PDACRFP_Q AAttachment2.txt

000010 01 CABEHIBC-ASOF-APR0106.

000100 03 HUDC-PARTB-HEADER. 10/22/97

000110************************************************************** 10/22/97

000120**** THE RECORD LENGTH HAS INCREASED TO 8000 BYTES. ******** 10/22/97

000121**** FILLER AREAS HAVE INCREASED OR BEEN ADDED FOR ******** 10/22/97

000122**** FUTURE USE. ******** 10/22/97

000130************************************************************** 10/22/97 000140************************************************************** 10/22/97

000150**** THIS 100C IS CONSIDERED HEADER INFO AT CWF. ********* 10/22/97

000160************************************************************** 10/22/97

000200 05 HUDC-DATE-STAMP PIC 9(07). CWFRHUDC

000300 05 HUDC-TIME-STAMP PIC 9(06). LV001

000400 05 HUDC-MASK PIC X(04). CWFRHUDC

000500 05 HUDC-TRANSID PIC X(04). CWFRHUDC

000600 88 HUDC-DME VALUE 'HUDC'. CWFRHUDC

000700 05 PIC X(79). CWFRHUDC

000710************************************************************** 10/22/97

000800 03 PIC XX. CWFRHUDC

000900 03 HUDC-PARTB-FIXED-DATA. CWFRHUDC

000910************************************************************** 10/22/97

000920**** THIS 998C FIXED AREA MATCHES WITH HEADER AREA USED **** 10/22/97

000921**** IN FULL CWF CLAIMS HISTORY - CIOCPTB. 300 BYTES **** 10/22/97

000922**** ARE RESERVED FOR CWF AT THE END OF THIS AREA. **** 10/22/97

000930************************************************************** 10/22/97

001000 05 HUDC-CLMNO PIC X(11). CWFRHUDC

001100 05 HUDC-EQUAT-BIC PIC X(02). CWFRHUDC

001110***** 1:6 IS SURNAME 7:1 IS FIRST INITIAL. CWFRHUBC

001200 05 HUDC-BENE-NAME PIC X(07). CWFRHUDC

001300 05 HUDC-SEX-CODE PIC X(01). CWFRHUDC

001400 05 HUDC-PROC-CARR PIC X(05). CWFRHUDC

001500 05 HUDC-PROC-CARR-BSI PIC X(04). DC

001600 05 HUDC-REQ-ID PIC X(04). CWFRHUDC

001700 05 HUDC-LINE-COUNT PIC 9(02). CWFRHUDC

001800 05 HUDC-ENTRY-CODE PIC X(01). CWFRHUDC

001900 05 HUDC-EXPN-DATE-FRST PIC S9(7) COMP-3. CWFRHUDC

002000 05 HUDC-EXPN-DATE-LAST PIC S9(7) COMP-3. CWFRHUDC

002100 05 HUDC-TOTALW-MED PIC S9(5)V99 COMP-3. CWFRHUDC

002200 05 PIC X(12). CWFRHUDC

002300 05 HUDC-TOTDED-MED PIC S9(5)V99 COMP-3. CWFRHUDC

002400 05 PIC X(12). CWFRHUDC

002500 05 HUDC-INVEST-IND PIC X(01). CWFRHUDC

002600 05 HUDC-SPLIT-IND PIC X(01). CWFRHUDC

002700 05 HUDC-MSP-FLAG PIC X(01). CWFRHUDC

002800 05 HUDC-PAY-DENIAL-IND PIC X(02). CWFRHUDC

002900***** 88 HUBC-PAID-CODES CWFRHUDC

003000***** '0 ' '1 ' '2 ' '3 '.

003100***** 88 HUDC-COST-AVOID-SPECIFIC VALUE CWFRHUDC

003200***** 'T ' 'U ' 'V ' 'Y ' 'Q ' 'E ' 'F ' 'G ' CWFRHUDC

003300***** 'H ' 'J ' 'K ' '00' '12' '13' '14'.

