Ì € 2
main
[mnemonic]
&(HP)HPEJ[pej]
Field Name Len Dat Typ J DPM Offset/Local/VAL
mnemonic 10 FREE L pej
accident 5 CHOICE L &(HP)HPEJ[pej]|5
active 1 YN L &(HP)HPEJ[pej]|0
empl.related 1 YN L &(HP)HPEJ[pej]|4
hcfa.description 10 FREE L &(HP)HPEJ[pej]|2
name 30 FREE L &(HP)HPEJ[pej]|1
possible.child.abuse 1 YN L &(HP)HPEJ[pej]|6
symptom.ind 1 CHOICE L &(HP)HPEJ[pej]|7
ub82.code 2 INT R &(HP)HPEJ[pej]|3
Ì € 2
payors
[mnemonic, payor]
&(HP)HPEJ[pej]P[pdy]
Field Name Len Dat Typ J DPM Offset/Local/VAL
payor 10 FREE L PBR.PAYOR pdy
injury.code 10 FREE L &(HP)HPEJ[pej]P[pdy]|0
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