28
| BETOS CODE 28 (CPT4 OR CODED BETOS) |
|
| BETOS29
| BETOS CODE 29 (CPT4 OR CODED BETOS) |
|
| BETOS3
| BETOS CODE 3 (CPT4 OR CODED BETOS) |
|
| BETOS30
| BETOS CODE 30 (CPT4 OR CODED BETOS) |
|
| BETOS31
| BETOS CODE 31 (CPT4 OR CODED BETOS) |
|
| BETOS32
| BETOS CODE 32 (CPT4 OR CODED BETOS) |
|
| BETOS33
| BETOS CODE 33 (CPT4 OR CODED BETOS) |
|
| BETOS34
| BETOS CODE 34 (CPT4 OR CODED BETOS) |
|
| BETOS35
| BETOS CODE 35 (CPT4 OR CODED BETOS) |
|
| BETOS36
| BETOS CODE 36 (CPT4 OR CODED BETOS) |
|
| BETOS37
| BETOS CODE 37 (CPT4 OR CODED BETOS) |
|
| BETOS38
| BETOS CODE 38 (CPT4 OR CODED BETOS) |
|
| BETOS39
| BETOS CODE 39 (CPT4 OR CODED BETOS) |
|
| BETOS4
| BETOS CODE 4 (CPT4 OR CODED BETOS) |
|
| BETOS40
| BETOS CODE 40 (CPT4 OR CODED BETOS) |
|
| BETOS41
| BETOS CODE 41 (CPT4 OR CODED BETOS) |
|
| BETOS42
| BETOS CODE 42 (CPT4 OR CODED BETOS) |
|
| BETOS43
| BETOS CODE 43 (CPT4 OR CODED BETOS) |
|
| BETOS44
| BETOS CODE 44 (CPT4 OR CODED BETOS) |
|
| BETOS45
| BETOS CODE 45 (CPT4 OR CODED BETOS) |
|
| BETOS46
| BETOS CODE 46 (CPT4 OR CODED BETOS) |
|
| BETOS47
| BETOS CODE 47 (CPT4 OR CODED BETOS) |
|
| BETOS48
| BETOS CODE 48 (CPT4 OR CODED BETOS) |
|
| BETOS49
| BETOS CODE 49 (CPT4 OR CODED BETOS) |
|
| BETOS5
| BETOS CODE 5 (CPT4 OR CODED BETOS) |
|
| BETOS50
| BETOS CODE 50 (CPT4 OR CODED BETOS) |
|
| BETOS51
| BETOS CODE 51 (CPT4 OR CODED BETOS) |
|
| BETOS52
| BETOS CODE 52 (CPT4 OR CODED BETOS) |
|
| BETOS53
| BETOS CODE 53 (CPT4 OR CODED BETOS) |
|
| BETOS54
| BETOS CODE 54 (CPT4 OR CODED BETOS) |
|
| BETOS55
| BETOS CODE 55 (CPT4 OR CODED BETOS) |
|
| BETOS56
| BETOS CODE 56 (CPT4 OR CODED BETOS) |
|
| BETOS57
| BETOS CODE 57 (CPT4 OR CODED BETOS) |
|
| BETOS58
| BETOS CODE 58 (CPT4 OR CODED BETOS) |
|
| BETOS59
| BETOS CODE 59 (CPT4 OR CODED BETOS) |
|
| BETOS6
| BETOS CODE 6 (CPT4 OR CODED BETOS) |
|
| BETOS60
| BETOS CODE 60 (CPT4 OR CODED BETOS) |
|
| BETOS61
| BETOS CODE 61 (CPT4 OR CODED BETOS) |
|
| BETOS62
| BETOS CODE 62 (CPT4 OR CODED BETOS) |
|
| BETOS63
| BETOS CODE 63 (CPT4 OR CODED BETOS) |
|
| BETOS64
| BETOS CODE 64 (CPT4 OR CODED BETOS) |
|
| BETOS65
| BETOS CODE 65 (CPT4 OR CODED BETOS) |
|
| BETOS66
| BETOS CODE 66 (CPT4 OR CODED BETOS) |
|
| BETOS67
| BETOS CODE 67 (CPT4 OR CODED BETOS) |
|
| BETOS68
| BETOS CODE 68 (CPT4 OR CODED BETOS) |
|
| BETOS69
| BETOS CODE 69 (CPT4 OR CODED BETOS) |
|
| BETOS7
| BETOS CODE 7 (CPT4 OR CODED BETOS) |
|
| BETOS8
| BETOS CODE 8 (CPT4 OR CODED BETOS) |
|
| BETOS9
| BETOS CODE 9 (CPT4 OR CODED BETOS) |
|
| CAREPAYM
| QC4b SOURCE OF PAYMENT - MEDICARE |
|
| CCMTCH1
| COLLAPSED CCSMATCH CODE #1 |
|
| CCMTCH10
| COLLAPSED CCSMATCH CODE #10 |
|
| CCMTCH11
| COLLAPSED CCSMATCH CODE #11 |
|
| CCMTCH12
| COLLAPSED CCSMATCH CODE #12 |
|
| CCMTCH13
| COLLAPSED CCSMATCH CODE #13 |
|
| CCMTCH14
| COLLAPSED CCSMATCH CODE #14 |
|
| CCMTCH15
| COLLAPSED CCSMATCH CODE #15 |
|
| CCMTCH16
| COLLAPSED CCSMATCH CODE #16 |
|
| CCMTCH17
| COLLAPSED CCSMATCH CODE #17 |
|
| CCMTCH18
| COLLAPSED CCSMATCH CODE #18 |
|
| CCMTCH19
| COLLAPSED CCSMATCH CODE #19 |
|
| CCMTCH2
| COLLAPSED CCSMATCH CODE #2 |
|
| CCMTCH20
| COLLAPSED CCSMATCH CODE #20 |
|
| CCMTCH21
| COLLAPSED CCSMATCH CODE #21 |
|
| CCMTCH22
| COLLAPSED CCSMATCH CODE #22 |
|
| CCMTCH23
| COLLAPSED CCSMATCH CODE #23 |
|
| CCMTCH24