003400***** 88 HUDC-COST-AVOID-ALL VALUE CWFRHUDC

003500***** 'T ' 'U ' 'V ' 'Y ' 'X ' 'Q ' 'E ' 'F ' CWFRHUDC

003600***** 'G ' 'H ' 'J ' 'K ' '00' '12' '13' '14' 003610***** '15' '16' '17' '18' '25' '26' '27'.

003700 05 HUDC-HCPCS-YEAR PIC 9(01). CWFRHUDC

003800 05 HUDC-MSP-AMT PIC S9(5)V99 COMP-3. CWFRHUDC

003900 05 HUDC-CPT-INTEREST PIC S9(3)V99 COMP-3. CWFRHUDC

004000 05 HUDC-DOC-CNTL-NUM PIC X(15). CWFRHUDC

004100 05 HUDC-DATE-BIRTH PIC S9(7) COMP-3. CWFRHUDC

004200 05 PIC X(10). CWFRHUDC

004210 05 HUDC-HEADER-REFER-NPI PIC X(10). CWFRHUDC

004300 05 HUDC-DATE-RECEIPT PIC S9(7) COMP-3. CWFRHUDC

004400 05 HUDC-DATE-PAY-DENY PIC S9(7) COMP-3. CWFRHUDC

004500 05 PIC X(04). DC

004600 05 HUDC-CSHDED PIC S9(3)V99 COMP-3. CWFRHUDC

004700 05 HUDC-REIMB PIC S9(5)V99 COMP-3. CWFRHUDC

004800 05 HUDC-REP-PAYEE-IND PIC X(01). CWFRHUDC

004900 05 HUDC-SUBMITTER-ID PIC X(10). CWFRHUDC

005000 05 HUDC-ACCIDENT-SW PIC X(01). CWFRHUDC

005100 05 HUDC-PATN-RELTP-IND PIC X(01). CWFRHUDC

005200 05 HUDC-WORK-RELTP-IND PIC X(01). CWFRHUDC

005300 05 HUDC-SIGNATURE-IND PIC X(01). CWFRHUDC

005400 05 HUDC-BENE-GONE-IND PIC X(01). CWFRHUDC

005500 05 HUDC-COMPLEMENT-IND PIC X(01). CWFRHUDC

005600 05 HUDC-COMPLEMENT-CARR PIC X(07). CWFRHUDC

005700 05 HUDC-MEDICARE-CHOICES-HMO-ID REDEFINES CWFRHUDC

005800 HUDC-COMPLEMENT-CARR. CWFRHUDC

005900 07 HUDC-MEDICARE-HMO-NUM PIC X(5). CWFRHUDC

006000 07 PIC X(2). CWFRHUDC

006100 05 HUDC-COMPLEMENT-ID-NO PIC X(20). CWFRHUDC

006200 05 HUDC-ASSIGN-IND PIC X(01). CWFRHUDC

006300 05 HUDC-PAID-BY-BENE PIC S9(4)V99 COMP-3. CWFRHUDC

006400 05 HUDC-PRIVACY-FLAG PIC X(01). CWFRHUDC

006500 05 HUDC-DATE-BILLED PIC S9(7) COMP-3. CWFRHUDC

006600 05 HUDC-CARRIER-HEADER-DATA. CWFRHUDC

006700 07 HUDC-EXAMINER-NO PIC X(02). CWFRHUDC

006800 07 HUDC-REMARKS PIC X(19). CWFRHUDC

006900 07 HUDC-IDE-FIELDS REDEFINES HUDC-REMARKS. CWFRHUDC

007000 09 HUDC-IDE-IDENTIFICATION PIC X(3). CWFRHUDC

007100 88 HUDC-IDE-PRESENT VALUE 'IDE'. CWFRHUDC

007200 09 HUDC-IDE-NUMBER PIC X(7). CWFRHUDC

007300 09 PIC X(9). CWFRHUDC

007400 07 HUDC-MICRO-IND PIC X(02). CWFRHUDC

007500 07 HUDC-UPIN PIC X(06). CWFRHUDC

007600 07 HUDC-DIAGNOSIS PIC X(05) OCCURS 4. CWFRHUDC

007700 07 PIC X(20). CWFRHUDC

007800 05 PIC X(46). CWFRHUDC

007900 05 HUDC-MEDICARE-STATUS PIC X(02). CWFRHUDC

008000 05 HUDC-SAMPLE PIC X(01). CWFRHUDC

008100 05 HUDC-ALERT-CODE PIC X(04). CWFRHUDC

008200 05 HUDC-CROSSOVER-ID-TABLE. DC

008300 07 HUDC-CROSSOVER-ID DC

008400 OCCURS 3 TIMES DC

008500 PIC 9(10). DC

008600 05 HUDC-DEMO-NUM PIC X(02). CWFRHUDC

008700 88 HUDC-DEMO-NUM-RUGS VALUE '01'. CWFRHUDC

