Rule Definition Project:NSF130 Map NameNSF130 Rule Numbe 0 Do Nothing Line Command Description 1 Do Nothing Rule Numbe 100 Read AA0 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_AA0-SUBMITTER-DATA 2 PERFORM RULE Perform Rule 8800 Rule Numbe 105 Read BA0 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_BA0-PROVIDER-DATA 2 PERFORM RULE Perform Rule 8805 Rule Numbe 110 Read BA1 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_BA1-PROVIDER-DATA-2 2 PERFORM RULE Perform Rule 8810 Rule Numbe 115 Read CA0 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_CA0-PATIENT-DATA 2 PERFORM RULE Perform Rule 8815 Rule Numbe 120 Read CB0 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_CB0-LEGAL-REPRE-DATA 2 PERFORM RULE Perform Rule 8820 Rule Numbe 125 Read DA0 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_DA0-INSURANCE-INFO 2 PERFORM RULE Perform Rule 8825 Rule Numbe 130 Read DA1 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_DA1-INSURANCE-CLM-LVL-INFO 2 PERFORM RULE Perform Rule 8830 Rule Numbe 135 Read DA2 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_DA2-Insur-Addr-Occur-1 2 PERFORM RULE Perform Rule 8835 Rule Numbe 140 Read EA0 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_EA0-CLAIM-LVL-INFO 2 PERFORM RULE Perform Rule 8840 Rule Numbe 145 Read EA1 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_EA1-CLAIM-LVL-INFO-TWO 2 PERFORM RULE Perform Rule 8845 Rule Numbe 150 Read EA2 record Line Command Description 1 PERFORM RULE Perform Rule 8850 Rule Numbe 155 Read FA0 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_FA0-SERVICE-LVL-DETAIL 2 PERFORM RULE Perform Rule 8855 Rule Numbe 160 Read FB0 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_FB0-SERVICE-LVL-DETAIL-MED 2 PERFORM RULE Perform Rule 8860 Rule Numbe 165 Read FB1 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_FB1-SERVICE-LVL-DETAIL-MED2 2 PERFORM RULE Perform Rule 8865 Rule Numbe 170 Read FB2 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_FB2-SERVICE LINE DETAIL-MED3 2 PERFORM RULE Perform Rule 8870 Rule Numbe 175 Read FD0 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_FD0-SERVICE-DETAIL-DENTAL 2 PERFORM RULE Perform Rule 8875 Rule Numbe 180 Read GA0 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_GA0-AMBULANCE-CERT-REC 2 PERFORM RULE Perform Rule 8880 Rule Numbe 185 Read GC0 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_GC0-CHIROPRACTIC-CERT-RECORD 2 PERFORM RULE Perform Rule 8885 Rule Numbe 190 Read GD0 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_GD0-DME-CERT-RECORD 2 PERFORM RULE Perform Rule 8890 Rule Numbe 195 Read GD1 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_GD1-DME-NARR-REC 2 PERFORM RULE Perform Rule 8895 Rule Numbe 200 Read GE0 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_GE0-ENTERAL-NUTRITION-THER-REC 2 PERFORM RULE Perform Rule 8900 Rule Numbe 205 Read GP0 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_GP0-PARENTERAL-NUTR-THER-REC 2 PERFORM RULE Perform Rule 8905 Rule Numbe 210 Read GU0 record Line Command Description 1 PERFORM RULE Perform Rule 8910 Rule Numbe 215 Read GX0 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_GX0-OXYGEN-CERT-REC 2 PERFORM RULE Perform Rule 8915 Rule Numbe 220 Read GX1 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_GX1-OXYGEN-NARR-REC 2 PERFORM RULE Perform Rule 8920 Rule Numbe 225 Read GX2 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_GX2-OXYGEN-FACILITY-REC 2 PERFORM RULE Perform Rule 8925 Rule Numbe 230 Read HA0 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_HA0-NARRATIVE-REC 2 PERFORM RULE Perform Rule 8930 Rule Numbe 235 Read XA0 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_XA0-CLAIM-TRAILER-REC 2 PERFORM RULE Perform Rule 8935 Rule Numbe 240 Read YA0 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_YA0-BATCH-TRAILER-REC 2 PERFORM RULE Perform Rule 8940 Rule Numbe 245 Read ZA0 record Line Command Description 1 Read Record READ D:\ECMAP_EXAMPLE\NSF130 nsfv103 v103_ZA0-FILE-TRAILER-REC 2 PERFORM RULE Perform Rule 8945 Rule Numbe 250 Read EA0 & XA0 record Line Command Description 1 PERFORM RULE Perform Rule 140 2 PERFORM RULE Perform Rule 235 Rule Numbe 255 Read Smapper Record for Cap Class & Batch ID Line Command Description 1 VAR1 = VAR2 MEM VAR Capability-Class = CONST 2 COMMENT Comment: READ D:\ECMAP_EXAMPLE\NSF130\NSF130 SMAPPER SMAP_REC KEY: CONST 00RECVER 3 COMMENT Comment: MEM VAR Capability-Class = REC FIELD SMAP_REC SEND_RECV_DAT 4 COMMENT Comment: MEM VAR Smapper-Batch-ID = CONST 5 COMMENT Comment: READ D:\ECMAP_EXAMPLE\NSF130\NSF130 SMAPPER SMAP_REC KEY: CONST 07BATCHID 6 COMMENT Comment: MEM VAR Smapper-Batch-ID = REC FIELD SMAP_REC SEND_RECV_DAT Rule Numbe 260 Read Previous Map INI File Line Command Description 1 COMMENT Comment: REC FIELD MAP-PROCESS-INI XMSN-BATCH-ID = MEM VAR Smapper-Ba Rule Numbe 265 Read CA1 record Line Command Description 1 COMMENT Comment: READ D:\ECMAP_EXAMPLE\NSF130\NSF130 testnsf.txt CA1-INDIAN-HEALTH-SVCS 2 Do Nothing Rule Numbe 270 Read FE0 record Line Command Description 1 COMMENT Comment: READ D:\ECMAP_EXAMPLE\NSF130\NSF130 testnsf.txt FE0-TPO-SEGMENT 2 Do Nothing Rule Numbe 275 Read DA3 record Line Command Description 1 COMMENT Comment: READ D:\ECMAP_EXAMPLE\NSF130\NSF130 testnsf.txt DA3-INSURANCE-CLM-LVL-INFO 2 Do Nothing Rule Numbe 280 Read FB3 record Line Command Description 1 COMMENT Comment: READ D:\ECMAP_EXAMPLE\NSF130\NSF130 testnsf.txt FB3-SERVICE-LINE-DETAIL-ME 2 Do Nothing Rule Numbe 1000 Write Record for Duplicate-File Check Line Command Description 1 Do Nothing Rule Numbe 1005 Write Map INI File Line Command Description 1 Do Nothing Rule Numbe 1010 Write Error Report Extract Line Command Description 1 WRITE RECORD WRITE D:\ECMAP_EXAMPLE\NSF130 errorrpt.txt REPORT-EXTRACT 2 IF THEN IF MEM VAR Error-Report-Extract EQ CONST Then Perform Rule 7680 Rule Numbe 1015 Write Initial Logs, Init Work Areas, Check Req Fi Line Command Description 1 PERFORM RULE Perform Rule 8950 2 PERFORM RULE Perform Rule 1030 3 PERFORM RULE Perform Rule 1040 4 PERFORM RULE Perform Rule 260 5 PERFORM RULE Perform Rule 1005 6 PERFORM RULE Perform Rule 7010 7 PERFORM RULE Perform Rule 7260 Rule Numbe 1020 Write Remaining Log File records Line Command Description 1 PERFORM RULE Perform Rule 1040 2 PERFORM RULE Perform Rule 1045 3 PERFORM RULE Perform Rule 1050 4 PERFORM RULE Perform Rule 1055 5 PERFORM RULE Perform Rule 1060 6 PERFORM RULE Perform Rule 1065 7 PERFORM RULE Perform Rule 1005 Rule Numbe 1025 Write '70' record to Log File Line Command Description 1 WRITE LOG Message No: CONST 70 Message Severity: CONST 70 Message Text: MEM VAR Error-Report-Extract Rule Numbe 1030 Write '71' record to Log File Line Command Description 1 WRITE LOG Message No: CONST 71 Message Severity: CONST 71 Message Text: MEM VAR A_MAP_VERSION Rule Numbe 1035 Write '79' record to Log File Line Command Description 1 WRITE LOG Message No: CONST 79 Message Severity: CONST 79 Message Text: MEM VAR File-Identifier Rule Numbe 1040 Write '80' record to Log File Line Command Description 1 WRITE LOG Message No: CONST 80 Message Severity: CONST 80 Message Text: SYS VAR EDI_OUT_FILENAME Rule Numbe 1045 Write '81' record to Log File Line Command Description 1 COMMENT Comment: READ D:\ECMAP_EXAMPLE\NSF130\NSF130 SMAPPER SMAP_REC KEY: CONST 00SENDER 2 COMMENT Comment: Message No: CONST 81 Message Severity: CONST 81 Message T 3 WRITE LOG Message No: CONST 81 Message Severity: CONST 81 Message Text: MEM VAR SEND_RCV_INFO Rule Numbe 1050 Write '82' record to Log File Line Command Description 1 COMMENT Comment: READ D:\ECMAP_EXAMPLE\NSF130\NSF130 SMAPPER SMAP_REC KEY: CONST 00RECVER 2 COMMENT Comment: Dest: SEND_RCV_INFO L .Source: SMAP_REC SEND_RECV_DATA R.S 3 WRITE LOG Message No: CONST 82 Message Severity: CONST 82 Message Text: MEM VAR SEND_RCV_INFO Rule Numbe 1055 Write '83' record to Log File Line Command Description 1 WRITE LOG Message No: CONST 83 Message Severity: CONST 83 Message Text: CONST CONST X1283700 3051 Rule Numbe 1060 Write '84' record to Log File Line Command Description 1 COMMENT Comment: READ D:\ECMAP_EXAMPLE\NSF130\NSF130 SMAPPER SMAP_REC KEY: CONST 00DAYSTOWA 2 WRITE LOG Message No: CONST 84 Message Severity: CONST 84 Message Text: REC FIELD SMAP_REC RETURN_DAYS_WAIT Rule Numbe 1065 Write '87' record to Log File Line Command Description 1 COMMENT Comment: READ D:\ECMAP_EXAMPLE\NSF130\NSF130 SMAPPER SMAP_REC KEY: CONST 08CONTRACT 2 COMMENT Comment: Dest: L87_CONTRACT L .Source: L87_SPACE R.Source: SMAP_RE 3 COMMENT Comment: Dest: L87_MSG_TEXT L .Source: L87_BILLING_UNITS R.Source: 4 WRITE LOG Message No: CONST 87 Message Severity: CONST 87 Message Text: MEM VAR L87_MSG_TEXT Rule Numbe 7000 Check if End of File Line Command Description 1 IF THEN IF SYS VAR COMBINED_BREAK EQ CONST 1 Then Perform Rule 7005 2 PERFORM RULE Perform Rule 8955 Rule Numbe 7005 Create Empty Map INI File Line Command Description 1 CLEAR RECORD Clear All Fields in Record MAP-PROCESS-INI 2 PERFORM RULE Perform Rule 1005 Rule Numbe 7010 Initialize File Totals Line Command Description 1 VAR1 = VAR2 MEM VAR L87_BILLING_UNITS = CONST 0 2 VAR1 = VAR2 MEM VAR File-Batch-Count = CONST 0 3 VAR1 = VAR2 MEM VAR File-Claim-Count = CONST 0 4 VAR1 = VAR2 MEM VAR File-Rec-Count = CONST 0 5 VAR1 = VAR2 MEM VAR File-Svc-Count = CONST 0 6 VAR1 = VAR2 MEM VAR File-Tot-Charges = CONST 0 7 VAR1 = VAR2 MEM VAR File-Tot-Paid-Amt = CONST 0 8 VAR1 = VAR2 MEM VAR File-Tot-Allowed-Amt = CONST 0 9 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI BATCH-COUNT-IN-FILE = CONST 0 10 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST N 11 VAR1 = VAR2 MEM VAR File-Receiver-ID = CONST 12 VAR1 = VAR2 MEM VAR Version-Code = CONST 0 13 VAR1 = VAR2 MEM VAR Retrans-Status = CONST 14 VAR1 = VAR2 MEM VAR Error-Report-Extract = CONST Rule Numbe 7015 Initialize Batch Totals Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Pay-To-Provider-Flag = CONST 2 VAR1 = VAR2 MEM VAR Batch-Claim-Count = CONST 0 3 VAR1 = VAR2 MEM VAR Batch-Rec-Count = CONST 0 4 VAR1 = VAR2 MEM VAR Batch-Svc-Count = CONST 0 5 VAR1 = VAR2 MEM VAR Batch-Tot-Charges = CONST 0 6 VAR1 = VAR2 MEM VAR Prov-Tax-Type = CONST 7 VAR1 = VAR2 MEM VAR Batch-EMC-Provider-ID = CONST 8 VAR1=VAR2+VAR3 MEM VAR File-Batch-Count = MEM VAR File-Batch-Count + CONST 1 9 VAR1 = VAR2 REC FIELD ZZZ-Record-Counter ZZZ-File-Text = CONST FILE: 10 VAR1 = VAR2 REC FIELD ZZZ-Record-Counter ZZZ-File-Counter = MEM VAR File-Counter 11 VAR1 = VAR2 REC FIELD ZZZ-Record-Counter ZZZ-Batch-Text = CONST BATCH: 12 VAR1 = VAR2 REC FIELD ZZZ-Record-Counter ZZZ-Batch-Counter = MEM VAR File-Batch-Count 13 WRITE LOG Message No: CONST 99 Message Severity: CONST 01 Message Text: REC FIELD ZZZ-Record-Counter ZZZ-Record-Text 14 VAR1 = VAR2 MEM VAR Batch-EMC-Provider-ID = REC FIELD BA0-PROVIDER-DATA BA0-02-EMC-PROV-ID 15 PERFORM RULE Perform Rule 7265 16 VAR1 = VAR2 MEM VAR Batch-EMC-Provider-ID = REC FIELD BA0-PROVIDER-DATA BA0-02-EMC-PROV-ID 17 VAR1 = VAR2 MEM VAR Batch-Type = REC FIELD BA0-PROVIDER-DATA BA0-03-BATCH-TYPE 18 VAR1 = VAR2 MEM VAR Batch-No-Alpha = REC FIELD BA0-PROVIDER-DATA BA0-04-BATCH-NO 19 VAR1 = VAR2 MEM VAR Batch-ID = REC FIELD BA0-PROVIDER-DATA BA0-05-BATCH-ID 20 VAR1 = VAR2 MEM VAR Batch-Prov-Tax-ID = REC FIELD BA0-PROVIDER-DATA BA0-06-PROV-TAX-ID Rule Numbe 7020 Initialize Claim Totals Line Command Description 1 CLEAR RECORD Clear All Fields in Record DA0-Primary-Payor-Record 2 CLEAR RECORD Clear All Fields in Record DA1-Primary-Payor-Record 3 CLEAR RECORD Clear All Fields in Record DA2-Primary-Payor-Record 4 CLEAR RECORD Clear All Fields in Record DA0-Insurance-Occur-1 5 CLEAR RECORD Clear All Fields in Record DA1-Insur-Info-Occur-1 6 CLEAR RECORD Clear All Fields in Record DA2-Insur-Addr-Occur-1 7 CLEAR RECORD Clear All Fields in Record DA0-Insurance-Occur-2 8 CLEAR RECORD Clear All Fields in Record DA1-Insur-Info-Occur-2 9 CLEAR RECORD Clear All Fields in Record DA2-Insur-Addr-Occur-2 10 CLEAR RECORD Clear All Fields in Record DA0-Insurance-Occur-3 11 CLEAR RECORD Clear All Fields in Record DA1-Insur-Info-Occur-3 12 CLEAR RECORD Clear All Fields in Record DA2-Insur-Addr-Occur-3 13 VAR1 = VAR2 MEM VAR Claim-Cxx-Count = CONST 0 14 VAR1 = VAR2 MEM VAR Claim-Dxx-Count = CONST 0 15 VAR1 = VAR2 MEM VAR Claim-Exx-Count = CONST 0 16 VAR1 = VAR2 MEM VAR Claim-FA0-records = CONST 0 17 VAR1 = VAR2 MEM VAR Claim-Fxx-Count = CONST 0 18 VAR1 = VAR2 MEM VAR Claim-Gxx-Count = CONST 0 19 VAR1 = VAR2 MEM VAR Claim-Hxx-Count = CONST 0 20 VAR1 = VAR2 MEM VAR Claim-Rec-Count = CONST 0 21 VAR1 = VAR2 MEM VAR Claim-Tot-Allow = CONST 0 22 VAR1 = VAR2 MEM VAR Claim-Tot-Charges = CONST 0 23 VAR1 = VAR2 MEM VAR Claim-Tot-Coinsur = CONST 0 24 VAR1 = VAR2 MEM VAR Claim-Tot-Deduct = CONST 0 25 VAR1 = VAR2 MEM VAR Claim-Tot-Dis-Cost = CONST 0 26 VAR1 = VAR2 MEM VAR Claim-Tot-Dis-Other = CONST 0 27 VAR1 = VAR2 MEM VAR Claim-Tot-Payor-Paid = CONST 0 28 VAR1 = VAR2 MEM VAR Claim-Tot-Purch-Svc = CONST 0 29 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Patient-Address-Flag = CONST 30 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Legal-Rep-Flag = CONST 31 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records EA0-Refer-Prov-Flag = CONST 32 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records EA0-Refer-Prov-Flag-PRV = CONST 33 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records EA1-Supv-Prov-Flag = CONST 34 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records EA1-Supv-Prov-Flag-PRV = CONST 35 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Laboratory-Flag = CONST 36 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records EMT-Name-Flag = CONST 37 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Insured-Name-Flag-1 = CONST 38 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Payor-Name-Flag-1 = CONST 39 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Employer-Name-Flag-1 = CONST 40 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Insured-Name-Flag-2 = CONST 41 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Payor-Name-Flag-2 = CONST 42 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Employer-Name-Flag-2 = CONST 43 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Insured-Name-Flag-3 = CONST 44 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Payor-Name-Flag-3 = CONST 45 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Employer-Name-Flag-3 = CONST 46 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Related-Cause-Codes = CONST 47 VAR1 = VAR2 MEM VAR Patient-Control-Number = CONST 48 VAR1 = VAR2 MEM VAR Claim-Type = CONST 49 VAR1 = VAR2 MEM VAR Sequence Number = CONST 0 50 VAR1 = VAR2 MEM VAR Sequence-Number-Alpha = CONST 51 VAR1 = VAR2 MEM VAR SEQ01 = CONST 52 VAR1 = VAR2 MEM VAR SEQ02 = CONST 53 VAR1 = VAR2 MEM VAR SEQ03 = CONST 54 VAR1 = VAR2 MEM VAR Detail-Sequence-Number = CONST 0 55 VAR1 = VAR2 MEM VAR Claim-Edit-Ind = CONST 56 VAR1 = VAR2 MEM VAR Amount Workarea = CONST 0 57 VAR1 = VAR2 MEM VAR Doco-Indicator = CONST 58 VAR1 = VAR2 MEM VAR Doco-Type = CONST 59 VAR1 = VAR2 MEM VAR Employment-Status = CONST 60 VAR1 = VAR2 MEM VAR Emp-Stat-01 = CONST 61 VAR1 = VAR2 MEM VAR Emp-Stat-02 = CONST 62 VAR1 = VAR2 MEM VAR Emp-Stat-03 = CONST 63 VAR1 = VAR2 MEM VAR Marital-Status = CONST 64 VAR1 = VAR2 MEM VAR Patient-Relation = CONST 65 VAR1 = VAR2 MEM VAR Pat-Rel-01 = CONST 66 VAR1 = VAR2 MEM VAR Pat-Rel-02 = CONST 67 VAR1 = VAR2 MEM VAR Pat-Rel-03 = CONST 68 VAR1 = VAR2 MEM VAR Prov-Assignment-Ind = CONST 69 VAR1 = VAR2 MEM VAR Source-Pay = CONST 70 VAR1 = VAR2 MEM VAR Source-Pay-01 = CONST 71 VAR1 = VAR2 MEM VAR Source-Pay-02 = CONST 72 VAR1 = VAR2 MEM VAR Source-Pay-03 = CONST 73 VAR1 = VAR2 MEM VAR DA1-1-Flag = CONST N 74 VAR1 = VAR2 MEM VAR DA2-1-Flag = CONST N 75 VAR1 = VAR2 MEM VAR DA1-2-Flag = CONST N 76 VAR1 = VAR2 MEM VAR DA1-3-Flag = CONST N 77 PERFORM RULE Perform Rule 7275 Rule Numbe 7025 Initialize Claim Detail Line Command Description 1 VAR1 = VAR2 MEM VAR Detail-Line-Item-No = CONST 2 CLEAR RECORD Clear All Fields in Record SVC-CLAIM-DETAIL-RECORD-FA0 3 CLEAR RECORD Clear All Fields in Record SVC-CLAIM-DETAIL-RECORD-FB0 4 CLEAR RECORD Clear All Fields in Record SVC-CLAIM-DETAIL-RECORD-FB1 5 CLEAR RECORD Clear All Fields in Record SVC-CLAIM-DETAIL-RECORD-FB2 6 CLEAR RECORD Clear All Fields in Record SVC-CLAIM-DETAIL-RECORD-FD0 7 CLEAR RECORD Clear All Fields in Record SVC-CLAIM-DETAIL-RECORD-GA0 8 CLEAR RECORD Clear All Fields in Record SVC-CLAIM-DETAIL-RECORD-GC0 9 CLEAR RECORD Clear All Fields in Record SVC-CLAIM-DETAIL-RECORD-GD0 10 CLEAR RECORD Clear All Fields in Record SVC-CLAIM-DETAIL-RECORD-GD1 11 CLEAR RECORD Clear All Fields in Record SVC-CLAIM-DETAIL-RECORD-HA0 12 VAR1 = VAR2 MEM VAR FD0-NDX = CONST 0 13 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records FB1-Render-Prov-Flag = CONST 14 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records FB1-Render-Prov-Flag-PRV = CONST 15 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records FB1-Refer-Prov-Flag = CONST 16 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records FB1-Refer-Prov-Flag-PRV = CONST 17 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records FB1-Order-Prov-Flag = CONST 18 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records FB1-Order-Prov-Flag-PRV = CONST 19 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records FB1-Supv-Prov-Flag = CONST 20 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records FB1-Supv-Prov-Flag-PRV = CONST 21 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records FB0-Purch-Prov-Flag = CONST 22 VAR1 = VAR2 REC FIELD ZZZ-Remarks-Area ZZZ-HA0-05-Remarks = CONST 23 VAR1 = VAR2 REC FIELD ZZZ-Remarks-Area ZZZ-GC0-14-Symptom-Description = CONST 24 VAR1 = VAR2 REC FIELD ZZZ-Remarks-Area ZZZ-GD1-04-Extra-Narr-Data = CONST 25 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicators = CONST 26 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Ambulance-Cond-Codes = CONST Rule Numbe 7030 Initialize Error Report Record Line Command Description 1 CLEAR UNPROTECTED Clear All Unprotected Fields in Record: REPORT-EXTRACT 2 VAR1 = VAR2 REC FIELD REPORT-EXTRACT SUBMITTER-ID = REC FIELD AA0-SUBMITTER-DATA AA0-02-SUB-ID 3 VAR1 = VAR2 REC FIELD REPORT-EXTRACT CREATE-DATE = REC FIELD AA0-SUBMITTER-DATA AA0-15-CREAT-DTE 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT PROCESS-DATE = SYS VAR SYS_DATE 5 VAR1 = VAR2 REC FIELD REPORT-EXTRACT PROCESS-TIME = SYS VAR SYS_TIME 6 VAR1 = VAR2 REC FIELD REPORT-EXTRACT SEQUENCE-NUMBER = MEM VAR File-Counter 7 VAR1 = VAR2 REC FIELD REPORT-EXTRACT VENDOR-SOFTWARE-VERS = REC FIELD AA0-SUBMITTER-DATA AA0-26-VEND-SOFT-VER 8 VAR1 = VAR2 REC FIELD REPORT-EXTRACT RECEIVER-ID = MEM VAR Capability-Class 9 VAR1 = VAR2 REC FIELD REPORT-EXTRACT PAYER-ID = REC FIELD AA0-SUBMITTER-DATA AA0-17-RECV-ID 10 VAR1 = VAR2 REC FIELD REPORT-EXTRACT BILLING-PROVIDER-ID = MEM VAR Batch-EMC-Provider-ID 11 VAR1 = VAR2 REC FIELD REPORT-EXTRACT PATIENT-ID = REC FIELD CA0-PATIENT-DATA CA0-03-PAT-CONTROL-NO 12 VAR1 = VAR2 REC FIELD REPORT-EXTRACT PATIENT-LAST-NAME = REC FIELD CA0-PATIENT-DATA CA0-04-PAT-LAST-NAME 13 VAR1 = VAR2 REC FIELD REPORT-EXTRACT PATIENT-FIRST-INIT = REC FIELD CA0-PATIENT-DATA CA0-05-PAT-FIRST-NAME 14 VAR1 = VAR2 REC FIELD REPORT-EXTRACT LINE-ITEM-SEQ-NUM = REC FIELD SVC-CLAIM-DETAIL-RECORD-FA0 FA0-02-SEQUENCE-NO 15 VAR1 = VAR2 REC FIELD REPORT-EXTRACT CLAIM-CHARGE = REC FIELD XA0-CLAIM-TRAILER-REC XA0-12-TOTAL-CLAIM-CHARGES 16 VAR1 = VAR2 REC FIELD REPORT-EXTRACT BATCH-TYPE = MEM VAR Batch-Type Rule Numbe 7035 Map Error Report Details Line Command Description 1 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FILE NUMBER = REC FIELD MAP-PROCESS-INI FILES-IN-XMSN 2 VAR1 = VAR2 REC FIELD REPORT-EXTRACT BATCH-NUMBER = REC FIELD MAP-PROCESS-INI BATCH-COUNT-IN-FILE 3 VAR1 = VAR2 REC FIELD REPORT-EXTRACT CLAIM-NUMBER = REC FIELD MAP-PROCESS-INI CLAIM-COUNT-IN-BATCH 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT RECORD-NUMBER = REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT 5 VAR1 = VAR2 REC FIELD REPORT-EXTRACT PREVIOUS-REC-ID = REC FIELD MAP-PROCESS-INI PREV-RECORD-ID 6 VAR1 = VAR2 REC FIELD REPORT-EXTRACT CURRENT-REC-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 7 VAR1 = VAR2 REC FIELD REPORT-EXTRACT ERROR-NUMBER = MEM VAR Error-Number Rule Numbe 7040 Move AA0.15 Creation Date to CCYYMMDD Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR CCYYMMDD = REC FIELD AA0-SUBMITTER-DATA AA0-15-CREAT-DTE 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24055 Rule Numbe 7045 Verify AA0.16 Submission Time Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 TABLE CONVERSION TABLE: HOURS Source: REC FIELD AA0-SUBMITTER-DATA AA0-16-SUB-HOUR Dest: MEM VAR Time Work Area Fail: Status: MEM VAR: 3 TABLE CONVERSION TABLE: MIN-SEC Source: REC FIELD AA0-SUBMITTER-DATA AA0-16-SUB-MINUTE Dest: MEM VAR Time Work Area Fail: Status: MEM VAR: 4 TABLE CONVERSION TABLE: MIN-SEC Source: REC FIELD AA0-SUBMITTER-DATA AA0-16-SUB-SECOND Dest: MEM VAR Time Work Area Fail: Status: MEM VAR: 5 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24025 Rule Numbe 7050 Move AA0.19 Version Number to Numeric W.A. Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Version-Code = REC FIELD AA0-SUBMITTER-DATA AA0-19-VERS-NATIONAL 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24035 Rule Numbe 7055 Move AA0.20 Version Number to Numeric W.A. Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Version-Code = REC FIELD AA0-SUBMITTER-DATA AA0-20-VERS-LOCAL 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24040 Rule Numbe 7060 Move BA0.04 Batch Number to Numeric W.A. Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Batch-No = REC FIELD BA0-PROVIDER-DATA BA0-04-BATCH-NO 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24070 Rule Numbe 7065 Move GA0.17 Ambulance Miles to Numeric W.A. Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Miles = REC FIELD SVC-CLAIM-DETAIL-RECORD-GA0 GA0-17-MILES 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24550 Rule Numbe 7070 Move DA1.09 Disallow Cost to Numeric W.A.-1 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD DA1-Insur-Info-Occur-1 DA1-09-DISALLOW-COST-CONTAIN 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24190 Rule Numbe 7075 Move DA1.10 Disallow Other to Numeric W.A.-1 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD DA1-Insur-Info-Occur-1 DA1-10-DISALLOWED-OTHER 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24195 Rule Numbe 7080 Move DA1.11 Allowed Amount to Numeric W.A.-1 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD DA1-Insur-Info-Occur-1 DA1-11-ALLOWED-AMOUNT 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24200 Rule Numbe 7085 Move DA1.12 Deduct Amount to Numeric W.A.-1 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD DA1-Insur-Info-Occur-1 DA1-12-DEDUCTIBLE-AMOUNT 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24205 Rule Numbe 7090 Move DA1.13 Coinsur Amount to Numeric W.A.-1 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD DA1-Insur-Info-Occur-1 DA1-13-COINSURANCE-AMOUNT 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24210 Rule Numbe 7095 Move DA1.14 Payer Amount Paid to Numeric W.A.-1 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD DA1-Insur-Info-Occur-1 DA1-14-PAYOR-AMOUNT-PAID 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24215 Rule Numbe 7100 Move DA1.24 Balance Due to Numeric W.A.-1 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD DA1-Insur-Info-Occur-1 DA1-24-BALANCE-DUE 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24220 Rule Numbe 7105 Move DA1.09 Disallow Cost to Numeric W.A.-2 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD DA1-Insur-Info-Occur-2 DA1-09-DISALLOW-COST-CONTAIN 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24250 Rule Numbe 7110 Move DA1.10 Disallow Other to Numeric W.A.-2 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD DA1-Insur-Info-Occur-2 DA1-10-DISALLOWED-OTHER 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24255 Rule Numbe 7115 Move DA1.11 Allowed Amount to Numeric W.A.-2 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD DA1-Insur-Info-Occur-2 DA1-11-ALLOWED-AMOUNT 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24260 Rule Numbe 7120 Move DA1.12 Deduct Amount to Numeric W.A.-2 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD DA1-Insur-Info-Occur-2 DA1-12-DEDUCTIBLE-AMOUNT 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24265 Rule Numbe 7125 Move DA1.13 Coinsur Amount to Numeric W.A.-2 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD DA1-Insur-Info-Occur-2 DA1-13-COINSURANCE-AMOUNT 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24270 Rule Numbe 7130 Move DA1.14 Payer Amount Paid to Numeric W.A.-2 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD DA1-Insur-Info-Occur-2 DA1-14-PAYOR-AMOUNT-PAID 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24275 Rule Numbe 7135 Move DA1.24 Balance Due to Numeric W.A.-2 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD DA1-Insur-Info-Occur-2 DA1-24-BALANCE-DUE 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24280 Rule Numbe 7140 Move DA1.09 Disallow Cost to Numeric W.A.-3 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD DA1-Insur-Info-Occur-3 DA1-09-DISALLOW-COST-CONTAIN 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24305 Rule Numbe 7145 Move DA1.10 Disallow Other to Numeric W.A.-3 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD DA1-Insur-Info-Occur-3 DA1-10-DISALLOWED-OTHER 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24310 Rule Numbe 7150 Move DA1.11 Allowed Amount to Numeric W.A.-3 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD DA1-Insur-Info-Occur-3 DA1-11-ALLOWED-AMOUNT 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24315 Rule Numbe 7155 Move DA1.12 Deduct Amount to Numeric W.A.-3 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD DA1-Insur-Info-Occur-3 DA1-12-DEDUCTIBLE-AMOUNT 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24320 Rule Numbe 7160 Move DA1.13 Coinsur Amount to Numeric W.A.-3 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD DA1-Insur-Info-Occur-3 DA1-13-COINSURANCE-AMOUNT 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24325 Rule Numbe 7165 Move DA1.14 Payer Amount Paid to Numeric W.A.-3 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD DA1-Insur-Info-Occur-3 DA1-14-PAYOR-AMOUNT-PAID 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24330 Rule Numbe 7170 Move DA1.24 Balance Due to Numeric W.A.-3 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD DA1-Insur-Info-Occur-3 DA1-24-BALANCE-DUE 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24335 Rule Numbe 7175 Move EA0.31 Lab Charges to Numeric W.A. Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD EA0-CLAIM-LVL-INFO EA0-31-LAB-CHARGES 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24355 Rule Numbe 7180 Move FA0.13 Line Charges to Numeric W.A. Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD SVC-CLAIM-DETAIL-RECORD-FA0 FA0-13-LINE-CHARGES 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24390 Rule Numbe 7185 Move FA0.18 Units to Numeric W.A. Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Units-Workarea = REC FIELD SVC-CLAIM-DETAIL-RECORD-FA0 FA0-18-UNITS-OF-SVC 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24395 Rule Numbe 7190 Move FA0.19 Anest Minutes to Numeric W.A. Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Anesth-Minutes = REC FIELD SVC-CLAIM-DETAIL-RECORD-FA0 FA0-19-ANES-OXYGEN-MINUTES 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24400 Rule Numbe 7195 Move FA0.27 Disallow Cost to Numeric W.A. Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD SVC-CLAIM-DETAIL-RECORD-FA0 FA0-27-DISALLOW-COST-CONTAIN 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24405 Rule Numbe 7200 Move FA0.28 Disallow Other to Numeric W.A. Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD SVC-CLAIM-DETAIL-RECORD-FA0 FA0-28-DISALLOW-OTHER 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24410 Rule Numbe 7205 Move FA0.35 Primary Paid Amt to Numeric W.A. Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD SVC-CLAIM-DETAIL-RECORD-FA0 FA0-35-PRIMARY-PAID-AMOUNT 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24415 Rule Numbe 7210 Move FA0.48 Obligated Amt to Numeric W.A. Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD SVC-CLAIM-DETAIL-RECORD-FA0 FA0-48-OBLIGATED-ACCEPT-AMT 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24420 Rule Numbe 7215 Move FA0.49 Drug Discount Amt to Numeric W.A. Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD SVC-CLAIM-DETAIL-RECORD-FA0 FA0-49-DRUG-DISCOUNT-AMT 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24425 Rule Numbe 7220 Move FB0.05 Purch Svc Charge to Numeric W.A. Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD SVC-CLAIM-DETAIL-RECORD-FB0 FB0-05-PUR-SVC-CHARGE 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24445 Rule Numbe 7225 Move FB0.06 Allowed Amt to Numeric W.A. Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD SVC-CLAIM-DETAIL-RECORD-FB0 FB0-06-ALLOWED-AMOUNT 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24450 Rule Numbe 7230 Move FB0.07 Deduct Amt to Numeric W.A. Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD SVC-CLAIM-DETAIL-RECORD-FB0 FB0-06-ALLOWED-AMOUNT 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24455 Rule Numbe 7235 Move FB0.08 Coinsur Amt to Numeric W.A. Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD SVC-CLAIM-DETAIL-RECORD-FB0 FB0-07-DEDUCTIBLE-AMOUNT 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24460 Rule Numbe 7240 Move FA0.02 Sequence Number to Numeric W.A. Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD SVC-CLAIM-DETAIL-RECORD-FB0 FB0-08-COINSURANCE-AMOUNT 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24465 Rule Numbe 7245 Move XA0.19 Patient Paid Amt to Numeric W.A. Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1 = VAR2 MEM VAR Detail-Sequence-Number = REC FIELD FA0-SERVICE-LVL-DETAIL FA0-02-SEQUENCE-NO 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24435 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24735 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24435 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24735 Rule Numbe 7250 Check if Submission Time Present Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 1 VAR1 = VAR2 IF REC FIELD AA0-SUBMITTER-DATA AA0-16-SUB-TIME GT CONST Then Perform Rule 155 Else Rule 0 1 IF THEN ELSE SYS VAR ERR_OCCURRED = CONST N 1 IF THEN ELSE IF REC FIELD AA0-SUBMITTER-DATA AA0-16-SUB-TIME GT CONST Then Perform Rule 155 Else Rule 0 2 VAR1 = VAR2 MEM VAR Amount Workarea = REC FIELD XA0-CLAIM-TRAILER-REC XA0-19-PAT-AMOUNT-PAID Rule Numbe 7255 Move Zeroes to Submission Time Line Command Description 1 VAR1 = VAR2 REC FIELD AA0-SUBMITTER-DATA AA0-16-SUB-TIME = MEM VAR DEFAULT-TIME Rule Numbe 7260 Check if AA0 required fields are present Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI FILES-IN-XMSN= REC FIELD MAP-PROCESS-INI FILES-IN-XMSN+ CONST 1 3 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 5 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD AA0-SUBMITTER-DATA AA0-01-REC-ID 6 VAR1=VAR2+VAR3 MEM VAR File-Counter = MEM VAR File-Counter + CONST 1 7 IF THEN IF REC FIELD AA0-SUBMITTER-DATA AA0-02-SUB-ID EQ CONST Then Perform Rule 24000 8 IF THEN IF REC FIELD AA0-SUBMITTER-DATA AA0-04-SUB-TYPE EQ CONST Then Perform Rule 24005 9 IF THEN ELSE IF REC FIELD AA0-SUBMITTER-DATA AA0-05-SUB-NO GT CONST Then Perform Rule 0 Else Rule 24010 10 IF THEN IF REC FIELD AA0-SUBMITTER-DATA AA0-06-SUB-NAME EQ CONST Then Perform Rule 24015 11 IF THEN ELSE IF REC FIELD AA0-SUBMITTER-DATA AA0-15-CREAT-DTE GT CONST Then Perform Rule 0 Else Rule 24055 12 IF THEN IF REC FIELD AA0-SUBMITTER-DATA AA0-15-CREAT-DTE GT SYS VAR SYS_DATE Then Perform Rule 24020 13 IF THEN IF REC FIELD AA0-SUBMITTER-DATA AA0-17-RECV-ID EQ CONST Then Perform Rule 24030 14 IF THEN ELSE IF REC FIELD AA0-SUBMITTER-DATA AA0-19-VERS-NATL-ALPHA GT CONST Then Perform Rule 0 Else Rule 24035 15 IF THEN IF REC FIELD AA0-SUBMITTER-DATA AA0-21-TEST-IND EQ CONST Then Perform Rule 24045 16 IF THEN IF REC FIELD AA0-SUBMITTER-DATA AA0-29-PROCESS-FRM-DT GT CONST Then Perform Rule 24870 17 IF THEN IF REC FIELD AA0-SUBMITTER-DATA AA0-30-PROCESS-THRU-DT GT CONST Then Perform Rule 24875 18 VAR1 = VAR2 MEM VAR File-Receiver-ID = REC FIELD AA0-SUBMITTER-DATA AA0-17-IOWA-REC-ID Rule Numbe 7265 Check if BA0 required fields are present Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI BATCH-COUNT-IN-FILE= REC FIELD MAP-PROCESS-INI BATCH-COUNT-IN-FILE+ CONST 1 3 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 5 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD BA0-PROVIDER-DATA BA0-01-REC-ID 6 VAR1 = VAR2 MEM VAR BA1-Flag = CONST N 7 IF THEN IF REC FIELD BA0-PROVIDER-DATA BA0-02-EMC-PROV-ID EQ CONST Then Perform Rule 24060 8 IF THEN IF REC FIELD BA0-PROVIDER-DATA BA0-03-BATCH-TYPE EQ CONST Then Perform Rule 24065 9 IF THEN IF REC FIELD BA0-PROVIDER-DATA BA0-04-BATCH-NO EQ CONST Then Perform Rule 24070 10 IF THEN IF REC FIELD BA0-PROVIDER-DATA BA0-06-PROV-TAX-ID EQ CONST Then Perform Rule 24080 11 IF THEN IF REC FIELD BA0-PROVIDER-DATA BA0-08-PROV-TAX-ID-TYPE EQ CONST Then Perform Rule 24085 12 PERFORM RULE Perform Rule 8280 Rule Numbe 7270 Check if BA1 required fields are present. Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD BA1-PROVIDER-DATA-2 BA1-01-RECORD-ID 5 VAR1 = VAR2 MEM VAR BA1-Flag = CONST Y 6 IF THEN IF REC FIELD BA1-PROVIDER-DATA-2 BA1-02-EMC-PROV-ID NE MEM VAR Batch-EMC-Provider-ID Then Perform Rule 24095 7 IF THEN IF REC FIELD BA1-PROVIDER-DATA-2 BA1-03-BATCH-TYPE NE MEM VAR Batch-Type Then Perform Rule 24100 8 IF THEN IF REC FIELD BA1-PROVIDER-DATA-2 BA1-04-BATCH-NO NE MEM VAR Batch-No-Alpha Then Perform Rule 24105 9 IF THEN IF REC FIELD BA1-PROVIDER-DATA-2 BA1-05-BATCH-ID NE MEM VAR Batch-ID Then Perform Rule 24110 10 IF THEN IF REC FIELD BA1-PROVIDER-DATA-2 BA1-13-PAY-TO-ADDR-REDEFINES GT CONST Then Perform Rule 7540 Rule Numbe 7275 Check if CA0 required fields are present Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD CA0-PATIENT-DATA CA0-01-RECORD-ID 5 IF THEN IF REC FIELD CA0-PATIENT-DATA CA0-03-PAT-CONTROL-NO EQ CONST Then Perform Rule 24205 6 VAR1 = VAR2 MEM VAR Patient-Control-Number = REC FIELD CA0-PATIENT-DATA CA0-03-PAT-CONTROL-NO 7 IF THEN IF REC FIELD CA0-PATIENT-DATA CA0-11-PAT-ADDRESS-REDEFINES GT CONST Then Perform Rule 7545 8 IF THEN IF REC FIELD CA0-PATIENT-DATA CA0-04-PAT-LAST-NAME GT CONST Then Perform Rule 7545 9 IF THEN IF REC FIELD CA0-PATIENT-DATA CA0-05-PAT-FIRST-NAME GT CONST Then Perform Rule 7545 10 IF THEN IF REC FIELD CA0-PATIENT-DATA CA0-06-PAT-MI GT CONST Then Perform Rule 7545 11 IF THEN IF REC FIELD CA0-PATIENT-DATA CA0-07-PAT-GENERATION GT CONST Then Perform Rule 7545 Rule Numbe 7280 Check if CB0 required fields are present Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD CB0-LEGAL-REPRE-DATA CB0-01-RECORD-ID 5 IF THEN IF REC FIELD CB0-LEGAL-REPRE-DATA CB0-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24145 6 IF THEN IF REC FIELD CB0-LEGAL-REPRE-DATA CB0-04-RESP-PERS-REDEFINES GT CONST Then Perform Rule 7550 Rule Numbe 7285 Check if DA0 required fields are present Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 MEM VAR Sequence-Number-Error = REC FIELD DA0-INSURANCE-INFO DA0-02-SEQUENCE-NO 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 5 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD DA0-INSURANCE-INFO DA0-01-REC0RD-ID 6 IF THEN IF REC FIELD DA0-INSURANCE-INFO DA0-02-SEQUENCE-NO EQ CONST Then Perform Rule 24150 7 IF THEN IF REC FIELD DA0-INSURANCE-INFO DA0-02-SEQUENCE-NO LE MEM VAR Sequence Number Then Perform Rule 24155 8 IF THEN IF REC FIELD DA0-INSURANCE-INFO DA0-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24160 9 PERFORM RULE Perform Rule 8310 10 PERFORM RULE Perform Rule 7485 Rule Numbe 7290 Check if DA1 required fields are present Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-01-RECORD-ID 5 IF THEN IF REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-02-SEQUENCE-NO NE MEM VAR Sequence Number Then Perform Rule 24165 6 IF THEN IF REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 8665 7 IF THEN IF REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-30-AMT-PAID-TO-BENE EQ CONST Then Perform Rule 8665 8 IF THEN IF REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-33-AMT-PAID-TO-PROV EQ CONST Then Perform Rule 8670 9 IF THEN IF REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-36-INTEREST-PAID EQ CONST Then Perform Rule 8675 10 IF THEN IF REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-37-APPROVED-AMT EQ CONST Then Perform Rule 8680 11 PERFORM RULE Perform Rule 7695 Rule Numbe 7295 Check if DA2 required fields are present Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-01-RECORD-ID 5 IF THEN IF REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-02-SEQUENCE-NO EQ CONST 01 Then Perform Rule 7675 6 IF THEN IF REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-02-SEQUENCE-NO NE MEM VAR Sequence Number Then Perform Rule 24225 7 IF THEN IF REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24230 8 PERFORM RULE Perform Rule 7700 Rule Numbe 7300 Check if EA0 required fields are present Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD EA0-CLAIM-LVL-INFO EA0-01-RECORD-ID 5 IF THEN IF REC FIELD EA0-CLAIM-LVL-INFO EA0-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24350 6 PERFORM RULE Perform Rule 7400 7 PERFORM RULE Perform Rule 7490 8 IF THEN IF REC FIELD EA0-CLAIM-LVL-INFO EA0-20-REFER-PROV-ID-NO GT CONST Then Perform Rule 7570 9 IF THEN IF REC FIELD EA0-CLAIM-LVL-INFO EA0-20-REFER-PROV-ID-NO GT CONST Then Perform Rule 7615 10 IF THEN IF REC FIELD EA0-CLAIM-LVL-INFO EA0-24-REFER-PROV-REDEFINES GT CONST Then Perform Rule 7570 11 IF THEN IF REC FIELD EA0-CLAIM-LVL-INFO EA0-27-REFER-PROV-STATE GT CONST Then Perform Rule 7570 12 IF THEN IF REC FIELD EA0-CLAIM-LVL-INFO EA0-27-REFER-PROV-STATE GT CONST Then Perform Rule 7615 13 IF THEN IF REC FIELD EA0-CLAIM-LVL-INFO EA0-39-FACILITY-LAB-NAME GT CONST Then Perform Rule 7575 14 VAR1 = VAR2 MEM VAR EA1-Flag = CONST N 15 PERFORM RULE Perform Rule 7450 16 PERFORM RULE Perform Rule 8315 Rule Numbe 7305 Check if EA1 required fields are present Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-01-RECORD-ID 5 IF THEN IF REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24365 6 IF THEN IF REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-04-FACILITY-LAB-ID-NO GT CONST Then Perform Rule 7575 7 IF THEN IF REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-06-LABORATORY-REDEFINES GT CONST Then Perform Rule 7575 8 IF THEN IF REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-16-SUPV-PROV-ID-NO GT CONST Then Perform Rule 7580 9 IF THEN IF REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-16-SUPV-PROV-ID-NO GT CONST Then Perform Rule 7620 10 IF THEN IF REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-18-SUPV-PROV-REDEFINES GT CONST Then Perform Rule 7580 11 IF THEN IF REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-21-SUPV-PROV-STATE GT CONST Then Perform Rule 7620 12 IF THEN IF REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-22-EMT-NAME-REDEFINES GT CONST Then Perform Rule 7585 13 VAR1 = VAR2 MEM VAR EA1-Flag = CONST Y 14 VAR1 = VAR2 MEM VAR EA1-Lab-ID = REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-04-FACILITY-LAB-ID-NO Rule Numbe 7310 Check Patient Control Number (EA2) Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD EA2-EPSDT-CLAIM-RECORD EA2-01-RECORD-ID 5 IF THEN IF REC FIELD EA2-EPSDT-CLAIM-RECORD EA2-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24370 Rule Numbe 7315 Check if FA0 required fields are present Line Command Description 1 PERFORM RULE Perform Rule 7025 2 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 3 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 5 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD FA0-SERVICE-LVL-DETAIL FA0-01-RECORD-ID 6 IF THEN IF REC FIELD FA0-SERVICE-LVL-DETAIL FA0-02-SEQUENCE-NUMBER-ALPHA EQ CONST Then Perform Rule 24375 7 IF THEN IF REC FIELD FA0-SERVICE-LVL-DETAIL FA0-02-SEQUENCE-NO LE MEM VAR Detail-Sequence-Number Then Perform Rule 24380 8 IF THEN IF REC FIELD FA0-SERVICE-LVL-DETAIL FA0-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24385 9 VAR1 = VAR2 MEM VAR Detail-Line-Item-No = REC FIELD FA0-SERVICE-LVL-DETAIL FA0-04-LINE-ITEM-CONTROL-NO 10 IF THEN IF REC FIELD FA0-SERVICE-LVL-DETAIL FA0-51-APPROVED-AMT EQ CONST Then Perform Rule 8740 11 IF THEN IF REC FIELD FA0-SERVICE-LVL-DETAIL FA0-52-PAID-AMT EQ CONST Then Perform Rule 8745 12 IF THEN IF REC FIELD FA0-SERVICE-LVL-DETAIL FA0-53-BENE-LIABILITY-AMT EQ CONST Then Perform Rule 8750 13 IF THEN IF REC FIELD FA0-SERVICE-LVL-DETAIL FA0-54-BAL-BILL-LIMIT-CHG EQ CONST Then Perform Rule 8755 14 IF THEN IF REC FIELD FA0-SERVICE-LVL-DETAIL FA0-55-LIMIT-CHARGE-PRCNT EQ CONST Then Perform Rule 8760 15 PERFORM RULE Perform Rule 7240 16 CLEAR RECORD Clear All Fields in Record SVC-CLAIM-DETAIL-RECORD-FA0 17 VAR1 = VAR2 REC FIELD SVC-CLAIM-DETAIL-RECORD-FA0 FA0-00-GROUP-LEVEL-REDEFINES = REC FIELD FA0-SERVICE-LVL-DETAIL FA0-00-GROUP-LEVEL-REDEFINES 18 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-FA0 FA0-23-RENDERING-PROV-ID GT CONST Then Perform Rule 7605 19 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-FA0 FA0-24-REFERRING-PROV-ID GT CONST Then Perform Rule 7600 20 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-FA0 FA0-25-REFERRING-PROV-ST GT CONST Then Perform Rule 7600 21 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-FA0 FA0-25-REFERRING-PROV-ST GT CONST Then Perform Rule 7630 22 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-FA0 FA0-37-PROVIDER-SPECIALTY GT CONST Then Perform Rule 7605 23 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-FA0 FA0-37-PROVIDER-SPECIALTY GT CONST Then Perform Rule 7625 Rule Numbe 7320 Check if FB0 required fields are present Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-01-RECORD-ID 5 IF THEN IF REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-02-SEQUENCE-NO NE MEM VAR Detail-Sequence-Number Then Perform Rule 24430 6 IF THEN IF REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24435 7 IF THEN IF REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-04-LINE-ITEM-CONTROL-NO NE MEM VAR Detail-Line-Item-No Then Perform Rule 24440 8 CLEAR RECORD Clear All Fields in Record SVC-CLAIM-DETAIL-RECORD-FB0 9 VAR1 = VAR2 REC FIELD SVC-CLAIM-DETAIL-RECORD-FB0 FB0-00-GROUP-LEVEL-REDEFINES = REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-00-GROUP-LEVEL-REDEFINES 10 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-FB0 FB0-09-ORDERING-PROV-ID GT CONST Then Perform Rule 7595 11 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-FB0 FB0-10-ORDERING-PROV-ST GT CONST Then Perform Rule 7595 12 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-FB0 FB0-10-ORDERING-PROV-ST GT CONST Then Perform Rule 7635 13 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-FB0 FB0-12-PUR-SVC-STATE GT CONST Then Perform Rule 7590 14 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-FB0 FB0-27-PURCH-PROV-REDEFINES GT CONST Then Perform Rule 7590 Rule Numbe 7325 Check if FB1 required fields are present Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-01-RECORD-ID 5 IF THEN IF REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-02-SEQUENCE-NO NE MEM VAR Detail-Sequence-Number Then Perform Rule 24465 6 IF THEN IF REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24470 7 IF THEN IF REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-04-LINE-ITEM-CONTROL-NO NE MEM VAR Detail-Line-Item-No Then Perform Rule 24475 8 CLEAR RECORD Clear All Fields in Record SVC-CLAIM-DETAIL-RECORD-FB1 9 VAR1 = VAR2 REC FIELD SVC-CLAIM-DETAIL-RECORD-FB1 FB1-00-GROUP-LEVEL-REDEFINES = REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-00-GROUP-LEVEL-REDEFINES 10 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-FB1 FB1-06-ORDER-PROV-REDEFINES GT CONST Then Perform Rule 7595 11 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-FB1 FB1-09-ORDERING-PROV-UPIN GT CONST Then Perform Rule 7635 12 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-FB1 FB1-10-REFER-PROV-REDEFINES GT CONST Then Perform Rule 7600 13 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-FB1 FB1-13-REFERRING-PROV-UPIN GT CONST Then Perform Rule 7630 14 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-FB1 FB1-14-RENDER-PROV-REDEFINES GT CONST Then Perform Rule 7605 15 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-FB1 FB1-17-RENDERING-PROV-UPIN GT CONST Then Perform Rule 7625 16 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-FB1 FB1-18-SUPV-PROV-REDEFINES GT CONST Then Perform Rule 7610 17 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-FB1 FB1-22-SUPERVISING-PROV-UPIN GT CONST Then Perform Rule 7640 Rule Numbe 7330 Check if FB2 required fields are present Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-01-RECORD-ID 5 IF THEN IF REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-02-SEQUENCE-NO NE MEM VAR Detail-Sequence-Number Then Perform Rule 24480 6 IF THEN IF REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24485 7 IF THEN IF REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-04-LINE-ITEM-CONTROL-NO NE MEM VAR Detail-Line-Item-No Then Perform Rule 24490 8 CLEAR RECORD Clear All Fields in Record SVC-CLAIM-DETAIL-RECORD-FB2 9 VAR1 = VAR2 REC FIELD SVC-CLAIM-DETAIL-RECORD-FB2 FB2-00-GROUP-LEVEL-REDEFINES = REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-00-GROUP-LEVEL-REDEFINES Rule Numbe 7335 Check if FD0 required fields are present Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-01-RECORD-ID 5 IF THEN IF REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-02-SEQUENCE-NO NE MEM VAR Detail-Sequence-Number Then Perform Rule 24510 6 IF THEN IF REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24515 7 IF THEN IF REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-04-LINE-ITEM-CONTROL-NO NE MEM VAR Detail-Line-Item-No Then Perform Rule 24520 8 VAR1=VAR2+VAR3 MEM VAR FD0-NDX = MEM VAR FD0-NDX + CONST 1 9 IF THEN IF MEM VAR FD0-NDX EQ CONST 01 Then Perform Rule 7765 10 IF THEN IF MEM VAR FD0-NDX EQ CONST 02 Then Perform Rule 7770 11 IF THEN IF MEM VAR FD0-NDX EQ CONST 03 Then Perform Rule 7775 12 IF THEN IF MEM VAR FD0-NDX EQ CONST 04 Then Perform Rule 7780 13 IF THEN IF MEM VAR FD0-NDX EQ CONST 05 Then Perform Rule 7785 14 IF THEN IF MEM VAR FD0-NDX EQ CONST 06 Then Perform Rule 7790 15 IF THEN IF MEM VAR FD0-NDX EQ CONST 07 Then Perform Rule 7795 16 IF THEN IF MEM VAR FD0-NDX EQ CONST 08 Then Perform Rule 7800 Rule Numbe 7340 Check if FE0 required fields are present Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD FE0-TPO-SEGMENT FE0-01-RECORD-ID 5 IF THEN IF REC FIELD FE0-TPO-SEGMENT FE0-02-SEQUENCE-NO NE MEM VAR Detail-Sequence-Number Then Perform Rule 24525 6 IF THEN IF REC FIELD FE0-TPO-SEGMENT FE0-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24530 7 IF THEN IF REC FIELD FE0-TPO-SEGMENT FE0-04-LINE-ITEM-CONTROL-NO NE MEM VAR Detail-Line-Item-No Then Perform Rule 24535 Rule Numbe 7345 Check if GA0 required fields are present Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD GA0-AMBULANCE-CERT-REC GA0-01-RECORD-ID 5 IF THEN IF REC FIELD GA0-AMBULANCE-CERT-REC GA0-02-SEQUENCE-NO NE MEM VAR Detail-Sequence-Number Then Perform Rule 24540 6 IF THEN IF REC FIELD GA0-AMBULANCE-CERT-REC GA0-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24545 7 CLEAR RECORD Clear All Fields in Record SVC-CLAIM-DETAIL-RECORD-GA0 8 VAR1 = VAR2 REC FIELD SVC-CLAIM-DETAIL-RECORD-GA0 GA0-00-GROUP-LEVEL-REDEFINES = REC FIELD GA0-AMBULANCE-CERT-REC GA0-00-GROUP-LEVEL-REDEFINES 9 PERFORM RULE Perform Rule 8175 Rule Numbe 7350 Check if GC0 required fields are present Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD GC0-CHIROPRACTIC-CERT-RECORD GC0-01-RECORD-ID 5 IF THEN IF REC FIELD GC0-CHIROPRACTIC-CERT-RECORD GC0-02-SEQUENCE-NO NE MEM VAR Detail-Sequence-Number Then Perform Rule 24555 6 IF THEN IF REC FIELD GC0-CHIROPRACTIC-CERT-RECORD GC0-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24560 7 CLEAR RECORD Clear All Fields in Record SVC-CLAIM-DETAIL-RECORD-GC0 8 VAR1 = VAR2 REC FIELD SVC-CLAIM-DETAIL-RECORD-GC0 GC0-00-GROUP-LEVEL-REDEFINES = REC FIELD GC0-CHIROPRACTIC-CERT-RECORD GC0-00-GROUP-LEVEL-REDEFINES 9 VAR1 = VAR2 REC FIELD ZZZ-Remarks-Area ZZZ-GC0-14-Symptom-Description = CONST 10 VAR1 = VAR2 REC FIELD ZZZ-Remarks-Area ZZZ-GC0-14-Symptom-Description = REC FIELD SVC-CLAIM-DETAIL-RECORD-GC0 GC0-14-SYMPTOMS-DESRIPTION Rule Numbe 7355 Check if GD0 required fields are present Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD GD0-DME-CERT-RECORD GD0-01-RECORD-ID 5 IF THEN IF REC FIELD GD0-DME-CERT-RECORD GD0-02-SEQUENCE-NO NE MEM VAR Detail-Sequence-Number Then Perform Rule 24565 6 IF THEN IF REC FIELD GD0-DME-CERT-RECORD GD0-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24570 7 CLEAR RECORD Clear All Fields in Record SVC-CLAIM-DETAIL-RECORD-GD0 8 VAR1 = VAR2 REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-00-GROUP-LEVEL-REDEFINES = REC FIELD GD0-DME-CERT-RECORD GD0-00-GROUP-LEVEL-REDEFINES 9 PERFORM RULE Perform Rule 7835 Rule Numbe 7360 Check if GD1 required fields are present Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD GD1-DME-NARR-REC GD1-01-RECORD-ID 5 IF THEN IF REC FIELD GD1-DME-NARR-REC GD1-02-SEQUENCE-NO NE MEM VAR Detail-Sequence-Number Then Perform Rule 24575 6 IF THEN IF REC FIELD GD1-DME-NARR-REC GD1-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24580 7 CLEAR RECORD Clear All Fields in Record SVC-CLAIM-DETAIL-RECORD-GD1 8 VAR1 = VAR2 REC FIELD SVC-CLAIM-DETAIL-RECORD-GD1 GD1-00-GROUP-LEVEL-REDEFINES = REC FIELD GD1-DME-NARR-REC GD1-00-GROUP-LEVEL-REDEFINES 9 VAR1 = VAR2 REC FIELD ZZZ-Remarks-Area ZZZ-GD1-04-Extra-Narr-Data = CONST 10 VAR1 = VAR2 REC FIELD ZZZ-Remarks-Area ZZZ-GD1-04-Extra-Narr-Data = REC FIELD SVC-CLAIM-DETAIL-RECORD-GD1 GD1-04-NARRATIVE Rule Numbe 7365 Check Patient Control Number (GE0) Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-01-RECORD-ID 5 IF THEN IF REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-02-SEQUENCE-NO NE MEM VAR Detail-Sequence-Number Then Perform Rule 24585 6 IF THEN IF REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24590 Rule Numbe 7370 Check Patient Control Number (GP0) Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-01-RECORD-ID 5 IF THEN IF REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-02-SEQUENCE-NO NE MEM VAR Detail-Sequence-Number Then Perform Rule 24595 6 IF THEN IF REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24600 Rule Numbe 7375 Check Patient Control Number (GU0) Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD GU0-CERTIFICATION-RECORD GU0-01-RECORD-ID 5 IF THEN IF REC FIELD GU0-CERTIFICATION-RECORD GU0-02-SEQUENCE-NO NE MEM VAR Detail-Sequence-Number Then Perform Rule 24605 6 IF THEN IF REC FIELD GU0-CERTIFICATION-RECORD GU0-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24610 Rule Numbe 7380 Check Patient Control Number (GX0) Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD GX0-OXYGEN-CERT-REC GX0-01-RECORD-ID 5 IF THEN IF REC FIELD GX0-OXYGEN-CERT-REC GX0-02-SEQUENCE-NO NE MEM VAR Detail-Sequence-Number Then Perform Rule 24615 6 IF THEN IF REC FIELD GX0-OXYGEN-CERT-REC GX0-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24620 Rule Numbe 7385 Check Patient Control Number (GX1) Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD GX1-OXYGEN-NARR-REC GX1-01-RECORD-ID 5 IF THEN IF REC FIELD GX1-OXYGEN-NARR-REC GX1-02-SEQUENCE-NO NE MEM VAR Detail-Sequence-Number Then Perform Rule 24625 6 IF THEN IF REC FIELD GX1-OXYGEN-NARR-REC GX1-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24630 Rule Numbe 7390 Check Patient Control Number (GX2) Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD GX2-OXYGEN-FACILITY-REC GX2-01-RECORD-ID 5 IF THEN IF REC FIELD GX2-OXYGEN-FACILITY-REC GX2-02-SEQUENCE-NO NE MEM VAR Detail-Sequence-Number Then Perform Rule 24635 6 IF THEN IF REC FIELD GX2-OXYGEN-FACILITY-REC GX2-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24640 Rule Numbe 7395 Check if HA0 required fields are present Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD HA0-NARRATIVE-REC HA0-01-RECORD-ID 5 IF THEN IF REC FIELD HA0-NARRATIVE-REC HA0-02-SEQUENCE-NO NE MEM VAR Detail-Sequence-Number Then Perform Rule 24645 6 IF THEN IF REC FIELD HA0-NARRATIVE-REC HA0-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24650 7 IF THEN IF REC FIELD HA0-NARRATIVE-REC HA0-04-LINE-ITEM-CONTROL-NO NE MEM VAR Detail-Line-Item-No Then Perform Rule 24655 8 CLEAR RECORD Clear All Fields in Record SVC-CLAIM-DETAIL-RECORD-HA0 9 VAR1 = VAR2 REC FIELD SVC-CLAIM-DETAIL-RECORD-HA0 HA0-00-GROUP-LEVEL-REDEFINES = REC FIELD HA0-NARRATIVE-REC HA0-00-GROUP-LEVEL-REDEFINES 10 VAR1 = VAR2 REC FIELD ZZZ-Remarks-Area ZZZ-HA0-05-Remarks = CONST 11 VAR1 = VAR2 REC FIELD ZZZ-Remarks-Area ZZZ-HA0-05-Remarks = REC FIELD SVC-CLAIM-DETAIL-RECORD-HA0 HA0-05-EXTRA-NARRATIVE-DATA Rule Numbe 7400 Check if XA0 required fields are present Line Command Description 1 PERFORM RULE Perform Rule 0 Rule Numbe 7405 Check if YA0 required fields are present Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD YA0-BATCH-TRAILER-REC YA0-01-RECORD-ID 5 IF THEN IF REC FIELD YA0-BATCH-TRAILER-REC YA0-02-EMC-PROV-ID NE MEM VAR Batch-EMC-Provider-ID Then Perform Rule 24765 6 IF THEN IF REC FIELD YA0-BATCH-TRAILER-REC YA0-03-BATCH-TYPE NE MEM VAR Batch-Type Then Perform Rule 24770 7 IF THEN IF REC FIELD YA0-BATCH-TRAILER-REC YA0-04-BATCH-NO NE MEM VAR Batch-No-Alpha Then Perform Rule 24775 8 IF THEN IF REC FIELD YA0-BATCH-TRAILER-REC YA0-05-BATCH-ID NE MEM VAR Batch-ID Then Perform Rule 24780 9 IF THEN IF REC FIELD YA0-BATCH-TRAILER-REC YA0-06-PROV-TAX-ID NE MEM VAR Batch-Prov-Tax-ID Then Perform Rule 24785 10 PERFORM RULE Perform Rule 8465 Rule Numbe 7410 Check if ZA0 required fields are present Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD ZA0-FILE-TRAILER-REC ZA0-01-RECORD-ID 5 IF THEN IF REC FIELD ZA0-FILE-TRAILER-REC ZA0-02-SUB-ID NE REC FIELD AA0-SUBMITTER-DATA AA0-02-SUB-ID Then Perform Rule 24810 6 IF THEN IF REC FIELD ZA0-FILE-TRAILER-REC ZA0-04-RECEIVER-ID NE REC FIELD AA0-SUBMITTER-DATA AA0-17-RECV-ID Then Perform Rule 24815 7 PERFORM RULE Perform Rule 8495 Rule Numbe 7415 Check if CA1 required fields are present Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD CA1-INDIAN-HEALTH-SVCS CA1-01-RECORD-ID 5 IF THEN IF REC FIELD CA1-INDIAN-HEALTH-SVCS CA1-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24140 Rule Numbe 7420 Check if DA3 required fields are present Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-01-RECORD-ID 5 IF THEN IF REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-02-SEQUENCE-NO NE MEM VAR Sequence Number Then Perform Rule 24340 6 IF THEN IF REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24345 7 IF THEN IF REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-05-DOLLAR-AMOUNT-1 EQ CONST Then Perform Rule 8685 8 IF THEN IF REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-07-DOLLAR-AMOUNT-2 EQ CONST Then Perform Rule 8690 9 IF THEN IF REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-09-DOLLAR-AMOUNT-3 EQ CONST Then Perform Rule 8695 10 IF THEN IF REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-11-DOLLAR-AMOUNT-4 EQ CONST Then Perform Rule 8700 11 IF THEN IF REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-13-DOLLAR-AMOUNT-5 EQ CONST Then Perform Rule 8705 12 IF THEN IF REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-15-DOLLAR-AMOUNT-6 EQ CONST Then Perform Rule 8710 13 IF THEN IF REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-17-DOLLAR-AMOUNT-7 EQ CONST Then Perform Rule 8715 14 IF THEN IF REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-25-PROV-ADJUST-AMT EQ CONST Then Perform Rule 8720 15 IF THEN IF REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-26-BENE-ADJUST-AMT EQ CONST Then Perform Rule 8725 16 IF THEN IF REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-27-ORIG-APPROVE-AMT EQ CONST Then Perform Rule 8730 17 IF THEN IF REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-28-ORIG-PAID-AMT EQ CONST Then Perform Rule 8735 18 PERFORM RULE Perform Rule 7810 Rule Numbe 7425 Check if FB3 required fields are present Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD FB3-SERVICE-LINE-DETAIL-MED4 FB3-01-RECORD-ID 5 IF THEN IF REC FIELD FB3-SERVICE-LINE-DETAIL-MED4 FB3-02-SEQUENCE-NO NE MEM VAR Detail-Sequence-Number Then Perform Rule 24495 6 IF THEN IF REC FIELD FB3-SERVICE-LINE-DETAIL-MED4 FB3-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24500 7 IF THEN IF REC FIELD FB3-SERVICE-LINE-DETAIL-MED4 FB3-04-LINE-ITEM-CONTORL-NO NE MEM VAR Detail-Line-Item-No Then Perform Rule 24505 8 IF THEN IF REC FIELD FB3-SERVICE-LINE-DETAIL-MED4 FB3-06-DOLLAR-AMOUNT-1 EQ CONST Then Perform Rule 8765 9 IF THEN IF REC FIELD FB3-SERVICE-LINE-DETAIL-MED4 FB3-08-DOLLAR-AMOUNT-2 EQ CONST Then Perform Rule 8770 10 IF THEN IF REC FIELD FB3-SERVICE-LINE-DETAIL-MED4 FB3-10-DOLLAR-AMOUNT-3 EQ CONST Then Perform Rule 8775 11 IF THEN IF REC FIELD FB3-SERVICE-LINE-DETAIL-MED4 FB3-12-DOLLAR-AMOUNT-4 EQ CONST Then Perform Rule 8780 12 IF THEN IF REC FIELD FB3-SERVICE-LINE-DETAIL-MED4 FB3-14-DOLLAR-AMOUNT-5 EQ CONST Then Perform Rule 8785 13 IF THEN IF REC FIELD FB3-SERVICE-LINE-DETAIL-MED4 FB3-16-DOLLAR-AMOUNT-6 EQ CONST Then Perform Rule 8790 14 IF THEN IF REC FIELD FB3-SERVICE-LINE-DETAIL-MED4 FB3-18-DOLLAR-AMOUNT-7 EQ CONST Then Perform Rule 8795 15 CLEAR RECORD Clear All Fields in Record SVC-CLAIM-DETAIL-RECORD-FB3 16 VAR1 = VAR2 REC FIELD SVC-CLAIM-DETAIL-RECORD-FB3 FB3-00-GROUP-LEVEL-REDEFINES = REC FIELD FB3-SERVICE-LINE-DETAIL-MED4 FB3-00-GROUP-LEVEL-REDEFINES Rule Numbe 7430 Clear FB3 WA Line Command Description 1 CLEAR RECORD Clear All Fields in Record SVC-CLAIM-DETAIL-RECORD-FB3 Rule Numbe 7435 Clear DA3 - 1 WA Line Command Description 1 CLEAR RECORD Clear All Fields in Record DA3-Insur-Adjud-Status-1 Rule Numbe 7440 Clear DA3 - 2 WA Line Command Description 1 CLEAR RECORD Clear All Fields in Record DA3-Insur-Adjud-Status-2 Rule Numbe 7445 Clear DA3 - 3 WA Line Command Description 1 CLEAR RECORD Clear All Fields in Record DA3-Insur-Adjud-Status-3 Rule Numbe 7450 Check Accident Indicator Line Command Description 1 VAR1 = VAR2 MEM VAR DTP01-Qualifier = CONST 2 VAR1 = VAR2 MEM VAR DTP02-Qualifier = CONST 3 VAR1 = VAR2 MEM VAR Accident-Date = CONST 4 IF THEN ELSE IF REC FIELD EA0-CLAIM-LVL-INFO EA0-05-ACCIDENT-IND EQ CONST A Then Perform Rule 7455 Else Rule 7470 5 IF THEN ELSE IF REC FIELD EA0-CLAIM-LVL-INFO EA0-05-ACCIDENT-IND EQ CONST O Then Perform Rule 7455 Else Rule 7470 Rule Numbe 7455 Assign "439" to DTP01-Qualifier Line Command Description 1 VAR1 = VAR2 MEM VAR DTP01-Qualifier = CONST 439 2 IF THEN ELSE IF REC FIELD EA0-CLAIM-LVL-INFO EA0-11-ACCIDENT-HOUR GT CONST Then Perform Rule 7460 Else Rule 7465 Rule Numbe 7460 Assign "DT" to DTP02-Qualifier Line Command Description 1 VAR1 = VAR2 MEM VAR DTP02-Qualifier = CONST DT 2 VAR1 = VAR2 MEM VAR Accident-Date = CONST 000000000000 3 CONCATENATE Dest: Accident-Date L.Source: EA0-CLAIM-LVL-INFO EA0-07-ACCIDENT-SYMPTOM-DATE R.Source: EA0-CLAIM-LVL-INFO EA0-11-ACCIDENT-HOUR Placement: UnTrim Rule Numbe 7465 Assign "D8" to DTP02-Qualifier Line Command Description 1 VAR1 = VAR2 MEM VAR DTP02-Qualifier = CONST D8 2 VAR1 = VAR2 MEM VAR Accident-Date = CONST 3 VAR1 = VAR2 MEM VAR Accident-Date = REC FIELD EA0-CLAIM-LVL-INFO EA0-07-ACCIDENT-SYMPTOM-DATE Rule Numbe 7470 Check Symptom Indicator Line Command Description 1 IF THEN IF REC FIELD EA0-CLAIM-LVL-INFO EA0-06-SYMPTOM-IND EQ CONST 1 Then Perform Rule 7475 2 IF THEN IF REC FIELD EA0-CLAIM-LVL-INFO EA0-06-SYMPTOM-IND EQ CONST 2 Then Perform Rule 7480 Rule Numbe 7475 Assign "431" to DTP01-Qualifier Line Command Description 1 VAR1 = VAR2 MEM VAR DTP01-Qualifier = CONST 431 2 VAR1 = VAR2 MEM VAR DTP02-Qualifier = CONST D8 3 VAR1 = VAR2 MEM VAR Accident-Date = CONST 4 VAR1 = VAR2 MEM VAR Accident-Date = REC FIELD EA0-CLAIM-LVL-INFO EA0-07-ACCIDENT-SYMPTOM-DATE Rule Numbe 7480 Assign "484" to DTP02-Qualifier Line Command Description 1 VAR1 = VAR2 MEM VAR DTP01-Qualifier = CONST 484 2 VAR1 = VAR2 MEM VAR DTP02-Qualifier = CONST D8 3 VAR1 = VAR2 MEM VAR Accident-Date = CONST 4 VAR1 = VAR2 MEM VAR Accident-Date = REC FIELD EA0-CLAIM-LVL-INFO EA0-07-ACCIDENT-SYMPTOM-DATE Rule Numbe 7485 Check if Trading Partner's DA0 record Line Command Description 1 IF THEN IF REC FIELD DA0-INSURANCE-INFO DA0-07-PAYOR-ORGANIZATION-ID EQ MEM VAR File-Receiver-ID Then Perform Rule 7685 2 PERFORM RULE Perform Rule 7690 Rule Numbe 7490 Determine Related Cause Indicator for CLM1101 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Related-Cause-Codes = CONST 2 VAR1 = VAR2 MEM VAR CLM-NDX = CONST 0 3 VAR1 = VAR2 MEM VAR Related-Cause-Hold-Area = CONST 4 IF THEN IF REC FIELD EA0-CLAIM-LVL-INFO EA0-04-EMPL-RELATED-IND EQ CONST Y Then Perform Rule 7495 5 IF THEN IF REC FIELD EA0-CLAIM-LVL-INFO EA0-05-ACCIDENT-IND EQ CONST A Then Perform Rule 7500 6 IF THEN IF REC FIELD EA0-CLAIM-LVL-INFO EA0-05-ACCIDENT-IND EQ CONST O Then Perform Rule 7505 7 IF THEN IF REC FIELD EA0-CLAIM-LVL-INFO EA0-09-RESPONSIBILITY-IND EQ CONST Y Then Perform Rule 7510 8 IF THEN IF REC FIELD EA0-CLAIM-LVL-INFO EA0-12-ABUSE-IND EQ CONST Y Then Perform Rule 7515 Rule Numbe 7495 Assign "EM" to Related-Cause-Hold Line Command Description 1 VAR1 = VAR2 MEM VAR Related-Cause-Hold-Area = CONST EM 2 PERFORM RULE Perform Rule 7520 Rule Numbe 7500 Assign "AA" to Related-Cause-Hold Line Command Description 1 VAR1 = VAR2 MEM VAR Related-Cause-Hold-Area = CONST AA 2 PERFORM RULE Perform Rule 7520 Rule Numbe 7505 Assign "OA" to Related-Cause-Hold Line Command Description 1 VAR1 = VAR2 MEM VAR Related-Cause-Hold-Area = CONST OA 2 PERFORM RULE Perform Rule 7520 Rule Numbe 7510 Assign "RP" to Related-Cause-Hold Line Command Description 1 VAR1 = VAR2 MEM VAR Related-Cause-Hold-Area = CONST RP 2 PERFORM RULE Perform Rule 7520 Rule Numbe 7515 Assign "AB" to Related-Cause-Hold Line Command Description 1 VAR1 = VAR2 MEM VAR Related-Cause-Hold-Area = CONST AB 2 PERFORM RULE Perform Rule 7520 Rule Numbe 7520 Determine Related Cause Occurrence Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR CLM-NDX = MEM VAR CLM-NDX + CONST 1 2 IF THEN IF MEM VAR CLM-NDX EQ CONST 01 Then Perform Rule 7525 3 IF THEN IF MEM VAR CLM-NDX EQ CONST 02 Then Perform Rule 7530 4 IF THEN IF MEM VAR CLM-NDX EQ CONST 03 Then Perform Rule 7535 Rule Numbe 7525 Move Related Cause to 1st Occurrence Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Related-Cause-1 = MEM