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Text File  |  1995-01-10  |  2KB  |  132 lines
  1. ID
  2. 4
  3. 0 2 0 2 
  4. 1 2 2 2 
  5. 2 9 4 2 
  6. 3 1 6 3 
  7. C;Y1;X1;K"Activities"
  8. C;X2;K"# of Errors"
  9. C;X3;K"Activities"
  10. C;X4;K"# of Errors"
  11. C;X5;K"City"
  12. C;X6;K"Calls"
  13. C;X7;K"Month"
  14. C;X8;K"Machine A"
  15. C;X9;K"Machine B"
  16. C;Y2;X1;K"Spans calendar year"
  17. C;X2;K"20"
  18. C;X3;K"Spans calendar year"
  19. C;X4;K"9"
  20. C;X5;K"Tokyo"
  21. C;X6;K"456"
  22. C;X7;K"1"
  23. C;X8;K"2462"
  24. C;X9;K"2111"
  25. C;Y3;X1;K"POS incompatible with CPT"
  26. C;X2;K"8"
  27. C;X3;K"POS incompatible with CPT"
  28. C;X4;K"8"
  29. C;X5;K"Paris"
  30. C;X6;K"391"
  31. C;X7;K"2"
  32. C;X8;K"2564"
  33. C;X9;K"2291"
  34. C;Y4;X1;K"Service not payable"
  35. C;X2;K"16"
  36. C;X3;K"Service not payable"
  37. C;X4;K"14"
  38. C;X5;K"New York"
  39. C;X6;K"134"
  40. C;X7;K"3"
  41. C;X8;K"2588"
  42. C;X9;K"2319"
  43. C;Y5;X1;K"CPT4/HCPCS"
  44. C;X2;K"66"
  45. C;X3;K"CPT4/HCPCS"
  46. C;X4;K"55"
  47. C;X5;K"Delhi"
  48. C;X6;K"731"
  49. C;X7;K"4"
  50. C;X8;K"2694"
  51. C;X9;K"2458"
  52. C;Y6;X1;K"Group #"
  53. C;X2;K"32"
  54. C;X3;K"Group #"
  55. C;X4;K"5"
  56. C;X7;K"5"
  57. C;X8;K"2361"
  58. C;X9;K"2438"
  59. C;Y7;X1;K"Invalid carrier zip"
  60. C;X2;K"11"
  61. C;X3;K"Invalid carrier zip"
  62. C;X4;K"7"
  63. C;X7;K"8"
  64. C;X8;K"2678"
  65. C;X9;K"2841"
  66. C;Y8;X1;K"Prov sub ID"
  67. C;X2;K"28"
  68. C;X3;K"Prov sub ID"
  69. C;X4;K"22"
  70. C;X7;K"9"
  71. C;X8;K"2782"
  72. C;X9;K"2741"
  73. C;Y9;X1;K"No accident indicator"
  74. C;X2;K"13"
  75. C;X3;K"No accident indicator"
  76. C;X4;K"13"
  77. C;X7;K"10"
  78. C;X8;K"2894"
  79. C;X9;K"2958"
  80. C;Y10;X1;K"ID #"
  81. C;X2;K"193"
  82. C;X3;K"ID #"
  83. C;X4;K"160"
  84. C;X7;K"11"
  85. C;X8;K"2654"
  86. C;X9;K"2762"
  87. C;Y11;X1;K"Missing type of service"
  88. C;X2;K"21"
  89. C;X3;K"Missing type of service"
  90. C;X4;K"4"
  91. C;X7;K"12"
  92. C;X8;K"2453"
  93. C;X9;K"2363"
  94. C;Y12;X1;K"Medicare suffix"
  95. C;X2;K"76"
  96. C;X3;K"Medicare suffix"
  97. C;X4;K"60"
  98. C;Y13;X1;K"Invalid patient zip"
  99. C;X2;K"9"
  100. C;X3;K"Invalid patient zip"
  101. C;X4;K"9"
  102. C;Y14;X1;K"Missing date of accident"
  103. C;X2;K"13"
  104. C;X3;K"Missing date of accident"
  105. C;X4;K"13"
  106. C;Y15;X1;K"Blue Shield #"
  107. C;X2;K"32"
  108. C;X3;K"Blue Shield #"
  109. C;X4;K"32"
  110. C;Y16;X1;K"Invalid modifier"
  111. C;X2;K"11"
  112. C;X3;K"Invalid modifier"
  113. C;X4;K"9"
  114. C;Y17;X1;K"Referring MD"
  115. C;X2;K"36"
  116. C;X3;K"Referring MD"
  117. C;X4;K"32"
  118. C;Y18;X1;K"ID or group #"
  119. C;X2;K"95"
  120. C;X3;K"ID or group #"
  121. C;X4;K"67"
  122. C;Y19;X1;K"Non local Blue Cross"
  123. C;X2;K"16"
  124. C;X3;K"Non local Blue Cross"
  125. C;X4;K"9"
  126. C;Y20;X1;K"Invalid claim type"
  127. C;X2;K"23"
  128. C;X3;K"Invalid claim type"
  129. C;X4;K"21"
  130. F;W1 256 10
  131. E
  132.