008800 88 HUDC-DEMO-NUM-HHA VALUE '02'. CWFRHUDC

008900 88 HUDC-DEMO-NUM-TELEMED VALUE '03'. CWFRHUDC

009000 88 HUDC-DEMO-NUM-UMWA VALUE '04'. CWFRHUDC

009100 88 HUDC-DEMO-NUM-CHOICES VALUE '05'. CWFRHUDC

009200 88 HUDC-DEMO-NUM-CABG VALUE '06'. CWFRHUDC

009300 88 HUDC-DEMO-NUM-COE VALUE '07'. CWFRHUDC

009400 88 HUDC-DEMO-NUM-MPPP VALUE '08'. CWFRHUDC

009500 88 HUDC-DEMO-NUM-ESRD-MCO VALUE '15'. CWFRHUDC

009700 88 HUDC-DEMO-NUM-VALID VALUES '01' THRU '99'. CWFRHUDC

009800 05 HUDC-RELIG-NONMED-CODE PIC X. DC

009900 05 HUDC-SITE-OF-SERVICE PIC X(16). DC

010000 05 HUDC-CWF-IND PIC X(01). BC

010100 88 HUDC-CWF-CANCEL-ONLY VALUE 'G'. CWFRHUBC

010200 05 HUDC-HEADER-OVERRIDE-EDIT OCCURS 5 TIMES PIC X(4). DC

010300************************************************************** 10/22/97

010400**** THESE INDICATORS, IF USED, ARE DERIVED FROM ********* 10/22/97

010401**** OVERRIDE-EDIT VALUES, EITHER IN THE FIXED ********* 10/22/97

010402**** BODY OF THE CLAIM, OR FROM LINE ITEMS. ********* 10/22/97

010403**** THEY WERE ORIGINALLY REPLACED BY THE FILLER ******* 10/22/97

010404**** OF X(4); BUT NOW ARE OFFICIALLY DROPPED, FILLER ******* 10/22/97

010405**** AND ALL!! ******* 10/22/97

010410************************************************************** 10/22/97

010500**** 05 HUDC-HOSPICE-IND PIC X(01). DC

010600**** 05 HUDC-HMO-IND PIC X(01). DC

010700**** 05 HUDC-ED-OV PIC X(01). DC

010800**** 05 HUDC-ALIEN-OVERRIDE PIC X(01). BC

010900**** 05 FILLER PIC X(4). BC

010910 05 HUDC-LIAB-IND PIC X. BC

011000 05 HUDC-NCPDP-IND PIC X. BC

011010 05 HUDC-IHS-IND PIC X. BC

011300 05 PIC X(601). CWFRHUDC

011310 03 HUDC-PARTB-VARIABLE. CWFRHUDC

011400 04 FILLER OCCURS 13. CWFRHUDC

011500**************************************************************** CWFRHUDC

011501*** EACH LINE ITEM IS NOW 500C IN LENGTH. ******************* CWFRHUDC

011502**************************************************************** CWFRHUDC

011510 05 HUDC-LINE-ITEM. CWFRHUDC

011600 06 HUDC-LINE-HCFA-CNTL-DATA. CWFRHUDC

011700 07 HUDC-HCFA-PROV-SPEC PIC X(02). CWFRHUDC

011800 07 HUDC-HCFA-PROV-TYPE PIC X(01). CWFRHUDC

011900 07 HUDC-HCFA-TYPE PIC X(01). CWFRHUDC

012000 07 HUDC-HCFA-ASSIGN-IND PIC X(01). CWFRHUDC

012100 07 HUDC-HCFA-PAY-PROCESS-IND PIC X(02). CWFRHUDC

012200***** 88 HUDC-COST-AVOID-SPECIFIC VALUE CWFRHUDC

012300***** 'T ' 'U ' 'V ' 'Y ' 'Q ' 'E ' 'F ' 'G ' CWFRHUDC

012400***** 'H ' 'J ' 'K ' '00' '12' '13' '14'.

012500***** 88 HUDC-COST-AVOID-ALL VALUE CWFRHUDC

012600***** 'T ' 'U ' 'V ' 'Y ' 'X ' 'Q ' 'E ' 'F ' CWFRHUDC

012610***** 'G ' 'H ' 'J ' 'K ' '00' '12' '13' '14' 012620***** '15' '16' '17' '18' '25' '26' '27'.

