sHelp
                                     PHA.CLAIM.FORM
     i   2
 main
   claim.claim.segment
   claim.clinical.segment
   claim.cob.segment
   claim.compound.segment
   claim.coupon.segment
   claim.dur.segment
   claim.header
   claim.header.optional
   claim.info
   claim.info.optional
   claim.pharmacy.segment
   claim.prescriber.segment
   claim.pricing.segment
   claim.prior.segment
   claim.workers.segment
   header.header.segment
   header.insurance.segment
   header.patient.segment
   insurances
   reversal
   reversal.claim.segment
   reversal.dur.segment
   reversal.header.segment
   reversal.ins.segment
   reversal.optional
   reversal.patient.segment
   reversal.pricing.segment

 Ì   €   i   2
main
[mnemonic]
&(T)TCO[tco]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 mnemonic                    10 FREE     L                 tco                                                         
 active                       1 YN       L                 &(T)TCO[tco]|0                                              
 cds                         15 FREE     L  MIS.SCREEN     &(T)TCO[tco]|2                                          
 claims.per.txn               2 PINT     R                 &(T)TCO[tco]|4                                              
 last.update                 50 FREE     L                 &(T)TCO[tco]UPD                                             
 name                        30 FREE     L                 &(T)TCO[tco]|1                                              
 variable                     1 YN       L                 &(T)TCO[tco]|3                                              
 version                      1 CHOICE   L                 &(T)TCO[tco]|5                                              
 Ì   €   i   2
claim.claim.segment
[mnemonic,  claim.claim.q]
&(T)TCO[tco]C1[tcoC1]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 claim.claim.q                2 PINT     R                 tcoC1                                                       
 claim.claim.field           10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]C1[tcoC1]|0                                 
 Ì   €   i   2
claim.clinical.segment
[mnemonic,  claim.clinical.q]
&(T)TCO[tco]C11[tco11]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 claim.clinical.q             2 PINT     R                 tco11                                                       
 claim.clinical.field        10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]C11[tco11]|0                                
 Ì   €   i   2
claim.cob.segment
[mnemonic,  claim.cob.q]
&(T)TCO[tco]C5[tcoC5]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 claim.cob.q                  2 PINT     R                 tcoC5                                                       
 claim.cob.field             10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]C5[tcoC5]|0                                 
 Ì   €   i   2
claim.compound.segment
[mnemonic,  claim.compound.q]
&(T)TCO[tco]C9[tcoC9]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 claim.compound.q             2 PINT     R                 tcoC9                                                       
 claim.compound.field        10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]C9[tcoC9]|0                                 
 Ì   €   i   2
claim.coupon.segment
[mnemonic,  claim.coupon.q]
&(T)TCO[tco]C8[tcoC8]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 claim.coupon.q               2 PINT     R                 tcoC8                                                       
 claim.coupon.field          10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]C8[tcoC8]|0                                 
 Ì   €   i   2
claim.dur.segment
[mnemonic,  claim.dur.q]
&(T)TCO[tco]C7[tcoC7]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 claim.dur.q                  2 PINT     R                 tcoC7                                                       
 claim.dur.field             10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]C7[tcoC7]|0                                 
 Ì   €   i   2
claim.header
[mnemonic,  claim.header.q]
&(T)TCO[tco]CH[tcoCH]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 claim.header.q               3 PINT     R                 tcoCH                                                       
 claim.header.field          10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]CH[tcoCH]|0                                 
 Ì   €   i   2
claim.header.optional
[mnemonic,  claim.header.opt.q]
&(T)TCO[tco]CHO[tcoCh]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 claim.header.opt.q           3 PINT     R                 tcoCh                                                       
 claim.header.opt.field      10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]CHO[tcoCh]|0                                
 Ì   €   i   2
claim.info
[mnemonic,  claim.info.q]
&(T)TCO[tco]CI[tcoCI]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 claim.info.q                 3 PINT     R                 tcoCI                                                       
 claim.info.field            10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]CI[tcoCI]|0                                 
 Ì   €   i   2
claim.info.optional
[mnemonic,  claim.info.opt.q]
&(T)TCO[tco]CIO[tcoCi]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 claim.info.opt.q             3 PINT     R                 tcoCi                                                       
 claim.info.opt.field        10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]CIO[tcoCi]|0                                
 Ì   €   i   2
claim.pharmacy.segment
[mnemonic,  claim.pharmacy.q]
&(T)TCO[tco]C3[tcoC3]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 claim.pharmacy.q             2 PINT     R                 tcoC3                                                       
 claim.pharmacy.field        10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]C3[tcoC3]|0                                 
 Ì   €   i   2
claim.prescriber.segment
[mnemonic,  claim.prescriber.q]