| COLLAPSED CCSMATCH CODE #24 |
|
| CCMTCH25
| COLLAPSED CCSMATCH CODE #25 |
|
| CCMTCH3
| COLLAPSED CCSMATCH CODE #3 |
|
| CCMTCH4
| COLLAPSED CCSMATCH CODE #4 |
|
| CCMTCH5
| COLLAPSED CCSMATCH CODE #5 |
|
| CCMTCH6
| COLLAPSED CCSMATCH CODE #6 |
|
| CCMTCH7
| COLLAPSED CCSMATCH CODE #7 |
|
| CCMTCH8
| COLLAPSED CCSMATCH CODE #8 |
|
| CCMTCH9
| COLLAPSED CCSMATCH CODE #9 |
|
| CCS1
| CCS CONDITION CODE #1 |
|
| CCS10
| CCS CONDITION CODE #10 |
|
| CCS11
| CCS CONDITION CODE #11 |
|
| CCS12
| CCS CONDITION CODE #12 |
|
| CCS13
| CCS CONDITION CODE #13 |
|
| CCS14
| CCS CONDITION CODE #14 |
|
| CCS15
| CCS CONDITION CODE #15 |
|
| CCS16
| CCS CONDITION CODE #16 |
|
| CCS17
| CCS CONDITION CODE #17 |
|
| CCS18
| CCS CONDITION CODE #18 |
|
| CCS19
| CCS CONDITION CODE #19 |
|
| CCS2
| CCS CONDITION CODE #2 |
|
| CCS20
| CCS CONDITION CODE #20 |
|
| CCS21
| CCS CONDITION CODE #21 |
|
| CCS22
| CCS CONDITION CODE #22 |
|
| CCS23
| CCS CONDITION CODE #23 |
|
| CCS24
| CCS CONDITION CODE #24 |
|
| CCS25
| CCS CONDITION CODE #25 |
|
| CCS3
| CCS CONDITION CODE #3 |
|
| CCS4
| CCS CONDITION CODE #4 |
|
| CCS5
| CCS CONDITION CODE #5 |
|
| CCS6
| CCS CONDITION CODE #6 |
|
| CCS7
| CCS CONDITION CODE #7 |
|
| CCS8
| CCS CONDITION CODE #8 |
|
| CCS9
| CCS CONDITION CODE #9 |
|
| CCSMATCH
| PRINCIPAL COLLAPSED CCSMATCH CODE |
|
| CCSPR
| PRINCIPAL CCS CONDITION CODE |
|
| CHAMPAYM
| QC4f SRCE OF PMT-TRICARE/CHAMPVA/CHAMPUS |
|
| CHEKBX1
| QA10a CHECK BOX1 FOR PRINCIPAL SURG #1 |
|
| CHEKBX2
| QA10a CHECK BOX2 FOR PRINCIPAL SURG #2 |
|
| CHEKBX3
| QA10a CHECK BOX3 FOR PRINCIPAL SURG #3 |
|
| CHEKBX4
| QA10a CHECK BOX4 FOR PRINCIPAL SURG #4 |
|
| CHEKBX5
| QA10a CHECK BOX5 FOR PRINCIPAL SURG #5 |
|
| CHEKBX6
| QA10a CHECK BOX6 FOR PRINCIPAL SURG #6 |
|
| CHEKBX7
| QA10a CHECK BOX7 FOR PRINCIPAL SURG #7 |
|
| CHEKBX8
| QA10a CHECK BOX8 FOR PRINCIPAL SURG #8 |
|
| CKBX1
| QA4a CHECK BOX1 FOR PRINCIPAL DIAG #1 |
|
| CKBX10
| QA4a CHECK BOX10 FOR PRINCIPAL DIAG #10 |
|
| CKBX11
| QA4a CHECK BOX11 FOR PRINCIPAL DIAG #11 |
|
| CKBX12
| QA4a CHECK BOX12 FOR PRINCIPAL DIAG #12 |
|
| CKBX13
| QA4a CHECK BOX13 FOR PRINCIPAL DIAG #13 |
|
| CKBX14
| QA4a CHECK BOX14 FOR PRINCIPAL DIAG #14 |
|
| CKBX15
| QA4a CHECK BOX15 FOR PRINCIPAL DIAG #15 |
|
| CKBX16
| QA4a CHECK BOX16 FOR PRINCIPAL DIAG #16 |
|
| CKBX17
| QA4a CHECK BOX17 FOR PRINCIPAL DIAG #17 |
|
| CKBX18
| QA4a CHECK BOX18 FOR PRINCIPAL DIAG #18 |
|
| CKBX19
| QA4a CHECK BOX19 FOR PRINCIPAL DIAG #19 |
|
| CKBX2
| QA4a CHECK BOX2 FOR PRINCIPAL DIAG #2 |
|
| CKBX20
| QA4a CHECK BOX20 FOR PRINCIPAL DIAG #20 |
|
| CKBX21
| QA4a CHECK BOX21 FOR PRINCIPAL DIAG #21 |
|
| CKBX22
| QA4a CHECK BOX22 FOR PRINCIPAL DIAG #22 |
|
| CKBX23
| QA4a CHECK BOX23 FOR PRINCIPAL DIAG #23 |
|
| CKBX24
| QA4a CHECK BOX24 FOR PRINCIPAL DIAG #24 |
|
| CKBX25
| QA4a CHECK BOX25 FOR PRINCIPAL DIAG #25 |
|
| CKBX3
| QA4a CHECK BOX3 FOR PRINCIPAL DIAG #3 |
|
| CKBX4
| QA4a CHECK BOX4 FOR PRINCIPAL DIAG #4 |
|
| CKBX5
| QA4a CHECK BOX5 FOR PRINCIPAL DIAG #5 |
|
| CKBX6
| QA4a CHECK BOX6 FOR PRINCIPAL DIAG #6 |
|
| CKBX7
| QA4a CHECK BOX7 FOR PRINCIPAL DIAG #7 |
|
| CKBX8
| QA4a CHECK BOX8 FOR PRINCIPAL DIAG #8 |
|
| CKBX9
| QA4a CHECK BOX9 FOR PRINCIPAL DIAG #9 |
|
| COPAYAMT
| QC7c CO-PAYMENT AMOUNT |
|
| COVAID
| QC7ab INSURANCE PLAN - MEDICAID |
|
| COVCARE