012800 07 HUDC-HCFA-REIMB-IND PIC X(01). CWFRHUDC

012900 07 HUDC-HCFA-DED-IND PIC X(01). CWFRHUDC

013000 07 HUDC-HCFA-PROV-IND PIC X(01). CWFRHUDC

013100 07 HUDC-HCFA-PAYSCREEN-IND PIC X(01). CWFRHUDC

013200 07 PIC X(03). DC

013300 06 HUDC-PROC-CODE PIC X(05). CWFRHUDC

013400 06 HUDC-PROC-CODE-MOD1 PIC X(02). CWFRHUDC

013500 06 HUDC-PROC-CODE-MOD2 PIC X(02). CWFRHUDC

013600 06 HUDC-PROC-CODE-MOD3 PIC X(02). DC

013700 06 HUDC-PROC-CODE-MOD4 PIC X(02). DC

013800 06 HUDC-SUBMITTED-CHGS PIC S9(5)V99 COMP-3. CWFRHUDC

013900 06 HUDC-ALLOWED-CHGS PIC S9(5)V99 COMP-3. CWFRHUDC

014000 06 HUDC-SS-NUMBER PIC X(10). DC

014100 06 PIC X(6). DC

014200 06 HUDC-PLACE PIC X(2). DC

014300 06 HUDC-FROM-DATE PIC S9(7) COMP-3. CWFRHUDC

014400 06 HUDC-THRU-DATE PIC S9(7) COMP-3. CWFRHUDC

014500 06 HUDC-DOC-SUP PIC X(010). CWFRHUDC

014600 06 HUDC-SERVICES PIC 9(03). DC

014700 06 HUDC-ACTION-CODE PIC X(02). CWFRHUDC

014800 06 HUDC-SPEC-PRIC-IND PIC X(01). CWFRHUDC

014900 06 HUDC-LI-DIAGNOSIS PIC X(05). CWFRHUDC

015000 06 PIC X(17). DC

015100 06 HUDC-PATIENT-REIMB PIC S9(5)V99 COMP-3. CWFRHUDC

015200 06 HUDC-PROV-REIMB PIC S9(5)V99 COMP-3. CWFRHUDC

015300 06 HUDC-CSH-APPLIED PIC S9(3)V99 COMP-3. CWFRHUDC

015400 06 HUDC-BLOOD-LIMIT PIC X(04). CWFRHUDC

015500 06 FILLER REDEFINES HUDC-BLOOD-LIMIT. CWFRHUDC

015600 07 HUDC-LIM-AMT PIC S9(5)V99 COMP-3. CWFRHUDC

015700 06 FILLER REDEFINES HUDC-BLOOD-LIMIT. CWFRHUDC

015800 07 HUDC-BLD-DED PIC S9(7) COMP-3. CWFRHUDC

015900 06 HUDC-MSP-APPLIED PIC S9(5)V99 COMP-3. CWFRHUDC

016000 06 HUDC-MSP-CODE PIC X(01). CWFRHUDC

016100 06 FILLER OCCURS 5. CWFRHUDC

016200 07 HUDC-OTH-APPLIED PIC S9(5)V99 COMP-3. CWFRHUDC

016300 06 FILLER OCCURS 5. CWFRHUDC

016400 07 HUDC-OTH-APPL-IND PIC X(01). CWFRHUDC

016500 06 HUDC-COINS PIC S9(5)V99 COMP-3. CWFRHUDC

016600 06 HUDC-PHYS-SUP-NO-IND PIC 9(01). DC

016700 06 HUDC-LINE-UPIN PIC X(06). CWFRHUDC

016710 06 HUDC-LINE-RENDERING-SUPPLIER-NPI PIC X(10). CWFRHUDC

016800 06 PIC X(20). DC

016900 06 HUDC-SCRN-SUSPECT PIC X(04). DC

017000 06 HUDC-SCRN-RESULT PIC X(01). DC

017100 06 HUDC-DECISION PIC X. DC