VAR Related-Cause-Hold-Area Rule Numbe 7530 Move Related Cause to 2nd Occurrence Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Related-Cause-2 = MEM VAR Related-Cause-Hold-Area Rule Numbe 7535 Move Related Cause to 3rd Occurrence Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Related-Cause-3 = MEM VAR Related-Cause-Hold-Area Rule Numbe 7540 Assign "Y" to Pay-To Provider Flag Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Pay-To-Provider-Flag = CONST Y Rule Numbe 7545 Assign "Y" to Patient Address Flag Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Patient-Address-Flag = CONST Y Rule Numbe 7550 Assign "Y" to Legal Representative Flag Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Legal-Rep-Flag = CONST Y Rule Numbe 7555 Assign "Y" to Insured Name Flag-1 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Insured-Name-Flag-1 = CONST Y Rule Numbe 7560 Assign "Y" to Payor Name Flag-1 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Payor-Name-Flag-1 = CONST Y Rule Numbe 7565 Assign "Y" to Employer Name Flag-1 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Employer-Name-Flag-1 = CONST Y Rule Numbe 7570 Assign "Y" to EA0 Referring Prov Flag Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records EA0-Refer-Prov-Flag = CONST Y Rule Numbe 7575 Assign "Y" to Laboratory Flag Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Laboratory-Flag = CONST Y Rule Numbe 7580 Assign "Y" to EA1 Supv Provider Flag Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records EA1-Supv-Prov-Flag = CONST Y Rule Numbe 7585 Assign "Y" to EMT Name Flag Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records EMT-Name-Flag = CONST Y Rule Numbe 7590 Assign "Y" to Purchase Provider Flag Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records FB0-Purch-Prov-Flag = CONST Y Rule Numbe 7595 Assign "Y" to FB1 Ordering Provider Flag Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records FB1-Order-Prov-Flag = CONST Y Rule Numbe 7600 Assign "Y" to FB1 Referring Provider Flag Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records FB1-Refer-Prov-Flag = CONST Y Rule Numbe 7605 Assign "Y" to FB1 Rendering Provider Flag Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records FB1-Render-Prov-Flag = CONST Y Rule Numbe 7610 Assign "Y" to FB1 Superving Provider Flag Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records FB1-Supv-Prov-Flag = CONST Y Rule Numbe 7615 Assign "Y" to EA0 Referring Prov Flag (PRV) Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records EA0-Refer-Prov-Flag-PRV = CONST Y Rule Numbe 7620 Assign "Y" to EA1 Supv Provider Flag (PRV) Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records EA1-Supv-Prov-Flag-PRV = CONST Y Rule Numbe 7625 Assign "Y" to FB1 Rendering Provider Flag (PRV) Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records FB1-Render-Prov-Flag-PRV = CONST Y Rule Numbe 7630 Assign "Y" to FB1 Referring Provider Flag (PRV) Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records FB1-Refer-Prov-Flag-PRV = CONST Y Rule Numbe 7635 Assign "Y" to FB1 Ordering Provider Flag (PRV) Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records FB1-Order-Prov-Flag-PRV = CONST Y Rule Numbe 7640 Assign "Y" to FB1 Superving Provider Flag (PRV) Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records FB1-Supv-Prov-Flag-PRV = CONST Y Rule Numbe 7645 Assign "Y" to Insured Name Flag-2 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Insured-Name-Flag-2 = CONST Y Rule Numbe 7650 Assign "Y" to Payor Name Flag-2 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Payor-Name-Flag-2 = CONST Y Rule Numbe 7655 Assign "Y" to Employer Name Flag-2 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Employer-Name-Flag-2 = CONST Y Rule Numbe 7660 Assign "Y" to Insured Name Flag-3 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Insured-Name-Flag-3 = CONST Y Rule Numbe 7665 Assign "Y" to Payor Name Flag-3 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Payor-Name-Flag-3 = CONST Y Rule Numbe 7670 Assign "Y" to Employer Name Flag-3 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Flag-Records Employer-Name-Flag-3 = CONST Y Rule Numbe 7675 Assign "Y" to DA2-1-flag Line Command Description 1 VAR1 = VAR2 MEM VAR DA2-1-Flag = CONST Y Rule Numbe 7680 Move Output-Filename to Error-Report-Extract Line Command Description 1 VAR1 = VAR2 MEM VAR Error-Report-Extract = SYS VAR OUTPUT_FILENAME Rule Numbe 7685 Check if DA0 Trading Partner W.A. populated Line Command Description 1 IF THEN IF REC FIELD DA0-Primary-Payor-Record DA0-00-REDEFINES-INPUT EQ CONST Then Perform Rule 7705 Rule Numbe 7690 Map DA0 Segment to Work Areas Line Command Description 1 IF THEN IF REC FIELD DA0-INSURANCE-INFO DA0-02-SEQUENCE-NO EQ CONST 01 Then Perform Rule 7720 2 IF THEN IF REC FIELD DA0-INSURANCE-INFO DA0-02-SEQUENCE-NO EQ CONST 02 Then Perform Rule 7735 3 IF THEN IF REC FIELD DA0-INSURANCE-INFO DA0-02-SEQUENCE-NO EQ CONST 03 Then Perform Rule 7750 4 VAR1 = VAR2 MEM VAR Sequence Number = REC FIELD DA0-INSURANCE-INFO DA0-02-SEQUENCE-NO Rule Numbe 7695 Map DA1 Segment to Work Areas Line Command Description 1 IF THEN IF REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-02-SEQUENCE-NO EQ CONST 01 Then Perform Rule 7725 2 IF THEN IF REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-02-SEQUENCE-NO EQ CONST 02 Then Perform Rule 7740 3 IF THEN IF REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-02-SEQUENCE-NO EQ CONST 03 Then Perform Rule 7755 4 IF THEN IF REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-02-SEQUENCE-NO EQ REC FIELD DA0-Primary-Payor-Record DA0-02-SEQUENCE-NO Then Perform Rule 7710 5 PERFORM RULE Perform Rule 8410 6 PERFORM RULE Perform Rule 8525 Rule Numbe 7700 Map DA2 Segment to Work Area Line Command Description 1 IF THEN IF REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-02-SEQUENCE-NO EQ CONST 01 Then Perform Rule 7730 2 IF THEN IF REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-02-SEQUENCE-NO EQ CONST 02 Then Perform Rule 7745 3 IF THEN IF REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-02-SEQUENCE-NO EQ CONST 03 Then Perform Rule 7760 4 IF THEN IF REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-02-SEQUENCE-NO EQ REC FIELD DA0-Primary-Payor-Record DA0-02-SEQUENCE-NO Then Perform Rule 7715 Rule Numbe 7705 Store DA0 Data to Trading Part... Line Command Description 1 VAR1 = VAR2 REC FIELD DA0-Primary-Payor-Record DA0-00-REDEFINES-INPUT = REC FIELD DA0-INSURANCE-INFO DA0-00-REDEFINES-INPUT Rule Numbe 7710 Store DA1 Data to Trading Partner Work Area Line Command Description 1 VAR1 = VAR2 REC FIELD DA0-Primary-Payor-Record DA0-00-REDEFINES-INPUT = REC FIELD DA0-INSURANCE-INFO DA0-00-REDEFINES-INPUT Rule Numbe 7715 Store DA2 Data to Trading Partner Work Area Line Command Description 1 VAR1 = VAR2 REC FIELD DA1-Primary-Payor-Record DA1-00-REDEFINES-DA1-INPUT = REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-00-REDEFINES-DA1-INPUT Rule Numbe 7720 Store DA0 to 1st Occurrence Line Command Description 1 VAR1 = VAR2 REC FIELD DA2-Primary-Payor-Record DA2-00-REDEFINES-INPUT = REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-00-REDEFINES-INPUT Rule Numbe 7725 Store DA1 to 1st Occurrence Line Command Description 1 VAR1 = VAR2 REC FIELD DA1-Insur-Info-Occur-1 DA1-00-REDEFINES-DA1-INPUT = REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-00-REDEFINES-DA1-INPUT 2 IF THEN IF REC FIELD DA1-Insur-Info-Occur-1 DA1-04-PAYER-ADDR-REDEFINES GT CONST Then Perform Rule 7560 3 VAR1 = VAR2 MEM VAR DA1-1-Flag = CONST Y Rule Numbe 7730 Store DA2 to 1st Occurrence Line Command Description 1 VAR1 = VAR2 REC FIELD DA2-Insur-Addr-Occur-1 DA2-00-REDEFINES-INPUT = REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-00-REDEFINES-INPUT 2 IF THEN IF REC FIELD DA2-Insur-Addr-Occur-1 DA2-04-INSURED-ADDR-REDEFINES GT CONST Then Perform Rule 7555 3 IF THEN IF REC FIELD DA2-Insur-Addr-Occur-1 DA2-12-EMPLOYER-ADDR-REDEFINES GT CONST Then Perform Rule 7565 Rule Numbe 7735 Store DA0 to 2nd Occurrence Line Command Description 1 VAR1 = VAR2 MEM VAR SEQ02 = MEM VAR Sequence-Number-Alpha 2 VAR1 = VAR2 REC FIELD DA0-Insurance-Occur-2 DA0-00-REDEFINES-INPUT = REC FIELD DA0-INSURANCE-INFO DA0-00-REDEFINES-INPUT 3 IF THEN IF REC FIELD DA0-Insurance-Occur-2 DA0-18-INSURED-NAME-REDEFINES GT CONST Then Perform Rule 7645 4 IF THEN IF REC FIELD DA0-Insurance-Occur-2 DA0-07-PAYOR-ORGANIZATION-ID GT CONST Then Perform Rule 7650 5 IF THEN IF REC FIELD DA0-Insurance-Occur-2 DA0-09-PAYOR-NAME GT CONST Then Perform Rule 7650 6 PERFORM RULE Perform Rule 8330 7 PERFORM RULE Perform Rule 8335 8 PERFORM RULE Perform Rule 8340 Rule Numbe 7740 Store DA1 to 2nd Occurrence Line Command Description 1 VAR1 = VAR2 REC FIELD DA1-Insur-Info-Occur-2 DA1-00-REDEFINES-DA1-INPUT = REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-00-REDEFINES-DA1-INPUT 2 IF THEN IF REC FIELD DA1-Insur-Info-Occur-2 DA1-04-PAYER-ADDR-REDEFINES GT CONST Then Perform Rule 7650 3 VAR1 = VAR2 MEM VAR DA1-2-Flag = CONST Y Rule Numbe 7745 Store DA2 to 2nd Occurrence Line Command Description 1 VAR1 = VAR2 REC FIELD DA2-Insur-Addr-Occur-2 DA2-00-REDEFINES-INPUT = REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-00-REDEFINES-INPUT 2 IF THEN IF REC FIELD DA2-Insur-Addr-Occur-2 DA2-04-INSURED-ADDR-REDEFINES GT CONST Then Perform Rule 7645 3 IF THEN IF REC FIELD DA2-Insur-Addr-Occur-2 DA2-12-INSURED-EMPLOYER-NAME GT CONST Then Perform Rule 7655 Rule Numbe 7750 Store DA0 to 3rd Occurrence Line Command Description 1 VAR1 = VAR2 MEM VAR SEQ03 = MEM VAR Sequence-Number-Alpha 2 VAR1 = VAR2 REC FIELD DA0-Insurance-Occur-3 DA0-00-REDEFINES-INPUT = REC FIELD DA0-INSURANCE-INFO DA0-00-REDEFINES-INPUT 3 IF THEN IF REC FIELD DA0-Insurance-Occur-3 DA0-18-INSURED-NAME-REDEFINES GT CONST Then Perform Rule 7660 4 IF THEN IF REC FIELD DA0-Insurance-Occur-3 DA0-07-PAYOR-ORGANIZATION-ID GT CONST Then Perform Rule 7665 5 IF THEN IF REC FIELD DA0-Insurance-Occur-3 DA0-09-PAYOR-NAME GT CONST Then Perform Rule 7665 6 PERFORM RULE Perform Rule 8345 7 PERFORM RULE Perform Rule 8355 8 PERFORM RULE Perform Rule 8350 Rule Numbe 7755 Store DA1 to 3rd Occurrence Line Command Description 1 VAR1 = VAR2 REC FIELD DA1-Insur-Info-Occur-3 DA1-00-REDEFINES-DA1-INPUT = REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-00-REDEFINES-DA1-INPUT 2 IF THEN IF REC FIELD DA1-Insur-Info-Occur-3 DA1-04-PAYER-ADDR-REDEFINES GT CONST Then Perform Rule 7665 3 VAR1 = VAR2 MEM VAR DA1-3-Flag = CONST Y Rule Numbe 7760 Store DA2 to 3rd Occurrence Line Command Description 1 VAR1 = VAR2 REC FIELD DA2-Insur-Addr-Occur-3 DA2-00-REDEFINES-INPUT = REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-00-REDEFINES-INPUT 2 IF THEN IF REC FIELD DA2-Insur-Addr-Occur-3 DA2-04-INSURED-ADDR-REDEFINES GT CONST Then Perform Rule 7660 3 IF THEN IF REC FIELD DA2-Insur-Addr-Occur-3 DA2-12-EMPLOYER-ADDR-REDEFINES GT CONST Then Perform Rule 7670 Rule Numbe 7765 Store FD0 input to 1st SVC-FD0 Occurrence Line Command Description 1 VAR1 = VAR2 REC FIELD SVC-CLAIM-DETAIL-RECORD-FD0 SVC-FD0-01 = REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-00-GROUP-LEVEL-REDEFINES Rule Numbe 7770 Store FD0 input to 2nd SVC-FD0 Occurrence Line Command Description 1 VAR1 = VAR2 REC FIELD SVC-CLAIM-DETAIL-RECORD-FD0 SVC-FD0-02 = REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-00-GROUP-LEVEL-REDEFINES Rule Numbe 7775 Store FD0 input to 3rd SVC-FD0 Occurrence Line Command Description 1 VAR1 = VAR2 REC FIELD SVC-CLAIM-DETAIL-RECORD-FD0 SVC-FD0-03 = REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-00-GROUP-LEVEL-REDEFINES Rule Numbe 7780 Store FD0 input to 4th SVC-FD0 Occurrence Line Command Description 1 VAR1 = VAR2 REC FIELD SVC-CLAIM-DETAIL-RECORD-FD0 SVC-FD0-04 = REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-00-GROUP-LEVEL-REDEFINES Rule Numbe 7785 Store FD0 input to 5th SVC-FD0 Occurrence Line Command Description 1 VAR1 = VAR2 REC FIELD SVC-CLAIM-DETAIL-RECORD-FD0 SVC-FD0-05 = REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-00-GROUP-LEVEL-REDEFINES Rule Numbe 7790 Store FD0 input to 6th SVC-FD0 Occurrence Line Command Description 1 VAR1 = VAR2 REC FIELD SVC-CLAIM-DETAIL-RECORD-FD0 SVC-FD0-06 = REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-00-GROUP-LEVEL-REDEFINES Rule Numbe 7795 Store FD0 input to 7th SVC-FD0 Occurrence Line Command Description 1 VAR1 = VAR2 REC FIELD SVC-CLAIM-DETAIL-RECORD-FD0 SVC-FD0-07 = REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-00-GROUP-LEVEL-REDEFINES Rule Numbe 7800 Store FD0 input to 8th SVC-FD0 Occurrence Line Command Description 1 VAR1 = VAR2 REC FIELD SVC-CLAIM-DETAIL-RECORD-FD0 SVC-FD0-08 = REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-00-GROUP-LEVEL-REDEFINES Rule Numbe 7805 Move ZA0 data to Duplicate File Record Line Command Description 1 CLEAR RECORD Clear All Fields in Record DUP-FILE-RECORD 2 VAR1 = VAR2 REC FIELD DUP-FILE-RECORD DUP_01_DTE = REC FIELD AA0-SUBMITTER-DATA AA0-15-CREAT-DTE 3 IF THEN IF REC FIELD AA0-SUBMITTER-DATA AA0-16-SUB-TIME EQ CONST Then Perform Rule 7255 4 VAR1 = VAR2 REC FIELD DUP-FILE-RECORD DUP_02_TIM = REC FIELD AA0-SUBMITTER-DATA AA0-16-SUB-TIME 5 VAR1 = VAR2 REC FIELD DUP-FILE-RECORD DUP_03_REDEF = REC FIELD ZA0-FILE-TRAILER-REC ZA0-00-GROUP-REDEFINES 6 VAR1 = VAR2 REC FIELD DUP-FILE-RECORD DUP_11_CHG = REC FIELD ZA0-FILE-TRAILER-REC ZA0-09-FILE-TOTAL-CHARGES 7 VAR1 = VAR2 REC FIELD DUP-FILE-RECORD DUP_03_TYP = CONST NSF 8 VAR1 = VAR2 REC FIELD DUP-FILE-RECORD DUP_12_NSF = REC FIELD AA0-SUBMITTER-DATA AA0-19-VERS-NATIONAL 9 KEYED READ RECORD READ D:\ECMAP_EXAMPLE\NSF130 SMAPPER SMAP_REC KEY: CONST 07BATCHID STATUS: KEYED_IO_STATUS 10 VAR1 = VAR2 REC FIELD DUP-FILE-RECORD DUP_14_BATCH_ID = REC FIELD SMAP_REC SEND_RECV_DATA 11 PERFORM RULE Perform Rule 1000 Rule Numbe 7810 Map DA3 Segment to Work Area Line Command Description 1 IF THEN IF REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-02-SEQUENCE-NO EQ CONST 01 Then Perform Rule 7820 2 IF THEN IF REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-02-SEQUENCE-NO EQ CONST 02 Then Perform Rule 7825 3 IF THEN IF REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-02-SEQUENCE-NO EQ CONST 03 Then Perform Rule 7830 4 IF THEN IF REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-02-SEQUENCE-NO EQ REC FIELD DA0-Primary-Payor-Record DA0-02-SEQUENCE-NO Then Perform Rule 7815 Rule Numbe 7815 Store DA3 Data to Trading Partner Work Area Line Command Description 1 VAR1 = VAR2 REC FIELD DA3-Primary-Payor-Record DA3-00-REDEFINES-DA3-INPUT = REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-00-REDEFINES-DA3-INPUT Rule Numbe 7820 Store DA3 to 1st Occurrence Line Command Description 1 VAR1 = VAR2 REC FIELD DA3-Insur-Adjud-Status-1 DA3-00-REDEFINES-DA3-INPUT = REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-00-REDEFINES-DA3-INPUT Rule Numbe 7825 Store DA3 to 2nd Occurrence Line Command Description 1 VAR1 = VAR2 REC FIELD DA3-Insur-Adjud-Status-2 DA3-00-REDEFINES-DA3-INPUT = REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-00-REDEFINES-DA3-INPUT Rule Numbe 7830 Store DA3 to 3rd Occurrence Line Command Description 1 VAR1 = VAR2 REC FIELD DA3-Insur-Adjud-Status-3 DA3-00-REDEFINES-DA3-INPUT = REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-00-REDEFINES-DA3-INPUT Rule Numbe 7835 Process DME Conditions Line Command Description 1 VAR1 = VAR2 MEM VAR DME-NDX = CONST 0 2 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 3 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-08-AMBULATORY EQ CONST Y Then Perform Rule 7840 4 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-09-AMBULATION-THERAPY EQ CONST Y Then Perform Rule 7845 5 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-10-CONFINED-BED-CHAIR EQ CONST Y Then Perform Rule 7850 6 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-11-ROOM-CONFINED EQ CONST Y Then Perform Rule 7855 7 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-12-AMBULATION-MOBILITY EQ CONST Y Then Perform Rule 7860 8 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-13-BODY-POSITIONING EQ CONST Y Then Perform Rule 7865 9 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-14-RESPIRATORY-OTHER EQ CONST Y Then Perform Rule 7870 10 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-15-BREATHING-IMPAIRED EQ CONST Y Then Perform Rule 7875 11 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-16-FREQ-IMMED-CHANGES EQ CONST Y Then Perform Rule 7880 12 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-17-OPERATE-CONTROLS EQ CONST Y Then Perform Rule 7885 13 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-18-SIDERAILS-PART-BED EQ CONST Y Then Perform Rule 7890 14 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-19-OWNS-EQUIPMENT EQ CONST Y Then Perform Rule 7895 15 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-20-MATTRESS-SIDERAILS EQ CONST Y Then Perform Rule 7900 16 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-21-EQUIPMENT-ASSISTANCE EQ CONST Y Then Perform Rule 7905 17 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-22-ORTHOPEDIC-IMPAIR EQ CONST Y Then Perform Rule 7910 18 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-23-PLANNED-REGIMEN EQ CONST Y Then Perform Rule 7915 19 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-24-DECUBITUS-ULCERS EQ CONST Y Then Perform Rule 7920 20 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-25-EQUIPMENT-USE EQ CONST Y Then Perform Rule 7925 21 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-27-DIABETIC-CONTROL EQ CONST Y Then Perform Rule 7930 22 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-28-APNEA-EPISODES EQ CONST Y Then Perform Rule 7935 23 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-29-SURGERY-ALTERNATIVE EQ CONST Y Then Perform Rule 7940 24 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-30-TOTAL-KNEE-REPLACE EQ CONST Y Then Perform Rule 7945 25 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-33-LYMPHEDEMA EQ CONST Y Then Perform Rule 7950 26 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-40-CERTIFICATION-ON-FILE EQ CONST Y Then Perform Rule 7955 27 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-45-NURSING-HOME-IND EQ CONST Y Then Perform Rule 7600 28 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-48-RESPIRATORY-TRACT EQ CONST Y Then Perform Rule 7605 29 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-49-SUPV-OF-EQUIPMENT-USE EQ CONST Y Then Perform Rule 7610 30 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-50-PROPEL-LIFT-CHAIR EQ CONST Y Then Perform Rule 7615 31 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-51-LEG-ELEVATION EQ CONST Y Then Perform Rule 7620 32 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-52-PATIENT-WEIGHT EQ CONST Y Then Perform Rule 7625 33 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-53-RECLINING-WHEELCHAIR EQ CONST Y Then Perform Rule 7630 34 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-54-MANUAL-OPERATION EQ CONST Y Then Perform Rule 7635 35 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GD0 GD0-55-SIDE-TRANSFER-CHAIR EQ CONST Y Then Perform Rule 7640 Rule Numbe 7840 Move "10" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 10 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7845 Move "11" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 11 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7850 Move "12" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 12 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7855 Move "13" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 13 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7860 Move "14" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 14 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7865 Move "15" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 15 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7870 Move "16" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 16 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7875 Move "17" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 17 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7880 Move "18" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 18 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7885 Move "19" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 19 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7890 Move "20" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 20 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7895 Move "21" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 21 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7900 Move "22" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 22 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7905 Move "23" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 23 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7910 Move "24" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 24 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7915 Move "25" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 25 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7920 Move "26" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 26 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7925 Move "27" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 27 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7930 Move "28" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 28 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7935 Move "29" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 29 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7940 Move "30" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 30 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7945 Move "31" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 31 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7950 Move "32" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 32 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7955 Move "38" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 38 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7960 Move "33" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 33 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7965 Move "39" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 39 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7970 Move "40" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 40 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7975 Move "41" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 41 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7980 Move "42" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 42 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7985 Move "43" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 43 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7990 Move "44" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 44 2 PERFORM RULE Perform Rule 8005 Rule Numbe 7995 Move "45" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 45 2 PERFORM RULE Perform Rule 8005 Rule Numbe 8000 Move "46" to DME Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR DME-Workarea = CONST 46 2 PERFORM RULE Perform Rule 8005 Rule Numbe 8005 Move DME-Workarea to DME Condition Table Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR DME-NDX = MEM VAR DME-NDX + CONST 1 2 IF THEN IF MEM VAR DME-NDX EQ CONST 1 Then Perform Rule 8010 3 IF THEN IF MEM VAR DME-NDX EQ CONST 2 Then Perform Rule 8015 4 IF THEN IF MEM VAR DME-NDX EQ CONST 3 Then Perform Rule 8020 5 IF THEN IF MEM VAR DME-NDX EQ CONST 4 Then Perform Rule 8025 6 IF THEN IF MEM VAR DME-NDX EQ CONST 5 Then Perform Rule 8030 7 IF THEN IF MEM VAR DME-NDX EQ CONST 6 Then Perform Rule 8035 8 IF THEN IF MEM VAR DME-NDX EQ CONST 7 Then Perform Rule 8040 9 IF THEN IF MEM VAR DME-NDX EQ CONST 8 Then Perform Rule 8045 10 IF THEN IF MEM VAR DME-NDX EQ CONST 9 Then Perform Rule 8050 11 IF THEN IF MEM VAR DME-NDX EQ CONST 10 Then Perform Rule 8055 12 IF THEN IF MEM VAR DME-NDX EQ CONST 11 Then Perform Rule 8060 13 IF THEN IF MEM VAR DME-NDX EQ CONST 12 Then Perform Rule 8065 14 IF THEN IF MEM VAR DME-NDX EQ CONST 13 Then Perform Rule 8070 15 IF THEN IF MEM VAR DME-NDX EQ CONST 14 Then Perform Rule 8075 16 IF THEN IF MEM VAR DME-NDX EQ CONST 15 Then Perform Rule 8080 17 IF THEN IF MEM VAR DME-NDX EQ CONST 16 Then Perform Rule 8085 18 IF THEN IF MEM VAR DME-NDX EQ CONST 17 Then Perform Rule 8090 19 IF THEN IF MEM VAR DME-NDX EQ CONST 18 Then Perform Rule 8095 20 IF THEN IF MEM VAR DME-NDX EQ CONST 19 Then Perform Rule 8100 21 IF THEN IF MEM VAR DME-NDX EQ CONST 20 Then Perform Rule 8105 22 IF THEN IF MEM VAR DME-NDX EQ CONST 21 Then Perform Rule 8110 23 IF THEN IF MEM VAR DME-NDX EQ CONST 22 Then Perform Rule 8115 24 IF THEN IF MEM VAR DME-NDX EQ CONST 23 Then Perform Rule 8120 25 IF THEN IF MEM VAR DME-NDX EQ CONST 24 Then Perform Rule 8125 26 IF THEN IF MEM VAR DME-NDX EQ CONST 25 Then Perform Rule 8130 27 IF THEN IF MEM VAR DME-NDX EQ CONST 26 Then Perform Rule 8135 28 IF THEN IF MEM VAR DME-NDX EQ CONST 27 Then Perform Rule 8140 29 IF THEN IF MEM VAR DME-NDX EQ CONST 28 Then Perform Rule 8145 30 IF THEN IF MEM VAR DME-NDX EQ CONST 29 Then Perform Rule 8150 31 IF THEN IF MEM VAR DME-NDX EQ CONST 30 Then Perform Rule 8155 32 IF THEN IF MEM VAR DME-NDX EQ CONST 31 Then Perform Rule 8160 33 IF THEN IF MEM VAR DME-NDX EQ CONST 32 Then Perform Rule 8165 34 IF THEN IF MEM VAR DME-NDX EQ CONST 33 Then Perform Rule 8170 Rule Numbe 8010 Move DME-Workarea to DME Table Pos 1 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-1 = MEM VAR DME-Workarea Rule Numbe 8015 Move DME-Workarea to DME Table Pos 2 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-2 = MEM VAR DME-Workarea Rule Numbe 8020 Move DME-Workarea to DME Table Pos 3 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-3 = MEM VAR DME-Workarea Rule Numbe 8025 Move DME-Workarea to DME Table Pos 4 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-4 = MEM VAR DME-Workarea Rule Numbe 8030 Move DME-Workarea to DME Table Pos 5 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-5 = MEM VAR DME-Workarea Rule Numbe 8035 Move DME-Workarea to DME Table Pos 6 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-6 = MEM VAR DME-Workarea Rule Numbe 8040 Move DME-Workarea to DME Table Pos 7 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-7 = MEM VAR DME-Workarea Rule Numbe 8045 Move DME-Workarea to DME Table Pos 8 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-8 = MEM VAR DME-Workarea Rule Numbe 8050 Move DME-Workarea to DME Table Pos 9 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-9 = MEM VAR DME-Workarea Rule Numbe 8055 Move DME-Workarea to DME Table Pos 10 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-10 = MEM VAR DME-Workarea Rule Numbe 8060 Move DME-Workarea to DME Table Pos 11 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-11 = MEM VAR DME-Workarea Rule Numbe 8065 Move DME-Workarea to DME Table Pos 12 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-12 = MEM VAR DME-Workarea Rule Numbe 8070 Move DME-Workarea to DME Table Pos 13 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-13 = MEM VAR DME-Workarea Rule Numbe 8075 Move DME-Workarea to DME Table Pos 14 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-14 = MEM VAR DME-Workarea Rule Numbe 8080 Move DME-Workarea to DME Table Pos 15 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-15 = MEM VAR DME-Workarea Rule Numbe 8085 Move DME-Workarea to DME Table Pos 16 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-16 = MEM VAR DME-Workarea Rule Numbe 8090 Move DME-Workarea to DME Table Pos 17 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-17 = MEM VAR DME-Workarea Rule Numbe 8095 Move DME-Workarea to DME Table Pos 18 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-18 = MEM VAR DME-Workarea Rule Numbe 8100 Move DME-Workarea to DME Table Pos 19 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-19 = MEM VAR DME-Workarea Rule Numbe 8105 Move DME-Workarea to DME Table Pos 20 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-20 = MEM VAR DME-Workarea Rule Numbe 8110 Move DME-Workarea to DME Table Pos 21 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-21 = MEM VAR DME-Workarea Rule Numbe 8115 Move DME-Workarea to DME Table Pos 22 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-22 = MEM VAR DME-Workarea Rule Numbe 8120 Move DME-Workarea to DME Table Pos 23 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-23 = MEM VAR DME-Workarea Rule Numbe 8125 Move DME-Workarea to DME Table Pos 24 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-24 = MEM VAR DME-Workarea Rule Numbe 8130 Move DME-Workarea to DME Table Pos 25 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-25 = MEM VAR DME-Workarea Rule Numbe 8135 Move DME-Workarea to DME Table Pos 26 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-26 = MEM VAR DME-Workarea Rule Numbe 8140 Move DME-Workarea to DME Table Pos 27 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-27 = MEM VAR DME-Workarea Rule Numbe 8145 Move DME-Workarea to DME Table Pos 28 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-28 = MEM VAR DME-Workarea Rule Numbe 8150 Move DME-Workarea to DME Table Pos 29 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-29 = MEM VAR DME-Workarea Rule Numbe 8155 Move DME-Workarea to DME Table Pos 30 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-30 = MEM VAR DME-Workarea Rule Numbe 8160 Move DME-Workarea to DME Table Pos 31 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-31 = MEM VAR DME-Workarea Rule Numbe 8165 Move DME-Workarea to DME Table Pos 32 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-32 = MEM VAR DME-Workarea Rule Numbe 8170 Move DME-Workarea to DME Table Pos 33 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Condition-Indicator-33 = MEM VAR DME-Workarea Rule Numbe 8175 Process Ambulance Conditions Line Command Description 1 VAR1 = VAR2 MEM VAR AMB-NDX = CONST 0 2 VAR1 = VAR2 MEM VAR Ambulance-Workarea = CONST 3 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GA0 GA0-06-HOSPITAL-ADMIT EQ CONST Y Then Perform Rule 8180 4 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GA0 GA0-08-BED-CONFINED-BEFORE EQ CONST Y Then Perform Rule 8185 5 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GA0 GA0-09-BED-CONFINED-AFTER EQ CONST Y Then Perform Rule 8190 6 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GA0 GA0-10-MOVED-BY-STRETCHER EQ CONST Y Then Perform Rule 8195 7 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GA0 GA0-11-UNCONSCIOUS-SHOCK-IND EQ CONST Y Then Perform Rule 8200 8 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GA0 GA0-12-EMERGENCY-SITUATION EQ CONST Y Then Perform Rule 8205 9 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GA0 GA0-13-PHYSICAL-RESTRAINTS EQ CONST Y Then Perform Rule 8210 10 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GA0 GA0-14-VISIBLE-HEMORRHAGING EQ CONST Y Then Perform Rule 8215 11 IF THEN IF REC FIELD SVC-CLAIM-DETAIL-RECORD-GA0 GA0-16-MEDICALLY-NECESSARY EQ CONST Y Then Perform Rule 8220 Rule Numbe 8180 Move "01" to Ambulance Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR Ambulance-Workarea = CONST 01 2 PERFORM RULE Perform Rule 8225 Rule Numbe 8185 Move "02" to Ambulance Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR Ambulance-Workarea = CONST 02 2 PERFORM RULE Perform Rule 8225 