| QC7aa INSURANCE PLAN - MEDICARE |
|
| COVCHAM
| QC7ae INS PLAN - TRICARE/CHAMPVA/CHAMPUS |
|
| COVOTHR
| QC7ag INSURANCE PLAN - OTHER |
|
| COVOTOS
| QC7ag INSURANCE PLAN - OTHER (SPECIFY) |
|
| COVPINS
| QC7ac INSURANCE PLAN - PRIVATE INS |
|
| COVVA
| QC7ad INSURANCE PLAN - VA |
|
| COVWORK
| QC7af INSURANCE PLAN - WORKERS COMP |
|
| CPAYAID
| QC7dc CO-PAYMENT - MEDICAID |
|
| CPAYCARE
| QC7db CO-PAYMENT - MEDICARE |
|
| CPAYOTHR
| QC7de CO-PAYMENT - OTHER |
|
| CPAYOTOS
| QC7de CO-PAYMENT - OTHER (SPECIFY) |
|
| CPAYPAT
| QC7da CO-PAYMENT - PATIENT |
|
| CPAYPINS
| QC7dd CO-PAYMENT - PRIVATE INS |
|
| DISCAID
| QC6b ADJUST/DISCOUNT - MEDICAID |
|
| DISCARE
| QC6a ADJUST/DISCOUNT - MEDICARE |
|
| DISCNT
| QC6c ADJUST/DISCOUNT -CONTRACT AGREEMENT |
|
| DISCRTS
| QC6d ADJUST/DISCOUNT - COURTESY DISCOUNT |
|
| DISINSU
| QC6e ADJUST/DISCOUNT -INSURANCE WRITEOFF |
|
| DISOTH
| QC6h ADJUST/DISCOUNT - OTHER |
|
| DISOTOS
| QC6h ADJUST/DISCOUNT - OTHER (SPECIFY) |
|
| DISWORK
| QC6f ADJUST/DISCOUNT - WORKERS COMP |
|
| DUPERSID
| PUBLIC USE PERSON ID (DUID + PID) |
Identifiers |
| ELIGVET
| QC6g ADJUST/DISCOUNT - ELIGIBLE VETERAN |
|
| EPAYAID
| QC6k EXPECTS ADD PAYMENT - MEDICAID |
|
| EPAYCAR
| QC6j EXPECTS ADD PAYMENT - MEDICARE |
|
| EPAYCHAM
| QC6n EXP ADD PMT-TRICARE/CHAMPVA/CHAMPUS |
|
| EPAYOTH
| QC6p EXPECTS ADD PAYMENT - OTHER |
|
| EPAYOTOS
| QC6p EXPECTS ADD PAYMENT-OTHER (SPECIFY) |
|
| EPAYPAT
| QC6i EXPECTS ADD PAYMENT - PATIENT |
|
| EPAYPINS
| QC6l EXPECTS ADD PAYMENT - PRIVATE INS |
|
| EPAYVA
| QC6m EXPECTS ADD PAYMENT - VA |
|
| EPAYWORK
| QC6o EXPECTS ADD PAYMENT - WORKERS COMP |
|
| ERCHRINC
| QC2a ER CHARGE INCLUDED OR NOT |
|
| ERLINK
| LINK TO EMERGENCY ROOM - FORMID |
|
| EVNTBEGD
| QA2a,2c,5d,7c EVENT BEGIN DATE - DAY |
|
| EVNTBEGM
| QA2a,2c,5d,7c EVENT BEGIN DATE - MONTH |
|
| EVNTBEGY
| QA2a,2c,5d,7c EVENT BEGIN DATE - YEAR |
|
| EVNTENDD
| QA2a EVENT END DATE - DAY |
|
| EVNTENDM
| QA2a EVENT END DATE - MONTH |
|
| EVNTENDY
| QA2a EVENT END DATE - YEAR |
|
| EVNTTYPE
| EVENT TYPE |
|
| FEEORCAP
| QC3 FEE FOR SERVICE OR CAPITATED BASIS |
|
| FORMID
| UNIQUE FORM IDENTIFIER |
|
| FORMNUM
| COVER SHEET - FORM NUMBER OF THE TOTAL |
|
| FORMTOT
| COVER SHEET - TOTAL NUMBER OF FORMS |
|
| GFEEBEGD
| QA5c ADMIT DATE - DAY |
|
| GFEEBEGM
| QA5c ADMIT DATE - MONTH |
|
| GFEEBEGY
| QA5c ADMIT DATE - YEAR |
|
| GFEECOVS
| QA5b GLOBAL FEE COVER INPATIENT VISIT |
|
| GFEEENDD
| QA5c DISCHARGE DATE - DAY |
|
| GFEEENDM
| QA5c DISCHARGE DATE - MONTH |
|
| GFEEENDY
| QA5c DISCHARGE DATE - YEAR |
|
| GFEEFUTS
| QA5e FUTURE SERVICES BY THIS GLOBAL FEE |
|
| GFTYPE
| QA5d TYPE OF EVENT IN THIS GLOBAL FEE |
|
| GLOFEE
| QA5a GLOBAL FEE VISIT |
|
| GOTORVIS
| BOX3 FILTER ON GLOBAL FEE/NUMBR OF EVNTS |
|
| HHRKUID
| COVER SHEET - PATIENT ID |
|
| ICDCND1
| QA4a ORIG ICD9 CONDITION CODE #1 |
|
| ICDCND10
| QA4a ORIG ICD9 CONDITION CODE #10 |
|
| ICDCND11
| QA4a ORIG ICD9 CONDITION CODE #11 |
|
| ICDCND12
| QA4a ORIG ICD9 CONDITION CODE #12 |
|
| ICDCND13
| QA4a ORIG ICD9 CONDITION CODE #13 |
|
| ICDCND14
| QA4a ORIG ICD9 CONDITION CODE #14 |
|
| ICDCND15
| QA4a ORIG ICD9 CONDITION CODE #15 |
|
| ICDCND16
| QA4a ORIG ICD9 CONDITION CODE #16 |
|
| ICDCND17
| QA4a ORIG ICD9 CONDITION CODE #17 |
|
| ICDCND18
| QA4a ORIG ICD9 CONDITION CODE #18 |
|