017200 06 HUDC-SCRN-SAVINGS PIC S9(5)V99 COMP-3. DC

017300 06 HUDC-DME-ALLOWED PIC S9(5)V99 COMP-3. DC

017400 06 HUDC-NATL-DRUG-CO PIC X(11). DC

017500 06 HUDC-DME-UNIT-IND PIC 9. DC

017600 06 HUDC-DOCUMENT-IND PIC 9. DC

017700 06 HUDC-WAIVER-LIAB PIC X. DC

017800 06 HUDC-STATE-CODE PIC XX. DC

017900 06 HUDC-SUP-STATE-CODE PIC XX. DC

018000 06 HUDC-NOC-DESC PIC X(14). DC

018100 06 HUDC-POPZIP PIC X(5). CWFRHUDC

018200 06 FILLER-UNITS PIC X(6). CWFRHUDC

018300 06 HUDC-UNITS REDEFINES FILLER-UNITS CWFRHUDC

018400 PIC S9(7)V999 COMP-3. CWFRHUDC

018500 06 HUDC-LINE-OVERRIDE-EDIT OCCURS 5 TIMES PIC X(4). DC

018910 06 HUDC-SUSP-DUP-REV-IND PIC X. CWFRHUDC

018911 06 FILLER PIC X. CWFRHUDC

018912 06 HUDC-PRESCRIPTION. CWFRHUDC

018913 10 HUDC-VENDOR-ID PIC X(4). CWFRHUDC

018914 10 HUDC-HCPCS PIC X(5). CWFRHUDC

018915 10 HUDC-VENDOR-PR-NUMBER PIC X(21). CWFRHUDC

018920************************************************************** 10/22/97

018930**** THESE PLACE AND SERVICES FIELDS ARE NO LONGER ******** 10/22/97

018940**** USED; NEW FIELDS HAVE TAKEN THEIR PLACE IN ********* 10/22/97

018950**** PRIOR RELEASES. THEY HAVE NOT BEEN POPULATED ********* 10/22/97

018951**** IN SOME TIME, AND, ARE DELETED FOR R2006200. ********* 10/22/97

018960************************************************************** 10/22/97

019100****** 06 HUDC-PLACE-OLD PIC X(01). DC

019200****** 06 HUDC-SRVCS-OLD PIC X(02). CWFRHUDC

019310 06 PIC X(206). DC

019400 03 HUDC-PARTB-FROM-HBIP. CWFRHUDC

019500 05 HUDC-19-23. CWFRHUDC

019600 07 HUDC-PEND-ACC-DTE PIC S9(7) COMP-3. CWFRHUDC

019700 07 HUDC-PEND-ACC-CTR PIC S9(3) COMP-3. CWFRHUDC

019800 05 HUDC-25-27. CWFRHUDC

019900 07 PIC X(02). CWFRHUDC

020000 07 HUDC-REIN-CODE PIC X(01). CWFRHUDC

020100 05 PIC X(01). CWFRHUDC

020200 05 HUDC-44-55. CWFRHUDC

020300 07 HUDC-HI-REC-DTE PIC S9(7) COMP-3. CWFRHUDC

020400 07 HUDC-HI-PRO-DTE PIC S9(7) COMP-3. CWFRHUDC

020500 07 HUDC-REIN-SRCE-CDE PIC X(04). CWFRHUDC

020600 07 HUDC-DISP-CD PIC X(02). CWFRHUDC

020700 05 HUDC-DATA-INDICATORS PIC X(20). CWFRHUDC

020800 05 HUDC-LAF-CDE PIC X(02). CWFRHUDC

020900 05 HUDC-167-228. CWFRHUDC

