Call Graph
IBNCPDP1 ;OAK/ELZ - IB BILLING DETERMINATION PROCESSING FOR NEW RX REQUESTS ;5/22/08
Source file <IBNCPDP1.m>
| action | A | extended action | Ea | event driver | Ed | subscriber | Su | protocol | O | limited protocol | LP | run routine | RR | broker | B | edit | E | server | Se | P | screenman | SM | inquire | I |
| Name | Comments | DBIA/ICR reference |
|---|---|---|
| RX(DFN,IBD) | ; pharmacy package call, passing in IBD by ref
; this is called by PSO for all prescriptions issued, return is ; a response to bill ECME or not with array for billing data elements |
|
| GETINS | ; -- examine the insurance data for a patient
|
|
| RATEPRIC | ; determine rates/prices to use
|
|
| RXQ | ; final processing
; set the 3rd piece of IBRES (default Vet) |
|
| CT | ; files in claims tracking
|
|
| SETINSUR(IBADT,IBRT,IBELIG,IBINS,IBD,IBRES) | ; build insurance data array
; Input variables: ; IBADT - date of service/identify insurance as of this date ; IBRT - rate type variable - [1] rate type ien, [2] type (A/C/T), [3] eligibility (V/T/C) ; IBELIG - eligibility request flag (1/0) ; IBINS - insurance array as returned by RXINS^IBNCPDPU ; IBD - input/output - array entries passed in and certain array entries returned ; Output variable: ; IBRES - only returned if insurance errors |
|
| SETINX | ;
|
|
| RXPCT(IBD,BWHERE) | ; Penny drug cost calculation
; Input-IBD array, BWHERE ; Output-return quotient of drug true value with 4 decimal places, or 0 |
|
| RXPCTQ | ;
|
|
| EXEMPT | ; exemption reasons
; variable from SD call ^ variable from PSO ^ reason not billable |
| Name | Field # of Occurrence |
|---|---|
| ADDCOMM^BPSBUTL | RX+97 |
| ^DIE | RX+153, RX+158, RX+163, RX+168 |
| $$EXTERNAL^DILFD | SETINSUR+48 |
| $$GET1^DIQ | RX+45, RX+46, RX+52, RX+53, RX+54, SETINSUR+76, SETINSUR+81 |
| GETS^DIQ | RXPCT+8, RXPCT+18 |
| $$NAME^IBCEFG1 | SETINSUR+45 |
| STCHK^IBCNRU1 | SETINSUR+39 |
| $$PLCOV^IBCNSU3 | SETINSUR+27 |
| $$PTCOV^IBCNSU3 | RX+100 |
| $$RATECHG^IBCRCC | RATEPRIC+25 |
| $$BICOST^IBCRCI | RATEPRIC+15 |
| $$ITPTR^IBCRU2 | RATEPRIC+12 |
| $$EVNTITM^IBCRU3 | RATEPRIC+3 |
| $$BILLABLE^IBNCPDP | RX+120 |
| LOG^IBNCPDP2 | RXQ+11 |
| $$PHONE^IBNCPDP6 | SETINSUR+75 |
| START^IBNCPDP6 | RXQ+10 |
| $$ACDUTY^IBNCPDPU | RX+104 |
| $$RT^IBNCPDPU | RX+58 |
| CT^IBNCPDPU | CT+3 |
| RXINS^IBNCPDPU | RX+31 |
| $$SENS^IBNCPDR | RX+124 |
| $$MACHK^IBNCPDR4 | RX+127 |
| $$ROI^IBNCPDR4 | RX+128 |
| ROICLN^IBNCPDR4 | RX+136 |
