Ì 2
mis.ins.benefits.dict (main)
[mnemonic]
\GGMB[ggmb]
Field Name Len Dat Typ J DPM Offset/Local/VAL
mnemonic 10 FREE L ggmb
active 1 YN L \GGMB[ggmb]|0
conflicts 1 YN L \GGMB[ggmb]|2
name 30 FREE L \GGMB[ggmb]|1
product.type 3 CHOICE L \GGMB[ggmb]|3
Ì € 2
mis.ins.bene.eff.dates (eff.dt)
[mnemonic, effective.date]
\GGMB[ggmb]D[eD]
Field Name Len Dat Typ J DPM Offset/Local/VAL
effective.date 8 DATE L eD
effective.date.expiration 8 DATE L \GGMB[ggmb]D[eD]|0
effective.date.place.hold 1 FREE L \GGMB[ggmb]D[eD]|1
Ì € 2
mis.ins.benefits.facilities (facs)
[mnemonic,effective.date, facility]
\GGMB[ggmb]D[eD]F[gqb]
Field Name Len Dat Typ J DPM Offset/Local/VAL
facility 10 FREE L MIS.FACILITY gqb
anniv.date 5 FREE L \GGMB[ggmb]D[eD]F[gqb]L|1
bene.services 10 FREE L MIS.INS.BEN.SVC\GGMB[ggmb]D[eD]F[gqb]S|3
bene.services.no.auth 10 FREE L MIS.INS.BEN.SVC\GGMB[ggmb]D[eD]F[gqb]S|4
bene.year.basis 17 CHOICE L \GGMB[ggmb]D[eD]F[gqb]L|0
carry.over 2 INT R \GGMB[ggmb]D[eD]F[gqb]L|2
ded.any 1 FREE L VAL=IF{@ded.and.limits.main!@bene.services @Z.check.ma
VAL=rk}
ded.edit 1 YN L VAL=LOCAL
ded.view 1 YN L VAL=LOCAL
max.tot.pt.resp 9 MONEY R \GGMB[ggmb]D[eD]F[gqb]S|2
min.tot.pt.resp 9 MONEY R \GGMB[ggmb]D[eD]F[gqb]S|1
old.hcr.any 1 FREE L VAL=IF{@old.hcr.main @Z.check.mark}
old.hcr.view 1 YN L VAL=LOCAL
oop.exclude.list 10 FREE L MIS.SVC.GRP.SET\GGMB[ggmb]D[eD]F[gqb]L|3
pha.any 1 FREE L VAL=IF{%MIS.INS.BENE.check.pha.data("") @Z.check.mark}
pha.copay.charge 6 MONEY R \GGMB[ggmb]D[eD]F[gqb]PHA|5
pha.copay.charge.2 6 MONEY R \GGMB[ggmb]D[eD]F[gqb]PHA|7
pha.copay.percent 5 DEC R \GGMB[ggmb]D[eD]F[gqb]PHA|6
pha.copay.percent.2 5 DEC R \GGMB[ggmb]D[eD]F[gqb]PHA|8
pha.database 12 FREE L MIS.APPL \GGMB[ggmb]D[eD]F[gqb]PHADB
pha.edit 1 YN L VAL=LOCAL
pha.generic.req 1 YN L \GGMB[ggmb]D[eD]F[gqb]PHA|10
pha.max.charge 9 MONEY R \GGMB[ggmb]D[eD]F[gqb]PHA|9
pha.max.days 5 INT R \GGMB[ggmb]D[eD]F[gqb]PHA|1
pha.max.qty 6 INT R \GGMB[ggmb]D[eD]F[gqb]PHA|3
pha.max.refills 2 INT R \GGMB[ggmb]D[eD]F[gqb]PHA|4
pha.min.days 5 INT R \GGMB[ggmb]D[eD]F[gqb]PHA|0
pha.min.qty 6 INT R \GGMB[ggmb]D[eD]F[gqb]PHA|2
pha.view 1 YN L VAL=LOCAL
svc.any 1 FREE L VAL=IF{@svc.main @Z.check.mark.data;@First(@svc.grp,@s
VAL=vc.groups) @Z.check.mark.data}
svc.edit 1 YN L VAL=LOCAL
svc.view 1 YN L VAL=LOCAL
visit.copay 9 MONEY R \GGMB[ggmb]D[eD]F[gqb]S|0
Ì € 2
mis.ins.bene.deds.and.limits (deductibles.and.limits)
[mnemonic,effective.date,facility, in.out.network]
\GGMB[ggmb]D[eD]F[gqb]L[ggmbI]
Field Name Len Dat Typ J DPM Offset/Local/VAL
in.out.network 1 FREE L ggmbI
family.ded 9 MONEY R \GGMB[ggmb]D[eD]F[gqb]L[ggmbI]|4
family.ded.formula 1 PINT R \GGMB[ggmb]D[eD]F[gqb]L[ggmbI]|5
family.ded.inc.both 1 YN L \GGMB[ggmb]D[eD]F[gqb]L[ggmbI]|6
family.oop.max 9 MONEY R \GGMB[ggmb]D[eD]F[gqb]L[ggmbI]|12
family.oop.max.formula 17 CHOICE L \GGMB[ggmb]D[eD]F[gqb]L[ggmbI]|13
family.oop.max.inc.both 1 YN L \GGMB[ggmb]D[eD]F[gqb]L[ggmbI]|14
individ.ded 9 MONEY R \GGMB[ggmb]D[eD]F[gqb]L[ggmbI]|0
individ.ded.formula 17 CHOICE L \GGMB[ggmb]D[eD]F[gqb]L[ggmbI]|1