021000 07 HUDC-XRF-NUM PIC X(11). CWFRHUDC

021100 07 HUDC-COR-NAME PIC X(08). CWFRHUDC

021200 07 HUDC-STATE-CDE PIC X(02). CWFRHUDC

021300 07 HUDC-CTY-CDE PIC X(03). CWFRHUDC

021400 07 HUDC-HIMA-DOB PIC S9(7) COMP-3. CWFRHUDC

021500 07 HUDC-HIMA-SEX PIC X(01). CWFRHUDC

021600 07 HUDC-HIMA-RACE PIC X(01). CWFRHUDC

021700 07 HUDC-HIMA-ZIP PIC X(05). CWFRHUDC

021800 07 HUDC-HMO-DATA. CWFRHUDC

021900 09 HUDC-HMO-NO-PD PIC 9(01). CWFRHUDC

022000 09 FILLER OCCURS 2. CWFRHUDC

022100 11 HUDC-HMO PIC S9(4) COMP-3. CWFRHUDC

022200 11 HUDC-HMO-OPT PIC X(01). CWFRHUDC

022300 11 HUDC-HMO-EFF-DTE PIC S9(7) COMP-3. CWFRHUDC

022400 11 HUDC-HMO-TRM-DTE PIC S9(7) COMP-3. CWFRHUDC

022410 05 PIC X(44). CWFRHUDC

022420**************************************************************** CWFRHUDC

022430*** ONLINE FIELDS BELOW ARE USED FOR UTILIZATION ************** CWFRHUDC

022431*** EDITS AT CMS, AND, THEN DROPPED. ************* CWFRHUDC

022432*** THEY ARE NOT SAVED OR STORED. ************* CWFRHUDC

022440**************************************************************** CWFRHUDC

022500 03 HUDC-PARTB-ONLINE. CWFRHUDC

022700 05 HUDC-CANCEL-ALERT-SW PIC X(01). DC

022800 05 HUDC-AUTONOT-SW PIC X(01). DC

022900 05 HUDC-ONLINE-MED-TO-DED PIC S9(7)V99 COMP-3. DC

023000 05 HUDC-ONLINE-REST PIC X(01). DC

023100 05 HUDC-ONLINE-PROC-SITE PIC X(01). DC

023200 05 HUDC-ONLINE-ORIG-SITE PIC X(01). DC

023300 05 HUDC-CAB-DISP-CODE PIC X(02). CWFRHUDC

023400 05 HUDC-OLD-PARTB. CWFRHUDC

023500 07 HUDC-OLD-FIXED. CWFRHUDC

023600 09 HUDC-OLD-CARRIER-OF-REC PIC X(05). CWFRHUDC

023700**** THIS DATE CHANGED FROM X(4) TO S9(7) COMP-3 ON 01-17-03. CWFRHUBC

023800 09 HUDC-OLD-LST-MAM-DTE PIC S9(7) COMP-3. CWFRHUBC

023900 09 HUDC-OLD-LST-RISK-IND PIC X(01). CWFRHUDC

024000**** THIS DATE CHANGED FROM X(4) TO S9(7) COMP-3 ON 01-17-03. CWFRHUBC

024100 09 HUDC-OLD-PR-MAM-DTE PIC S9(7) COMP-3. CWFRHUBC

024200 09 HUDC-OLD-PR-RISK-IND PIC X(01). CWFRHUDC

024300 09 HUDC-OLD-DRUG-DED PIC S9(5) COMP-3. CWFRHUDC

024400 09 FILLER PIC X(03). CWFRHUDC

024500 07 HUDC-OLD-TRAILER. CWFRHUDC

024600 09 HUDC-OLD-YR PIC X(04). CWFRHUDC

