| [613] | 1 | EASEZP6I ;ALB/AMA - Print 1010EZ, Version 6 or greater, Cont. - OTHER INSURANCE PAGE ; 10/19/2000
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| 2 | ;;1.0;ENROLLMENT APPLICATION SYSTEM;**51,60**;Mar 15, 2001
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| 3 | ;
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| 4 | ;New page, to print multiple insurance companies
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| 5 | EN(EALNE,EAINFO) ;Entry point for VA 10-10EZ, Version 6 or greater, page "I"
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| 6 | ; Called from EN^EASEZP6F
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| 7 | N X,EASD
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| 8 | ;
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| 9 | ;Expecting 4 additional insurance companies or less, and with only 5
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| 10 | ;lines per entry, so no need to worry about going to another page
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| 11 | S EASD=$NA(^TMP("EASEZ",$J,"I"))
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| 12 | D HDR^EASEZP6F(.EALNE,.EAINFO)
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| 13 | W !!?42,"SECTION II - INSURANCE INFORMATION - ADDITIONAL"
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| 14 | W ?131,$C(13) W:EALNE("ULC")="-" ! W EALNE("UL")
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| 15 | ;
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| 16 | F X=1:1 Q:'$D(@EASD@(X)) D
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| 17 | . I X>1 W !?131,$C(13) W:EALNE("ULC")="-" ! W EALNE("UL")
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| 18 | . D AI
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| 19 | ;
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| 20 | D FT^EASEZP6F(.EALNE,.EAINFO)
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| 21 | Q
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| 22 | ;
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| 23 | AI ; Print SECTION II - ADDITIONAL INSURANCE INFORMATION
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| 24 | ;
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| 25 | W !,"1."_(X+1)_" HEALTH INSURANCE COMPANY NAME "_(X+1),?38,"|2."_(X+1)_" ADDRESS",?104,"|3."_(X+1)_" TELEPHONE"
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| 26 | W !?4,@EASD@(X,"17A"),?38,"| ",$P(@EASD@(X,"17E"),U),?104,"| ",@EASD@(X,"17I")
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| 27 | W !?38,"| ",$P(@EASD@(X,"17E"),U,2),?104,"|"
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| 28 | W ?131,$C(13) W:EALNE("ULC")="-" ! W EALNE("UL")
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| 29 | ;
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| 30 | W !,"4."_(X+1)_" NAME OF POLICY HOLDER",?50,"|5."_(X+1)_" POLICY NUMBER",?85,"|6."_(X+1)_" GROUP CODE"
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| 31 | W !?4,@EASD@(X,"17B"),?50,"| ",@EASD@(X,"17C"),?85,"| ",@EASD@(X,"17D")
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| 32 | W ?131,$C(13) W:EALNE("ULC")="-" ! W EALNE("UL")
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| 33 | Q
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