| ICDCND19
| QA4a ORIG ICD9 CONDITION CODE #19 |
|
| ICDCND2
| QA4a ORIG ICD9 CONDITION CODE #2 |
|
| ICDCND20
| QA4a ORIG ICD9 CONDITION CODE #20 |
|
| ICDCND21
| QA4a ORIG ICD9 CONDITION CODE #21 |
|
| ICDCND22
| QA4a ORIG ICD9 CONDITION CODE #22 |
|
| ICDCND23
| QA4a ORIG ICD9 CONDITION CODE #23 |
|
| ICDCND24
| QA4a ORIG ICD9 CONDITION CODE #24 |
|
| ICDCND25
| QA4a ORIG ICD9 CONDITION CODE #25 |
|
| ICDCND3
| QA4a ORIG ICD9 CONDITION CODE #3 |
|
| ICDCND4
| QA4a ORIG ICD9 CONDITION CODE #4 |
|
| ICDCND5
| QA4a ORIG ICD9 CONDITION CODE #5 |
|
| ICDCND6
| QA4a ORIG ICD9 CONDITION CODE #6 |
|
| ICDCND7
| QA4a ORIG ICD9 CONDITION CODE #7 |
|
| ICDCND8
| QA4a ORIG ICD9 CONDITION CODE #8 |
|
| ICDCND9
| QA4a ORIG ICD9 CONDITION CODE #9 |
|
| ICDPDS1
| QA4a ORIG TEXT DESC FOR DIAGNOSIS #1 |
|
| ICDPDS10
| QA4a ORIG TEXT DESC FOR DIAGNOSIS #10 |
|
| ICDPDS11
| QA4a ORIG TEXT DESC FOR DIAGNOSIS #11 |
|
| ICDPDS12
| QA4a ORIG TEXT DESC FOR DIAGNOSIS #12 |
|
| ICDPDS13
| QA4a ORIG TEXT DESC FOR DIAGNOSIS #13 |
|
| ICDPDS14
| QA4a ORIG TEXT DESC FOR DIAGNOSIS #14 |
|
| ICDPDS15
| QA4a ORIG TEXT DESC FOR DIAGNOSIS #15 |
|
| ICDPDS16
| QA4a ORIG TEXT DESC FOR DIAGNOSIS #16 |
|
| ICDPDS17
| QA4a ORIG TEXT DESC FOR DIAGNOSIS #17 |
|
| ICDPDS18
| QA4a ORIG TEXT DESC FOR DIAGNOSIS #18 |
|
| ICDPDS19
| QA4a ORIG TEXT DESC FOR DIAGNOSIS #19 |
|
| ICDPDS2
| QA4a ORIG TEXT DESC FOR DIAGNOSIS #2 |
|
| ICDPDS20
| QA4a ORIG TEXT DESC FOR DIAGNOSIS #20 |
|
| ICDPDS21
| QA4a ORIG TEXT DESC FOR DIAGNOSIS #21 |
|
| ICDPDS22
| QA4a ORIG TEXT DESC FOR DIAGNOSIS #22 |
|
| ICDPDS23
| QA4a ORIG TEXT DESC FOR DIAGNOSIS #23 |
|
| ICDPDS24
| QA4a ORIG TEXT DESC FOR DIAGNOSIS #24 |
|
| ICDPDS25
| QA4a ORIG TEXT DESC FOR DIAGNOSIS #25 |
|
| ICDPDS3
| QA4a ORIG TEXT DESC FOR DIAGNOSIS #3 |
|
| ICDPDS4
| QA4a ORIG TEXT DESC FOR DIAGNOSIS #4 |
|
| ICDPDS5
| QA4a ORIG TEXT DESC FOR DIAGNOSIS #5 |
|
| ICDPDS6
| QA4a ORIG TEXT DESC FOR DIAGNOSIS #6 |
|
| ICDPDS7
| QA4a ORIG TEXT DESC FOR DIAGNOSIS #7 |
|
| ICDPDS8
| QA4a ORIG TEXT DESC FOR DIAGNOSIS #8 |
|
| ICDPDS9
| QA4a ORIG TEXT DESC FOR DIAGNOSIS #9 |
|
| ICDPRC1
| ORIG ICD9 PROCEDURE CODE #1 |
|
| ICDPRC10
| ORIG ICD9 PROCEDURE CODE #10 |
|
| ICDPRC11
| ORIG ICD9 PROCEDURE CODE #11 |
|
| ICDPRC12
| ORIG ICD9 PROCEDURE CODE #12 |
|
| ICDPRC13
| ORIG ICD9 PROCEDURE CODE #13 |
|
| ICDPRC14
| ORIG ICD9 PROCEDURE CODE #14 |
|
| ICDPRC15
| ORIG ICD9 PROCEDURE CODE #15 |
|
| ICDPRC16
| ORIG ICD9 PROCEDURE CODE #16 |
|
| ICDPRC17
| ORIG ICD9 PROCEDURE CODE #17 |
|
| ICDPRC18
| ORIG ICD9 PROCEDURE CODE #18 |
|
| ICDPRC19
| ORIG ICD9 PROCEDURE CODE #19 |
|
| ICDPRC2
| ORIG ICD9 PROCEDURE CODE #2 |
|
| ICDPRC20
| ORIG ICD9 PROCEDURE CODE #20 |
|
| ICDPRC21
| ORIG ICD9 PROCEDURE CODE #21 |
|
| ICDPRC22
| ORIG ICD9 PROCEDURE CODE #22 |
|
| ICDPRC23
| ORIG ICD9 PROCEDURE CODE #23 |
|
| ICDPRC24
| ORIG ICD9 PROCEDURE CODE #24 |
|
| ICDPRC25
| ORIG ICD9 PROCEDURE CODE #25 |
|
| ICDPRC3
| ORIG ICD9 PROCEDURE CODE #3 |
|
| ICDPRC4
| ORIG ICD9 PROCEDURE CODE #4 |
|
| ICDPRC5
| ORIG ICD9 PROCEDURE CODE #5 |
|
| ICDPRC6
| ORIG ICD9 PROCEDURE CODE #6 |
|
| ICDPRC7
| ORIG ICD9 PROCEDURE CODE #7 |
|
| ICDPRC8
| ORIG ICD9 PROCEDURE CODE #8 |
|
| ICDPRC9
| ORIG ICD9 PROCEDURE CODE #9 |
|
| ICDPRCPR
| PRINCIPAL ICD9 PROCEDURE CODE |
|
| ICDPRIN
| QA4b PRINCIPAL DIAGNOSIS |