024700 09 HUDC-OLD-HH-VIS PIC S9(3) COMP-3. CWFRHUDC

024800 09 HUDC-OLD-BLD-DED PIC S9V9 COMP-3. CWFRHUDC

024900 09 HUDC-OLD-MED-EXP PIC S9(5)V99 COMP-3. CWFRHUDC

025000 09 HUDC-OLD-PSY-EXP PIC S9(5)V99 COMP-3. CWFRHUDC

025100 09 HUDC-OLD-RICR-PSY PIC S9(5)V99 COMP-3. CWFRHUDC

025200 09 HUDC-OLD-PTHPY-EXP PIC S9(5)V99 COMP-3. CWFRHUDC

025300 09 HUDC-OLD-RICR-PTHPY PIC S9(5)V99 COMP-3. CWFRHUDC

025400 09 HUDC-OLD-OT-EXP PIC S9(5)V99 COMP-3. CWFRHUDC

025500 09 HUDC-OLD-RICR-OT PIC S9(5)V99 COMP-3. CWFRHUDC

025600 09 HUDC-OLD-OOP-EXP PIC S9(5)V99 COMP-3. CWFRHUDC

025700 09 HUDC-OLD-OOP-DTE PIC S9(7) COMP-3. CWFRHUDC

025800 09 HUDC-OLD-RESP-HRS PIC S9(3) COMP-3. CWFRHUDC

025900 09 HUDC-OLD-RESP-DTE PIC S9(7) COMP-3. CWFRHUDC

026000 09 HUDC-OLD-RESP-USED PIC S9(3) COMP-3. CWFRHUDC

026100 09 HUDC-OLD-PRRESP-DTE PIC S9(7) COMP-3. CWFRHUDC

026200 09 HUDC-OLD-PRRESP-USED PIC S9(3) COMP-3. CWFRHUDC

026300 09 HUDC-OLD-DRUG-DTE PIC S9(7) COMP-3. CWFRHUDC

026400 09 HUDC-OLD-TRLR1-IV-DTE PIC S9(7) COMP-3. CWFRHUDC

026500 09 HUDC-OLD-IMMUNO-DTE PIC S9(7) COMP-3. CWFRHUDC

026600 05 HUDC-NEW-PARTB. CWFRHUDC

026700 07 HUDC-NEW-FIXED. CWFRHUDC

026800 09 HUDC-NEW-CARRIER-OF-REC PIC X(05). CWFRHUDC

026900**** THIS DATE CHANGED FROM X(4) TO S9(7) COMP-3 ON 01-17-03. CWFRHUBC

027000 09 HUDC-NEW-LST-MAM-DTE PIC S9(7) COMP-3. CWFRHUBC

027100 09 HUDC-NEW-LST-RISK-IND PIC X(01). CWFRHUDC

027200**** THIS DATE CHANGED FROM X(4) TO S9(7) COMP-3 ON 01-17-03. CWFRHUBC

027300 09 HUDC-NEW-PR-MAM-DTE PIC S9(7) COMP-3. CWFRHUBC

027400 09 HUDC-NEW-PR-RISK-IND PIC X(01). CWFRHUDC

027500 09 HUDC-NEW-DRUG-DED PIC S9(5) COMP-3. CWFRHUDC

027600 09 FILLER PIC X(03). CWFRHUDC

027700 07 HUDC-NEW-TRAILER. CWFRHUDC

027800 09 HUDC-NEW-YR PIC X(04). CWFRHUDC

027900 09 HUDC-NEW-HH-VIS PIC S9(3) COMP-3. CWFRHUDC

028000 09 HUDC-NEW-BLD-DED PIC S9V9 COMP-3. CWFRHUDC

028100 09 HUDC-NEW-MED-EXP PIC S9(5)V99 COMP-3. CWFRHUDC

028200 09 HUDC-NEW-PSY-EXP PIC S9(5)V99 COMP-3. CWFRHUDC

028300 09 HUDC-NEW-RICR-PSY PIC S9(5)V99 COMP-3. CWFRHUDC

028400 09 HUDC-NEW-PTHPY-EXP PIC S9(5)V99 COMP-3. CWFRHUDC

028500 09 HUDC-NEW-RICR-PTHPY PIC S9(5)V99 COMP-3. CWFRHUDC