Rule Numbe 8190 Move "03" to Ambulance Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR Ambulance-Workarea = CONST 03 2 PERFORM RULE Perform Rule 8225 Rule Numbe 8195 Move "04" to Ambulance Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR Ambulance-Workarea = CONST 04 2 PERFORM RULE Perform Rule 8225 Rule Numbe 8200 Move "05" to Ambulance Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR Ambulance-Workarea = CONST 05 2 PERFORM RULE Perform Rule 8225 Rule Numbe 8205 Move "06" to Ambulance Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR Ambulance-Workarea = CONST 06 2 PERFORM RULE Perform Rule 8225 Rule Numbe 8210 Move "07" to Ambulance Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR Ambulance-Workarea = CONST 07 2 PERFORM RULE Perform Rule 8225 Rule Numbe 8215 Move "08" to Ambulance Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR Ambulance-Workarea = CONST 08 2 PERFORM RULE Perform Rule 8225 Rule Numbe 8220 Move "09" to Ambulance Workarea Line Command Description 1 VAR1 = VAR2 MEM VAR Ambulance-Workarea = CONST 09 2 PERFORM RULE Perform Rule 8225 Rule Numbe 8225 Move Ambulance-Workarea to Ambulance Condition Ta Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR AMB-NDX = MEM VAR AMB-NDX + CONST 1 2 IF THEN IF MEM VAR AMB-NDX EQ CONST 1 Then Perform Rule 8230 3 IF THEN IF MEM VAR AMB-NDX EQ CONST 2 Then Perform Rule 8235 4 IF THEN IF MEM VAR AMB-NDX EQ CONST 3 Then Perform Rule 8240 5 IF THEN IF MEM VAR AMB-NDX EQ CONST 4 Then Perform Rule 8245 6 IF THEN IF MEM VAR AMB-NDX EQ CONST 5 Then Perform Rule 8250 7 IF THEN IF MEM VAR AMB-NDX EQ CONST 6 Then Perform Rule 8255 8 IF THEN IF MEM VAR AMB-NDX EQ CONST 7 Then Perform Rule 8260 9 IF THEN IF MEM VAR AMB-NDX EQ CONST 8 Then Perform Rule 8265 10 IF THEN IF MEM VAR AMB-NDX EQ CONST 9 Then Perform Rule 8270 Rule Numbe 8230 Move Ambulance-Workarea to Ambul Table Pos 1 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Ambul-Cond-Code-1 = MEM VAR Ambulance-Workarea Rule Numbe 8235 Move Ambulance-Workarea to Ambul Table Pos 2 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Ambul-Cond-Code-2 = MEM VAR Ambulance-Workarea Rule Numbe 8240 Move Ambulance-Workarea to Ambul Table Pos 3 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Ambul-Cond-Code-3 = MEM VAR Ambulance-Workarea Rule Numbe 8245 Move Ambulance-Workarea to Ambul Table Pos 4 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Ambul-Cond-Code-4 = MEM VAR Ambulance-Workarea Rule Numbe 8250 Move Ambulance-Workarea to Ambul Table Pos 5 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Ambul-Cond-Code-5 = MEM VAR Ambulance-Workarea Rule Numbe 8255 Move Ambulance-Workarea to Ambul Table Pos 6 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Ambul-Cond-Code-6 = MEM VAR Ambulance-Workarea Rule Numbe 8260 Move Ambulance-Workarea to Ambul Table Pos 7 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Ambul-Cond-Code-7 = MEM VAR Ambulance-Workarea Rule Numbe 8265 Move Ambulance-Workarea to Ambul Table Pos 8 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Ambul-Cond-Code-8 = MEM VAR Ambulance-Workarea Rule Numbe 8270 Move Ambulance-Workarea to Ambul Table Pos 9 Line Command Description 1 VAR1 = VAR2 REC FIELD ZZZ-Condition Codes ZZZ-Ambul-Cond-Code-9 = MEM VAR Ambulance-Workarea Rule Numbe 8275 CONV: AA0.23 Retrans Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 TABLE CONVERSION TABLE: RETRANS Source: REC FIELD AA0-SUBMITTER-DATA AA0-23-RETRANS-STATUS Dest: MEM VAR Retrans-Status Fail: Status: MEM VAR: 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24050 Rule Numbe 8280 CONV: BA0.08 Tax Type Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 TABLE CONVERSION TABLE: TAXTYPE Source: REC FIELD BA0-PROVIDER-DATA BA0-08-PROV-TAX-ID-TYPE Dest: MEM VAR Prov-Tax-Type Fail: Status: MEM VAR: 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24090 Rule Numbe 8285 CONV: CA0.19 Employment Status Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 TABLE CONVERSION TABLE: PATEMPL Source: REC FIELD CA0-PATIENT-DATA CA0-19-PAT-EMPLOYMENT-STATUS Dest: MEM VAR Employment-Status Fail: Status: MEM VAR: 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24125 Rule Numbe 8290 CONV: CA0.17 Marital Status Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 TABLE CONVERSION TABLE: MARITAL Source: REC FIELD CA0-PATIENT-DATA CA0-17-PAT-MARITAL-STATUS Dest: MEM VAR Marital-Status Fail: Status: MEM VAR: 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24120 Rule Numbe 8295 CONV: CA0.23 Claim Filing Indicator Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 TABLE CONVERSION TABLE: CLAIMEDT Source: REC FIELD CA0-PATIENT-DATA CA0-23-CLAIM-EDITING-IND Dest: MEM VAR Claim-Edit-Ind Fail: Status: MEM VAR: 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24130 Rule Numbe 8300 CONV: CA0.24 Claim Type Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 TABLE CONVERSION TABLE: CLAIMTYP Source: REC FIELD CA0-PATIENT-DATA CA0-24-TYPE-OF-CLAIM-IND Dest: MEM VAR Claim-Type Fail: Status: MEM VAR: 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24135 Rule Numbe 8305 CONV: DA0.17 Patient Relationship #1 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 TABLE CONVERSION TABLE: PATREL Source: REC FIELD DA0-Insurance-Occur-1 DA0-17-PAT-RELATION-TO-INSURED Dest: MEM VAR Patient-Relation Fail: Status: MEM VAR: 3 VAR1 = VAR2 MEM VAR Pat-Rel-01 = MEM VAR Patient-Relation 4 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24180 Rule Numbe 8310 CONV: DA0.02 Sequence Number Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 TABLE CONVERSION TABLE: SEQNUMB Source: REC FIELD DA0-INSURANCE-INFO DA0-02-SEQUENCE-NO Dest: MEM VAR Sequence-Number-Alpha Fail: CONST Status: MEM VAR: 3 VAR1 = VAR2 MEM VAR Sequence-Number-Error = REC FIELD DA0-Insurance-Occur-1 DA0-02-SEQUENCE-NO 4 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24150 Rule Numbe 8315 CONV: EA0.36 Provider Assignment Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 TABLE CONVERSION TABLE: PRVASIGN Source: REC FIELD EA0-CLAIM-LVL-INFO EA0-36-PROV-ASSIGN-IND Dest: MEM VAR Prov-Assignment-Ind Fail: REC FIELD EA0-CLAIM-LVL-INFO Status: EA0-36-PROV-ASSIGN-IND MEM VAR: 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24360 Rule Numbe 8320 CONV: DA0.25 Employment Status #1 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 TABLE CONVERSION TABLE: PATEMPL Source: REC FIELD DA0-Insurance-Occur-1 DA0-25-INSURED-EMPLOYMENT-STAT Dest: MEM VAR Employment-Status Fail: Status: MEM VAR: 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24185 Rule Numbe 8325 CONV: DA0.05 Source of Pay #1 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 TABLE CONVERSION TABLE: SRCPAY Source: REC FIELD DA0-Insurance-Occur-1 DA0-05-SOURCE-OF-PAY Dest: MEM VAR Source-Pay Fail: Status: MEM VAR: 3 VAR1 = VAR2 MEM VAR Source-Pay-01 = MEM VAR Source-Pay 4 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24175 Rule Numbe 8330 CONV: DA0.17 Patient Relationship #2 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 TABLE CONVERSION TABLE: PATREL Source: REC FIELD DA0-Insurance-Occur-2 DA0-17-PAT-RELATION-TO-INSURED Dest: MEM VAR Patient-Relation Fail: Status: MEM VAR: 3 VAR1 = VAR2 MEM VAR Pat-Rel-02 = MEM VAR Patient-Relation 4 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24240 Rule Numbe 8335 CONV: DA0.25 Employment Status #2 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 TABLE CONVERSION TABLE: PATEMPL Source: REC FIELD DA0-Insurance-Occur-2 DA0-25-INSURED-EMPLOYMENT-STAT Dest: MEM VAR Employment-Status Fail: Status: MEM VAR: 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24245 Rule Numbe 8340 CONV: DA0.05 Source of Pay #2 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 TABLE CONVERSION TABLE: SRCPAY Source: REC FIELD DA0-Insurance-Occur-2 DA0-05-SOURCE-OF-PAY Dest: MEM VAR Source-Pay Fail: Status: MEM VAR: 3 VAR1 = VAR2 MEM VAR Source-Pay-02 = MEM VAR Source-Pay 4 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24235 Rule Numbe 8345 CONV: DA0.17 Patient Relationship #3 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 TABLE CONVERSION TABLE: PATREL Source: REC FIELD DA0-Insurance-Occur-3 DA0-17-PAT-RELATION-TO-INSURED Dest: MEM VAR Patient-Relation Fail: Status: MEM VAR: 3 VAR1 = VAR2 MEM VAR Pat-Rel-03 = MEM VAR Patient-Relation 4 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24295 Rule Numbe 8350 CONV: DA0.05 Source of Pay #3 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 TABLE CONVERSION TABLE: SRCPAY Source: REC FIELD DA0-Insurance-Occur-3 DA0-05-SOURCE-OF-PAY Dest: MEM VAR Source-Pay Fail: Status: MEM VAR: 3 VAR1 = VAR2 MEM VAR Source-Pay-03 = MEM VAR Source-Pay 4 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24290 Rule Numbe 8355 CONV: DA0.25 Employment Status #3 Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 TABLE CONVERSION TABLE: PATEMPL Source: REC FIELD DA0-Insurance-Occur-3 DA0-25-INSURED-EMPLOYMENT-STAT Dest: MEM VAR Employment-Status Fail: Status: MEM VAR: 3 IF THEN IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 24300 Rule Numbe 8360 Balance Claim Totals Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 3 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI PREV-RECORD-ID = REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD XA0-CLAIM-TRAILER-REC XA0-01-RECORD-ID 5 IF THEN IF REC FIELD XA0-CLAIM-TRAILER-REC XA0-03-PAT-CONTROL-NO NE MEM VAR Patient-Control-Number Then Perform Rule 24660 6 IF THEN IF MEM VAR DA2-1-Flag EQ CONST N Then Perform Rule 24285 7 IF THEN IF MEM VAR Claim-Cxx-Count EQ CONST 0 Then Perform Rule 24745 8 IF THEN IF MEM VAR Claim-Cxx-Count GT CONST 0 Then Perform Rule 8530 9 IF THEN IF MEM VAR Claim-Dxx-Count EQ CONST 0 Then Perform Rule 24750 10 IF THEN IF MEM VAR Claim-Dxx-Count GT CONST 0 Then Perform Rule 8535 11 IF THEN IF MEM VAR Claim-Exx-Count EQ CONST 0 Then Perform Rule 24755 12 IF THEN IF MEM VAR Claim-Exx-Count GT CONST 0 Then Perform Rule 8540 13 IF THEN IF MEM VAR Claim-Fxx-Count EQ CONST 0 Then Perform Rule 24760 14 IF THEN IF MEM VAR Claim-Fxx-Count GT CONST 0 Then Perform Rule 8545 15 IF THEN IF MEM VAR Claim-Gxx-Count GT CONST 0 Then Perform Rule 8550 16 IF THEN IF MEM VAR Claim-Hxx-Count GT CONST 0 Then Perform Rule 8555 17 IF THEN IF MEM VAR Claim-Rec-Count GT CONST 0 Then Perform Rule 8560 18 IF THEN IF MEM VAR Claim-Tot-Charges GT CONST 0 Then Perform Rule 8565 19 IF THEN IF MEM VAR Claim-Tot-Dis-Cost GT CONST 0 Then Perform Rule 8570 20 IF THEN IF MEM VAR Claim-Tot-Dis-Other GT CONST 0 Then Perform Rule 8575 21 IF THEN IF MEM VAR Claim-Tot-Allow GT CONST 0 Then Perform Rule 8580 22 IF THEN IF MEM VAR Claim-Tot-Deduct GT CONST 0 Then Perform Rule 8590 23 IF THEN IF MEM VAR Claim-Tot-Coinsur GT CONST 0 Then Perform Rule 8595 24 IF THEN IF MEM VAR Claim-Tot-Payor-Paid GT CONST 0 Then Perform Rule 8600 25 IF THEN IF MEM VAR Claim-Tot-Purch-Svc GT CONST 0 Then Perform Rule 8605 26 PERFORM RULE Perform Rule 8470 Rule Numbe 8365 Execute Claim Accums Line Command Description 1 PERFORM RULE Perform Rule 8485 2 PERFORM RULE Perform Rule 8435 Rule Numbe 8370 Add Claim Amounts for Balancing Line Command Description 1 PERFORM RULE Perform Rule 8380 2 PERFORM RULE Perform Rule 8385 3 PERFORM RULE Perform Rule 8390 4 PERFORM RULE Perform Rule 8395 5 PERFORM RULE Perform Rule 8400 6 PERFORM RULE Perform Rule 8405 7 PERFORM RULE Perform Rule 8410 Rule Numbe 8375 Add to Record Claim Count Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR Claim-Rec-Count = MEM VAR Claim-Rec-Count + CONST 1 Rule Numbe 8380 Add to Claim Total Charges Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR Claim-Tot-Charges = MEM VAR Claim-Tot-Charges + REC FIELD SVC-CLAIM-DETAIL-RECORD-FA0 FA0-13-LINE-CHARGES Rule Numbe 8385 Add to Claim-Disallow-Cost Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR Claim-Tot-Dis-Cost = MEM VAR Claim-Tot-Dis-Cost + REC FIELD SVC-CLAIM-DETAIL-RECORD-FA0 FA0-27-DISALLOW-COST-CONTAIN Rule Numbe 8390 Add to Claim-Total Disallow Other Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR Claim-Tot-Dis-Other = MEM VAR Claim-Tot-Dis-Other + REC FIELD SVC-CLAIM-DETAIL-RECORD-FA0 FA0-28-DISALLOW-OTHER Rule Numbe 8395 Add to Claim-Total Allowed Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR Claim-Tot-Allow = MEM VAR Claim-Tot-Allow + REC FIELD SVC-CLAIM-DETAIL-RECORD-FB0 FB0-06-ALLOWED-AMOUNT Rule Numbe 8400 Add to Claim-Total Deduct Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR Claim-Tot-Deduct = MEM VAR Claim-Tot-Deduct + REC FIELD SVC-CLAIM-DETAIL-RECORD-FB0 FB0-07-DEDUCTIBLE-AMOUNT Rule Numbe 8405 Add to Claim-Total Coinsurance Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR Claim-Tot-Coinsur = MEM VAR Claim-Tot-Coinsur + REC FIELD SVC-CLAIM-DETAIL-RECORD-FB0 FB0-08-COINSURANCE-AMOUNT Rule Numbe 8410 Add to Claim-Total Payor Paid Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR Claim-Tot-Payor-Paid = MEM VAR Claim-Tot-Payor-Paid + REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-14-PAYOR-AMOUNT-PAID Rule Numbe 8415 Add to Claim-Total Purch Services Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR Claim-Tot-Purch-Svc = MEM VAR Claim-Tot-Purch-Svc + REC FIELD SVC-CLAIM-DETAIL-RECORD-FB0 FB0-05-PUR-SVC-CHARGE Rule Numbe 8420 Add to XMSN Record Count Line Command Description 1 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT= REC FIELD MAP-PROCESS-INI XMSN-RECORD-COUNT+ CONST 1 Rule Numbe 8425 Increment FA0 count and Fxx Count Line Command Description 1 PERFORM RULE Perform Rule 8430 2 PERFORM RULE Perform Rule 8450 Rule Numbe 8430 Increment FA0 Count Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR Claim-FA0-records = MEM VAR Claim-FA0-records + CONST 1 Rule Numbe 8435 Increment Cxx Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR Claim-Cxx-Count = MEM VAR Claim-Cxx-Count + CONST 1 2 PERFORM RULE Perform Rule 8375 3 PERFORM RULE Perform Rule 8480 Rule Numbe 8440 Increment Dxx Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR Claim-Dxx-Count = MEM VAR Claim-Dxx-Count + CONST 1 2 PERFORM RULE Perform Rule 8375 3 PERFORM RULE Perform Rule 8480 Rule Numbe 8445 Increment Exx Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR Claim-Exx-Count = MEM VAR Claim-Exx-Count + CONST 1 2 PERFORM RULE Perform Rule 8375 3 PERFORM RULE Perform Rule 8480 Rule Numbe 8450 Increment Fxx Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR Claim-Fxx-Count = MEM VAR Claim-Fxx-Count + CONST 1 2 PERFORM RULE Perform Rule 8375 3 PERFORM RULE Perform Rule 8480 Rule Numbe 8455 Increment Gxx Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR Claim-Gxx-Count = MEM VAR Claim-Gxx-Count + CONST 1 2 PERFORM RULE Perform Rule 8375 3 PERFORM RULE Perform Rule 8480 Rule Numbe 8460 Increment Hxx Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR Claim-Hxx-Count = MEM VAR Claim-Hxx-Count + CONST 1 2 PERFORM RULE Perform Rule 8375 3 PERFORM RULE Perform Rule 8480 Rule Numbe 8465 Balance Batch Totals Line Command Description 1 PERFORM RULE Perform Rule 8480 2 IF THEN IF MEM VAR Batch-Svc-Count GT CONST 0 Then Perform Rule 8610 3 IF THEN IF MEM VAR Batch-Rec-Count GT CONST 0 Then Perform Rule 8615 4 IF THEN IF MEM VAR Batch-Claim-Count GT CONST 0 Then Perform Rule 8620 5 IF THEN IF MEM VAR Batch-Tot-Charges GT CONST 0 Then Perform Rule 8625 6 PERFORM RULE Perform Rule 8500 Rule Numbe 8470 Execute Batch Accums Line Command Description 1 PERFORM RULE Perform Rule 8475 2 PERFORM RULE Perform Rule 8480 3 PERFORM RULE Perform Rule 8490 Rule Numbe 8475 Add to Batch-Service Line Count Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR Batch-Svc-Count = MEM VAR Batch-Svc-Count + MEM VAR Claim-FA0-records Rule Numbe 8480 Add to Batch-Record Count Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR Batch-Rec-Count = MEM VAR Batch-Rec-Count + CONST 1 Rule Numbe 8485 Add to Batch-Claim Count Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR Batch-Claim-Count = MEM VAR Batch-Claim-Count + CONST 1 2 VAR1=VAR2+VAR3 REC FIELD MAP-PROCESS-INI CLAIM-COUNT-IN-BATCH= REC FIELD MAP-PROCESS-INI CLAIM-COUNT-IN-BATCH+ CONST 1 Rule Numbe 8490 Add to Batch-Total Charges Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR Batch-Tot-Charges = MEM VAR Batch-Tot-Charges + MEM VAR Claim-Tot-Charges Rule Numbe 8495 Balance File Totals Line Command Description 1 IF THEN IF MEM VAR File-Svc-Count GT CONST 0 Then Perform Rule 8630 2 IF THEN IF MEM VAR File-Rec-Count GT CONST 0 Then Perform Rule 8635 3 IF THEN IF MEM VAR File-Claim-Count GT CONST 0 Then Perform Rule 8640 4 IF THEN IF MEM VAR File-Batch-Count GT CONST 0 Then Perform Rule 8645 5 IF THEN IF MEM VAR File-Tot-Charges GT CONST 0 Then Perform Rule 8650 6 PERFORM RULE Perform Rule 8655 7 PERFORM RULE Perform Rule 8660 Rule Numbe 8500 Execute File Accums Line Command Description 1 PERFORM RULE Perform Rule 8505 2 PERFORM RULE Perform Rule 8510 3 PERFORM RULE Perform Rule 8515 4 PERFORM RULE Perform Rule 8520 Rule Numbe 8505 Add to File-Service Line Count Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR File-Svc-Count = MEM VAR File-Svc-Count + MEM VAR Batch-Svc-Count 2 VAR1 = VAR2 MEM VAR Batch-Svc-Count = CONST 0 Rule Numbe 8510 Add to File-Record Count Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR File-Rec-Count = MEM VAR File-Rec-Count + MEM VAR Batch-Rec-Count 2 VAR1 = VAR2 MEM VAR Batch-Rec-Count = CONST 0 Rule Numbe 8515 Add to File-Claim Count Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR File-Claim-Count = MEM VAR File-Claim-Count + MEM VAR Batch-Claim-Count 2 VAR1 = VAR2 MEM VAR L87_BILLING_UNITS = MEM VAR File-Claim-Count 3 VAR1 = VAR2 MEM VAR Batch-Claim-Count = CONST 0 4 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CLAIM-COUNT-IN-BATCH = CONST 0 Rule Numbe 8520 Add to File-Total Charges Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR File-Tot-Charges = MEM VAR File-Tot-Charges + MEM VAR Batch-Tot-Charges 2 VAR1 = VAR2 MEM VAR Batch-Tot-Charges = CONST 0 Rule Numbe 8525 Add to DA3 File Totals Line Command Description 1 VAR1=VAR2+VAR3 MEM VAR File-Tot-Paid-Amt = MEM VAR File-Tot-Paid-Amt + REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-30-AMT-PAID-TO-BENE 2 VAR1=VAR2+VAR3 MEM VAR File-Tot-Paid-Amt = MEM VAR File-Tot-Paid-Amt + REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-33-AMT-PAID-TO-PROV 3 VAR1=VAR2+VAR3 MEM VAR File-Tot-Allowed-Amt = MEM VAR File-Tot-Allowed-Amt + REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-37-APPROVED-AMT Rule Numbe 8530 Balance Claim Cxx Count Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 IF THEN IF MEM VAR Claim-Cxx-Count NE REC FIELD XA0-CLAIM-TRAILER-REC XA0-04-RECORD-CXX-COUNT Then Perform Rule 24665 Rule Numbe 8535 Balance Claim Dxx Count Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 IF THEN IF MEM VAR Claim-Dxx-Count NE REC FIELD XA0-CLAIM-TRAILER-REC XA0-05-RECORD-DXX-COUNT Then Perform Rule 24670 Rule Numbe 8540 Balance Claim Exx Count Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 IF THEN IF MEM VAR Claim-Exx-Count NE REC FIELD XA0-CLAIM-TRAILER-REC XA0-06-RECORD-EXX-COUNT Then Perform Rule 24675 Rule Numbe 8545 Balance Claim Fxx Count Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 IF THEN IF MEM VAR Claim-Fxx-Count NE REC FIELD XA0-CLAIM-TRAILER-REC XA0-07-RECORD-FXX-COUNT Then Perform Rule 24680 Rule Numbe 8550 Balance Claim Gxx Count Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 IF THEN IF MEM VAR Claim-Gxx-Count NE REC FIELD XA0-CLAIM-TRAILER-REC XA0-08-RECORD-GXX-COUNT Then Perform Rule 24685 Rule Numbe 8555 Balance Claim Hxx Count Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 IF THEN IF MEM VAR Claim-Hxx-Count NE REC FIELD XA0-CLAIM-TRAILER-REC XA0-09-RECORD-HXX-COUNT Then Perform Rule 24690 Rule Numbe 8560 Balance Claim Record Count Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 IF THEN IF MEM VAR Claim-Rec-Count NE REC FIELD XA0-CLAIM-TRAILER-REC XA0-10-CLAIM-RECORD-COUNT Then Perform Rule 24695 Rule Numbe 8565 Balance Claim Total Charges Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 IF THEN IF MEM VAR Claim-Tot-Charges NE REC FIELD XA0-CLAIM-TRAILER-REC XA0-12-TOTAL-CLAIM-CHARGES Then Perform Rule 24700 Rule Numbe 8570 Balance Claim Total Disallowed Cost Amount Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 IF THEN IF MEM VAR Claim-Tot-Dis-Cost NE REC FIELD XA0-CLAIM-TRAILER-REC XA0-13-TOTAL-DISAL-COST-CONT-C Then Perform Rule 24705 Rule Numbe 8575 Balance Claim Total Disallowed Other Amount Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 IF THEN IF MEM VAR Claim-Tot-Dis-Other NE REC FIELD XA0-CLAIM-TRAILER-REC XA0-14-TOT-DISAL-OTHER-CHGS Then Perform Rule 24710 Rule Numbe 8580 Balance Claim Total Allowed Amount Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 IF THEN IF MEM VAR Claim-Tot-Allow NE REC FIELD XA0-CLAIM-TRAILER-REC XA0-15-TOTAL-ALLOWED-AMOUNT Then Perform Rule 24715 Rule Numbe 8590 Balance Claim Total Deductible Amount Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 IF THEN IF MEM VAR Claim-Tot-Coinsur NE REC FIELD XA0-CLAIM-TRAILER-REC XA0-17-TOTAL-COINSUR-AMOUNT Then Perform Rule 24720 Rule Numbe 8595 Balance Claim Total Coinsurance Amount Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 IF THEN IF MEM VAR Claim-Tot-Payor-Paid NE REC FIELD XA0-CLAIM-TRAILER-REC XA0-18-TOTAL-PAYOR-AMOUNT-PAID Then Perform Rule 24725 Rule Numbe 8600 Balance Claim Total Payor Amount Paid Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 IF THEN IF MEM VAR Claim-Tot-Purch-Svc NE REC FIELD XA0-CLAIM-TRAILER-REC XA0-20-TOTAL-PURCHASE-SVC-CHGS Then Perform Rule 24740 Rule Numbe 8605 Balance Claim Total Purchase S... Line Command Description 1 VAR1 = VAR2 SYS VAR ERR_OCCURRED = CONST N 2 IF THEN IF MEM VAR Claim-Tot-Purch-Svc NE REC FIELD XA0-CLAIM-TRAILER-REC XA0-20-TOTAL-PURCHASE-SVC-CHGS Then Perform Rule 24740 Rule Numbe 8610 Balance Batch Service Line Count Line Command Description 1 IF THEN IF MEM VAR Batch-Svc-Count NE REC FIELD YA0-BATCH-TRAILER-REC YA0-08-BATCH-SVC-LINE-COUNT Then Perform Rule 24790 Rule Numbe 8615 Balance Batch Record Count Line Command Description 1 IF THEN IF MEM VAR Batch-Rec-Count NE REC FIELD YA0-BATCH-TRAILER-REC YA0-09-BATCH-RECORD-COUNT Then Perform Rule 24795 Rule Numbe 8620 Balance Batch Claim Count Line Command Description 1 IF THEN IF MEM VAR Batch-Claim-Count NE REC FIELD YA0-BATCH-TRAILER-REC YA0-10-BATCH-CLAIM-COUNT Then Perform Rule 24800 Rule Numbe 8625 Balance Batch Total Charges Line Command Description 1 IF THEN IF MEM VAR Batch-Tot-Charges NE REC FIELD YA0-BATCH-TRAILER-REC YA0-11-BATCH-TOTAL-CHARGES Then Perform Rule 24805 Rule Numbe 8630 Balance File Service Line Count Line Command Description 1 IF THEN IF MEM VAR File-Svc-Count NE REC FIELD ZA0-FILE-TRAILER-REC ZA0-05-FILE-SVC-LINE-COUNT Then Perform Rule 24820 Rule Numbe 8635 Balance File Record Count Line Command Description 1 IF THEN IF MEM VAR File-Rec-Count NE REC FIELD ZA0-FILE-TRAILER-REC ZA0-06-FILE-RECORD-COUNT Then Perform Rule 24825 Rule Numbe 8640 Balance File Claim Count Line Command Description 1 IF THEN IF MEM VAR File-Claim-Count NE REC FIELD ZA0-FILE-TRAILER-REC ZA0-07-FILE-CLAIM-COUNT Then Perform Rule 24830 Rule Numbe 8645 Balance File Batch Count Line Command Description 1 IF THEN IF MEM VAR File-Batch-Count NE REC FIELD ZA0-FILE-TRAILER-REC ZA0-08-BATCH-COUNT Then Perform Rule 24835 Rule Numbe 8650 Balance File Total Charges Line Command Description 1 IF THEN IF MEM VAR File-Tot-Charges NE REC FIELD ZA0-FILE-TRAILER-REC ZA0-09-FILE-TOTAL-CHARGES Then Perform Rule 24840 Rule Numbe 8655 Balance File Total Paid Amount Line Command Description 1 IF THEN IF MEM VAR File-Tot-Paid-Amt NE REC FIELD ZA0-FILE-TRAILER-REC ZA0-10-FILE-TOTAL-PAID-AMT Then Perform Rule 24860 Rule Numbe 8660 Balance File Total Allowed Amount Line Command Description 1 IF THEN IF MEM VAR File-Tot-Allowed-Amt NE REC FIELD ZA0-FILE-TRAILER-REC ZA0-11-FILE-TOT-ALLOW-AMT Then Perform Rule 24865 Rule Numbe 8665 Zero-Fill DA1.30 Amount Paid to Beneficiary Line Command Description 1 VAR1 = VAR2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-30-AMT-PAID-TO-BENE-ALPA = CONST 000000000 Rule Numbe 8670 Zero-Fill DA1.33 Amount to Paid to Provider Line Command Description 1 VAR1 = VAR2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-33-AMT-PAID-TO-PROV-ALPHA = CONST 000000000 Rule Numbe 8675 Zero-Fill DA1.36 Interest Paid Line Command Description 1 VAR1 = VAR2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-36-INTEREST-PAID-ALPHA = CONST 000000000 Rule Numbe 8680 Zero-Fill DA1.37 Approved Amount Line Command Description 1 VAR1 = VAR2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-37-APPROVED-AMT-ALPHA = CONST 000000000 Rule Numbe 8685 Zero-Fill DA3.05 Dollar Amount - 1 Line Command Description 1 VAR1 = VAR2 REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-05-DOLLAR-AMOUNT-1-ALPHA = CONST 0000000 Rule Numbe 8690 Zero-Fill DA3.07 Dollar Amount - 2 Line Command Description 1 VAR1 = VAR2 REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-07-DOLLAR-AMOUNT-2-ALPHA = CONST 0000000 Rule Numbe 8695 Zero-Fill DA3.09 Dollar Amount - 3 Line Command Description 1 VAR1 = VAR2 REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-09-DOLLAR-AMOUNT-3-ALPHA = CONST 0000000 Rule Numbe 8700 Zero-Fill DA3.11 Dollar Amount - 4 Line Command Description 1 VAR1 = VAR2 REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-11-DOLLAR-AMOUNT-4-ALPHA = CONST 0000000 Rule Numbe 8705 Zero-Fill DA3.13 Dollar Amount - 5 Line Command Description 1 VAR1 = VAR2 REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-13-DOLLAR-AMOUNT-5-ALPHA = CONST 0000000 Rule Numbe 8710 Zero-Fill DA3.15 Dollar Amount - 6 Line Command Description 1 VAR1 = VAR2 REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-15-DOLLAR-AMOUNT-6-ALPHA = CONST 0000000 Rule Numbe 8715 Zero-Fill DA3.17 Dollar Amount - 7 Line Command Description 1 VAR1 = VAR2 REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-17-DOLLAR-AMOUNT-7-ALPHA = CONST 0000000 Rule Numbe 8720 Zero-Fill DA3.25 Provider Adjustment Amount Line Command Description 1 VAR1 = VAR2 REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-25-PROV-ADJUST-AMT-ALPHA = CONST 0000000 Rule Numbe 8725 Zero-Fill DA3.25 Provider Adjustment Amount Line Command Description 1 VAR1 = VAR2 REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-26-BENE-ADJUST-AMT-ALPHA = CONST 0000000 Rule Numbe 8730 Zero-Fill DA3.27 Original Approved Amount Line Command Description 1 VAR1 = VAR2 REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-27-ORIG-APPROVE-AMT-ALPHA = CONST 0000000 Rule Numbe 8735 Zero-Fill DA3.28 Original Paid Amount Line Command Description 1 VAR1 = VAR2 REC FIELD DA3-INSURANCE-CLM-LVL-INFO-3 DA3-28-ORIG-PAID-AMT-ALPHA = CONST 0000000 Rule Numbe 8740 Zero-Fill FA0.51 Approved Amount Line Command Description 1 VAR1 = VAR2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-51-APPROVED-AMT-ALPHA = CONST 0000000 Rule Numbe 8745 Zero-Fill FA0.52 Paid Amount Line Command Description 1 VAR1 = VAR2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-52-PAID-AMT-ALPHA = CONST 0000000 Rule Numbe 8750 Zero-Fill FA0.53 Beneficiary Liablility Amount Line Command Description 1 VAR1 = VAR2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-53-BENE-LIABILITY-AMT-ALPH = CONST 0000000 Rule Numbe 8755 Zero-Fill FA0.54 Balance Bill Limiting Charge Line Command Description 1 VAR1 = VAR2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-54-BAL-BILL-LIMIT-CHG-ALPH = CONST 0000000 Rule Numbe 8760 Zero-Fill FA0.55 Limiting Charge Percent Line Command Description 1 VAR1 = VAR2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-55-LIMIT-CHARGE-PRCNT-ALPH = CONST 0000000 Rule Numbe 8765 Zero-Fill FB3.06 Dollar Amount - 1 Line Command Description 1 VAR1 = VAR2 REC FIELD FB3-SERVICE-LINE-DETAIL-MED4 FB3-06-DOLLAR-AMOUNT-1-ALPHA = CONST 0000000 Rule Numbe 8770 Zero-Fill FB3.08 Dollar Amount - 2 Line Command Description 1 VAR1 = VAR2 REC FIELD FB3-SERVICE-LINE-DETAIL-MED4 FB3-08-DOLLAR-AMOUNT-2-ALPHA = CONST 0000000 Rule Numbe 8775 Zero-Fill FB3.10 Dollar Amount - 3 Line Command Description 1 VAR1 = VAR2 REC FIELD FB3-SERVICE-LINE-DETAIL-MED4 FB3-10-DOLLAR-AMOUNT-3-ALPHA = CONST 0000000 Rule Numbe 8780 Zero-Fill FB3.12 Dollar Amount - 4 Line Command Description 1 VAR1 = VAR2 REC FIELD FB3-SERVICE-LINE-DETAIL-MED4 FB3-12-DOLLAR-AMOUNT-4-ALPHA = CONST 0000000 Rule Numbe 8785 Zero-Fill FB3.14 Dollar Amount - 5 Line Command Description 1 VAR1 = VAR2 REC FIELD FB3-SERVICE-LINE-DETAIL-MED4 FB3-14-DOLLAR-AMOUNT-5-ALPHA = CONST 0000000 Rule Numbe 8790 Zero-Fill FB3.16 Dollar Amount - 6 Line Command Description 1 VAR1 = VAR2 REC FIELD FB3-SERVICE-LINE-DETAIL-MED4 FB3-16-DOLLAR-AMOUNT-6-ALPHA = CONST 0000000 Rule Numbe 8795 Zero-Fill FB3.18 Dollar Amount - 7 Line Command Description 1 VAR1 = VAR2 REC FIELD FB3-SERVICE-LINE-DETAIL-MED4 FB3-18-DOLLAR-AMOUNT-7-ALPHA = CONST 0000000 Rule Numbe 8800 Map v.103 AA0 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-01-REC-ID = REC FIELD v103_AA0-SUBMITTER-DATA AA0-01-REC-ID 2 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-02-SUB-ID = REC FIELD v103_AA0-SUBMITTER-DATA AA0-02-SUB-ID 3 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-03-RESERVED = REC FIELD v103_AA0-SUBMITTER-DATA AA0-03-RESERVED 4 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-03-RESERVED = REC FIELD v103_AA0-SUBMITTER-DATA AA0-04-SUB-TYPE 5 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-05-SUB-NO = REC FIELD v103_AA0-SUBMITTER-DATA AA0-05-SUB-NO 6 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-06-SUB-NAME = REC FIELD v103_AA0-SUBMITTER-DATA AA0-06-SUB-NAME 7 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-07-SUB-ADDR1 = REC FIELD v103_AA0-SUBMITTER-DATA AA0-07-SUB-ADDR1 8 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-08-SUB-ADDR2 = REC FIELD v103_AA0-SUBMITTER-DATA AA0-08-SUB-ADDR2 9 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-09-SUB-CITY = REC FIELD v103_AA0-SUBMITTER-DATA AA0-09-SUB-CITY 10 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-10-SUB-STATE = REC FIELD v103_AA0-SUBMITTER-DATA AA0-10-SUB-STATE 11 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-11-SUB-ZIP = REC FIELD v103_AA0-SUBMITTER-DATA AA0-11-SUB-ZIP 12 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-12-SUB-REG = REC FIELD v103_AA0-SUBMITTER-DATA AA0-12-SUB-REG 13 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-13-SUB-CONT = REC FIELD v103_AA0-SUBMITTER-DATA AA0-13-SUB-CONT 14 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-14-SUB-PHONE = REC FIELD v103_AA0-SUBMITTER-DATA AA0-14-SUB-PHONE 15 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-15-CREAT-DTE = REC FIELD v103_AA0-SUBMITTER-DATA AA0-15-CREAT-DTE 16 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-15-DATE-TIME-RECVR-ID = REC FIELD v103_AA0-SUBMITTER-DATA AA0-15-DATE-TIME-RECVR-ID 17 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-16-SUB-HOUR = REC FIELD v103_AA0-SUBMITTER-DATA AA0-16-SUB-HOUR 18 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-16-SUB-TIME = REC FIELD v103_AA0-SUBMITTER-DATA AA0-16-SUB-TIME 19 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-16-SUB-MINUTE = REC FIELD v103_AA0-SUBMITTER-DATA AA0-16-SUB-MINUTE 20 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-16-SUB-SECOND = REC FIELD v103_AA0-SUBMITTER-DATA AA0-16-SUB-SECOND 21 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-17-IOWA-REC-ID = REC FIELD v103_AA0-SUBMITTER-DATA AA0-17-IOWA-REC-ID 