|
| LTCUOS
| QA1 LONG TERM CARE UNIT (SPECIFY) |
|
| MCPT1
| QA6a ORIG CPT4 PROCEDURE CODE #1 |
|
| MCPT10
| QA6a ORIG CPT4 PROCEDURE CODE #10 |
|
| MCPT11
| QA6a ORIG CPT4 PROCEDURE CODE #11 |
|
| MCPT12
| QA6a ORIG CPT4 PROCEDURE CODE #12 |
|
| MCPT13
| QA6a ORIG CPT4 PROCEDURE CODE #13 |
|
| MCPT14
| QA6a ORIG CPT4 PROCEDURE CODE #14 |
|
| MCPT15
| QA6a ORIG CPT4 PROCEDURE CODE #15 |
|
| MCPT16
| QA6a ORIG CPT4 PROCEDURE CODE #16 |
|
| MCPT17
| QA6a ORIG CPT4 PROCEDURE CODE #17 |
|
| MCPT18
| QA6a ORIG CPT4 PROCEDURE CODE #18 |
|
| MCPT19
| QA6a ORIG CPT4 PROCEDURE CODE #19 |
|
| MCPT2
| QA6a ORIG CPT4 PROCEDURE CODE #2 |
|
| MCPT20
| QA6a ORIG CPT4 PROCEDURE CODE #20 |
|
| MCPT21
| QA6a ORIG CPT4 PROCEDURE CODE #21 |
|
| MCPT22
| QA6a ORIG CPT4 PROCEDURE CODE #22 |
|
| MCPT23
| QA6a ORIG CPT4 PROCEDURE CODE #23 |
|
| MCPT24
| QA6a ORIG CPT4 PROCEDURE CODE #24 |
|
| MCPT25
| QA6a ORIG CPT4 PROCEDURE CODE #25 |
|
| MCPT26
| QA6a ORIG CPT4 PROCEDURE CODE #26 |
|
| MCPT27
| QA6a ORIG CPT4 PROCEDURE CODE #27 |
|
| MCPT28
| QA6a ORIG CPT4 PROCEDURE CODE #28 |
|
| MCPT29
| QA6a ORIG CPT4 PROCEDURE CODE #29 |
|
| MCPT3
| QA6a ORIG CPT4 PROCEDURE CODE #3 |
|
| MCPT30
| QA6a ORIG CPT4 PROCEDURE CODE #30 |
|
| MCPT31
| QA6a ORIG CPT4 PROCEDURE CODE #31 |
|
| MCPT32
| QA6a ORIG CPT4 PROCEDURE CODE #32 |
|
| MCPT33
| QA6a ORIG CPT4 PROCEDURE CODE #33 |
|
| MCPT34
| QA6a ORIG CPT4 PROCEDURE CODE #34 |
|
| MCPT35
| QA6a ORIG CPT4 PROCEDURE CODE #35 |
|
| MCPT36
| QA6a ORIG CPT4 PROCEDURE CODE #36 |
|
| MCPT37
| QA6a ORIG CPT4 PROCEDURE CODE #37 |
|
| MCPT38
| QA6a ORIG CPT4 PROCEDURE CODE #38 |
|
| MCPT39
| QA6a ORIG CPT4 PROCEDURE CODE #39 |
|
| MCPT4
| QA6a ORIG CPT4 PROCEDURE CODE #4 |
|
| MCPT40
| QA6a ORIG CPT4 PROCEDURE CODE #40 |
|
| MCPT41
| QA6a ORIG CPT4 PROCEDURE CODE #41 |
|
| MCPT42
| QA6a ORIG CPT4 PROCEDURE CODE #42 |
|
| MCPT43
| QA6a ORIG CPT4 PROCEDURE CODE #43 |
|
| MCPT44
| QA6a ORIG CPT4 PROCEDURE CODE #44 |
|
| MCPT45
| QA6a ORIG CPT4 PROCEDURE CODE #45 |
|
| MCPT46
| QA6a ORIG CPT4 PROCEDURE CODE #46 |
|
| MCPT47
| QA6a ORIG CPT4 PROCEDURE CODE #47 |
|
| MCPT48
| QA6a ORIG CPT4 PROCEDURE CODE #48 |
|
| MCPT49
| QA6a ORIG CPT4 PROCEDURE CODE #49 |
|
| MCPT5
| QA6a ORIG CPT4 PROCEDURE CODE #5 |
|
| MCPT50
| QA6a ORIG CPT4 PROCEDURE CODE #50 |
|
| MCPT51
| QA6a ORIG CPT4 PROCEDURE CODE #51 |
|
| MCPT52
| QA6a ORIG CPT4 PROCEDURE CODE #52 |
|
| MCPT53
| QA6a ORIG CPT4 PROCEDURE CODE #53 |
|
| MCPT54
| QA6a ORIG CPT4 PROCEDURE CODE #54 |
|
| MCPT55
| QA6a ORIG CPT4 PROCEDURE CODE #55 |
|
| MCPT56
| QA6a ORIG CPT4 PROCEDURE CODE #56 |
|
| MCPT57
| QA6a ORIG CPT4 PROCEDURE CODE #57 |
|
| MCPT58
| QA6a ORIG CPT4 PROCEDURE CODE #58 |
|
| MCPT59
| QA6a ORIG CPT4 PROCEDURE CODE #59 |
|
| MCPT6
| QA6a ORIG CPT4 PROCEDURE CODE #6 |
|
| MCPT60
| QA6a ORIG CPT4 PROCEDURE CODE #60 |
|
| MCPT61
| QA6a ORIG CPT4 PROCEDURE CODE #61 |
|
| MCPT62
| QA6a ORIG CPT4 PROCEDURE CODE #62 |
|
| MCPT63
| QA6a ORIG CPT4 PROCEDURE CODE #63 |
|
| MCPT64
| QA6a ORIG CPT4 PROCEDURE CODE #64 |
|
| MCPT65
| QA6a ORIG CPT4 PROCEDURE CODE #65 |
|
| MCPT66
| QA6a ORIG CPT4 PROCEDURE CODE #66 |
|
| MCPT67
| QA6a ORIG CPT4 PROCEDURE CODE #67 |
|
| MCPT68
| QA6a ORIG CPT4 PROCEDURE CODE #68 |
|
| MCPT69
| QA6a ORIG CPT4 PROCEDURE CODE #69 |
|
| MCPT7
| QA6a ORIG CPT4 PROCEDURE CODE #7 |