&(T)TCO[tco]C4[tcoC4]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 claim.prescriber.q           2 PINT     R                 tcoC4                                                       
 claim.prescriber.field      10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]C4[tcoC4]|0                                 
 Ì   €   i   2
claim.pricing.segment
[mnemonic,  claim.pricing.q]
&(T)TCO[tco]C2[tcoC2]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 claim.pricing.q              2 PINT     R                 tcoC2                                                       
 claim.pricing.field         10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]C2[tcoC2]|0                                 
 Ì   €   i   2
claim.prior.segment
[mnemonic,  claim.prior.q]
&(T)TCO[tco]C10[tco10]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 claim.prior.q                2 PINT     R                 tco10                                                       
 claim.prior.field           10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]C10[tco10]|0                                
 Ì   €   i   2
claim.workers.segment
[mnemonic,  claim.workers.q]
&(T)TCO[tco]C6[tcoC6]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 claim.workers.q              2 PINT     R                 tcoC6                                                       
 claim.workers.field         10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]C6[tcoC6]|0                                 
 Ì   €   i   2
header.header.segment
[mnemonic,  header.header.q]
&(T)TCO[tco]H1[tcoH1]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 header.header.q              2 PINT     R                 tcoH1                                                       
 header.header.field         10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]H1[tcoH1]|0                                 
 Ì   €   i   2
header.insurance.segment
[mnemonic,  header.insurance.q]
&(T)TCO[tco]H2[tcoH2]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 header.insurance.q           2 PINT     R                 tcoH2                                                       
 header.insurance.field      10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]H2[tcoH2]|0                                 
 Ì   €   i   2
header.patient.segment
[mnemonic,  header.patient.q]
&(T)TCO[tco]H3[tcoH3]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 header.patient.q             2 PINT     R                 tcoH3                                                       
 header.patient.field        10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]H3[tcoH3]|0                                 
 Ì   €   i   2
insurances
[mnemonic,  insurance]
&(T)TCO[tco]I[ggm]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 insurance                   10 FREE     L  MIS.INS        ggm                                                     
 Ì   €   i   2
reversal
[mnemonic,  reversal.q]
&(T)TCO[tco]R[tcoR]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 reversal.q                   3 PINT     R                 tcoR                                                        
 reversal.field              10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]R[tcoR]|0                                   
 Ì   €   i   2
reversal.claim.segment
[mnemonic,  reversal.claim.q]
&(T)TCO[tco]R4[tcoR4]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 reversal.claim.q             2 PINT     R                 tcoR4                                                       
 reversal.claim.field        10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]R4[tcoR4]|0                                 
 Ì   €   i   2
reversal.dur.segment
[mnemonic,  reversal.dur.q]
&(T)TCO[tco]R5[tcoR5]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 reversal.dur.q               2 PINT     R                 tcoR5                                                       
 reversal.dur.field          10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]R5[tcoR5]|0                                 
 Ì   €   i   2
reversal.header.segment
[mnemonic,  reversal.header.q]
&(T)TCO[tco]R1[tcoR1]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 reversal.header.q            2 PINT     R                 tcoR1                                                       
 reversal.header.field       10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]R1[tcoR1]|0                                 
 Ì   €   i   2
reversal.ins.segment
[mnemonic,  reversal.ins.q]
&(T)TCO[tco]R3[tcoR3]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 reversal.ins.q               2 PINT     R                 tcoR3                                                       
 reversal.ins.field          10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]R3[tcoR3]|0                                 
 Ì   €   i   2
reversal.optional
[mnemonic,  reversal.opt.q]
&(T)TCO[tco]RO[tcoRO]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 reversal.opt.q               3 PINT     R                 tcoRO                                                       
 reversal.opt.field          10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]RO[tcoRO]|0                                 
 Ì   €   i   2
reversal.patient.segment
[mnemonic,  reversal.patient.q]
&(T)TCO[tco]R2[tcoR2]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 reversal.patient.q           2 PINT     R                 tcoR2                                                       
 reversal.patient.field      10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]R2[tcoR2]|0                                 
 Ì   €   i   2
reversal.pricing.segment
[mnemonic,  reversal.pricing.q]
&(T)TCO[tco]R6[tcoR6]

 Field Name                 Len Dat Typ  J  DPM            Offset/Local/VAL
 reversal.pricing.q           2 PINT     R                 tcoR6                                                       
 reversal.pricing.field      10 FREE     L  PHA.CLAIM.FIELD&(T)TCO[tco]R6[tcoR6]|0                                 

 Index Files                        Subscripts/Physical Base

 insurance.x                        [insurance] = mnemonic
                                      &(T)TCOI[ggm]