| # | Name | Location | Type | Details | Index | Description |
|---|---|---|---|---|---|---|
| .01 | transaction number(+) | 0;1 | FREE TEXT | B | This is the transaction number. The format is: Station number (3 digits) - Sequential Number | |
| .02 | patient(+) | 0;2 | POINTER | 354.7 | This is the pointer to the patient copay account. The ien stored here is the same as the patient's dfn. | |
| .03 | trans effective date(+) | 0;3 | DATE-TIME | AE | This is the effective date of the transaction that is used to determine the month/year in which to count the transaction amount towards the patient's cap. | |
| .04 | ib action pointer | 0;4 | POINTER | 350 | This is a pointer to the INTEGRATED BILLING ACTION (#350) file. This will only be filled in for entries that have been billed. | |
| .05 | status(+) | 0;5 | SET OF CODES | P:PENDING TRANSMISSION C:COMPLETE Y:CANCELLED PENDING TRANSMISSION X:CANCELLED COMPLETE | AC | This is the status of this transaction. |
| .06 | resulting from(+) | 0;6 | FREE TEXT | This is a soft link pointer to indicate where this transaction came from. The information should be in the following format: Station Number:File Number:IEN;refill number (if any) | ||
| .07 | units | 0;7 | NUMERIC | This is the number of units for this transaction. | ||
| .08 | total charge | 0;8 | NUMERIC | This is the total charge for this transaction. | ||
| .09 | brief description | 0;9 | FREE TEXT | This is descriptive information regarding this transaction. | ||
| .1 | parent transaction entry | 0;10 | POINTER | 354.71 | AF | This is a pointer to the parent transaction entry. If this is the same as this entry, then this is the parent. |
| .11 | billed amount | 0;11 | NUMERIC | This is the amount that was billed for this transaction. | ||
| .12 | non-billable amount | 0;12 | NUMERIC | This is the non-billable amount for this transaction. | ||
| .13 | institution | 0;13 | POINTER | 4 | This pointer indicates where this account transaction came from. | |
| .14 | user adding entry | 0;14 | POINTER | 200 | This is the person who added this entry. This may be a remote person since they are also stored in the New Person file. | |
| .15 | date entry added | 0;15 | DATE-TIME | This indicates when this entry was added. | ||
| .16 | user last updating | 0;16 | POINTER | 200 | This is the person who last updated this transaction. | |
| .17 | date last updated | 0;17 | DATE-TIME | This is the last date/time this transaction was updated. | ||
| .18 | action type | 0;18 | POINTER | 350.1 | This pointer to the action type identifies what action type this transaction was created with. | |
| .19 | cancellation reason | 0;19 | POINTER | 350.3 | This is the reason this transaction is cancelled. | |
| .2 | pfss remote transaction | 0;20 | BOOLEAN | 0:NO 1:YES | This field is a flag/indicator that this billing transaction is from a PFSS remote system to the local VistA M system. It is used to determine which system should be used for update processing. | |
| 1 | transmission record | 1;0 | MULTIPLE | 354.711 | This is a record of transmission(s) to each facility that is a treating facility for the patient. This record will indicate if a transmission has been accepted or not at the individual facilities. |