|
| MCPT8
| QA6a ORIG CPT4 PROCEDURE CODE #8 |
|
| MCPT9
| QA6a ORIG CPT4 PROCEDURE CODE #9 |
|
| MCPTCH1
| QA6b CHARGE FOR SERVICE #1 |
|
| MCPTCH10
| QA6b CHARGE FOR SERVICE #10 |
|
| MCPTCH11
| QA6b CHARGE FOR SERVICE #11 |
|
| MCPTCH12
| QA6b CHARGE FOR SERVICE #12 |
|
| MCPTCH13
| QA6b CHARGE FOR SERVICE #13 |
|
| MCPTCH14
| QA6b CHARGE FOR SERVICE #14 |
|
| MCPTCH15
| QA6b CHARGE FOR SERVICE #15 |
|
| MCPTCH16
| QA6b CHARGE FOR SERVICE #16 |
|
| MCPTCH17
| QA6b CHARGE FOR SERVICE #17 |
|
| MCPTCH18
| QA6b CHARGE FOR SERVICE #18 |
|
| MCPTCH19
| QA6b CHARGE FOR SERVICE #19 |
|
| MCPTCH2
| QA6b CHARGE FOR SERVICE #2 |
|
| MCPTCH20
| QA6b CHARGE FOR SERVICE #20 |
|
| MCPTCH21
| QA6b CHARGE FOR SERVICE #21 |
|
| MCPTCH22
| QA6b CHARGE FOR SERVICE #22 |
|
| MCPTCH23
| QA6b CHARGE FOR SERVICE #23 |
|
| MCPTCH24
| QA6b CHARGE FOR SERVICE #24 |
|
| MCPTCH25
| QA6b CHARGE FOR SERVICE #25 |
|
| MCPTCH26
| QA6b CHARGE FOR SERVICE #26 |
|
| MCPTCH27
| QA6b CHARGE FOR SERVICE #27 |
|
| MCPTCH28
| QA6b CHARGE FOR SERVICE #28 |
|
| MCPTCH29
| QA6b CHARGE FOR SERVICE #29 |
|
| MCPTCH3
| QA6b CHARGE FOR SERVICE #3 |
|
| MCPTCH30
| QA6b CHARGE FOR SERVICE #30 |
|
| MCPTCH31
| QA6b CHARGE FOR SERVICE #31 |
|
| MCPTCH32
| QA6b CHARGE FOR SERVICE #32 |
|
| MCPTCH33
| QA6b CHARGE FOR SERVICE #33 |
|
| MCPTCH34
| QA6b CHARGE FOR SERVICE #34 |
|
| MCPTCH35
| QA6b CHARGE FOR SERVICE #35 |
|
| MCPTCH36
| QA6b CHARGE FOR SERVICE #36 |
|
| MCPTCH37
| QA6b CHARGE FOR SERVICE #37 |
|
| MCPTCH38
| QA6b CHARGE FOR SERVICE #38 |
|
| MCPTCH39
| QA6b CHARGE FOR SERVICE #39 |
|
| MCPTCH4
| QA6b CHARGE FOR SERVICE #4 |
|
| MCPTCH40
| QA6b CHARGE FOR SERVICE #40 |
|
| MCPTCH41
| QA6b CHARGE FOR SERVICE #41 |
|
| MCPTCH42
| QA6b CHARGE FOR SERVICE #42 |
|
| MCPTCH43
| QA6b CHARGE FOR SERVICE #43 |
|
| MCPTCH44
| QA6b CHARGE FOR SERVICE #44 |
|
| MCPTCH45
| QA6b CHARGE FOR SERVICE #45 |
|
| MCPTCH46
| QA6b CHARGE FOR SERVICE #46 |
|
| MCPTCH47
| QA6b CHARGE FOR SERVICE #47 |
|
| MCPTCH48
| QA6b CHARGE FOR SERVICE #48 |
|
| MCPTCH49
| QA6b CHARGE FOR SERVICE #49 |
|
| MCPTCH5
| QA6b CHARGE FOR SERVICE #5 |
|
| MCPTCH50
| QA6b CHARGE FOR SERVICE #50 |
|
| MCPTCH51
| QA6b CHARGE FOR SERVICE #51 |
|
| MCPTCH52
| QA6b CHARGE FOR SERVICE #52 |
|
| MCPTCH53
| QA6b CHARGE FOR SERVICE #53 |
|
| MCPTCH54
| QA6b CHARGE FOR SERVICE #54 |
|
| MCPTCH55
| QA6b CHARGE FOR SERVICE #55 |
|
| MCPTCH56
| QA6b CHARGE FOR SERVICE #56 |
|
| MCPTCH57
| QA6b CHARGE FOR SERVICE #57 |
|
| MCPTCH58
| QA6b CHARGE FOR SERVICE #58 |
|
| MCPTCH59
| QA6b CHARGE FOR SERVICE #59 |
|
| MCPTCH6
| QA6b CHARGE FOR SERVICE #6 |
|
| MCPTCH60
| QA6b CHARGE FOR SERVICE #60 |
|
| MCPTCH61
| QA6b CHARGE FOR SERVICE #61 |
|
| MCPTCH62
| QA6b CHARGE FOR SERVICE #62 |
|
| MCPTCH63
| QA6b CHARGE FOR SERVICE #63 |
|
| MCPTCH64
| QA6b CHARGE FOR SERVICE #64 |
|
| MCPTCH65
| QA6b CHARGE FOR SERVICE #65 |
|
| MCPTCH66
| QA6b CHARGE FOR SERVICE #66 |
|
| MCPTCH67
| QA6b CHARGE FOR SERVICE #67 |
|
| MCPTCH68
| QA6b CHARGE FOR SERVICE #68 |
|
| MCPTCH69
| QA6b CHARGE FOR SERVICE #69 |
|
| MCPTCH7
| QA6b CHARGE FOR SERVICE #7 |
|
| MCPTCH8
| QA6b CHARGE FOR SERVICE #8 |
|
| MCPTCH9
| QA6b CHARGE FOR SERVICE #9 |
|
| MCPTDS1
| QA6a DESCRIPTION OF SERVICE #1 |
|
| MCPTDS10
| QA6a DESCRIPTION OF SERVICE #10 |
|
| MCPTDS11