individ.ded.inc.both 1 YN L \GGMB[ggmb]D[eD]F[gqb]L[ggmbI]|2
individ.max.bene 11 MONEY R \GGMB[ggmb]D[eD]F[gqb]L[ggmbI]|16
individ.max.bene.inc.both 1 YN L \GGMB[ggmb]D[eD]F[gqb]L[ggmbI]|17
individ.oop.max 9 MONEY R \GGMB[ggmb]D[eD]F[gqb]L[ggmbI]|8
individ.oop.max.formula 17 CHOICE L \GGMB[ggmb]D[eD]F[gqb]L[ggmbI]|9
individ.oop.max.inc.both 1 YN L \GGMB[ggmb]D[eD]F[gqb]L[ggmbI]|10
Ì € 2
mis.ins.benefits.pha.cls.excl (pha.drug.class.exclusions)
[mnemonic,effective.date,facility, pha.drug.class]
\GGMB[ggmb]D[eD]F[gqb]PHA["CL",tdc]
Field Name Len Dat Typ J DPM Offset/Local/VAL
pha.drug.class 10 FREE L PHA.CLASS tdc
Ì 2
mis.ins.bene.svc.pcp.limits (svc.pcp.lims)
[mnemonic,effective.date,facility,svc.grp, svc.pcp.lim.queue]
\GGMB[ggmb]D[eD]F[gqb]S[gsh]L[gpcpL]
Field Name Len Dat Typ J DPM Offset/Local/VAL
svc.pcp.lim.queue 3 PINT R gpcpL
svc.pcp.lim.period 10 FREE L MIS.SVC.PER \GGMB[ggmb]D[eD]F[gqb]S[gsh]L[gpcpL]|1
svc.pcp.lim.qty 5 PINT R \GGMB[ggmb]D[eD]F[gqb]S[gsh]L[gpcpL]|0
Ì € 2
mis.ins.bene.svc.pcp.lim.cpay (svc.pcp.copays)
[mnemonic,effective.date,facility,svc.grp,svc.pcp.lim.queue, svc.pcp.lim.copay.qty]
\GGMB[ggmb]D[eD]F[gqb]S[gsh]L[gpcpL]C[gpcpC]
Field Name Len Dat Typ J DPM Offset/Local/VAL
svc.pcp.lim.copay.qty 5 PINT R gpcpC
svc.pcp.lim.copay.dol 9 MONEY R \GGMB[ggmb]D[eD]F[gqb]S[gsh]L[gpcpL]C[gpcpC]|0
svc.pcp.lim.copay.per 5 PDEC R \GGMB[ggmb]D[eD]F[gqb]S[gsh]L[gpcpL]C[gpcpC]|1
Ì 2
mis.ins.bene.svc.specs (svc.specs)
[mnemonic,effective.date,facility,svc.grp, svc.spec]
\GGMB[ggmb]D[eD]F[gqb]S[gsh]S[gsd]
Field Name Len Dat Typ J DPM Offset/Local/VAL
svc.spec 10 FREE L MIS.ABS.SVC gsd
svc.spec.fee.dol 9 MONEY R \GGMB[ggmb]D[eD]F[gqb]S[gsh]S[gsd]|1
svc.spec.fee.per 5 PDEC R \GGMB[ggmb]D[eD]F[gqb]S[gsh]S[gsd]|2
svc.spec.per.vis.or.svc 1 CHOICE L \GGMB[ggmb]D[eD]F[gqb]S[gsh]S[gsd]|0
Ì € 2
mis.ins.bene.svc.spec.limits (ss.lim)
[mnemonic,effective.date,facility,svc.grp,svc.spec, svc.spec.lim.queue]
\GGMB[ggmb]D[eD]F[gqb]S[gsh]S[gsd]L[gsdL]
Field Name Len Dat Typ J DPM Offset/Local/VAL
svc.spec.lim.queue 3 PINT R gsdL
svc.spec.lim.period 10 FREE L MIS.SVC.PER \GGMB[ggmb]D[eD]F[gqb]S[gsh]S[gsd]L[gsdL]|1
svc.spec.lim.qty 5 PINT R \GGMB[ggmb]D[eD]F[gqb]S[gsh]S[gsd]L[gsdL]|0
Ì € 2
mis.ins.bene.svc.spec.lim.cpay (ss.copay)
[mnemonic,effective.date,facility,svc.grp,svc.spec,svc.spec.lim.queue, svc.spec.lim.copay.qty]
\GGMB[ggmb]D[eD]F[gqb]S[gsh]S[gsd]L[gsdL]C[gsdC]
Field Name Len Dat Typ J DPM Offset/Local/VAL
svc.spec.lim.copay.qty 5 PINT R gsdC
svc.spec.lim.copay.dol 9 MONEY R \GGMB[ggmb]D[eD]F[gqb]S[gsh]S[gsd]L[gsdL]C[gsdC]|0
svc.spec.lim.copay.per 5 PDEC R \GGMB[ggmb]D[eD]F[gqb]S[gsh]S[gsd]L[gsdL]C[gsdC]|1
Ì € 2
mis.ins.benefits.locations (locs)
[mnemonic,effective.date, location]
\GGMB[ggmb]D[eD]L[ggn]
Field Name Len Dat Typ J DPM Offset/Local/VAL
location 10 FREE L MIS.LOCN.DICT ggn
loc.bene.services 10 FREE L MIS.INS.BEN.SVC\GGMB[ggmb]D[eD]L[ggn]|0
loc.bene.services.no.auth 10 FREE L MIS.INS.BEN.SVC\GGMB[ggmb]D[eD]L[ggn]|1
loc.svc.any 1 FREE L VAL=IF{@loc.bene.services!@loc.bene.services.no.auth @
VAL=Z.check.mark.data}
|
|
| | | | | | | | |