22 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-17-RECV-ID = REC FIELD v103_AA0-SUBMITTER-DATA AA0-17-RECV-ID 23 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-18-RECV-TYPE = REC FIELD v103_AA0-SUBMITTER-DATA AA0-18-RECV-TYPE 24 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-19-VERS-NATIONAL = REC FIELD v103_AA0-SUBMITTER-DATA AA0-19-VERS-NATIONAL 25 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-19-VERS-NATL-ALPHA = REC FIELD v103_AA0-SUBMITTER-DATA AA0-19-VERS-NATL-ALPHA 26 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-20-VERS-LOCAL = REC FIELD v103_AA0-SUBMITTER-DATA AA0-20-VERS-LOCAL 27 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-20-VERS-LOCAL-ALPHA = REC FIELD v103_AA0-SUBMITTER-DATA AA0-20-VERS-LOCAL-ALPHA 28 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-21-TEST-IND = REC FIELD v103_AA0-SUBMITTER-DATA AA0-21-TEST-IND 29 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-22-PASS = REC FIELD v103_AA0-SUBMITTER-DATA AA0-22-PASS 30 RECFLD1 = RECFLD2 REC FIELD AA0-SUBMITTER-DATA AA0-23-RETRANS-STATUS = REC FIELD v103_AA0-SUBMITTER-DATA AA0-23-RETRANS-STATUS Rule Numbe 8805 Map v.103 BA0 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-01-REC-ID = REC FIELD v103_BA0-PROVIDER-DATA BA0-01-REC-ID 2 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-02-EMC-PROV-ID = REC FIELD v103_BA0-PROVIDER-DATA BA0-02-EMC-PROV-ID 3 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-03-BATCH-TYPE = REC FIELD v103_BA0-PROVIDER-DATA BA0-03-BATCH-TYPE 4 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-04-BATCH-NO = REC FIELD v103_BA0-PROVIDER-DATA BA0-04-BATCH-NO 5 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-04-BATCH-NO-ALPHA = REC FIELD v103_BA0-PROVIDER-DATA BA0-04-BATCH-NO-ALPHA 6 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-05-BATCH-ID = REC FIELD v103_BA0-PROVIDER-DATA BA0-05-BATCH-ID 7 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-06-PROV-TAX-ID = REC FIELD v103_BA0-PROVIDER-DATA BA0-06-PROV-TAX-ID 8 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-07-RESERVED = REC FIELD v103_BA0-PROVIDER-DATA BA0-07-RESERVED 9 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-08-PROV-TAX-ID-TYPE = REC FIELD v103_BA0-PROVIDER-DATA BA0-08-PROV-TAX-ID-TYPE 10 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-09-PROV-MEDICARE-NO = REC FIELD v103_BA0-PROVIDER-DATA BA0-09-PROV-MEDICARE-NO 11 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-10-PROV-UPIN-USIN-ID = REC FIELD v103_BA0-PROVIDER-DATA BA0-10-PROV-UPIN-USIN-ID 12 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-11-RESERVED = REC FIELD v103_BA0-PROVIDER-DATA BA0-11-RESERVED 13 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-12-PROV-MEDICAID-NO = REC FIELD v103_BA0-PROVIDER-DATA BA0-12-PROV-MEDICAID-NO 14 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-13-PROV-CHAMPUS-NO = REC FIELD v103_BA0-PROVIDER-DATA BA0-13-PROV-CHAMPUS-NO 15 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-14-PROV-BLUE-SHIELD-NO = REC FIELD v103_BA0-PROVIDER-DATA BA0-14-PROV-BLUE-SHIELD-NO 16 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-15-PROV-COMMERICAL-NO = REC FIELD v103_BA0-PROVIDER-DATA BA0-15-PROV-COMMERICAL-NO 17 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-16-PROV-NO-1 = REC FIELD v103_BA0-PROVIDER-DATA BA0-16-PROV-NO-1 18 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-17-PROV-NO-2 = REC FIELD v103_BA0-PROVIDER-DATA BA0-17-PROV-NO-2 19 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-18-PROV-ORGANIZATION-NAME = REC FIELD v103_BA0-PROVIDER-DATA BA0-18-PROV-ORGANIZATION-NAME 20 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-19-PROV-LAST-NAME = REC FIELD v103_BA0-PROVIDER-DATA BA0-19-PROV-LAST-NAME 21 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-20-PROV-FIRST-NAME = REC FIELD v103_BA0-PROVIDER-DATA BA0-20-PROV-FIRST-NAME 22 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-21-PROV-MI = REC FIELD v103_BA0-PROVIDER-DATA BA0-21-PROV-MI 23 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-22-PROV-SPECIALTY = REC FIELD v103_BA0-PROVIDER-DATA BA0-22-PROV-SPECIALTY 24 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-23-SPECIALTY-LICENSE-NO = REC FIELD v103_BA0-PROVIDER-DATA BA0-23-SPECIALTY-LICENSE-NO 25 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-24-STATE-LICENSE-NO = REC FIELD v103_BA0-PROVIDER-DATA BA0-24-STATE-LICENSE-NO 26 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-25-DENTIST-LICENSE-NO = REC FIELD v103_BA0-PROVIDER-DATA BA0-25-DENTIST-LICENSE-NO 27 RECFLD1 = RECFLD2 REC FIELD BA0-PROVIDER-DATA BA0-26-ANESTHESIA-LICENSE-NO = REC FIELD v103_BA0-PROVIDER-DATA BA0-26-ANESTHESIA-LICENSE-NO Rule Numbe 8810 Map v.103 BA1 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD BA1-PROVIDER-DATA-2 BA1-01-RECORD-ID = REC FIELD v103_BA1-PROVIDER-DATA-2 BA1-01-RECORD-ID 2 RECFLD1 = RECFLD2 REC FIELD BA1-PROVIDER-DATA-2 BA1-02-EMC-PROV-ID = REC FIELD v103_BA1-PROVIDER-DATA-2 BA1-02-EMC-PROV-ID 3 RECFLD1 = RECFLD2 REC FIELD BA1-PROVIDER-DATA-2 BA1-03-BATCH-TYPE = REC FIELD v103_BA1-PROVIDER-DATA-2 BA1-03-BATCH-TYPE 4 RECFLD1 = RECFLD2 REC FIELD BA1-PROVIDER-DATA-2 BA1-04-BATCH-NO = REC FIELD v103_BA1-PROVIDER-DATA-2 BA1-04-BATCH-NO 5 RECFLD1 = RECFLD2 REC FIELD BA1-PROVIDER-DATA-2 BA1-04-BATCH-NUMBER-ALPHA = REC FIELD v103_BA1-PROVIDER-DATA-2 BA1-04-BATCH-NUMBER-ALPHA 6 RECFLD1 = RECFLD2 REC FIELD BA1-PROVIDER-DATA-2 BA1-05-BATCH-ID = REC FIELD v103_BA1-PROVIDER-DATA-2 BA1-05-BATCH-ID 7 RECFLD1 = RECFLD2 REC FIELD BA1-PROVIDER-DATA-2 BA1-06-PROV-TYPE-ORG = REC FIELD v103_BA1-PROVIDER-DATA-2 BA1-06-PROV-TYPE-ORG 8 RECFLD1 = RECFLD2 REC FIELD BA1-PROVIDER-DATA-2 BA1-07-PROV-SVC-ADDR1 = REC FIELD v103_BA1-PROVIDER-DATA-2 BA1-07-PROV-SVC-ADDR1 9 RECFLD1 = RECFLD2 REC FIELD BA1-PROVIDER-DATA-2 BA1-08-PROV-SVC-ADDR2 = REC FIELD v103_BA1-PROVIDER-DATA-2 BA1-08-PROV-SVC-ADDR2 10 RECFLD1 = RECFLD2 REC FIELD BA1-PROVIDER-DATA-2 BA1-09-PROV-SVC-CITY = REC FIELD v103_BA1-PROVIDER-DATA-2 BA1-09-PROV-SVC-CITY 11 RECFLD1 = RECFLD2 REC FIELD BA1-PROVIDER-DATA-2 BA1-10-PROV-SVC-STATE = REC FIELD v103_BA1-PROVIDER-DATA-2 BA1-10-PROV-SVC-STATE 12 RECFLD1 = RECFLD2 REC FIELD BA1-PROVIDER-DATA-2 BA1-11-PROV-SVC-ZIP = REC FIELD v103_BA1-PROVIDER-DATA-2 BA1-11-PROV-SVC-ZIP 13 RECFLD1 = RECFLD2 REC FIELD BA1-PROVIDER-DATA-2 BA1-12-PROV-SVC-PHONE = REC FIELD v103_BA1-PROVIDER-DATA-2 BA1-12-PROV-SVC-PHONE 14 RECFLD1 = RECFLD2 REC FIELD BA1-PROVIDER-DATA-2 BA1-13-PROV-PAY-TO-ADDR1 = REC FIELD v103_BA1-PROVIDER-DATA-2 BA1-13-PROV-PAY-TO-ADDR1 15 RECFLD1 = RECFLD2 REC FIELD BA1-PROVIDER-DATA-2 BA1-13-PAY-TO-ADDR-REDEFINES = REC FIELD v103_BA1-PROVIDER-DATA-2 BA1-13-PAY-TO-ADDR-REDEFINES 16 RECFLD1 = RECFLD2 REC FIELD BA1-PROVIDER-DATA-2 BA1-14-PROV-PAY-TO-ADDR2 = REC FIELD v103_BA1-PROVIDER-DATA-2 BA1-14-PROV-PAY-TO-ADDR2 17 RECFLD1 = RECFLD2 REC FIELD BA1-PROVIDER-DATA-2 BA1-15-PROV-PAY-TO-CITY = REC FIELD v103_BA1-PROVIDER-DATA-2 BA1-15-PROV-PAY-TO-CITY 18 RECFLD1 = RECFLD2 REC FIELD BA1-PROVIDER-DATA-2 BA1-16-PROV-PAY-TO-STATE = REC FIELD v103_BA1-PROVIDER-DATA-2 BA1-16-PROV-PAY-TO-STATE 19 RECFLD1 = RECFLD2 REC FIELD BA1-PROVIDER-DATA-2 BA1-17-PROV-PAY-TO-ZIP = REC FIELD v103_BA1-PROVIDER-DATA-2 BA1-17-PROV-PAY-TO-ZIP 20 RECFLD1 = RECFLD2 REC FIELD BA1-PROVIDER-DATA-2 BA1-18-PROV-PAY-TO-PHONE = REC FIELD v103_BA1-PROVIDER-DATA-2 BA1-18-PROV-PAY-TO-PHONE Rule Numbe 8815 Map v.103 CA0 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-01-RECORD-ID = REC FIELD v103_CA0-PATIENT-DATA CA0-01-RECORD-ID 2 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-02-RESERVED = REC FIELD v103_CA0-PATIENT-DATA CA0-02-RESERVED 3 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-03-PAT-CONTROL-NO = REC FIELD v103_CA0-PATIENT-DATA CA0-03-PAT-CONTROL-NO 4 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-04-PAT-LAST-NAME = REC FIELD v103_CA0-PATIENT-DATA CA0-04-PAT-LAST-NAME 5 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-05-PAT-FIRST-NAME = REC FIELD v103_CA0-PATIENT-DATA CA0-05-PAT-FIRST-NAME 6 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-06-PAT-MI = REC FIELD v103_CA0-PATIENT-DATA CA0-06-PAT-MI 7 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-07-PAT-GENERATION = REC FIELD v103_CA0-PATIENT-DATA CA0-07-PAT-GENERATION 8 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-08-PAT-DATE-OF-BIRTH = REC FIELD v103_CA0-PATIENT-DATA CA0-08-PAT-DATE-OF-BIRTH 9 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-09-PAT-SEX = REC FIELD v103_CA0-PATIENT-DATA CA0-09-PAT-SEX 10 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-10-PAT-TYPE-OF-RESIDENCE = REC FIELD v103_CA0-PATIENT-DATA CA0-10-PAT-TYPE-OF-RESIDENCE 11 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-11-PAT-ADDR1 = REC FIELD v103_CA0-PATIENT-DATA CA0-11-PAT-ADDR1 12 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-11-PAT-ADDRESS-REDEFINES = REC FIELD v103_CA0-PATIENT-DATA CA0-11-PAT-ADDRESS-REDEFINES 13 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-12-PAT-ADDR2 = REC FIELD v103_CA0-PATIENT-DATA CA0-12-PAT-ADDR2 14 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-13-PAT-CITY = REC FIELD v103_CA0-PATIENT-DATA CA0-13-PAT-CITY 15 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-14-PAT-STATE = REC FIELD v103_CA0-PATIENT-DATA CA0-14-PAT-STATE 16 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-15-PAT-ZIP = REC FIELD v103_CA0-PATIENT-DATA CA0-15-PAT-ZIP 17 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-16-PAT-PHONE = REC FIELD v103_CA0-PATIENT-DATA CA0-16-PAT-PHONE 18 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-17-PAT-MARITAL-STATUS = REC FIELD v103_CA0-PATIENT-DATA CA0-17-PAT-MARITAL-STATUS 19 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-18-PAT-STUDENT-STATUS = REC FIELD v103_CA0-PATIENT-DATA CA0-18-PAT-STUDENT-STATUS 20 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-19-PAT-EMPLOYMENT-STATUS = REC FIELD v103_CA0-PATIENT-DATA CA0-19-PAT-EMPLOYMENT-STATUS 21 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-20-PAT-DEATH-IND = REC FIELD v103_CA0-PATIENT-DATA CA0-20-PAT-DEATH-IND 22 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-21-PAT-DATE-OF-DEATH = REC FIELD v103_CA0-PATIENT-DATA CA0-21-PAT-DATE-OF-DEATH 23 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-22-OTHER-INSURANCE-IND = REC FIELD v103_CA0-PATIENT-DATA CA0-22-OTHER-INSURANCE-IND 24 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-23-CLAIM-EDITING-IND = REC FIELD v103_CA0-PATIENT-DATA CA0-23-CLAIM-EDITING-IND 25 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-24-TYPE-OF-CLAIM-IND = REC FIELD v103_CA0-PATIENT-DATA CA0-24-TYPE-OF-CLAIM-IND 26 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-25-LEGAL-REPRESENTATIVE-IN = REC FIELD v103_CA0-PATIENT-DATA CA0-25-LEGAL-REPRESENTATIVE-IN 27 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-26-ORIGIN-CODE = REC FIELD v103_CA0-PATIENT-DATA CA0-26-ORIGIN-CODE 28 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-27-PAYOR-CLM-CONTROL-NO = REC FIELD v103_CA0-PATIENT-DATA CA0-27-PAYOR-CLM-CONTROL-NO 29 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-28-PROVIDER-NUMBER = REC FIELD v103_CA0-PATIENT-DATA CA0-28-PROVIDER-NUMBER 30 RECFLD1 = RECFLD2 REC FIELD CA0-PATIENT-DATA CA0-29-CLAIM-ID-NO = REC FIELD v103_CA0-PATIENT-DATA CA0-29-CLAIM-ID-NO Rule Numbe 8820 Map v.103 CB0 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD CB0-LEGAL-REPRE-DATA CB0-01-RECORD-ID = REC FIELD v103_CB0-LEGAL-REPRE-DATA CB0-01-RECORD-ID 2 RECFLD1 = RECFLD2 REC FIELD CB0-LEGAL-REPRE-DATA CB0-02-RESERVED = REC FIELD v103_CB0-LEGAL-REPRE-DATA CB0-02-RESERVED 3 RECFLD1 = RECFLD2 REC FIELD CB0-LEGAL-REPRE-DATA CB0-03-PAT-CONTROL-NO = REC FIELD v103_CB0-LEGAL-REPRE-DATA CB0-03-PAT-CONTROL-NO 4 RECFLD1 = RECFLD2 REC FIELD CB0-LEGAL-REPRE-DATA CB0-04-RESP-PERSON-LAST-NAME = REC FIELD v103_CB0-LEGAL-REPRE-DATA CB0-04-RESP-PERSON-LAST-NAME 5 RECFLD1 = RECFLD2 REC FIELD CB0-LEGAL-REPRE-DATA CB0-04-RESP-PERS-REDEFINES = REC FIELD v103_CB0-LEGAL-REPRE-DATA CB0-04-RESP-PERS-REDEFINES 6 RECFLD1 = RECFLD2 REC FIELD CB0-LEGAL-REPRE-DATA CB0-05-RESP-PERSON-FIRST-NAME = REC FIELD v103_CB0-LEGAL-REPRE-DATA CB0-05-RESP-PERSON-FIRST-NAME 7 RECFLD1 = RECFLD2 REC FIELD CB0-LEGAL-REPRE-DATA CB0-06-RESP-PERSON-MI = REC FIELD v103_CB0-LEGAL-REPRE-DATA CB0-06-RESP-PERSON-MI 8 RECFLD1 = RECFLD2 REC FIELD CB0-LEGAL-REPRE-DATA CB0-07-RESP-PERSON-ADDR1 = REC FIELD v103_CB0-LEGAL-REPRE-DATA CB0-07-RESP-PERSON-ADDR1 9 RECFLD1 = RECFLD2 REC FIELD CB0-LEGAL-REPRE-DATA CB0-08-RESP-PERSON-ADDR2 = REC FIELD v103_CB0-LEGAL-REPRE-DATA CB0-08-RESP-PERSON-ADDR2 10 RECFLD1 = RECFLD2 REC FIELD CB0-LEGAL-REPRE-DATA CB0-09-RESP-PERSON-CITY = REC FIELD v103_CB0-LEGAL-REPRE-DATA CB0-09-RESP-PERSON-CITY 11 RECFLD1 = RECFLD2 REC FIELD CB0-LEGAL-REPRE-DATA CB0-10-RESP-PERSON-STATE = REC FIELD v103_CB0-LEGAL-REPRE-DATA CB0-10-RESP-PERSON-STATE 12 RECFLD1 = RECFLD2 REC FIELD CB0-LEGAL-REPRE-DATA CB0-11-RESP-PERSON-ZIP = REC FIELD v103_CB0-LEGAL-REPRE-DATA CB0-11-RESP-PERSON-ZIP 13 RECFLD1 = RECFLD2 REC FIELD CB0-LEGAL-REPRE-DATA CB0-12-RESP-PERSON-PHONE = REC FIELD v103_CB0-LEGAL-REPRE-DATA CB0-12-RESP-PERSON-PHONE Rule Numbe 8825 Map v.103 DA0 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-01-REC0RD-ID = REC FIELD v103_DA0-INSURANCE-INFO DA0-01-REC0RD-ID 2 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-00-REDEFINES-INPUT = REC FIELD v103_DA0-INSURANCE-INFO DA0-00-REDEFINES-INPUT 3 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-02-SEQUENCE-NO = REC FIELD v103_DA0-INSURANCE-INFO DA0-02-SEQUENCE-NO 4 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-02-SEQUENCE-NUM-ALPHA = REC FIELD v103_DA0-INSURANCE-INFO DA0-02-SEQUENCE-NUM-ALPHA 5 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-03-PAT-CONTROL-NO = REC FIELD v103_DA0-INSURANCE-INFO DA0-03-PAT-CONTROL-NO 6 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-04-CLAIM-FILING-IND = REC FIELD v103_DA0-INSURANCE-INFO DA0-04-CLAIM-FILING-IND 7 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-05-SOURCE-OF-PAY = REC FIELD v103_DA0-INSURANCE-INFO DA0-05-SOURCE-OF-PAY 8 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-06-INSURANCE-TYPE-CODE = REC FIELD v103_DA0-INSURANCE-INFO DA0-06-INSURANCE-TYPE-CODE 9 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-07-PAYOR-ORGANIZATION-ID = REC FIELD v103_DA0-INSURANCE-INFO DA0-07-PAYOR-ORGANIZATION-ID 10 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-08-PAYOR-CLAIM-OFFICE-NO = REC FIELD v103_DA0-INSURANCE-INFO DA0-08-PAYOR-CLAIM-OFFICE-NO 11 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-09-PAYOR-NAME = REC FIELD v103_DA0-INSURANCE-INFO DA0-09-PAYOR-NAME 12 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-10-GROUP-NO = REC FIELD v103_DA0-INSURANCE-INFO DA0-10-GROUP-NO 13 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-11-GROUP-NAME = REC FIELD v103_DA0-INSURANCE-INFO DA0-11-GROUP-NAME 14 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-12-PPO-HMO-IND = REC FIELD v103_DA0-INSURANCE-INFO DA0-12-PPO-HMO-IND 15 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-13-PPO-ID = REC FIELD v103_DA0-INSURANCE-INFO DA0-13-PPO-ID 16 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-14-PRIOR-AUTH-NO = REC FIELD v103_DA0-INSURANCE-INFO DA0-14-PRIOR-AUTH-NO 17 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-15-ASSIGN-OF-BENEFITS-IND = REC FIELD v103_DA0-INSURANCE-INFO DA0-15-ASSIGN-OF-BENEFITS-IND 18 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-16-PAT-SIGNATURE-SOURCE = REC FIELD v103_DA0-INSURANCE-INFO DA0-16-PAT-SIGNATURE-SOURCE 19 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-17-PAT-RELATION-TO-INSURED = REC FIELD v103_DA0-INSURANCE-INFO DA0-17-PAT-RELATION-TO-INSURED 20 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-18-INSURED-ID-NO = REC FIELD v103_DA0-INSURANCE-INFO DA0-18-INSURED-ID-NO 21 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-19-INSURED-LAST-NAME = REC FIELD v103_DA0-INSURANCE-INFO DA0-19-INSURED-LAST-NAME 22 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-20-INSURED-FIRST-NAME = REC FIELD v103_DA0-INSURANCE-INFO DA0-20-INSURED-FIRST-NAME 23 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-21-INSURED-MI = REC FIELD v103_DA0-INSURANCE-INFO DA0-21-INSURED-MI 24 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-22-INSURED-GENERATION = REC FIELD v103_DA0-INSURANCE-INFO DA0-22-INSURED-GENERATION 25 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-23-INSURED-SEX = REC FIELD v103_DA0-INSURANCE-INFO DA0-23-INSURED-SEX 26 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-24-INSURED-DATE-OF-BIRTH = REC FIELD v103_DA0-INSURANCE-INFO DA0-24-INSURED-DATE-OF-BIRTH 27 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-25-INSURED-EMPLOYMENT-STAT = REC FIELD v103_DA0-INSURANCE-INFO DA0-25-INSURED-EMPLOYMENT-STAT 28 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-26-SUPPLEMENTAL-INS-IND = REC FIELD v103_DA0-INSURANCE-INFO DA0-26-SUPPLEMENTAL-INS-IND 29 RECFLD1 = RECFLD2 REC FIELD DA0-INSURANCE-INFO DA0-27-INSURANCE-LOCATION = REC FIELD v103_DA0-INSURANCE-INFO DA0-27-INSURANCE-LOCATION Rule Numbe 8830 Map v.103 DA1 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-01-RECORD-ID = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-01-RECORD-ID 2 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-00-REDEFINES-DA1-INPUT = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-00-REDEFINES-DA1-INPUT 3 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-02-SEQUENCE-NO = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-02-SEQUENCE-NO 4 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-02-SEQUENCE-NUM-ALPHA = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-02-SEQUENCE-NUM-ALPHA 5 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-03-PAT-CONTROL-NO = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-03-PAT-CONTROL-NO 6 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-04-PAYOR-ADDR1 = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-04-PAYOR-ADDR1 7 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-04-PAYER-ADDR-REDEFINES = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-04-PAYER-ADDR-REDEFINES 8 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-05-PAYOR-ADDR2 = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-05-PAYOR-ADDR2 9 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-06-PAYOR-CITY = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-06-PAYOR-CITY 10 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-07-PAYOR-STATE = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-07-PAYOR-STATE 11 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-08-PAYOR-ZIP = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-08-PAYOR-ZIP 12 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-09-DISALLOW-COST-ALPHA = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-09-DISALLOW-COST-ALPHA 13 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-09-DISALLOW-COST-CONTAIN = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-09-DISALLOW-COST-CONTAIN 14 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-10-DISALLOWED-OTHER = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-10-DISALLOWED-OTHER 15 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-10-DISALLOW-OTHER-ALPHA = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-10-DISALLOW-OTHER-ALPHA 16 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-11-ALLOWED-AMOUNT = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-11-ALLOWED-AMOUNT 17 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-11-ALLOWED-AMT-ALPHA = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-11-ALLOWED-AMT-ALPHA 18 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-12-DEDUCTIBLE-AMOUNT = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-12-DEDUCTIBLE-AMOUNT 19 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-12-DEDUCTIBLE-AMT-ALPHA = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-12-DEDUCTIBLE-AMT-ALPHA 20 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-13-COINSURANCE-AMOUNT = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-13-COINSURANCE-AMOUNT 21 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-13-COINSURANCE-AMT-ALPHA = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-13-COINSURANCE-AMT-ALPHA 22 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-14-PAYOR-AMOUNT-PAID = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-14-PAYOR-AMOUNT-PAID 23 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-14-PAYOR-AMT-ALPHA = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-14-PAYOR-AMT-ALPHA 24 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-15-ZERO-PAY-IND = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-15-ZERO-PAY-IND 25 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-16-ADJUDICATION-IND-1 = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-16-ADJUDICATION-IND-1 26 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-17-ADJUDICATION-IND-2 = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-17-ADJUDICATION-IND-2 27 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-18-ADJUDICATION-3 = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-18-ADJUDICATION-3 28 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-19-CHAMPUS-SPONSOR-BRANCH = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-19-CHAMPUS-SPONSOR-BRANCH 29 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-20-CHAMPUS-SPONSOR-GRADE = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-20-CHAMPUS-SPONSOR-GRADE 30 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-21-CHAMPUS-SPONSOR-STATUS = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-21-CHAMPUS-SPONSOR-STATUS 31 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-22-INS-CARD-EFFECT-DATE = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-22-INS-CARD-EFFECT-DATE 32 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-23-INS-CARD-TERM-DATE = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-23-INS-CARD-TERM-DATE 33 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-24-BALANCE-DUE = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-24-BALANCE-DUE 34 RECFLD1 = RECFLD2 REC FIELD DA1-INSURANCE-CLM-LVL-INFO DA1-24-BALANCE-DUE-ALPHA = REC FIELD v103_DA1-INSURANCE-CLM-LVL-INFO DA1-24-BALANCE-DUE-ALPHA Rule Numbe 8835 Map v.103 DA2 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-01-RECORD-ID = REC FIELD v103_DA2-INSURANCE-CLM-LVL-INFO-2 DA2-01-RECORD-ID 2 RECFLD1 = RECFLD2 REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-00-REDEFINES-INPUT = REC FIELD v103_DA2-INSURANCE-CLM-LVL-INFO-2 DA2-00-REDEFINES-INPUT 3 RECFLD1 = RECFLD2 REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-02-SEQUENCE-NO = REC FIELD v103_DA2-INSURANCE-CLM-LVL-INFO-2 DA2-02-SEQUENCE-NO 4 RECFLD1 = RECFLD2 REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-02-SEQUENCE-NUM-ALPHA = REC FIELD v103_DA2-INSURANCE-CLM-LVL-INFO-2 DA2-02-SEQUENCE-NUM-ALPHA 5 RECFLD1 = RECFLD2 REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-03-PAT-CONTROL-NO = REC FIELD v103_DA2-INSURANCE-CLM-LVL-INFO-2 DA2-03-PAT-CONTROL-NO 6 RECFLD1 = RECFLD2 REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-04-INSURED-ADDR1 = REC FIELD v103_DA2-INSURANCE-CLM-LVL-INFO-2 DA2-04-INSURED-ADDR1 7 RECFLD1 = RECFLD2 REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-04-INSURED-ADDR-REDEFINES = REC FIELD v103_DA2-INSURANCE-CLM-LVL-INFO-2 DA2-04-INSURED-ADDR-REDEFINES 8 RECFLD1 = RECFLD2 REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-05-INSURED-ADDR2 = REC FIELD v103_DA2-INSURANCE-CLM-LVL-INFO-2 DA2-05-INSURED-ADDR2 9 RECFLD1 = RECFLD2 REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-06-INSURED-CITY = REC FIELD v103_DA2-INSURANCE-CLM-LVL-INFO-2 DA2-06-INSURED-CITY 10 RECFLD1 = RECFLD2 REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-07-INSURED-STATE = REC FIELD v103_DA2-INSURANCE-CLM-LVL-INFO-2 DA2-07-INSURED-STATE 11 RECFLD1 = RECFLD2 REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-08-INSURED-ZIP = REC FIELD v103_DA2-INSURANCE-CLM-LVL-INFO-2 DA2-08-INSURED-ZIP 12 RECFLD1 = RECFLD2 REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-09-INSURED-PHONE = REC FIELD v103_DA2-INSURANCE-CLM-LVL-INFO-2 DA2-09-INSURED-PHONE 13 RECFLD1 = RECFLD2 REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-10-INSURED-RETIRE-DT = REC FIELD v103_DA2-INSURANCE-CLM-LVL-INFO-2 DA2-10-INSURED-RETIRE-DT 14 RECFLD1 = RECFLD2 REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-11-INSURED-SPOUSE-RETIRE = REC FIELD v103_DA2-INSURANCE-CLM-LVL-INFO-2 DA2-11-INSURED-SPOUSE-RETIRE 15 RECFLD1 = RECFLD2 REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-12-INSURED-EMPLOYER-NAME = REC FIELD v103_DA2-INSURANCE-CLM-LVL-INFO-2 DA2-12-INSURED-EMPLOYER-NAME 16 RECFLD1 = RECFLD2 REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-12-EMPLOYER-ADDR-REDEFINES = REC FIELD v103_DA2-INSURANCE-CLM-LVL-INFO-2 DA2-12-EMPLOYER-ADDR-REDEFINES 17 RECFLD1 = RECFLD2 REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-13-INSURED-EMPLOYER-ADDR1 = REC FIELD v103_DA2-INSURANCE-CLM-LVL-INFO-2 DA2-13-INSURED-EMPLOYER-ADDR1 18 RECFLD1 = RECFLD2 REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-14-INSURED-EMPLOYER-ADDR2 = REC FIELD v103_DA2-INSURANCE-CLM-LVL-INFO-2 DA2-14-INSURED-EMPLOYER-ADDR2 19 RECFLD1 = RECFLD2 REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-15-INSURED-EMPLOYER-CITY = REC FIELD v103_DA2-INSURANCE-CLM-LVL-INFO-2 DA2-15-INSURED-EMPLOYER-CITY 20 RECFLD1 = RECFLD2 REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-16-INSURED-EMPLOYER-ST = REC FIELD v103_DA2-INSURANCE-CLM-LVL-INFO-2 DA2-16-INSURED-EMPLOYER-ST 21 RECFLD1 = RECFLD2 REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-17-INSURED-EMPLOYER-ZIP = REC FIELD v103_DA2-INSURANCE-CLM-LVL-INFO-2 DA2-17-INSURED-EMPLOYER-ZIP 22 RECFLD1 = RECFLD2 REC FIELD DA2-INSURANCE-CLM-LVL-INFO-2 DA2-18-EMPLOYEE-ID-NO = REC FIELD v103_DA2-INSURANCE-CLM-LVL-INFO-2 DA2-18-EMPLOYEE-ID-NO Rule Numbe 8840 Map v.103 EA0 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-01-RECORD-ID = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-01-RECORD-ID 2 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-02-RESERVED = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-02-RESERVED 3 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-03-PAT-CONTROL-NO = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-03-PAT-CONTROL-NO 4 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-04-EMPL-RELATED-IND = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-04-EMPL-RELATED-IND 5 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-05-ACCIDENT-IND = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-05-ACCIDENT-IND 6 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-06-SYMPTOM-IND = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-06-SYMPTOM-IND 7 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-07-ACCIDENT-SYMPTOM-DATE = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-07-ACCIDENT-SYMPTOM-DATE 8 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-08-EXT-CAUSE-OF-ACCIDENT = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-08-EXT-CAUSE-OF-ACCIDENT 9 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-09-RESPONSIBILITY-IND = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-09-RESPONSIBILITY-IND 10 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-10-ACCIDENT-STATE = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-10-ACCIDENT-STATE 11 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-11-ACCIDENT-HOUR = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-11-ACCIDENT-HOUR 12 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-12-ABUSE-IND = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-12-ABUSE-IND 13 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-13-RELEASE-OF-INFO = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-13-RELEASE-OF-INFO 14 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-14-RELEASE-OF-INFO-DATE = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-14-RELEASE-OF-INFO-DATE 15 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-15-SAME-SIMILAR-SYMPTOM-IN = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-15-SAME-SIMILAR-SYMPTOM-IN 16 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-16-SAME-SIMILAR-SYM-DATE = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-16-SAME-SIMILAR-SYM-DATE 17 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-17-DISABILITY-TYPE = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-17-DISABILITY-TYPE 18 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-18-DISABILITY-FROM-DATE = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-18-DISABILITY-FROM-DATE 19 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-19-DISABILITY-TO-DATE = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-19-DISABILITY-TO-DATE 20 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-20-REFER-PROV-ID-NO = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-20-REFER-PROV-ID-NO 21 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-21-REFER-PROV-UPIN = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-21-RESERVED 22 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-24-REFER-PROV-LAST = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-22-REFER-PROV-LAST 23 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-24-REFER-PROV-REDEFINES = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-22-REFER-PROV-REDEFINES 24 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-25-REFER-PROV-FIRST = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-23-REFER-PROV-FIRST 25 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-26-REFER-PROV-MI = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-24-REFER-PROV-MI 26 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-27-REFER-PROV-STATE = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-25-REFER-PROV-STATE 27 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-28-ADMISSION-DATE-1 = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-26-ADMISSION-DATE-1 28 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-29-DISCHARGE-DATE-1 = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-27-DISCHARGE-DATE-1 29 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-30-LAB-IND = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-28-LAB-IND 30 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-31-LAB-CHARGES = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-29-LAB-CHARGES 31 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-31-LAB-CHARGES-ALPHA = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-29-LAB-CHARGES-ALPHA 32 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-32-DIAGNOSIS-CODE-1 = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-30-DIAGNOSIS-CODE-1 33 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-33-DIAGNOSIS-CODE-2 = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-31-DIAGNOSIS-CODE-2 34 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-34-DIAGNOSIS-CODE-3 = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-32-DIAGNOSIS-CODE-3 35 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-35-DIAGNOSIS-CODE-4 = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-33-DIAGNOSIS-CODE-4 36 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-36-PROV-ASSIGN-IND = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-34-PROV-ASSIGN-IND 37 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-37-PROV-SIGNATURE-IND = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-35-PROV-SIGNATURE-IND 38 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-38-PROV-SIGNATURE-DATE = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-36-PROV-SIGNATURE-DATE 39 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-39-FACILITY-LAB-NAME = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-37-FACILITY-LAB-NAME 40 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-40-DOCUMENTATION-IND = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-38-DOCUMENTATION-IND 41 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-41-TYPE-OF-DOCUMENTATION = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-39-TYPE-OF-DOCUMENTATION 42 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-42-FUNCTNL-STATUS-CODE = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-40-FUNCTNL-STATUS-CODE 43 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-43-SPECIAL-PROGRAM-IND = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-41-SPECIAL-PROGRAM-IND 44 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-44-CHAMPUS-NONAVAIL-IND = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-42-CHAMPUS-NONAVAIL-IND 45 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-45-SUPV-PROV-IND = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-43-SUPV-PROV-IND 46 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-46-SUB/RESUBMISSION-CODE = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-44-RESUBMISSION-CODE 47 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-47-RESUB-REFERENCE-NO = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-45-RESUB-REFERENCE-NO 48 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-48-DATE-LAST-SEEN = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-46-DATE-LAST-SEEN 49 RECFLD1 = RECFLD2 REC FIELD EA0-CLAIM-LVL-INFO EA0-49-DATE-DOCUMENT-SENT = REC FIELD v103_EA0-CLAIM-LVL-INFO EA0-47-DATE-DOCUMENT-SENT Rule Numbe 8845 Map v.103 EA1 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-01-RECORD-ID = REC FIELD v103_EA1-CLAIM-LVL-INFO-TWO EA1-01-RECORD-ID 2 RECFLD1 = RECFLD2 REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-02-RESERVED = REC FIELD v103_EA1-CLAIM-LVL-INFO-TWO EA1-02-RESERVED 3 RECFLD1 = RECFLD2 REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-03-PAT-CONTROL-NO = REC FIELD v103_EA1-CLAIM-LVL-INFO-TWO EA1-03-PAT-CONTROL-NO 4 RECFLD1 = RECFLD2 REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-04-FACILITY-LAB-ID-NO = REC FIELD v103_EA1-CLAIM-LVL-INFO-TWO EA1-04-FACILITY-LAB-ID-NO 5 RECFLD1 = RECFLD2 REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-05-RESERVED = REC FIELD v103_EA1-CLAIM-LVL-INFO-TWO EA1-05-RESERVED 6 RECFLD1 = RECFLD2 REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-06-FACILITY-LAB-ADDR1 = REC FIELD v103_EA1-CLAIM-LVL-INFO-TWO EA1-06-FACILITY-LAB-ADDR1 7 RECFLD1 = RECFLD2 REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-06-LABORATORY-REDEFINES = REC FIELD v103_EA1-CLAIM-LVL-INFO-TWO EA1-06-LABORATORY-REDEFINES 8 RECFLD1 = RECFLD2 REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-07-FACILITY-LAB-ADDR2 = REC FIELD v103_EA1-CLAIM-LVL-INFO-TWO EA1-07-FACILITY-LAB-ADDR2 9 RECFLD1 = RECFLD2 REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-08-FACILITY-LAB-CITY = REC FIELD v103_EA1-CLAIM-LVL-INFO-TWO EA1-08-FACILITY-LAB-CITY 10 RECFLD1 = RECFLD2 REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-09-FACILITY-LAB-STATE = REC FIELD v103_EA1-CLAIM-LVL-INFO-TWO EA1-09-FACILITY-LAB-STATE 11 RECFLD1 = RECFLD2 REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-10-FACILITY-LAB-ZIP-CODE = REC FIELD v103_EA1-CLAIM-LVL-INFO-TWO EA1-10-FACILITY-LAB-ZIP-CODE 12 RECFLD1 = RECFLD2 REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-11-MEDICAL-RECORD-NUMBER = REC FIELD v103_EA1-CLAIM-LVL-INFO-TWO EA1-11-MEDICAL-RECORD-NUMBER 13 RECFLD1 = RECFLD2 REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-12-RETURN-TO-WORK-DATE = REC FIELD v103_EA1-CLAIM-LVL-INFO-TWO EA1-12-RETURN-TO-WORK-DATE 14 RECFLD1 = RECFLD2 REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-13-CONSULT-SURGERY-DATE = REC FIELD v103_EA1-CLAIM-LVL-INFO-TWO EA1-13-CONSULT-SURGERY-DATE 15 RECFLD1 = RECFLD2 REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-14-ADMISSION-DATE-2 = REC FIELD v103_EA1-CLAIM-LVL-INFO-TWO EA1-14-ADMISSION-DATE-2 16 RECFLD1 = RECFLD2 REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-15-DISCHARGE-DATE-2 = REC FIELD v103_EA1-CLAIM-LVL-INFO-TWO EA1-15-DISCHARGE-DATE-2 17 RECFLD1 = RECFLD2 REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-16-SUPV-PROV-ID-NO = REC FIELD v103_EA1-CLAIM-LVL-INFO-TWO EA1-16-SUPV-PROV-ID-NO 18 RECFLD1 = RECFLD2 REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-17-RESERVED = REC FIELD v103_EA1-CLAIM-LVL-INFO-TWO EA1-17-RESERVED 19 RECFLD1 = RECFLD2 REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-18-SUPR-PROV-LAST = REC FIELD v103_EA1-CLAIM-LVL-INFO-TWO EA1-18-SUPR-PROV-LAST 20 RECFLD1 = RECFLD2 REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-18-SUPV-PROV-REDEFINES = REC FIELD v103_EA1-CLAIM-LVL-INFO-TWO EA1-18-SUPV-PROV-REDEFINES 21 RECFLD1 = RECFLD2 REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-19-SUPV-PROV-FIRST = REC FIELD v103_EA1-CLAIM-LVL-INFO-TWO EA1-19-SUPV-PROV-FIRST 22 RECFLD1 = RECFLD2 REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-20-SUPV-PROV-MI = REC FIELD v103_EA1-CLAIM-LVL-INFO-TWO EA1-20-SUPV-PROV-MI 23 RECFLD1 = RECFLD2 REC FIELD EA1-CLAIM-LVL-INFO-TWO EA1-21-SUPV-PROV-STATE = REC FIELD v103_EA1-CLAIM-LVL-INFO-TWO EA1-21-SUPV-PROV-STATE Rule Numbe 8850 Map v.103 EA2 Record Fields to v.301 Line Command Description 1 Do Nothing Rule Numbe 8855 Map v.103 FA0 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-01-RECORD-ID = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-01-RECORD-ID 2 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-00-GROUP-LEVEL-REDEFINES = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-00-GROUP-LEVEL-REDEFINES 3 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-02-SEQUENCE-NO = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-02-SEQUENCE-NO 4 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-02-SEQUENCE-NUMBER-ALPHA = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-02-SEQUENCE-NUMBER-ALPHA 5 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-03-PAT-CONTROL-NO = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-03-PAT-CONTROL-NO 6 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-04-LINE-ITEM-CONTROL-NO = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-04-LINE-ITEM-CONTROL-NO 7 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-05-SVC-FROM-DATE = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-05-SVC-FROM-DATE 8 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-06-SVC-TO-DATE = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-06-SVC-TO-DATE 9 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-07-PLACE-OF-SVC = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-07-PLACE-OF-SVC 10 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-08-TYPE-OF-SVC-CODE = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-08-TYPE-OF-SVC-CODE 11 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-09-HCPCS-PROCEDURE-CD = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-09-HCPCS-PROCEDURE-CD 12 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-10-HCPCS-MODIFIER-1 = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-10-HCPCS-MODIFIER-1 13 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-11-HCPCS-MODIFIER-2 = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-11-HCPCS-MODIFIER-2 14 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-12-HCPCS-MODIFIER-3 = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-12-HCPCS-MODIFIER-3 15 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-13-LINE-CHARGES = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-13-LINE-CHARGES 16 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-13-LINE-CHARGES-ALPHA = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-13-LINE-CHARGES-ALPHA 17 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-14-DIAG-CODE-POINTER1 = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-14-DIAG-CODE-POINTER1 18 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-15-DIAG-CODE-POINTER2 = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-15-DIAG-CODE-POINTER2 19 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-16-DIAG-CODE-POINTER3 = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-16-DIAG-CODE-POINTER3 20 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-17-DIAG-CODE-POINTER4 = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-17-DIAG-CODE-POINTER4 21 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-18-UNITS-OF-SVC = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-18-UNITS-OF-SVC 22 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-18-UNITS-OF-SVC-ALPHA = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-18-UNITS-OF-SVC-ALPHA 23 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-19-ANES-OXYGEN-MINUTES = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-19-ANES-OXYGEN-MINUTES 24 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-19-ANES-OXY-MIN-ALPHA = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-19-ANES-OXY-MIN-ALPHA 25 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-20-EMERGENCY-IND = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-20-EMERGENCY-IND 26 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-21-COB-IND = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-21-COB-IND 27 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-22-HMSA-IND = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-22-HMSA-IND 28 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-23-RENDERING-PROV-ID = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-23-RENDERING-PROV-ID 29 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-24-REFERRING-PROV-ID = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-24-REFERRING-PROV-ID 30 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-25-REFERRING-PROV-ST = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-25-REFERRING-PROV-ST 31 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-26-PUR-SVC-IND = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-26-PUR-SVC-IND 32 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-27-DISALLOW-COST-ALPHA = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-27-DISALLOW-COST-ALPHA 33 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-27-DISALLOW-COST-CONTAIN = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-27-DISALLOW-COST-CONTAIN 34 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-28-DISALLOW-OTHER = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-28-DISALLOW-OTHER 35 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-28-DISALLOW-OTHER-ALPHA = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-28-DISALLOW-OTHER-ALPHA 36 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-29-REVIEW-BY-CODE-IND = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-29-REVIEW-BY-CODE-IND 37 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-30-MULTI-PROCEDURE-IND = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-30-MULTI-PROCEDURE-IND 38 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-31-MAMMOGRAPHY-CERT-NO = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-31-MAMMOGRAPHY-CERT-NO 39 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-32-CLASS-FINDINGS = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-32-CLASS-FINDINGS 40 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-33-PODIATRY-SVC-COND = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-33-PODIATRY-SVC-COND 41 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-34-CLIA-ID-NO = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-34-CLIA-ID-NO 42 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-35-PRIMARY-PAID-ALPHA = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-35-PRIMARY-PAID-ALPHA 43 RECFLD1 = RECFLD2 REC FIELD FA0-SERVICE-LVL-DETAIL FA0-35-PRIMARY-PAID-AMOUNT = REC FIELD v103_FA0-SERVICE-LVL-DETAIL FA0-35-PRIMARY-PAID-AMOUNT Rule Numbe 8860 Map v.103 FB0 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-01-RECORD-ID = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-01-RECORD-ID 2 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-00-GROUP-LEVEL-REDEFINES = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-00-GROUP-LEVEL-REDEFINES 3 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-02-SEQUENCE-NO = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-02-SEQUENCE-NO 4 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-02-SEQUENCE-NUM-ALPHA = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-02-SEQUENCE-NUM-ALPHA 5 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-03-PAT-CONTROL-NO = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-03-PAT-CONTROL-NO 6 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-04-LINE-ITEM-CONTROL-NO = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-04-LINE-ITEM-CONTROL-NO 7 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-05-PUR-SVC-CHARGE = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-05-PUR-SVC-CHARGE 8 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-05-PUR-SVC-CHARGE-ALPHA = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-05-PUR-SVC-CHARGE-ALPHA 9 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-06-ALLOWED-AMOUNT = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-06-ALLOWED-AMOUNT 10 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-06-ALLOWED-AMOUNT-ALPHA = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-06-ALLOWED-AMOUNT-ALPHA 11 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-07-DEDUCTIBLE-AMOUNT = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-07-DEDUCTIBLE-AMOUNT 12 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-07-DEDUCTIBLE-AMOUNT-ALPHA = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-07-DEDUCTIBLE-AMOUNT-ALPHA 13 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-08-COINSURANCE-AMOUNT = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-08-COINSURANCE-AMOUNT 14 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-08-COINSURANCE-AMT-ALPHA = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-08-COINSURANCE-AMT-ALPHA 15 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-09-ORDERING-PROV-ID = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-09-ORDERING-PROV-ID 16 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-10-ORDERING-PROV-ST = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-10-ORDERING-PROV-ST 17 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-11-PUR-SVC-PROV-ID = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-11-PUR-SVC-PROV-ID 18 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-12-PUR-SVC-STATE = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-12-PUR-SVC-STATE 19 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-13-PEN-GRAMS-OF-PROTEIN = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-13-PEN-GRAMS-ALPHA 20 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-13-PEN-GRAMS-OF-PROTEIN = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-13-PEN-GRAMS-OF-PROTEIN 21 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-14-PEN-CALORIES = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-14-PEN-CALORIES 22 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-15-NATIONAL-DRUG-CODE = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-15-NATIONAL-DRUG-CODE 23 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-16-NATIONAL-DRUG-UNIT-ALPH = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-16-NATIONAL-DRUG-UNIT-ALPH 24 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-16-NATIONAL-DRUG-UNITS = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-16-NATIONAL-DRUG-UNITS 25 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-17-PRESCRIPTION-NO = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-17-PRESCRIPTION-NO 26 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-18-PRESCRIPTION-DATE = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-18-PRESCRIPTION-DATE 27 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-19-PRESCRIPTION-NO-OF-MTHS = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-19-PRESCRIPTION-NO-OF-MTHS 28 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-20-SPEC-PRICING-IND = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-20-SPEC-PRICING-IND 29 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-21-COPAY-STATUS = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-21-COPAY-STATUS 30 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-22-EPSDT-IND = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-22-EPSDT-IND 31 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-23-FAMILY-PLANNING-IND = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-23-FAMILY-PLANNING-IND 32 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-24-DME-CHARGE-IND = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-24-DME-CHARGE-IND 33 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-25-HMSA-FACILITY-ID = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-25-HMSA-FACILITY-ID 34 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-26-HMSA-FACILITY-ZIP = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-26-HMSA-FACILITY-ZIP 35 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-27-PUR-SVC-NAME = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-27-PUR-SVC-NAME 36 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-28-PUR-SVC-ADDR1 = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-28-PUR-SVC-ADDR1 37 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-29-PUR-SVC-ADDR2 = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-29-PUR-SVC-ADDR2 38 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-30-PUR-SVC-CITY = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-30-PUR-SVC-CITY 39 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-31-PUR-SVC-ZIP = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-31-PUR-SVC-ZIP 40 RECFLD1 = RECFLD2 REC FIELD FB0-SERVICE-LVL-DETAIL-MED FB0-32-PUR-SVC-PHONE = REC FIELD v103_FB0-SERVICE-LVL-DETAIL-MED FB0-32-PUR-SVC-PHONE Rule Numbe 8865 Map v.103 FB1 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-01-RECORD-ID = REC FIELD v103_FB1-SERVICE-LVL-DETAIL-MED2 FB1-01-RECORD-ID 2 RECFLD1 = RECFLD2 REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-00-GROUP-LEVEL-REDEFINES = REC FIELD v103_FB1-SERVICE-LVL-DETAIL-MED2 FB1-00-GROUP-LEVEL-REDEFINES 3 RECFLD1 = RECFLD2 REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-02-SEQUENCE-NO = REC FIELD v103_FB1-SERVICE-LVL-DETAIL-MED2 FB1-02-SEQUENCE-NO 4 RECFLD1 = RECFLD2 REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-02-SEQUENCE-NUM-ALPHA = REC FIELD v103_FB1-SERVICE-LVL-DETAIL-MED2 FB1-02-SEQUENCE-NUM-ALPHA 5 RECFLD1 = RECFLD2 REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-03-PAT-CONTROL-NO = REC FIELD v103_FB1-SERVICE-LVL-DETAIL-MED2 FB1-03-PAT-CONTROL-NO 6 RECFLD1 = RECFLD2 REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-04-LINE-ITEM-CONTROL-NO = REC FIELD v103_FB1-SERVICE-LVL-DETAIL-MED2 FB1-04-LINE-ITEM-CONTROL-NO 7 RECFLD1 = RECFLD2 REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-05-PLACE-OF-SVC-NAME = REC FIELD v103_FB1-SERVICE-LVL-DETAIL-MED2 FB1-05-PLACE-OF-SVC-NAME 8 RECFLD1 = RECFLD2 REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-06-ORDERING-PROV-LAST = REC FIELD v103_FB1-SERVICE-LVL-DETAIL-MED2 FB1-06-ORDERING-PROV-LAST 9 RECFLD1 = RECFLD2 REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-07-ORDERING-PROV-FIRST = REC FIELD v103_FB1-SERVICE-LVL-DETAIL-MED2 FB1-07-ORDERING-PROV-FIRST 10 RECFLD1 = RECFLD2 REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-08-ORDERING-PROV-MI = REC FIELD v103_FB1-SERVICE-LVL-DETAIL-MED2 FB1-08-ORDERING-PROV-MI 11 RECFLD1 = RECFLD2 REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-09-ORDERING-PROV-UPIN = REC FIELD v103_FB1-SERVICE-LVL-DETAIL-MED2 FB1-09-ORDERING-PROV-UPIN 12 RECFLD1 = RECFLD2 REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-10-REFERRING-PROV-LAST = REC FIELD v103_FB1-SERVICE-LVL-DETAIL-MED2 FB1-10-REFERRING-PROV-LAST 13 RECFLD1 = RECFLD2 REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-11-REFERRING-PROV-FIRST = REC FIELD v103_FB1-SERVICE-LVL-DETAIL-MED2 FB1-11-REFERRING-PROV-FIRST 14 RECFLD1 = RECFLD2 REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-12-REFERRING-PROV-MI = REC FIELD v103_FB1-SERVICE-LVL-DETAIL-MED2 FB1-12-REFERRING-PROV-MI 15 RECFLD1 = RECFLD2 REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-13-REFERRING-PROV-UPIN = REC FIELD v103_FB1-SERVICE-LVL-DETAIL-MED2 FB1-13-REFERRING-PROV-UPIN 16 RECFLD1 = RECFLD2 REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-14-RENDERING-PROV-LAST = REC FIELD v103_FB1-SERVICE-LVL-DETAIL-MED2 FB1-14-RENDERING-PROV-LAST 17 RECFLD1 = RECFLD2 REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-15-RENDERING-PROV-FIRST = REC FIELD v103_FB1-SERVICE-LVL-DETAIL-MED2 FB1-15-RENDERING-PROV-FIRST 18 RECFLD1 = RECFLD2 REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-16-RENDERING-PROV-MI = REC FIELD v103_FB1-SERVICE-LVL-DETAIL-MED2 FB1-16-RENDERING-PROV-MI 19 RECFLD1 = RECFLD2 REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-17-RENDERING-PROV-UPIN = REC FIELD v103_FB1-SERVICE-LVL-DETAIL-MED2 FB1-17-RENDERING-PROV-UPIN 20 RECFLD1 = RECFLD2 REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-18-SUPERVISING-PROV-LAST = REC FIELD v103_FB1-SERVICE-LVL-DETAIL-MED2 FB1-18-SUPERVISING-PROV-LAST 21 RECFLD1 = RECFLD2 REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-19-SUPERVISING-PROV-FIRST = REC FIELD v103_FB1-SERVICE-LVL-DETAIL-MED2 FB1-19-SUPERVISING-PROV-FIRST 22 RECFLD1 = RECFLD2 REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-19-SUPERVISING-PROV-FIRST = REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-19-SUPERVISING-PROV-FIRST 23 RECFLD1 = RECFLD2 REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-20-SUPERVISING-PROV-MI = REC FIELD v103_FB1-SERVICE-LVL-DETAIL-MED2 FB1-20-SUPERVISING-PROV-MI 24 RECFLD1 = RECFLD2 REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-21-SUPERVISING-PROV-ID = REC FIELD v103_FB1-SERVICE-LVL-DETAIL-MED2 FB1-21-SUPERVISING-PROV-ID 25 RECFLD1 = RECFLD2 REC FIELD FB1-SERVICE-LVL-DETAIL-MED2 FB1-22-SUPERVISING-PROV-UPIN = REC FIELD v103_FB1-SERVICE-LVL-DETAIL-MED2 FB1-22-SUPERVISING-PROV-UPIN Rule Numbe 8870 Map v.103 FB2 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-01-RECORD-ID = REC FIELD v103_FB2-SERVICE LINE DETAIL-MED3 FB2-01-RECORD-ID 2 RECFLD1 = RECFLD2 REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-00-GROUP-LEVEL-REDEFINES = REC FIELD v103_FB2-SERVICE LINE DETAIL-MED3 FB2-00-GROUP-LEVEL-REDEFINES 3 RECFLD1 = RECFLD2 REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-02-SEQUENCE-NO = REC FIELD v103_FB2-SERVICE LINE DETAIL-MED3 FB2-02-SEQUENCE-NO 4 RECFLD1 = RECFLD2 REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-02-SEQUENCE-NUM-ALPHA = REC FIELD v103_FB2-SERVICE LINE DETAIL-MED3 FB2-02-SEQUENCE-NUM-ALPHA 5 RECFLD1 = RECFLD2 REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-03-PAT-CONTROL-NO = REC FIELD v103_FB2-SERVICE LINE DETAIL-MED3 FB2-03-PAT-CONTROL-NO 6 RECFLD1 = RECFLD2 REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-04-LINE-ITEM-CONTROL-NO = REC FIELD v103_FB2-SERVICE LINE DETAIL-MED3 FB2-04-LINE-ITEM-CONTROL-NO 7 RECFLD1 = RECFLD2 REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-05-PROV-TYPE-IND-A = REC FIELD v103_FB2-SERVICE LINE DETAIL-MED3 FB2-05-PROV-TYPE-IND-A 8 RECFLD1 = RECFLD2 REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-06-PROV-A-ADDR-1 = REC FIELD v103_FB2-SERVICE LINE DETAIL-MED3 FB2-06-PROV-A-ADDR-1 9 RECFLD1 = RECFLD2 REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-07-PROV-A-ADDR-2 = REC FIELD v103_FB2-SERVICE LINE DETAIL-MED3 FB2-07-PROV-A-ADDR-2 10 RECFLD1 = RECFLD2 REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-08-PROV-A-CITY = REC FIELD v103_FB2-SERVICE LINE DETAIL-MED3 FB2-08-PROV-A-CITY 11 RECFLD1 = RECFLD2 REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-09-PROV-A-STATE = REC FIELD v103_FB2-SERVICE LINE DETAIL-MED3 FB2-09-PROV-A-STATE 12 RECFLD1 = RECFLD2 REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-10-PROV-A-ZIP = REC FIELD v103_FB2-SERVICE LINE DETAIL-MED3 FB2-10-PROV-A-ZIP 13 RECFLD1 = RECFLD2 REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-11-PROV-TYPE-IND-B = REC FIELD v103_FB2-SERVICE LINE DETAIL-MED3 FB2-11-PROV-TYPE-IND-B 14 RECFLD1 = RECFLD2 REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-12-PROV-B-ADDR-1 = REC FIELD v103_FB2-SERVICE LINE DETAIL-MED3 FB2-12-PROV-B-ADDR-1 15 RECFLD1 = RECFLD2 REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-13-PROV-B-ADDR-2 = REC FIELD v103_FB2-SERVICE LINE DETAIL-MED3 FB2-13-PROV-B-ADDR-2 16 RECFLD1 = RECFLD2 REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-14-PROV-B-CITY = REC FIELD v103_FB2-SERVICE LINE DETAIL-MED3 FB2-14-PROV-B-CITY 17 RECFLD1 = RECFLD2 REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-15-PROV-B-STATE = REC FIELD v103_FB2-SERVICE LINE DETAIL-MED3 FB2-15-PROV-B-STATE 18 RECFLD1 = RECFLD2 REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-16-PROV-B-ZIP = REC FIELD v103_FB2-SERVICE LINE DETAIL-MED3 FB2-16-PROV-B-ZIP 19 RECFLD1 = RECFLD2 REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-17-PROV-TYPE-IND-C = REC FIELD v103_FB2-SERVICE LINE DETAIL-MED3 FB2-17-PROV-TYPE-IND-C 20 RECFLD1 = RECFLD2 REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-18-PROV-C-ADDR-1 = REC FIELD v103_FB2-SERVICE LINE DETAIL-MED3 FB2-18-PROV-C-ADDR-1 21 RECFLD1 = RECFLD2 REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-19-PROV-C-ADDR-2 = REC FIELD v103_FB2-SERVICE LINE DETAIL-MED3 FB2-19-PROV-C-ADDR-2 22 RECFLD1 = RECFLD2 REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-20-PROV-C-CITY = REC FIELD v103_FB2-SERVICE LINE DETAIL-MED3 FB2-20-PROV-C-CITY 23 RECFLD1 = RECFLD2 REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-21-PROV-C-STATE = REC FIELD v103_FB2-SERVICE LINE DETAIL-MED3 FB2-21-PROV-C-STATE 24 RECFLD1 = RECFLD2 REC FIELD FB2-SERVICE LINE DETAIL-MED3 FB2-22-PROV-C-ZIP = REC FIELD v103_FB2-SERVICE LINE DETAIL-MED3 FB2-22-PROV-C-ZIP Rule Numbe 8875 Map v.103 FD0 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-01-RECORD-ID = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-01-RECORD-ID 2 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-00-GROUP-LEVEL-REDEFINES = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-00-GROUP-LEVEL-REDEFINES 3 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-02-SEQUENCE-NO = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-02-SEQUENCE-NO 4 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-02-SEQUENCE-NUM-ALPHA = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-02-SEQUENCE-NUM-ALPHA 5 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-03-PAT-CONTROL-NO = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-03-PAT-CONTROL-NO 6 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-04-LINE-ITEM-CONTROL-NO = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-04-LINE-ITEM-CONTROL-NO 7 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-05-TOOTH-CODE-NUMBER-1 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-05-TOOTH-CODE-NUMBER-1 8 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-06-TOOTH-SURFACE-1 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-06-TOOTH-SURFACE-1 9 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-07-TOOTH-CODE-NUMBER-2 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-07-TOOTH-CODE-NUMBER-2 10 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-08-TOOTH-SURFACE-2 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-08-TOOTH-SURFACE-2 11 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-09-TOOTH-CODE-NUMBER-3 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-09-TOOTH-CODE-NUMBER-3 12 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-10-TOOTH-SURFACE-3 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-10-TOOTH-SURFACE-3 13 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-11-TOOTH-CODE-NUMBER-4 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-11-TOOTH-CODE-NUMBER-4 14 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-12-TOOTH-SURFACE-4 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-12-TOOTH-SURFACE-4 15 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-13-INITIAL-PLACE-IND = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-13-INITIAL-PLACE-IND 16 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-14-PRIOR-PLACE-DATE = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-14-PRIOR-PLACE-DATE 17 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-15-IMPRESS-PRESCRIPT-DT = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-15-IMPRESS-PRESCRIPT-DT 18 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-16-REPLACEMENT-REASON = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-16-REPLACEMENT-REASON 19 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-17-ORTHO-TREAT-IND = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-17-ORTHO-TREAT-IND 20 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-18-TREATMENT-LENGTH = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-18-TREATMENT-LENGTH 21 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-19-DATE-APPL-INSERTED = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-19-DATE-APPL-INSERTED 22 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-20-DATE-APPL-REMOVED = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-20-DATE-APPL-REMOVED 23 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-21-RESERVED = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-21-RESERVED 24 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-22-DATE-APPL-REPLACED = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-22-DATE-APPL-REPLACED 25 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-23-MOS-TREAT-REMAINING = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-23-MOS-TREAT-REMAINING 26 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-24-DT-1ST-VISIT-CUR-SER = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-24-DT-1ST-VISIT-CUR-SER 27 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-25-RESERVED = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-25-RESERVED 28 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-26-PRE-DETERMINATION-ID = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-26-PRE-DETERMINATION-ID 29 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-27-RESERVED = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-27-RESERVED 30 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-28-MISSING-PRIMARY-TEETH = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-28-MISSING-PRIMARY-TEETH 31 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-29-MISSING-PERM-TOOTH-1 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-29-MISSING-PERM-TOOTH-1 32 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-30-MISSING-PERM-TOOTH-2 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-30-MISSING-PERM-TOOTH-2 33 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-31-MISSING-PERM-TOOTH-3 