| QA6a DESCRIPTION OF SERVICE #11 |
|
| MCPTDS12
| QA6a DESCRIPTION OF SERVICE #12 |
|
| MCPTDS13
| QA6a DESCRIPTION OF SERVICE #13 |
|
| MCPTDS14
| QA6a DESCRIPTION OF SERVICE #14 |
|
| MCPTDS15
| QA6a DESCRIPTION OF SERVICE #15 |
|
| MCPTDS16
| QA6a DESCRIPTION OF SERVICE #16 |
|
| MCPTDS17
| QA6a DESCRIPTION OF SERVICE #17 |
|
| MCPTDS18
| QA6a DESCRIPTION OF SERVICE #18 |
|
| MCPTDS19
| QA6a DESCRIPTION OF SERVICE #19 |
|
| MCPTDS2
| QA6a DESCRIPTION OF SERVICE #2 |
|
| MCPTDS20
| QA6a DESCRIPTION OF SERVICE #20 |
|
| MCPTDS21
| QA6a DESCRIPTION OF SERVICE #21 |
|
| MCPTDS22
| QA6a DESCRIPTION OF SERVICE #22 |
|
| MCPTDS23
| QA6a DESCRIPTION OF SERVICE #23 |
|
| MCPTDS24
| QA6a DESCRIPTION OF SERVICE #24 |
|
| MCPTDS25
| QA6a DESCRIPTION OF SERVICE #25 |
|
| MCPTDS26
| QA6a DESCRIPTION OF SERVICE #26 |
|
| MCPTDS27
| QA6a DESCRIPTION OF SERVICE #27 |
|
| MCPTDS28
| QA6a DESCRIPTION OF SERVICE #28 |
|
| MCPTDS29
| QA6a DESCRIPTION OF SERVICE #29 |
|
| MCPTDS3
| QA6a DESCRIPTION OF SERVICE #3 |
|
| MCPTDS30
| QA6a DESCRIPTION OF SERVICE #30 |
|
| MCPTDS31
| QA6a DESCRIPTION OF SERVICE #31 |
|
| MCPTDS32
| QA6a DESCRIPTION OF SERVICE #32 |
|
| MCPTDS33
| QA6a DESCRIPTION OF SERVICE #33 |
|
| MCPTDS34
| QA6a DESCRIPTION OF SERVICE #34 |
|
| MCPTDS35
| QA6a DESCRIPTION OF SERVICE #35 |
|
| MCPTDS36
| QA6a DESCRIPTION OF SERVICE #36 |
|
| MCPTDS37
| QA6a DESCRIPTION OF SERVICE #37 |
|
| MCPTDS38
| QA6a DESCRIPTION OF SERVICE #38 |
|
| MCPTDS39
| QA6a DESCRIPTION OF SERVICE #39 |
|
| MCPTDS4
| QA6a DESCRIPTION OF SERVICE #4 |
|
| MCPTDS40
| QA6a DESCRIPTION OF SERVICE #40 |
|
| MCPTDS41
| QA6a DESCRIPTION OF SERVICE #41 |
|
| MCPTDS42
| QA6a DESCRIPTION OF SERVICE #42 |
|
| MCPTDS43
| QA6a DESCRIPTION OF SERVICE #43 |
|
| MCPTDS44
| QA6a DESCRIPTION OF SERVICE #44 |
|
| MCPTDS45
| QA6a DESCRIPTION OF SERVICE #45 |
|
| MCPTDS46
| QA6a DESCRIPTION OF SERVICE #46 |
|
| MCPTDS47
| QA6a DESCRIPTION OF SERVICE #47 |
|
| MCPTDS48
| QA6a DESCRIPTION OF SERVICE #48 |
|
| MCPTDS49
| QA6a DESCRIPTION OF SERVICE #49 |
|
| MCPTDS5
| QA6a DESCRIPTION OF SERVICE #5 |
|
| MCPTDS50
| QA6a DESCRIPTION OF SERVICE #50 |
|
| MCPTDS51
| QA6a DESCRIPTION OF SERVICE #51 |
|
| MCPTDS52
| QA6a DESCRIPTION OF SERVICE #52 |
|
| MCPTDS53
| QA6a DESCRIPTION OF SERVICE #53 |
|
| MCPTDS54
| QA6a DESCRIPTION OF SERVICE #54 |
|
| MCPTDS55
| QA6a DESCRIPTION OF SERVICE #55 |
|
| MCPTDS56
| QA6a DESCRIPTION OF SERVICE #56 |
|
| MCPTDS57
| QA6a DESCRIPTION OF SERVICE #57 |
|
| MCPTDS58
| QA6a DESCRIPTION OF SERVICE #58 |
|
| MCPTDS59
| QA6a DESCRIPTION OF SERVICE #59 |
|
| MCPTDS6
| QA6a DESCRIPTION OF SERVICE #6 |
|
| MCPTDS60
| QA6a DESCRIPTION OF SERVICE #60 |
|
| MCPTDS61
| QA6a DESCRIPTION OF SERVICE #61 |
|
| MCPTDS62
| QA6a DESCRIPTION OF SERVICE #62 |
|
| MCPTDS63
| QA6a DESCRIPTION OF SERVICE #63 |
|
| MCPTDS64
| QA6a DESCRIPTION OF SERVICE #64 |
|
| MCPTDS65
| QA6a DESCRIPTION OF SERVICE #65 |
|
| MCPTDS66
| QA6a DESCRIPTION OF SERVICE #66 |
|
| MCPTDS67
| QA6a DESCRIPTION OF SERVICE #67 |
|
| MCPTDS68
| QA6a DESCRIPTION OF SERVICE #68 |
|
| MCPTDS69
| QA6a DESCRIPTION OF SERVICE #69 |
|
| MCPTDS7
| QA6a DESCRIPTION OF SERVICE #7 |
|
| MCPTDS8
| QA6a DESCRIPTION OF SERVICE #8 |
|
| MCPTDS9
| QA6a DESCRIPTION OF SERVICE #9 |
|
| MORECAID
| QC6t PAYMENT>CHARGES - MEDICAID |
|
| MORECARE