028600 09 HUDC-NEW-OT-EXP PIC S9(5)V99 COMP-3. CWFRHUDC

028700 09 HUDC-NEW-RICR-OT PIC S9(5)V99 COMP-3. CWFRHUDC

028800 09 HUDC-NEW-OOP-EXP PIC S9(5)V99 COMP-3. CWFRHUDC

028900 09 HUDC-NEW-OOP-DTE PIC S9(7) COMP-3. CWFRHUDC

029000 09 HUDC-NEW-RESP-HRS PIC S9(3) COMP-3. CWFRHUDC

029100 09 HUDC-NEW-RESP-DTE PIC S9(7) COMP-3. CWFRHUDC

029200 09 HUDC-NEW-RESP-USED PIC S9(3) COMP-3. CWFRHUDC

029300 09 HUDC-NEW-PRRESP-DTE PIC S9(7) COMP-3. CWFRHUDC

029400 09 HUDC-NEW-PRRESP-USED PIC S9(3) COMP-3. CWFRHUDC

029500 09 HUDC-NEW-DRUG-DTE PIC S9(7) COMP-3. CWFRHUDC

029600 09 HUDC-NEW-TRLR1-IV-DTE PIC S9(7) COMP-3. CWFRHUDC

029700 09 HUDC-NEW-IMMUNO-DTE PIC S9(7) COMP-3. CWFRHUDC

029800 05 HUDC-ONLINE-AUTOADJ-DATA. CWFRHUDC

029900 07 HUDC-SUB-CSH-DED PIC S9(5)V99 COMP-3. CWFRHUDC

030000 07 HUDC-SUB-PSYCH PIC S9(5)V99 COMP-3. CWFRHUDC

030100 07 HUDC-SUB-PT PIC S9(5)V99 COMP-3. CWFRHUDC

030200 07 HUDC-SUB-OT PIC S9(5)V99 COMP-3. CWFRHUDC

030300 07 FILLER PIC X(01). CWFRHUDC

030310 05 FILLER PIC X(39). DC

030400***************************************************************** CWFRHUDC

030500* CWFRHUDC RX1: RECORD REARRANGED THIS DATE, SO IT 10/04/04 *

030600* RX1: LOOKS MORE LIKE THE SATELLITE'S REC. 10/04/04 *

030700* CWFRHUDC RXX: ADD ALIEN-OVERRIDE CODE. 01/04/04 *

030800* CWFRHUDC R06: CHANGE PAY-DENIAL/PAY-PROCESS-IND 04/02/02 *

030900* CWFRHUDC R06: TO 2 POSITIONS EACH. 04/02/02 *

031000* CWFRHUDC R06: RENAME HH-OVERRIDE TO CB-OV 04/02/02 *

031100* CWFRHUDC R06: RENAME ABCROSS-IND TO ED-OV. 04/02/02 *

031200* CWFRHUDC R05: MILLENIUM COMPLIANT DATES 01/04/99 * CWFRHUDC

031300* CWFRHUDC R04: PAYOR-ID, FILLER FIELDS 01/02/97 * CWFRHUDC

031400* CWFRHUDC R03: IDE, CHOICES FIELDS 10/01/96 * CWFRHUDC

031500* CWFRHUDC R02: CONVERT SUP-STATE-CODE TO NUMERIC 01/18/95 * CWFRHUDC

031600* PART-B DURABLE MEDICAL EQUIPMENT 3946 BYTES * CWFRHUDC

031700* REVISON1 ADD SUP-STATE-CODE 12/06/94 * CWFRHUDC

031800***************************************************************** CWFRHUDC

031900**** 05 HUDC-UTIL-BYPASS PIC X(01). DC

032000**** 06 HUDC-100-PERC-REIMB-IND PIC X(01). DC