source: FOIAVistA/trunk/r/INTEGRATED_BILLING-IB-PRQ--IBD--IBQ--PRQS/IBCF1TP.m@ 1442

Last change on this file since 1442 was 628, checked in by George Lilly, 15 years ago

initial load of FOIAVistA 6/30/08 version

File size: 2.4 KB
Line 
1IBCF1TP ;ALB/MJB - UB-82 TEST PATTERN PRINT ;23 SEP 88 13:42
2 ;;Version 2.0 ; INTEGRATED BILLING ;; 21-MAR-94
3 ;;Per VHA Directive 10-93-142, this routine should not be modified.
4 ;
5 ;MAP TO DGCRTP
6 ;
7ZIS ;
8 ;***
9 ;S XRTL=$ZU(0),XRTN="IBCF1TP-1" D T0^%ZOSV ;start rt clock
10 ;
11 S %ZIS="QM" D ^%ZIS G:POP Q
12 I $D(IO("Q")) K IO("Q") S ZTRTN="ENP^IBCF1TP",ZTDESC="IB - TEST UB-82 PRINT" D ^%ZTLOAD K ZTSK D HOME^%ZIS G Q
13 U IO
14 ;***
15 ;I $D(XRT0) S:'$D(XRTN) XRTN="IBCF1TP" D T1^%ZOSV ;stop rt clock
16 ;
17 D ENP
18Q I $D(ZTQUEUED) S ZTREQ="@"
19 K DGPGM,DGVAR,POP
20 ;***
21 ;I $D(XRT0) S:'$D(XRTN) XRTN="IBCF1TP" D T1^%ZOSV ;stop rt clock
22 Q
23ENP ;
24 ;***
25 ;S XRTL=$ZU(0),XRTN="IBCF1TP-2" D T0^%ZOSV ;start rt clock
26 ;
27 W @IOF,?24,"*** UB-82 TEST PATTERN ***",!,"AGENT CASHIER",!,"AGENT CASHIER STREET",?24," F. L. 2",?57,"BILL NUMBER",?74,"XXX"
28 W !,"CITY STATE ZIP",!,"PHONE #",?24,"BC/BS #",?38,"FED TAX #",?71,"F. L. 9"
29 W !!,"PATIENT NAME",?33,"PATIENT ADDRESS",!!,"PT DOB",?8,"X",?10,"X",?14,"ADM DT",?21,"HR",?25,"X",?28,"X",?30,"AH",?33,"DH",?36,"XX",?40,"FROM",?48,"TO",?70,"F. L. 27",!!
30 W "OC",?3,"DATE" W ?11,"OC",?14,"DATE" W ?22,"OC",?25,"DATE",?35,"OC",?38,"DATE",?46,"OC",?49,"DATE"
31 W !,"MAILING ADDRESS NAME",!,"STREET ADDRESS 1",?30,"CC",?33,"CC",?36,"CC",?39,"CC",?42,"CC",?61,"F. L. 45"
32 W !,"STREET ADDRESS 2",!,"STREET ADDRESS 3"
33 W !,"CITY",?$X+2,"STATE",?$X+2,"ZIP"
348 W !!!!,"000 DAYS MEDICAL CARE",!
35 F I=1:1:3 W !,"REV CODE ",I,?24,"000.00",?31,"000",?35,"00",?39," 0000.00"
36 W !!,"SUBTOTAL",?39," 00000.00"
37 F I=1:1 Q:$Y=30 W !
38 W !!,"TOTAL",?39," 00000.00"
39 F I=1:1 Q:$Y=40 W !
40 F I=1:1:3 W !,"PAYER ",I,?24,"X",?27,"X"
41 F I=1:1 Q:$Y=45 W !
42 F I=1:1:3 W !,"INSURED NAME ",I,?23,"X",?26,"XX",?29,"POLICY # ",I,?46,"GROUP NAME ",I,?61,"GROUP # ",I
43 F I=1:1 Q:$Y=50 W !
44 W "X",?2,"X",?4,"EMPLOYER NAME",?42,"CITY STATE ZIP"
45 F I=1:1 Q:$Y=53 W !
46 W "PRINCIPAL DIAGNOSIS",?44,"CODE" F I=51,58,65,72 W ?I,"CODE"
47 W !!,"X",?3,"PRINCIPAL PROCEDURE",?44,"CODE",?51,"DATE",?57,"CODE",?63,"DATE",?68,"CODE",?74,"DATE"
48 F I=1:1 Q:$Y=56 W !
49 W !?22,"TX. AUTH.",?33,"Dept. Veterans Affairs",?56,"F. L. 93"
50 W !!,"Patient ID: ","XXXXXXXXX",!,"Bill Type: ","XXXX XXXXXXX",!,"UB-82 TEST PATTERN",!,"**TEST PATTERN**"
5116 F I=1:1 Q:$Y=62 W !
52 W ?46,"UB-82 SIGNER NAME",!,?46,"UB-82 SIGNER TITLE",?69,"DATE"
53 K I
54 I $D(ZTQUEUED) S ZTREQ="@" Q
55 D ^%ZISC
56 ;***
57 ;I $D(XRT0) S:'$D(XRTN) XRTN="IBCF1TP" D T1^%ZOSV ;stop rt clock
58 Q
59 ;IBCF1TP
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