| QC6s PAYMENT>CHARGES - MEDICARE |
|
| MOREPINS
| QC6u PAYMENT>CHARGES - PRIVATE INS |
|
| MPSID
| UNIQUE MPC IDENTIFIER |
|
| MPSTYPE
| SINGLE, GLOBAL, OR REPEAT VISIT EVENT |
|
| MREVTYOS
| QA1 OTHER SVCE SOMEWHERE ELSE (SPECIFY) |
|
| MREVTYPE
| QA1 TYPE OF MEDICAL SERVICE RECEIVED |
|
| NODRG
| QA8 DRG NOT RECORDED |
|
| NOICDPRN
| NO PRINCIPAL DIAGNOSIS CHECKED |
|
| OTHAID
| QC7fc SOURCE OF PAYMENT - MEDICAID |
|
| OTHCARE
| QC7fb SOURCE OF PAYMENT - MEDICARE |
|
| OTHCHAM
| QC7ff SOURCE PMT-TRICARE/CHAMPVA/CHAMPUS |
|
| OTHIDVIS
| QA7a OTHER IDENTICAL VISITS |
|
| OTHOTHR
| QC7fh SOURCE OF PAYMENT - OTHER |
|
| OTHOTOS
| QC7fh SOURCE OF PAYMENT -OTHER (SPECIFY) |
|
| OTHPAT
| QC7fa SOURCE OF PAYMENT - PATIENT |
|
| OTHPAY
| QC7e ANY OTHER PAYMENTS |
|
| OTHPINS
| QC7fd SOURCE OF PAYMENT - PRIVATE INS |
|
| OTHRPAYM
| QC4h SOURCE OF PAYMENT - OTHER |
|
| OTHVA
| QC7fe SOURCE OF PAYMENT - VA |
|
| OTHWORK
| QC7fg SOURCE OF PAYMENT - WORKERS COMP |
|
| OTPAYMOS
| QC4h SOURCE OF PAYMENT - OTHER (SPECIFY) |
|
| PAIRID
| PERSON PROVIDER RU LEVEL IDENTIFIER |
|
| PATPAYM
| QC4a SOURCE OF PAYMENT - PATIENT |
|
| PAYMOTH
| QC6v PAYMENT>CHARGES - OTHER |
|
| PAYMOTOS
| QC6v PAYMENT>CHARGES - OTHER (SPECIFY) |
|
| PDDIRID
| COVER SHEET - PROVIDER DIRECTORY ID |
|
| PERSID
| CONFIDENTIAL INTERNAL USE ONLY PERSON ID |
Identifiers |
| PINSPAYM
| QC4d SOURCE OF PAYMENT - PRIVATE INS |
|
| PROVNAME
| COVER SHEET - PROVIDER NAME |
|
| SLIDSCA
| QC6q CHARITY CARE OR SLIDING SCALE |
|
| SRGBET1
| QA10a BETOS CODE FOR CPT4 SURG CODE #1 |
|
| SRGBET2
| QA10a BETOS CODE FOR CPT4 SURG CODE #2 |
|
| SRGBET3
| QA10a BETOS CODE FOR CPT4 SURG CODE #3 |
|
| SRGBET4
| QA10a BETOS CODE FOR CPT4 SURG CODE #4 |
|
| SRGBET5
| QA10a BETOS CODE FOR CPT4 SURG CODE #5 |
|
| SRGBET6
| QA10a BETOS CODE FOR CPT4 SURG CODE #6 |
|
| SRGBET7
| QA10a BETOS CODE FOR CPT4 SURG CODE #7 |
|
| SRGBET8
| QA10a BETOS CODE FOR CPT4 SURG CODE #8 |
|
| SRGBETPR
| PRINCIPAL BETOS FOR CPT4 SURG PROC CODE |
|
| SRGCPT1
| QA10a ORIG CPT4 SURG PROCEDURE CODE #1 |
|
| SRGCPT2
| QA10a ORIG CPT4 SURG PROCEDURE CODE #2 |
|
| SRGCPT3
| QA10a ORIG CPT4 SURG PROCEDURE CODE #3 |
|
| SRGCPT4
| QA10a ORIG CPT4 SURG PROCEDURE CODE #4 |
|
| SRGCPT5
| QA10a ORIG CPT4 SURG PROCEDURE CODE #5 |
|
| SRGCPT6
| QA10a ORIG CPT4 SURG PROCEDURE CODE #6 |
|
| SRGCPT7
| QA10a ORIG CPT4 SURG PROCEDURE CODE #7 |
|
| SRGCPT8
| QA10a ORIG CPT4 SURG PROCEDURE CODE #8 |
|
| SRGDES1
| QA10a DESCRIPTION OF SURG SERVICE #1 |
|
| SRGDES2
| QA10a DESCRIPTION OF SURG SERVICE #2 |
|
| SRGDES3
| QA10a DESCRIPTION OF SURG SERVICE #3 |
|
| SRGDES4
| QA10a DESCRIPTION OF SURG SERVICE #4 |
|
| SRGDES5
| QA10a DESCRIPTION OF SURG SERVICE #5 |
|
| SRGDES6
| QA10a DESCRIPTION OF SURG SERVICE #6 |
|
| SRGDES7
| QA10a DESCRIPTION OF SURG SERVICE #7 |
|
| SRGDES8
| QA10a DESCRIPTION OF SURG SERVICE #8 |
|
| STAYDRG
| QA8 DRG FOR INPATIENT STAY |
|
| STAYLINK
| LINK TO HOSPITAL STAY - FORMID |
|
| SURGPRIN
| QA10b PRINCIPAL SURGICAL PROCEDURE CODE |
|
| TOTLCHRG
| QC2,C2a,C2b TOTAL CHARGES |
|
| TOTLPAYM
| QC5 TOTAL PAYMENTS |
|
| VAPAYM
| QC4e SOURCE OF PAYMENT - VA |
|
| VISNUM
| QA7b NUMBER OF OTHER IDENTICAL VISITS |
|
| WHSPC
| QA5d EVENT TYPE IN GLOBAL FEE (SPECIFY) |
|
| WORKPAYM
| QC4g SOURCE OF PAYMENT - WORKERS COMP |
|
540 Gaither Road Rockville, MD 20850