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-31-MISSING-PERM-TOOTH-3 34 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-32-MISSING-PERM-TOOTH-4 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-32-MISSING-PERM-TOOTH-4 35 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-33-MISSING-PERM-TOOTH-5 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-33-MISSING-PERM-TOOTH-5 36 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-34-MISSING-PERM-TOOTH-6 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-34-MISSING-PERM-TOOTH-6 37 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-35-MISSING-PERM-TOOTH-7 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-35-MISSING-PERM-TOOTH-7 38 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-36-MISSING-PERM-TOOTH-8 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-36-MISSING-PERM-TOOTH-8 39 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-37-MISSING-PERM-TOOTH-9 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-37-MISSING-PERM-TOOTH-9 40 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-38-MISSING-PERM-TOOTH-10 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-38-MISSING-PERM-TOOTH-10 41 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-39-MISSING-PERM-TOOTH-11 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-39-MISSING-PERM-TOOTH-11 42 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-40-MISSING-PERM-TOOTH-12 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-40-MISSING-PERM-TOOTH-12 43 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-41-MISSING-PERM-TOOTH-13 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-41-MISSING-PERM-TOOTH-13 44 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-42-MISSING-PERM-TOOTH-14 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-42-MISSING-PERM-TOOTH-14 45 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-43-MISSING-PERM-TOOTH-15 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-43-MISSING-PERM-TOOTH-15 46 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-44-MISSING-PERM-TOOTH-16 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-44-MISSING-PERM-TOOTH-16 47 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-45-MISSING-PERM-TOOTH-17 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-45-MISSING-PERM-TOOTH-17 48 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-46-MISSING-PERM-TOOTH-18 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-46-MISSING-PERM-TOOTH-18 49 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-47-MISSING-PERM-TOOTH-19 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-47-MISSING-PERM-TOOTH-19 50 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-48-MISSING-PERM-TOOTH-20 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-48-MISSING-PERM-TOOTH-20 51 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-49-MISSING-PERM-TOOTH-21 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-49-MISSING-PERM-TOOTH-21 52 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-50-MISSING-PERM-TOOTH-22 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-50-MISSING-PERM-TOOTH-22 53 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-51-MISSING-PERM-TOOTH-23 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-51-MISSING-PERM-TOOTH-23 54 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-52-MISSING-PERM-TOOTH-24 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-52-MISSING-PERM-TOOTH-24 55 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-53-MISSING-PERM-TOOTH-25 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-53-MISSING-PERM-TOOTH-25 56 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-54-MISSING-PERM-TOOTH-26 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-54-MISSING-PERM-TOOTH-26 57 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-55-MISSING-PERM-TOOTH-27 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-55-MISSING-PERM-TOOTH-27 58 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-56-MISSING-PERM-TOOTH-28 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-56-MISSING-PERM-TOOTH-28 59 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-57-MISSING-PERM-TOOTH-29 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-57-MISSING-PERM-TOOTH-29 60 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-58-MISSING-PERM-TOOTH-30 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-58-MISSING-PERM-TOOTH-30 61 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-59-MISSING-PERM-TOOTH-31 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-59-MISSING-PERM-TOOTH-31 62 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-60-MISSING-PERM-TOOTH-32 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-60-MISSING-PERM-TOOTH-32 63 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-61-MISSING-PERM-TOOTH-33 = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-61-MISSING-PERM-TOOTH-33 64 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-62-QUADRANT = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-62-QUADRANT 65 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-63-TOOTH-POCKET-MEASURE = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-63-TOOTH-POCKET-MEASURE 66 RECFLD1 = RECFLD2 REC FIELD FD0-SERVICE-DETAIL-DENTAL FD0-64-FILLER-NATIONAL = REC FIELD v103_FD0-SERVICE-DETAIL-DENTAL FD0-64-FILLER-NATIONAL Rule Numbe 8880 Map v.103 GA0 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD GA0-AMBULANCE-CERT-REC GA0-01-RECORD-ID = REC FIELD v103_GA0-AMBULANCE-CERT-REC GA0-01-RECORD-ID 2 RECFLD1 = RECFLD2 REC FIELD GA0-AMBULANCE-CERT-REC GA0-00-GROUP-LEVEL-REDEFINES = REC FIELD v103_GA0-AMBULANCE-CERT-REC GA0-00-GROUP-LEVEL-REDEFINES 3 RECFLD1 = RECFLD2 REC FIELD GA0-AMBULANCE-CERT-REC GA0-02-SEQUENCE-NO = REC FIELD v103_GA0-AMBULANCE-CERT-REC GA0-02-SEQUENCE-NO 4 RECFLD1 = RECFLD2 REC FIELD GA0-AMBULANCE-CERT-REC GA0-02-SEQUENCE-NUM-ALPHA = REC FIELD v103_GA0-AMBULANCE-CERT-REC GA0-02-SEQUENCE-NUM-ALPHA 5 RECFLD1 = RECFLD2 REC FIELD GA0-AMBULANCE-CERT-REC GA0-03-PAT-CONTROL-NO = REC FIELD v103_GA0-AMBULANCE-CERT-REC GA0-03-PAT-CONTROL-NO 6 RECFLD1 = RECFLD2 REC FIELD GA0-AMBULANCE-CERT-REC GA0-04-RESERVED = REC FIELD v103_GA0-AMBULANCE-CERT-REC GA0-04-RESERVED 7 RECFLD1 = RECFLD2 REC FIELD GA0-AMBULANCE-CERT-REC GA0-05-PATIENTS-WEIGHT = REC FIELD v103_GA0-AMBULANCE-CERT-REC GA0-05-PATIENTS-WEIGHT 8 RECFLD1 = RECFLD2 REC FIELD GA0-AMBULANCE-CERT-REC GA0-06-HOSPITAL-ADMIT = REC FIELD v103_GA0-AMBULANCE-CERT-REC GA0-06-HOSPITAL-ADMIT 9 RECFLD1 = RECFLD2 REC FIELD GA0-AMBULANCE-CERT-REC GA0-07-TYPE-OF-TRANSPORT = REC FIELD v103_GA0-AMBULANCE-CERT-REC GA0-07-TYPE-OF-TRANSPORT 10 RECFLD1 = RECFLD2 REC FIELD GA0-AMBULANCE-CERT-REC GA0-08-BED-CONFINED-BEFORE = REC FIELD v103_GA0-AMBULANCE-CERT-REC GA0-08-BED-CONFINED-BEFORE 11 RECFLD1 = RECFLD2 REC FIELD GA0-AMBULANCE-CERT-REC GA0-09-BED-CONFINED-AFTER = REC FIELD v103_GA0-AMBULANCE-CERT-REC GA0-09-BED-CONFINED-AFTER 12 RECFLD1 = RECFLD2 REC FIELD GA0-AMBULANCE-CERT-REC GA0-10-MOVED-BY-STRETCHER = REC FIELD v103_GA0-AMBULANCE-CERT-REC GA0-10-MOVED-BY-STRETCHER 13 RECFLD1 = RECFLD2 REC FIELD GA0-AMBULANCE-CERT-REC GA0-11-UNCONSCIOUS-SHOCK-IND = REC FIELD v103_GA0-AMBULANCE-CERT-REC GA0-11-UNCONSCIOUS-SHOCK-IND 14 RECFLD1 = RECFLD2 REC FIELD GA0-AMBULANCE-CERT-REC GA0-12-EMERGENCY-SITUATION = REC FIELD v103_GA0-AMBULANCE-CERT-REC GA0-12-EMERGENCY-SITUATION 15 RECFLD1 = RECFLD2 REC FIELD GA0-AMBULANCE-CERT-REC GA0-13-PHYSICAL-RESTRAINTS = REC FIELD v103_GA0-AMBULANCE-CERT-REC GA0-13-PHYSICAL-RESTRAINTS 16 RECFLD1 = RECFLD2 REC FIELD GA0-AMBULANCE-CERT-REC GA0-14-VISIBLE-HEMORRHAGING = REC FIELD v103_GA0-AMBULANCE-CERT-REC GA0-14-VISIBLE-HEMORRHAGING 17 RECFLD1 = RECFLD2 REC FIELD GA0-AMBULANCE-CERT-REC GA0-15-TRANSPORTED-TO-FOR = REC FIELD v103_GA0-AMBULANCE-CERT-REC GA0-15-TRANSPORTED-TO-FOR 18 RECFLD1 = RECFLD2 REC FIELD GA0-AMBULANCE-CERT-REC GA0-16-MEDICALLY-NECESSARY = REC FIELD v103_GA0-AMBULANCE-CERT-REC GA0-16-MEDICALLY-NECESSARY 19 RECFLD1 = RECFLD2 REC FIELD GA0-AMBULANCE-CERT-REC GA0-17-MILES = REC FIELD v103_GA0-AMBULANCE-CERT-REC GA0-17-MILES 20 RECFLD1 = RECFLD2 REC FIELD GA0-AMBULANCE-CERT-REC GA0-18-ORIGIN-INFO = REC FIELD v103_GA0-AMBULANCE-CERT-REC GA0-18-ORIGIN-INFO 21 RECFLD1 = RECFLD2 REC FIELD GA0-AMBULANCE-CERT-REC GA0-19-DESTINATION-INFO = REC FIELD v103_GA0-AMBULANCE-CERT-REC GA0-19-DESTINATION-INFO 22 RECFLD1 = RECFLD2 REC FIELD GA0-AMBULANCE-CERT-REC GA0-20-PURPOSE-OF-ROUND-TRIP = REC FIELD v103_GA0-AMBULANCE-CERT-REC GA0-20-PURPOSE-OF-ROUND-TRIP 23 RECFLD1 = RECFLD2 REC FIELD GA0-AMBULANCE-CERT-REC GA0-21-PURPOSE-OF-STRETCHER = REC FIELD v103_GA0-AMBULANCE-CERT-REC GA0-21-PURPOSE-OF-STRETCHER Rule Numbe 8885 Map v.103 GC0 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD GC0-CHIROPRACTIC-CERT-RECORD GC0-01-RECORD-ID = REC FIELD v103_GC0-CHIROPRACTIC-CERT-RECORD GC0-01-RECORD-ID 2 RECFLD1 = RECFLD2 REC FIELD GC0-CHIROPRACTIC-CERT-RECORD GC0-00-GROUP-LEVEL-REDEFINES = REC FIELD v103_GC0-CHIROPRACTIC-CERT-RECORD GC0-00-GROUP-LEVEL-REDEFINES 3 RECFLD1 = RECFLD2 REC FIELD GC0-CHIROPRACTIC-CERT-RECORD GC0-02-SEQUENCE-NO = REC FIELD v103_GC0-CHIROPRACTIC-CERT-RECORD GC0-02-SEQUENCE-NO 4 RECFLD1 = RECFLD2 REC FIELD GC0-CHIROPRACTIC-CERT-RECORD GC0-02-SEQUENCE-NUM-ALPHA = REC FIELD v103_GC0-CHIROPRACTIC-CERT-RECORD GC0-02-SEQUENCE-NUM-ALPHA 5 RECFLD1 = RECFLD2 REC FIELD GC0-CHIROPRACTIC-CERT-RECORD GC0-03-PAT-CONTROL-NO = REC FIELD v103_GC0-CHIROPRACTIC-CERT-RECORD GC0-03-PAT-CONTROL-NO 6 RECFLD1 = RECFLD2 REC FIELD GC0-CHIROPRACTIC-CERT-RECORD GC0-04-RESERVED = REC FIELD v103_GC0-CHIROPRACTIC-CERT-RECORD GC0-04-RESERVED 7 RECFLD1 = RECFLD2 REC FIELD GC0-CHIROPRACTIC-CERT-RECORD GC0-05-INITIAL-TREATMENT-DATE = REC FIELD v103_GC0-CHIROPRACTIC-CERT-RECORD GC0-05-INITIAL-TREATMENT-DATE 8 RECFLD1 = RECFLD2 REC FIELD GC0-CHIROPRACTIC-CERT-RECORD GC0-06-DATE-OF-LAST-XRAY = REC FIELD v103_GC0-CHIROPRACTIC-CERT-RECORD GC0-06-DATE-OF-LAST-XRAY 9 RECFLD1 = RECFLD2 REC FIELD GC0-CHIROPRACTIC-CERT-RECORD GC0-07-COUNT-WITHIN-SERIES = REC FIELD v103_GC0-CHIROPRACTIC-CERT-RECORD GC0-07-COUNT-WITHIN-SERIES 10 RECFLD1 = RECFLD2 REC FIELD GC0-CHIROPRACTIC-CERT-RECORD GC0-07-FILLER = REC FIELD v103_GC0-CHIROPRACTIC-CERT-RECORD GC0-07-FILLER 11 RECFLD1 = RECFLD2 REC FIELD GC0-CHIROPRACTIC-CERT-RECORD GC0-07-NO-IN-SERIES = REC FIELD v103_GC0-CHIROPRACTIC-CERT-RECORD GC0-07-NO-IN-SERIES 12 RECFLD1 = RECFLD2 REC FIELD GC0-CHIROPRACTIC-CERT-RECORD GC0-08-LEVEL-OF-SUBLUXATION-1 = REC FIELD v103_GC0-CHIROPRACTIC-CERT-RECORD GC0-08-LEVEL-OF-SUBLUXATION-1 13 RECFLD1 = RECFLD2 REC FIELD GC0-CHIROPRACTIC-CERT-RECORD GC0-08-FILLER = REC FIELD v103_GC0-CHIROPRACTIC-CERT-RECORD GC0-08-FILLER 14 RECFLD1 = RECFLD2 REC FIELD GC0-CHIROPRACTIC-CERT-RECORD GC0-08-LEVEL-OF-SUBLUXATION-2 = REC FIELD v103_GC0-CHIROPRACTIC-CERT-RECORD GC0-08-LEVEL-OF-SUBLUXATION-2 15 RECFLD1 = RECFLD2 REC FIELD GC0-CHIROPRACTIC-CERT-RECORD GC0-09-TREATMENT-MO-YR-IND = REC FIELD v103_GC0-CHIROPRACTIC-CERT-RECORD GC0-09-TREATMENT-MO-YR-IND 16 RECFLD1 = RECFLD2 REC FIELD GC0-CHIROPRACTIC-CERT-RECORD GC0-09-TREATMENT-MO-YRS-AMT = REC FIELD v103_GC0-CHIROPRACTIC-CERT-RECORD GC0-09-TREATMENT-MO-YRS-AMT 17 RECFLD1 = RECFLD2 REC FIELD GC0-CHIROPRACTIC-CERT-RECORD GC0-10-NO-TREATMENT-MONTH = REC FIELD v103_GC0-CHIROPRACTIC-CERT-RECORD GC0-10-NO-TREATMENT-MONTH 18 RECFLD1 = RECFLD2 REC FIELD GC0-CHIROPRACTIC-CERT-RECORD GC0-11-NATURE-OF-CONDITION = REC FIELD v103_GC0-CHIROPRACTIC-CERT-RECORD GC0-11-NATURE-OF-CONDITION 19 RECFLD1 = RECFLD2 REC FIELD GC0-CHIROPRACTIC-CERT-RECORD GC0-12-DATE-OF-MANIFESTATION = REC FIELD v103_GC0-CHIROPRACTIC-CERT-RECORD GC0-12-DATE-OF-MANIFESTATION 20 RECFLD1 = RECFLD2 REC FIELD GC0-CHIROPRACTIC-CERT-RECORD GC0-13-COMPLICATION-IND = REC FIELD v103_GC0-CHIROPRACTIC-CERT-RECORD GC0-13-COMPLICATION-IND 21 RECFLD1 = RECFLD2 REC FIELD GC0-CHIROPRACTIC-CERT-RECORD GC0-14-SYMPTOMS-DESRIPTION = REC FIELD v103_GC0-CHIROPRACTIC-CERT-RECORD GC0-14-SYMPTOMS-DESRIPTION Rule Numbe 8890 Map v.103 GD0 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-01-RECORD-ID = REC FIELD v103_GD0-DME-CERT-RECORD GD0-01-RECORD-ID 2 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-00-GROUP-LEVEL-REDEFINES = REC FIELD v103_GD0-DME-CERT-RECORD GD0-00-GROUP-LEVEL-REDEFINES 3 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-02-SEQUENCE-NO = REC FIELD v103_GD0-DME-CERT-RECORD GD0-02-SEQUENCE-NO 4 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-02-SEQUENCE-NUM-ALPHA = REC FIELD v103_GD0-DME-CERT-RECORD GD0-02-SEQUENCE-NUM-ALPHA 5 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-03-PAT-CONTROL-NO = REC FIELD v103_GD0-DME-CERT-RECORD GD0-03-PAT-CONTROL-NO 6 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-04-CERTIFICATION-TYPE = REC FIELD v103_GD0-DME-CERT-RECORD GD0-04-CERTIFICATION-TYPE 7 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-05-MEDICAL-NECESSITY = REC FIELD v103_GD0-DME-CERT-RECORD GD0-05-MEDICAL-NECESSITY 8 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-06-PROGNOSIS = REC FIELD v103_GD0-DME-CERT-RECORD GD0-06-PROGNOSIS 9 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-07-HCPCS PROCEDURE-CODE = REC FIELD v103_GD0-DME-CERT-RECORD GD0-07-HCPCS PROCEDURE-CODE 10 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-08-AMBULATORY = REC FIELD v103_GD0-DME-CERT-RECORD GD0-08-AMBULATORY 11 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-09-AMBULATION-THERAPY = REC FIELD v103_GD0-DME-CERT-RECORD GD0-09-AMBULATION-THERAPY 12 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-10-CONFINED-BED-CHAIR = REC FIELD v103_GD0-DME-CERT-RECORD GD0-10-CONFINED-BED-CHAIR 13 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-11-ROOM-CONFINED = REC FIELD v103_GD0-DME-CERT-RECORD GD0-11-ROOM-CONFINED 14 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-12-AMBULATION-MOBILITY = REC FIELD v103_GD0-DME-CERT-RECORD GD0-12-AMBULATION-MOBILITY 15 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-13-BODY-POSITIONING = REC FIELD v103_GD0-DME-CERT-RECORD GD0-13-BODY-POSITIONING 16 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-14-RESPIRATORY-OTHER = REC FIELD v103_GD0-DME-CERT-RECORD GD0-14-RESPIRATORY-OTHER 17 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-15-BREATHING-IMPAIRED = REC FIELD v103_GD0-DME-CERT-RECORD GD0-15-BREATHING-IMPAIRED 18 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-16-FREQ-IMMED-CHANGES = REC FIELD v103_GD0-DME-CERT-RECORD GD0-16-FREQ-IMMED-CHANGES 19 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-17-OPERATE-CONTROLS = REC FIELD v103_GD0-DME-CERT-RECORD GD0-17-OPERATE-CONTROLS 20 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-18-SIDERAILS-PART-BED = REC FIELD v103_GD0-DME-CERT-RECORD GD0-18-SIDERAILS-PART-BED 21 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-19-OWNS-EQUIPMENT = REC FIELD v103_GD0-DME-CERT-RECORD GD0-19-OWNS-EQUIPMENT 22 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-20-MATTRESS-SIDERAILS = REC FIELD v103_GD0-DME-CERT-RECORD GD0-20-MATTRESS-SIDERAILS 23 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-21-EQUIPMENT-ASSISTANCE = REC FIELD v103_GD0-DME-CERT-RECORD GD0-21-EQUIPMENT-ASSISTANCE 24 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-22-ORTHOPEDIC-IMPAIR = REC FIELD v103_GD0-DME-CERT-RECORD GD0-22-ORTHOPEDIC-IMPAIR 25 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-23-PLANNED-REGIMEN = REC FIELD v103_GD0-DME-CERT-RECORD GD0-23-PLANNED-REGIMEN 26 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-24-DECUBITUS-ULCERS = REC FIELD v103_GD0-DME-CERT-RECORD GD0-24-DECUBITUS-ULCERS 27 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-25-EQUIPMENT-USE = REC FIELD v103_GD0-DME-CERT-RECORD GD0-25-EQUIPMENT-USE 28 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-26-INSULIN-DEPENDENT = REC FIELD v103_GD0-DME-CERT-RECORD GD0-26-INSULIN-DEPENDENT 29 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-27-DIABETIC-CONTROL = REC FIELD v103_GD0-DME-CERT-RECORD GD0-27-DIABETIC-CONTROL 30 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-28-APNEA-EPISODES = REC FIELD v103_GD0-DME-CERT-RECORD GD0-28-APNEA-EPISODES 31 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-29-SURGERY-ALTERNATIVE = REC FIELD v103_GD0-DME-CERT-RECORD GD0-29-SURGERY-ALTERNATIVE 32 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-30-TOTAL-KNEE-REPLACE = REC FIELD v103_GD0-DME-CERT-RECORD GD0-30-TOTAL-KNEE-REPLACE 33 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-31-DATE-SURGERY = REC FIELD v103_GD0-DME-CERT-RECORD GD0-31-DATE-SURGERY 34 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-32-DATE-CPM = REC FIELD v103_GD0-DME-CERT-RECORD GD0-32-DATE-CPM 35 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-33-LYMPHEDEMA = REC FIELD v103_GD0-DME-CERT-RECORD GD0-33-LYMPHEDEMA 36 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-34-ORDERING-PROV-LAST = REC FIELD v103_GD0-DME-CERT-RECORD GD0-34-ORDERING-PROV-LAST 37 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-35-ORDERING-PROV-FIRST = REC FIELD v103_GD0-DME-CERT-RECORD GD0-35-ORDERING-PROV-FIRST 38 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-36-ORDERING-PROV-MI = REC FIELD v103_GD0-DME-CERT-RECORD GD0-36-ORDERING-PROV-MI 39 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-37-ORDERING-PROV-ID = REC FIELD v103_GD0-DME-CERT-RECORD GD0-37-ORDERING-PROV-ID 40 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-38-ORDERING-PROV-PHONE = REC FIELD v103_GD0-DME-CERT-RECORD GD0-38-ORDERING-PROV-PHONE 41 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-39-DATE-CERTIFICATION = REC FIELD v103_GD0-DME-CERT-RECORD GD0-39-DATE-CERTIFICATION 42 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-40-CERTIFICATION-ON-FILE = REC FIELD v103_GD0-DME-CERT-RECORD GD0-40-CERTIFICATION-ON-FILE 43 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-41-DIAGNOSIS-CODE-1 = REC FIELD v103_GD0-DME-CERT-RECORD GD0-41-DIAGNOSIS-CODE-1 44 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-42-DIAGNOSIS-CODE-2 = REC FIELD v103_GD0-DME-CERT-RECORD GD0-42-DIAGNOSIS-CODE-2 45 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-43-DIAGNOSIS-CODE-3 = REC FIELD v103_GD0-DME-CERT-RECORD GD0-43-DIAGNOSIS-CODE-3 46 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-44-DIAGNOSIS-CODE-4 = REC FIELD v103_GD0-DME-CERT-RECORD GD0-44-DIAGNOSIS-CODE-4 47 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-45-NURSING-HOME-IND = REC FIELD v103_GD0-DME-CERT-RECORD GD0-45-NURSING-HOME-IND 48 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-46-NH-FROM-DATE = REC FIELD v103_GD0-DME-CERT-RECORD GD0-46-NH-FROM-DATE 49 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-47-NH-TO-DATE = REC FIELD v103_GD0-DME-CERT-RECORD GD0-47-NH-TO-DATE 50 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-48-RESPIRATORY-TRACT = REC FIELD v103_GD0-DME-CERT-RECORD GD0-48-RESPIRATORY-TRACT 51 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-49-SUPV-OF-EQUIPMENT-USE = REC FIELD v103_GD0-DME-CERT-RECORD GD0-49-SUPV-OF-EQUIPMENT-USE 52 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-50-PROPEL-LIFT-CHAIR = REC FIELD v103_GD0-DME-CERT-RECORD GD0-50-PROPEL-LIFT-CHAIR 53 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-51-LEG-ELEVATION = REC FIELD v103_GD0-DME-CERT-RECORD GD0-51-LEG-ELEVATION 54 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-52-PATIENT-WEIGHT = REC FIELD v103_GD0-DME-CERT-RECORD GD0-52-PATIENT-WEIGHT 55 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-53-RECLINING-WHEELCHAIR = REC FIELD v103_GD0-DME-CERT-RECORD GD0-53-RECLINING-WHEELCHAIR 56 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-54-MANUAL-OPERATION = REC FIELD v103_GD0-DME-CERT-RECORD GD0-54-MANUAL-OPERATION 57 RECFLD1 = RECFLD2 REC FIELD GD0-DME-CERT-RECORD GD0-55-SIDE-TRANSFER-CHAIR = REC FIELD v103_GD0-DME-CERT-RECORD GD0-55-SIDE-TRANSFER-CHAIR Rule Numbe 8895 Map v.103 GD1 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD GD1-DME-NARR-REC GD1-01-RECORD-ID = REC FIELD v103_GD1-DME-NARR-REC GD1-01-RECORD-ID 2 RECFLD1 = RECFLD2 REC FIELD GD1-DME-NARR-REC GD1-00-GROUP-LEVEL-REDEFINES = REC FIELD v103_GD1-DME-NARR-REC GD1-00-GROUP-LEVEL-REDEFINES 3 RECFLD1 = RECFLD2 REC FIELD GD1-DME-NARR-REC GD1-02-SEQUENCE-NO = REC FIELD v103_GD1-DME-NARR-REC GD1-02-SEQUENCE-NO 4 RECFLD1 = RECFLD2 REC FIELD GD1-DME-NARR-REC GD1-02-SEQUENCE-NUM-ALPHA = REC FIELD v103_GD1-DME-NARR-REC GD1-02-SEQUENCE-NUM-ALPHA 5 RECFLD1 = RECFLD2 REC FIELD GD1-DME-NARR-REC GD1-03-PAT-CONTROL-NO = REC FIELD v103_GD1-DME-NARR-REC GD1-03-PAT-CONTROL-NO 6 RECFLD1 = RECFLD2 REC FIELD GD1-DME-NARR-REC GD1-04-NARRATIVE = REC FIELD v103_GD1-DME-NARR-REC GD1-04-NARRATIVE Rule Numbe 8900 Map v.103 GE0 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-01-RECORD-ID = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-01-RECORD-ID 2 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-02-SEQUENCE-NO = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-02-SEQUENCE-NO 3 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-02-SEQUENCE-NUM-ALPHA = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-02-SEQUENCE-NUM-ALPHA 4 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-03-PAT-CONTROL-NO = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-03-PAT-CONTROL-NO 5 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-04-CERTIFICATION-TYPE = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-04-CERTIFICATION-TYPE 6 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-05-ONSET-DT-OF-THERAPY = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-05-ONSET-DT-OF-THERAPY 7 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-06-THERAPY-DURATION = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-06-THERAPY-DURATION 8 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-07-LAST-CERT-DATE = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-07-LAST-CERT-DATE 9 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-08-NO-MONTHS-CERT = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-08-NO-MONTHS-CERT 10 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-09-DT-LAST-SEEN-BY-PHY = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-09-DT-LAST-SEEN-BY-PHY 11 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-10-NON-VISIT-IND = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-10-NON-VISIT-IND 12 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-11-PAT-AGE = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-11-PAT-AGE 13 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-12-PAT-HEIGHT = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-12-PAT-HEIGHT 14 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-13-PAT-WEIGHT = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-13-PAT-WEIGHT 15 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-14-LEVEL-OF-CONS-IND = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-14-LEVEL-OF-CONS-IND 16 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-15-AMBULATORY-IND = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-15-AMBULATORY-IND 17 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-16-OTHER-FORMS-OF-NUTR-IND = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-16-OTHER-FORMS-OF-NUTR-IND 18 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-17-METHOD-ADMIN-IND = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-17-METHOD-ADMIN-IND 19 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-18-ADMIN-TECH-IND = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-18-ADMIN-TECH-IND 20 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-19-TOTAL-CAL-PER-DAY = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-19-TOTAL-CAL-PER-DAY 21 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-20-PRODUCT-NAME-1 = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-20-PRODUCT-NAME-1 22 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-21-CAL-PER-PRODUCT-1 = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-21-CAL-PER-PRODUCT-1 23 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-22-HCPCS-PROCEDURE-CODE = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-22-HCPCS-PROCEDURE-CODE 24 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-23-HCPCS-MODIFIER-1 = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-23-HCPCS-MODIFIER-1 25 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-24-HCPCS-MODIFIER-2 = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-24-HCPCS-MODIFIER-2 26 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-25-ENTERAL-FREQ-FED-1 = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-25-ENTERAL-FREQ-FED-1 27 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-26-NARRATIVE-FIELD = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-26-NARRATIVE-FIELD 28 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-27-PRODUCT-NAME-2 = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-27-PRODUCT-NAME-2 29 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-28-CAL-PER-PRODUCT-2 = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-28-CAL-PER-PRODUCT-2 30 RECFLD1 = RECFLD2 REC FIELD GE0-ENTERAL-NUTRITION-THER-REC GE0-29-ENTERAL-FREQ-FED-2 = REC FIELD v103_GE0-ENTERAL-NUTRITION-THER-REC GE0-29-ENTERAL-FREQ-FED-2 Rule Numbe 8905 Map v.103 GP0 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-01-RECORD-ID = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-01-RECORD-ID 2 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-02-SEQUENCE-NO = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-02-SEQUENCE-NO 3 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-02-SEQUENCE-NUM-ALPHA = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-02-SEQUENCE-NUM-ALPHA 4 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-03-PAT-CONTROL-NO = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-03-PAT-CONTROL-NO 5 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-04-CERTIFICATION-TYPE = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-04-CERTIFICATION-TYPE 6 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-05-ONSET-DT-OF-THERAPY = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-05-ONSET-DT-OF-THERAPY 7 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-06-THERAPY-DURATION = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-06-THERAPY-DURATION 8 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-07-LAST-CERT-DATE = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-07-LAST-CERT-DATE 9 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-08-NO-OF-MONTHS-CERT = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-08-NO-OF-MONTHS-CERT 10 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-09-DT-LAST-SEEN-BY-PHY = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-09-DT-LAST-SEEN-BY-PHY 11 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-10-NON-VISIT-IND = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-10-NON-VISIT-IND 12 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-11-PAT-AGE = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-11-PAT-AGE 13 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-12-PAT-HEIGHT = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-12-PAT-HEIGHT 14 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-13-PAT-WEIGHT = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-13-PAT-WEIGHT 15 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-14-LEVEL-OF-CONS-IND = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-14-LEVEL-OF-CONS-IND 16 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-15-AMBULATORY-IND = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-15-AMBULATORY-IND 17 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-16-OTHER-FORMS-OF-NUTR-IND = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-16-OTHER-FORMS-OF-NUTR-IND 18 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-17-TYPE-OF-MIX-IND = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-17-TYPE-OF-MIX-IND 19 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-18-PARENTERAL-FREQ-FED = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-18-PARENTERAL-FREQ-FED 20 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-19-HCPCS-PROCEDURE-CODE = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-19-HCPCS-PROCEDURE-CODE 21 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-20-HCPCS-MODIFIER-1 = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-20-HCPCS-MODIFIER-1 22 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-21-HCPCS-MODIFIER-2 = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-21-HCPCS-MODIFIER-2 23 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-22-AMINO-ACID-NAME = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-22-AMINO-ACID-NAME 24 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-23-AMINO-ACID-VOLUME = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-23-AMINO-ACID-VOLUME 25 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-24-AMINO-ACID-CONC = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-24-AMINO-ACID-CONC 26 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-25-AMINO-ACID-WEIGHT = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-25-AMINO-ACID-WEIGHT 27 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-26-DEXTROSE-VOLUME = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-26-DEXTROSE-VOLUME 28 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-27-DEXTROSE-CONC = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-27-DEXTROSE-CONC 29 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-28-LIPIDS-VOLUME = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-28-LIPIDS-VOLUME 30 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-29-LIPIDS-CONC = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-29-LIPIDS-CONC 31 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-30-LIPIDS-FREQ = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-30-LIPIDS-FREQ 32 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-31-NARRATIVE-FIELD = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-31-NARRATIVE-FIELD 33 RECFLD1 = RECFLD2 REC FIELD GP0-PARENTERAL-NUTR-THER-REC GP0-32-ADMIN-TECH-IND = REC FIELD v103_GP0-PARENTERAL-NUTR-THER-REC GP0-32-ADMIN-TECH-IND Rule Numbe 8910 Map v.103 GU0 Record Fields to v.301 Line Command Description 1 Do Nothing Rule Numbe 8915 Map v.103 GX0 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-01-RECORD-ID = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-01-RECORD-ID 2 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-02-SEQUENCE-NO = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-02-SEQUENCE-NO 3 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-02-SEQUENCE-NUM-ALPHA = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-02-SEQUENCE-NUM-ALPHA 4 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-03-PAT-CONTROL-NO = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-03-PAT-CONTROL-NO 5 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-04-CERTIFICATION-TYPE = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-04-CERTIFICATION-TYPE 6 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-05-OXYGEN-SYSTEM = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-05-OXYGEN-SYSTEM 7 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-06-LENGTH-OF-NEED = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-06-LENGTH-OF-NEED 8 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-07-EQUIPMENT-TYPE-1 = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-07-EQUIPMENT-TYPE-1 9 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-08-EQUIPMENT-TYPE-2 = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-08-EQUIPMENT-TYPE-2 10 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-09-EQUIPMENT-REASON = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-09-EQUIPMENT-REASON 11 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-10-PRESCRIBED-FROM-DATE = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-10-PRESCRIBED-FROM-DATE 12 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-11-PRESCRIBED-TO-DATE = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-11-PRESCRIBED-TO-DATE 13 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-12-DATE-PRESCRIBED = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-12-DATE-PRESCRIBED 14 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-13-DATE-EVALUATED = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-13-DATE-EVALUATED 15 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-14-OXY-FLOW-RATE = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-14-OXY-FLOW-RATE 16 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-15-FREQUENCY-OF-USE = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-15-FREQUENCY-OF-USE 17 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-16-DURATION = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-16-DURATION 18 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-17-ARTERIAL-BLOOD-GAS-4LPM = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-17-OTHER 19 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-22-ARTERIAL-BLOOD-GAS = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-18-ARTERIAL-BLOOD-GAS 20 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-23-OXIMETRY = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-19-OXIMETRY 21 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-24-DATE-TESTED = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-20-DATE-TESTED 22 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-25-ENTITY-PERF-OXIM-TST = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-21-TEST-FACILITY-NAME 23 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-26-TEST-CONDITIONS = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-22-TEST-CONDITIONS 24 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-27-CLINICAL-FINDINGS = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-23-CLINICAL-FINDINGS 25 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-28-PORT-OXY-FLOW-RATE = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-24-PORT-OXY-FLOW-RATE 26 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-29-ORDERING-PROV-ID = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-25-ORDERING-PROV-ID 27 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-30-ORDERING-PROV-PHONE = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-26-ORDERING-PROV-PHONE 28 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-31-DIAGNOSIS-CODE-1 = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-27-DIAGNOSIS-CODE-1 29 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-32-DIAGNOSIS-CODE-2 = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-28-DIAGNOSIS-CODE-2 30 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-33-DIAGNOSIS-CODE-3 = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-29-DIAGNOSIS-CODE-3 31 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-34-DIAGNOSIS-CODE-4 = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-30-DIAGNOSIS-CODE-4 32 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-35-CERT-ON-FILE = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-31-CERT-ON-FILE 33 RECFLD1 = RECFLD2 REC FIELD GX0-OXYGEN-CERT-REC GX0-36-DELIVERY-SYSTEM-TYPE = REC FIELD v103_GX0-OXYGEN-CERT-REC GX0-32-DELIVERY-SYSTEM-TYPE Rule Numbe 8920 Map v.103 GX1 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD GX1-OXYGEN-NARR-REC GX1-01-RECORD-ID = REC FIELD v103_GX1-OXYGEN-NARR-REC GX1-01-RECORD-ID 2 RECFLD1 = RECFLD2 REC FIELD GX1-OXYGEN-NARR-REC GX1-02-SEQUENCE-NO = REC FIELD v103_GX1-OXYGEN-NARR-REC GX1-02-SEQUENCE-NO 3 RECFLD1 = RECFLD2 REC FIELD GX1-OXYGEN-NARR-REC GX1-02-SEQUENCE-NUM-ALPHA = REC FIELD v103_GX1-OXYGEN-NARR-REC GX1-02-SEQUENCE-NUM-ALPHA 4 RECFLD1 = RECFLD2 REC FIELD GX1-OXYGEN-NARR-REC GX1-03-PAT-CONTROL-NO = REC FIELD v103_GX1-OXYGEN-NARR-REC GX1-03-PAT-CONTROL-NO 5 RECFLD1 = RECFLD2 REC FIELD GX1-OXYGEN-NARR-REC GX1-04-TEST-RESULTS = REC FIELD v103_GX1-OXYGEN-NARR-REC GX1-04-TEST-RESULTS 6 RECFLD1 = RECFLD2 REC FIELD GX1-OXYGEN-NARR-REC GX1-05-MEDICAL-FINDINGS = REC FIELD v103_GX1-OXYGEN-NARR-REC GX1-05-MEDICAL-FINDINGS 7 RECFLD1 = RECFLD2 REC FIELD GX1-OXYGEN-NARR-REC GX1-06-EXERCISE-ROUTINE = REC FIELD v103_GX1-OXYGEN-NARR-REC GX1-06-EXERCISE-ROUTINE Rule Numbe 8925 Map v.103 GX2 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD GX2-OXYGEN-FACILITY-REC GX2-01-RECORD-ID = REC FIELD v103_GX2-OXYGEN-FACILITY-REC GX2-01-RECORD-ID 2 RECFLD1 = RECFLD2 REC FIELD GX2-OXYGEN-FACILITY-REC GX2-02-SEQUENCE-NO = REC FIELD v103_GX2-OXYGEN-FACILITY-REC GX2-02-SEQUENCE-NO 3 RECFLD1 = RECFLD2 REC FIELD GX2-OXYGEN-FACILITY-REC GX2-02-SEQUENCE-NUM-ALPHA = REC FIELD v103_GX2-OXYGEN-FACILITY-REC GX2-02-SEQUENCE-NUM-ALPHA 4 RECFLD1 = RECFLD2 REC FIELD GX2-OXYGEN-FACILITY-REC GX2-03-PAT-CONTROL-NO = REC FIELD v103_GX2-OXYGEN-FACILITY-REC GX2-03-PAT-CONTROL-NO 5 RECFLD1 = RECFLD2 REC FIELD GX2-OXYGEN-FACILITY-REC GX2-04-TEST-FACILITY-ADDR1 = REC FIELD v103_GX2-OXYGEN-FACILITY-REC GX2-04-TEST-FACILITY-ADDR1 6 RECFLD1 = RECFLD2 REC FIELD GX2-OXYGEN-FACILITY-REC GX2-05-TEST-FACILITY-ADDR2 = REC FIELD v103_GX2-OXYGEN-FACILITY-REC GX2-05-TEST-FACILITY-ADDR2 7 RECFLD1 = RECFLD2 REC FIELD GX2-OXYGEN-FACILITY-REC GX2-06-TEST-FACILITY-CITY = REC FIELD v103_GX2-OXYGEN-FACILITY-REC GX2-06-TEST-FACILITY-CITY 8 RECFLD1 = RECFLD2 REC FIELD GX2-OXYGEN-FACILITY-REC GX2-07-TEST-FACILITY-ST = REC FIELD v103_GX2-OXYGEN-FACILITY-REC GX2-07-TEST-FACILITY-ST 9 RECFLD1 = RECFLD2 REC FIELD GX2-OXYGEN-FACILITY-REC GX2-08-TEST-FACILITY-ZIP = REC FIELD v103_GX2-OXYGEN-FACILITY-REC GX2-08-TEST-FACILITY-ZIP 10 RECFLD1 = RECFLD2 REC FIELD GX2-OXYGEN-FACILITY-REC GX2-09-PAT-FACILITY-NAME = REC FIELD v103_GX2-OXYGEN-FACILITY-REC GX2-09-PAT-FACILITY-NAME 11 RECFLD1 = RECFLD2 REC FIELD GX2-OXYGEN-FACILITY-REC GX2-10-PAT-FACILITY-ADDR1 = REC FIELD v103_GX2-OXYGEN-FACILITY-REC GX2-10-PAT-FACILITY-ADDR1 12 RECFLD1 = RECFLD2 REC FIELD GX2-OXYGEN-FACILITY-REC GX2-11-PAT-FACILITY-ADDR2 = REC FIELD v103_GX2-OXYGEN-FACILITY-REC GX2-11-PAT-FACILITY-ADDR2 13 RECFLD1 = RECFLD2 REC FIELD GX2-OXYGEN-FACILITY-REC GX2-12-PAT-FACILITY-CITY = REC FIELD v103_GX2-OXYGEN-FACILITY-REC GX2-12-PAT-FACILITY-CITY 14 RECFLD1 = RECFLD2 REC FIELD GX2-OXYGEN-FACILITY-REC GX2-13-PAT-FACILITY-ST = REC FIELD v103_GX2-OXYGEN-FACILITY-REC GX2-13-PAT-FACILITY-ST 15 RECFLD1 = RECFLD2 REC FIELD GX2-OXYGEN-FACILITY-REC GX2-14-PAT-FACILITY-ZIP = REC FIELD v103_GX2-OXYGEN-FACILITY-REC GX2-14-PAT-FACILITY-ZIP Rule Numbe 8930 Map v.103 HA0 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD HA0-NARRATIVE-REC HA0-01-RECORD-ID = REC FIELD v103_HA0-NARRATIVE-REC HA0-01-RECORD-ID 2 RECFLD1 = RECFLD2 REC FIELD HA0-NARRATIVE-REC HA0-00-GROUP-LEVEL-REDEFINES = REC FIELD v103_HA0-NARRATIVE-REC HA0-00-GROUP-LEVEL-REDEFINES 3 RECFLD1 = RECFLD2 REC FIELD HA0-NARRATIVE-REC HA0-02-SEQUENCE-NO = REC FIELD v103_HA0-NARRATIVE-REC HA0-02-SEQUENCE-NO 4 RECFLD1 = RECFLD2 REC FIELD HA0-NARRATIVE-REC HA0-02-SEQUENCE-NUM-ALPHA = REC FIELD v103_HA0-NARRATIVE-REC HA0-02-SEQUENCE-NUM-ALPHA 5 RECFLD1 = RECFLD2 REC FIELD HA0-NARRATIVE-REC HA0-03-PAT-CONTROL-NO = REC FIELD v103_HA0-NARRATIVE-REC HA0-03-PAT-CONTROL-NO 6 RECFLD1 = RECFLD2 REC FIELD HA0-NARRATIVE-REC HA0-04-LINE-ITEM-CONTROL-NO = REC FIELD v103_HA0-NARRATIVE-REC HA0-04-LINE-ITEM-CONTROL-NO 7 RECFLD1 = RECFLD2 REC FIELD HA0-NARRATIVE-REC HA0-05-EXTRA-NARRATIVE-DATA = REC FIELD v103_HA0-NARRATIVE-REC HA0-05-EXTRA-NARRATIVE-DATA Rule Numbe 8935 Map v.103 XA0 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-01-RECORD-ID = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-01-RECORD-ID 2 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-02-RESERVED = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-02-RESERVED 3 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-03-PAT-CONTROL-NO = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-03-PAT-CONTROL-NO 4 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-04-RECORD-CXX-COUNT = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-04-RECORD-CXX-COUNT 5 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-04-RECORD-CXX-COUNT-ALPHA = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-04-RECORD-CXX-COUNT-ALPHA 6 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-05-RECORD-DXX-COUNT = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-05-RECORD-DXX-COUNT 7 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-05-RECORD-DXX-COUNT-ALPHA = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-05-RECORD-DXX-COUNT-ALPHA 8 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-06-RECORD-EXX-COUNT = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-06-RECORD-EXX-COUNT 9 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-06-RECORD-EXX-COUNT-ALPHA = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-06-RECORD-EXX-COUNT-APLHA 10 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-07-RECORD-FXX-COUNT = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-07-RECORD-FXX-COUNT 11 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-07-RECORD-FXX-COUNT-ALPHA = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-07-RECORD-FXX-COUNT-ALPHA 12 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-08-RECORD-GXX-COUNT = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-08-RECORD-GXX-COUNT 13 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-08-RECORD-GXX-COUNT-ALPHA = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-08-RECORD-GXX-COUNT-ALPHA 14 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-09-RECORD-HXX-COUNT = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-09-RECORD-HXX-COUNT 15 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-09-RECORD-HXX-COUNT-ALPHA = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-09-RECORD-HXX-COUNT-ALPHA 16 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-10-CLAIM-RECORD-COUNT = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-10-CLAIM-RECORD-COUNT 17 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-10-CLAIM-RECORD-COUNT-AN = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-10-CLAIM-RECORD-COUNT-AN 18 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-11-RESERVED = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-11-RESERVED 19 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-12-TOTAL-CLAIM-CHARGE-AN = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-12-TOTAL-CLAIM-CHARGE-AN 20 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-12-TOTAL-CLAIM-CHARGES = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-12-TOTAL-CLAIM-CHARGES 21 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-13-TOTAL-DISAL-COST-AN = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-13-TOTAL-DISAL-COST-ALPHA 22 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-13-TOTAL-DISAL-COST-CONT-C = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-13-TOTAL-DISAL-COST-CONT-C 23 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-14-TOT-DISAL-OTHER-AN = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-14-TOT-DISAL-OTHER-AN 24 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-14-TOT-DISAL-OTHER-CHGS = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-14-TOT-DISAL-OTHER-CHGS 25 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-15-TOTAL-ALLOWED-AMOUNT = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-15-TOTAL-ALLOWED-AMOUNT 26 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-15-TOTAL-ALLOWED-AMT-AN = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-15-TOTAL-ALLOWED-AMT-AN 27 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-16-TOTAL-DEDUCTIBLE-AMOUNT = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-16-TOTAL-DEDUCTIBLE-AMOUNT 28 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-16-TOTAL-DEDUCTIBLE-AMT-AN = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-16-TOTAL-DEDUCTIBLE-AMT-AN 29 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-17-TOTAL-COINSUR-AMOUNT = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-17-TOTAL-COINSUR-AMOUNT 30 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-17-TOTAL-COINSUR-AMT-AN = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-17-TOTAL-COINSUR-AMT-AN 31 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-18-TOTAL-PAYOR-AMOUNT-PAID = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-18-TOTAL-PAYOR-AMOUNT-AN 32 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-18-TOTAL-PAYOR-AMT-AN = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-18-TOTAL-PAYOR-AMOUNT-PAID 33 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-19-PAT-AMOUNT-PAID = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-19-PAT-AMOUNT-PAID 34 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-19-PAT-AMOUNT-PAID-ALPHA = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-19-PAT-AMOUNT-PAID-ALPHA 35 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-20-TOTAL-PURCHASE-SVC-AN = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-20-TOTAL-PURCHASE-SVC-AN 36 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-20-TOTAL-PURCHASE-SVC-CHGS = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-20-TOTAL-PURCHASE-SVC-CHGS 37 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-21-PROV-DISCOUNT-INFO = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-21-PROV-DISCOUNT-INFO 38 RECFLD1 = RECFLD2 REC FIELD XA0-CLAIM-TRAILER-REC XA0-22-REMARKS = REC FIELD v103_XA0-CLAIM-TRAILER-REC XA0-22-REMARKS Rule Numbe 8940 Map v.103 YA0 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD YA0-BATCH-TRAILER-REC YA0-01-RECORD-ID = REC FIELD v103_YA0-BATCH-TRAILER-REC YA0-01-RECORD-ID 2 RECFLD1 = RECFLD2 REC FIELD YA0-BATCH-TRAILER-REC YA0-02-EMC-PROV-ID = REC FIELD v103_YA0-BATCH-TRAILER-REC YA0-02-EMC-PROV-ID 3 RECFLD1 = RECFLD2 REC FIELD YA0-BATCH-TRAILER-REC YA0-03-BATCH-TYPE = REC FIELD v103_YA0-BATCH-TRAILER-REC YA0-03-BATCH-TYPE 4 RECFLD1 = RECFLD2 REC FIELD YA0-BATCH-TRAILER-REC YA0-04-BATCH-NO = REC FIELD v103_YA0-BATCH-TRAILER-REC YA0-04-BATCH-NO 5 RECFLD1 = RECFLD2 REC FIELD YA0-BATCH-TRAILER-REC YA0-04-BATCH-NO-ALPHA = REC FIELD v103_YA0-BATCH-TRAILER-REC YA0-04-BATCH-NO-ALPHA 6 RECFLD1 = RECFLD2 REC FIELD YA0-BATCH-TRAILER-REC YA0-05-BATCH-ID = REC FIELD v103_YA0-BATCH-TRAILER-REC YA0-05-BATCH-ID 7 RECFLD1 = RECFLD2 REC FIELD YA0-BATCH-TRAILER-REC YA0-06-PROV-TAX-ID = REC FIELD v103_YA0-BATCH-TRAILER-REC YA0-06-PROV-TAX-ID 8 RECFLD1 = RECFLD2 REC FIELD YA0-BATCH-TRAILER-REC YA0-07-RESERVED = REC FIELD v103_YA0-BATCH-TRAILER-REC YA0-07-RESERVED 9 RECFLD1 = RECFLD2 REC FIELD YA0-BATCH-TRAILER-REC YA0-08-BATCH-SVC-LINE-COUNT-AN = REC FIELD v103_YA0-BATCH-TRAILER-REC YA0-08-BATCH-SVC-LINE-CNT-AN 10 RECFLD1 = RECFLD2 REC FIELD YA0-BATCH-TRAILER-REC YA0-08-BATCH-SVC-LINE-COUNT = REC FIELD v103_YA0-BATCH-TRAILER-REC YA0-08-BATCH-SVC-LINE-COUNT 11 RECFLD1 = RECFLD2 REC FIELD YA0-BATCH-TRAILER-REC YA0-09-BATCH-RECORD-COUNT = REC FIELD v103_YA0-BATCH-TRAILER-REC YA0-09-BATCH-RECORD-COUNT 12 RECFLD1 = RECFLD2 REC FIELD YA0-BATCH-TRAILER-REC YA0-09-BATCH-RECORD-COUNT-AN = REC FIELD v103_YA0-BATCH-TRAILER-REC YA0-09-BATCH-RECORD-COUNT-AN 13 RECFLD1 = RECFLD2 REC FIELD YA0-BATCH-TRAILER-REC YA0-10-BATCH-CLAIM-COUNT = REC FIELD v103_YA0-BATCH-TRAILER-REC YA0-10-BATCH-CLAIM-COUNT 14 RECFLD1 = RECFLD2 REC FIELD YA0-BATCH-TRAILER-REC YA0-10-BATCH-CLAIM-COUNT-AN = REC FIELD v103_YA0-BATCH-TRAILER-REC YA0-10-BATCH-CLAIM-COUNT-AN 15 RECFLD1 = RECFLD2 REC FIELD YA0-BATCH-TRAILER-REC YA0-11-BATCH-TOTAL-CHARGES-AN = REC FIELD v103_YA0-BATCH-TRAILER-REC YA0-11-BATCH-TOTAL-CHARGE-AN 16 RECFLD1 = RECFLD2 REC FIELD YA0-BATCH-TRAILER-REC YA0-11-BATCH-TOTAL-CHARGES = REC FIELD v103_YA0-BATCH-TRAILER-REC YA0-11-BATCH-TOTAL-CHARGES Rule Numbe 8945 Map v.103 ZA0 Record Fields to v.301 Line Command Description 1 RECFLD1 = RECFLD2 REC FIELD ZA0-FILE-TRAILER-REC ZA0-01-RECORD-ID = REC FIELD v103_ZA0-FILE-TRAILER-REC ZA0-01-RECORD-ID 2 RECFLD1 = RECFLD2 REC FIELD ZA0-FILE-TRAILER-REC ZA0-00-GROUP-REDEFINES = REC FIELD v103_ZA0-FILE-TRAILER-REC ZA0-00-GROUP-REDEFINES 3 RECFLD1 = RECFLD2 REC FIELD ZA0-FILE-TRAILER-REC ZA0-02-SUB-ID = REC FIELD v103_ZA0-FILE-TRAILER-REC ZA0-02-SUB-ID 4 RECFLD1 = RECFLD2 REC FIELD ZA0-FILE-TRAILER-REC ZA0-03-RESERVED = REC FIELD v103_ZA0-FILE-TRAILER-REC ZA0-03-RESERVED 5 RECFLD1 = RECFLD2 REC FIELD ZA0-FILE-TRAILER-REC ZA0-04-RECEIVER-ID = REC FIELD v103_ZA0-FILE-TRAILER-REC ZA0-04-RECEIVER-ID 6 RECFLD1 = RECFLD2 REC FIELD ZA0-FILE-TRAILER-REC ZA0-04-IOWA-RECVR-ID = REC FIELD v103_ZA0-FILE-TRAILER-REC ZA0-04-IOWA-RECVR-ID 7 RECFLD1 = RECFLD2 REC FIELD ZA0-FILE-TRAILER-REC ZA0-05-FILE-SVC-LINE-COUNT-AN = REC FIELD v103_ZA0-FILE-TRAILER-REC ZA0-05-FILE-SVC-LINE-CNT-AN 8 RECFLD1 = RECFLD2 REC FIELD ZA0-FILE-TRAILER-REC ZA0-05-FILE-SVC-LINE-COUNT = REC FIELD v103_ZA0-FILE-TRAILER-REC ZA0-05-FILE-SVC-LINE-COUNT 9 RECFLD1 = RECFLD2 REC FIELD ZA0-FILE-TRAILER-REC ZA0-06-FILE-RECORD-COUNT = REC FIELD v103_ZA0-FILE-TRAILER-REC ZA0-06-FILE-RECORD-COUNT 10 RECFLD1 = RECFLD2 REC FIELD ZA0-FILE-TRAILER-REC ZA0-06-FILE-RECORD-COUNT-AN = REC FIELD v103_ZA0-FILE-TRAILER-REC ZA0-06-FILE-RECORD-COUNT-AN 11 RECFLD1 = RECFLD2 REC FIELD ZA0-FILE-TRAILER-REC ZA0-07-FILE-CLAIM-COUNT = REC FIELD v103_ZA0-FILE-TRAILER-REC ZA0-07-FILE-CLAIM-COUNT 12 RECFLD1 = RECFLD2 REC FIELD ZA0-FILE-TRAILER-REC ZA0-07-FILE-CLAIM-COUNT-AN = REC FIELD v103_ZA0-FILE-TRAILER-REC ZA0-07-FILE-CLAIM-COUNT-AN 13 RECFLD1 = RECFLD2 REC FIELD ZA0-FILE-TRAILER-REC ZA0-08-BATCH-COUNT = REC FIELD v103_ZA0-FILE-TRAILER-REC ZA0-08-BATCH-COUNT 14 RECFLD1 = RECFLD2 REC FIELD ZA0-FILE-TRAILER-REC ZA0-08-BATCH-COUNT-AN = REC FIELD v103_ZA0-FILE-TRAILER-REC ZA0-08-BATCH-COUNT-AN 15 RECFLD1 = RECFLD2 REC FIELD ZA0-FILE-TRAILER-REC ZA0-09-FILE-TOTAL-CHARGES = REC FIELD v103_ZA0-FILE-TRAILER-REC ZA0-09-FILE-TOTAL-CHARGES 16 RECFLD1 = RECFLD2 REC FIELD ZA0-FILE-TRAILER-REC ZA0-09-FILE-TOTAL-CHARGES-AN = REC FIELD v103_ZA0-FILE-TRAILER-REC ZA0-09-FILE-TOTAL-CHARGES-AN Rule Numbe 8950 Assign Log Record Variables Line Command Description 1 VAR1 = VAR2 MEM VAR OUT_FILENAME = SYS VAR OUTPUT_FILENAME 2 VAR1 = VAR2 MEM VAR A_MAP_VERSION = CONST T9999D99_IABCN13O_V00001 Rule Numbe 8955 EOF Processing Line Command Description 1 IF THEN ELSE IF SYS VAR ERR_OCCURRED EQ CONST Y Then Perform Rule 30005 Else Rule 8960 Rule Numbe 8960 Check USER-ERROR Line Command Description 1 IF THEN ELSE IF MEM VAR USER-ERROR EQ CONST Y Then Perform Rule 30005 Else Rule 32105 Rule Numbe 24000 Abort Transaction - Submitter ID missing Line Command Description 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD AA0-SUBMITTER-DATA AA0-01-REC-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST AA002010 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD AA0-SUBMITTER-DATA AA0-02-SUB-ID 5 PERFORM RULE Perform Rule 7035 6 PERFORM RULE Perform Rule 1010 7 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST Y Rule Numbe 24005 Abort Transaction - Submission Type missing Line Command Description 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD AA0-SUBMITTER-DATA AA0-01-REC-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST AA004010 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD AA0-SUBMITTER-DATA AA0-04-SUB-TYPE 5 PERFORM RULE Perform Rule 7035 6 PERFORM RULE Perform Rule 1010 7 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST Y Rule Numbe 24010 Abort Transaction - Submission Number not numeric Line Command Description 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD AA0-SUBMITTER-DATA AA0-01-REC-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST AA005010 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD AA0-SUBMITTER-DATA AA0-05-SUB-NO 5 PERFORM RULE Perform Rule 7035 6 PERFORM RULE Perform Rule 1010 7 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST Y Rule Numbe 24015 Abort Transaction - Submitter Name missing Line Command Description 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD AA0-SUBMITTER-DATA AA0-01-REC-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST AA006010 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD AA0-SUBMITTER-DATA AA0-06-SUB-NAME 5 PERFORM RULE Perform Rule 7035 6 PERFORM RULE Perform Rule 1010 7 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST Y Rule Numbe 24020 Abort Transaction - Invalid Future Date Used Line Command Description 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD AA0-SUBMITTER-DATA AA0-01-REC-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST AA015020 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD AA0-SUBMITTER-DATA AA0-15-CREAT-DTE 5 PERFORM RULE Perform Rule 7035 6 PERFORM RULE Perform Rule 1010 7 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST Y Rule Numbe 24025 Abort Transaction - Submission Time invalid Line Command Description 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD AA0-SUBMITTER-DATA AA0-01-REC-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST AA016010 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD AA0-SUBMITTER-DATA AA0-16-SUB-TIME 5 PERFORM RULE Perform Rule 7035 6 PERFORM RULE Perform Rule 1010 7 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST Y Rule Numbe 24030 Abort Transaction - Receiver ID missing Line Command Description 1 PERFORM RULE Perform Rule 7030 1 PERFORM RULE Perform Rule 7030 1 PERFORM RULE Perform Rule 7030 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD AA0-SUBMITTER-DATA AA0-01-REC-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST AA017010 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD AA0-SUBMITTER-DATA AA0-17-RECV-ID 5 PERFORM RULE Perform Rule 105 6 PERFORM RULE Perform Rule 1010 7 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST Y Rule Numbe 24035 Abort Transaction - National Version Code missing Line Command Description 2 PERFORM RULE Perform Rule 7030 Rule Numbe 24040 Abort Transaction - Local Version Code not numeri Line Command Description 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD AA0-SUBMITTER-DATA AA0-01-REC-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST AA020010 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD AA0-SUBMITTER-DATA AA0-20-VERS-LOCAL-ALPHA 5 PERFORM RULE Perform Rule 7035 6 PERFORM RULE Perform Rule 1010 7 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST Y Rule Numbe 24045 Abort Transaction -Test/Prod Ind missing Line Command Description 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD AA0-SUBMITTER-DATA AA0-01-REC-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST AA021010 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD AA0-SUBMITTER-DATA AA0-21-TEST-IND 5 PERFORM RULE Perform Rule 7035 6 PERFORM RULE Perform Rule 1010 7 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST Y Rule Numbe 24050 Abort Transaction -Retransmission Status missing Line Command Description 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD AA0-SUBMITTER-DATA AA0-01-REC-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST AA023010 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD AA0-SUBMITTER-DATA AA0-23-RETRANS-STATUS 5 PERFORM RULE Perform Rule 7035 6 PERFORM RULE Perform Rule 1010 7 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST Y Rule Numbe 24055 Abort Transaction - Creation Date invalid or miss Line Command Description 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD AA0-SUBMITTER-DATA AA0-01-REC-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST AA015010 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD AA0-SUBMITTER-DATA AA0-15-CREAT-DTE 5 PERFORM RULE Perform Rule 7035 6 PERFORM RULE Perform Rule 1010 7 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST Y Rule Numbe 24060 Abort Transaction - EMC Provider ID missing Line Command Description 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD BA0-PROVIDER-DATA BA0-01-REC-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST BA002010 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD BA0-PROVIDER-DATA BA0-02-EMC-PROV-ID 5 PERFORM RULE Perform Rule 7035 6 PERFORM RULE Perform Rule 1010 7 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST Y Rule Numbe 24065 Abort Transaction - Batch Type missing/invalid Line Command Description 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD BA0-PROVIDER-DATA BA0-01-REC-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST BA003010 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD BA0-PROVIDER-DATA BA0-03-BATCH-TYPE 5 PERFORM RULE Perform Rule 7035 6 PERFORM RULE Perform Rule 1010 7 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST Y Rule Numbe 24070 Abort Transaction - Batch Number not numeric/miss Line Command Description 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD BA0-PROVIDER-DATA BA0-01-REC-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST BA004010 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD BA0-PROVIDER-DATA BA0-04-BATCH-NO-ALPHA 5 PERFORM RULE Perform Rule 7035 6 PERFORM RULE Perform Rule 1010 7 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST Y Rule Numbe 24080 Abort Transaction - Provider Tax ID missing Line Command Description 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD BA0-PROVIDER-DATA BA0-01-REC-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST BA008010 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD BA0-PROVIDER-DATA BA0-08-PROV-TAX-ID-TYPE 5 PERFORM RULE Perform Rule 7035 6 PERFORM RULE Perform Rule 1010 7 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST Y Rule Numbe 24085 Abort Transaction - Provider Tax ID Type Missing Line Command Description 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD BA0-PROVIDER-DATA BA0-01-REC-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST BA008010 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD BA0-PROVIDER-DATA BA0-08-PROV-TAX-ID-TYPE 5 PERFORM RULE Perform Rule 7035 6 PERFORM RULE Perform Rule 1010 7 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST Y Rule Numbe 24090 Abort Transaction - Provider Tax ID Type Invalid Line Command Description 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD BA1-PROVIDER-DATA-2 BA1-01-RECORD-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST BA102010 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD BA1-PROVIDER-DATA-2 BA1-02-EMC-PROV-ID 5 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-EXPECTED-CONTENTS = MEM VAR Batch-EMC-Provider-ID 6 PERFORM RULE Perform Rule 7035 7 PERFORM RULE Perform Rule 1010 8 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST Y Rule Numbe 24095 Abort Transaction - EMC Provider ID mismatched Line Command Description 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD BA1-PROVIDER-DATA-2 BA1-01-RECORD-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST BA103010 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD BA1-PROVIDER-DATA-2 BA1-03-BATCH-TYPE 5 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-EXPECTED-CONTENTS = MEM VAR Batch-Type 6 PERFORM RULE Perform Rule 7035 7 PERFORM RULE Perform Rule 1010 8 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST Y Rule Numbe 24100 Abort Transaction - Batch Type mismatched Line Command Description 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD BA1-PROVIDER-DATA-2 BA1-01-RECORD-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST BA104010 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD BA1-PROVIDER-DATA-2 BA1-04-BATCH-NUMBER-ALPHA 5 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-EXPECTED-CONTENTS = MEM VAR Batch-No 6 PERFORM RULE Perform Rule 7035 7 PERFORM RULE Perform Rule 1010 8 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST Y Rule Numbe 24105 Abort Transaction - Batch Number mismatched Line Command Description 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD BA1-PROVIDER-DATA-2 BA1-01-RECORD-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST BA105010 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD BA1-PROVIDER-DATA-2 BA1-05-BATCH-ID 5 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-EXPECTED-CONTENTS = MEM VAR Batch-ID 6 PERFORM RULE Perform Rule 7035 7 PERFORM RULE Perform Rule 1010 8 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST Y Rule Numbe 24110 Abort Transaction - Batch ID mismatched Line Command Description 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD CA0-PATIENT-DATA CA0-01-RECORD-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST CA003010 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD CA0-PATIENT-DATA CA0-03-PAT-CONTROL-NO 5 PERFORM RULE Perform Rule 7035 6 PERFORM RULE Perform Rule 1010 7 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST Y Rule Numbe 24115 Abort Transaction - Patient Control Number missin Line Command Description 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD CA0-PATIENT-DATA CA0-01-RECORD-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST CA017010 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD CA0-PATIENT-DATA CA0-17-PAT-MARITAL-STATUS 5 PERFORM RULE Perform Rule 7035 6 PERFORM RULE Perform Rule 1010 7 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST Y Rule Numbe 24120 Abort Transaction - Patient Marital Status invali Line Command Description 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD CA0-PATIENT-DATA CA0-01-RECORD-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST CA019010 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD CA0-PATIENT-DATA CA0-19-PAT-EMPLOYMENT-STATUS 5 PERFORM RULE Perform Rule 7035 6 PERFORM RULE Perform Rule 1010 7 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST Y Rule Numbe 24125 Abort Transaction - Patient Employment Status inv Line Command Description 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD CA0-PATIENT-DATA CA0-01-RECORD-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST CA023010 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD CA0-PATIENT-DATA CA0-23-CLAIM-EDITING-IND 5 PERFORM RULE Perform Rule 7035 6 PERFORM RULE Perform Rule 1010 7 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST Y Rule Numbe 24130 Abort Transaction - Claim Editing Indicator inval Line Command Description 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD CA0-PATIENT-DATA CA0-01-RECORD-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST CA024010 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD CA0-PATIENT-DATA CA0-24-TYPE-OF-CLAIM-IND 5 PERFORM RULE Perform Rule 7035 6 PERFORM RULE Perform Rule 1010 7 VAR1 = VAR2 MEM VAR Error-Flag-Local = CONST Y Rule Numbe 24135 Abort Transaction - Claim Type (CA0.24) invalid Line Command Description 1 PERFORM RULE Perform Rule 7030 2 VAR1 = VAR2 REC FIELD MAP-PROCESS-INI CURRENT-RECORD-ID = REC FIELD CA1-INDIAN-HEALTH-SVCS CA1-01-RECORD-ID 3 VAR1 = VAR2 MEM VAR Error-Number = CONST CA103010 4 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-CONTENTS = REC FIELD CA1-INDIAN-HEALTH-SVCS CA1-03-PAT-CONTROL-NO 5 VAR1 = VAR2 REC FIELD REPORT-EXTRACT FIELD-EXPECTED-CONTENTS = MEM VAR Patient-Control-Number 6 PERFORM RULE Perform Rule 7035 7 PERFORM RULE Perform Rule 1010 8 VAR1 = VAR2 MEM VAR Error-Flag-Local = CO