| $$ERMSG^IBNCPNB | SETINSUR+40 |
| $$NDC^IBNCPNB | RATEPRIC+12 |
| $$PAPERBIL^IBNCPNB | RX+93 |
| $$RXSTATUS^IBNCPRR | RX+150 |
| GETINDIC^IBNCPUT2 | RX+106 |
| $$COSTTYP^IBNCPUT3 | RX+63 |
| DATA^IBRXUTL | RXPCT+14 |
| $$MWC^PSOBPSU2 | RXPCT+24 |
| CL^SDCO21 | RX+110 |
| FileNo | Call Tags |
|---|---|
| 2.312 | EXTERNAL^DILFD |
| ^IBT(356 - [#356] | Classic Fileman Calls |
| ^IBCNR(366.03 - [#366.03] | GET1^DIQ |
| ^PSDRUG - [#50] | GETS^DIQ |
| 50.1 | GETS^DIQ |
| ^BPSTL - [#9002313.57] | GET1^DIQ |
| 9002313.57902 | GET1^DIQ |
| Name | Line Occurrences (* Changed, ! Killed) |
|---|---|
| ^BPSF(9002313.92 - [#9002313.92] | SETINSUR+54, SETINSUR+61, SETINSUR+62, SETINSUR+65 |
| ^BPSTL - [#9002313.57] | RX+48 |
| ^BPSTL("AEC" | RX+43 |
| ^DGCR(399.3 - [#399.3] | RATEPRIC+19 |
| ^DIC(36 - [#36] | SETINSUR+44, SETINSUR+60 |
| ^IBA(355.3 - [#355.3] | SETINSUR+36, SETINSUR+44, SETINSUR+78 |
| ^IBE(350.9 - [#350.9] | RX+79 |
| ^IBE(355.1 - [#355.1] | SETINSUR+33 |
| ^IBE(356.8 - [#356.8] | RX+146 |
| ^IBT(356 - [#356] | RX+83, RX+145 |
| ^TMP($J | RXPCT+15, RXPCT+16, RXPCT+29! |
| Name | Line Occurrences |
|---|---|
| $$RXPCT | RATEPRIC+19 |
| CT | RX+100, RX+117, RX+120, RX+139, RATEPRIC+2, RATEPRIC+4, RATEPRIC+7, RATEPRIC+13, RATEPRIC+30, RATEPRIC+53 |
| GETINS | RX+90 |
| RXPCTQ | RXPCT+6 |
| RXQ | RX+25, RX+68, RX+74, RX+75, RX+76, RX+93, RX+100, RX+117, RX+120, RX+139 , RX+174, GETINS+3, RATEPRIC+2, RATEPRIC+4, RATEPRIC+7, RATEPRIC+13, RATEPRIC+30 |
| SETINSUR | RX+70, RX+86 |
| SETINX | SETINSUR+104 |
| >> | Not killed explicitly |
| * | Changed |
| ! | Killed |
| ~ | Newed |
| Name | Field # of Occurrence |
|---|---|
| BPS57 | RX+20~, RX+42*, RX+43*, RX+45, RX+46, RX+48, RX+52, RX+53, RX+54 |
| >> BRXIEN | RX+43 |
| BWHERE | RX+40, RATEPRIC+19, SETINSUR+34, RXPCT~, RXPCT+5 |
| DA | RX+151~, RX+153*, RX+157~, RX+158*, RX+162~, RX+163*, RX+167~, RX+168* |
| DFN | RX~, RX+25, RX+31, RX+58, RX+100, RX+104, RX+110, RX+128, RX+150, CT+3 |
| DIE | RX+151~, RX+153*, RX+157~, RX+158*, RX+162~, RX+163*, RX+167~, RX+168* |
| DR | RX+151~, RX+153*, RX+157~, RX+158*, RX+162~, RX+163*, RX+167~, RX+168* |
| DT | RX+28 |
| IBACDUTY | RX+16~, RX+104*, RX+109 |
| IBADMINFEE | RX+16~, RATEPRIC+28*, RATEPRIC+41, RATEPRIC+43, RATEPRIC+45 |
| IBADT | RX+16~, RX+28*, RX+31, RX+58, RX+63, RX+70, RX+81, RX+86, RX+100, RX+110 , RX+127, RX+128, RATEPRIC+3, RATEPRIC+15, RATEPRIC+25, CT+3, SETINSUR~, SETINSUR+27 |
| IBANY | RX+16~, RX+100 |
| IBARR | RX+16~, RX+110, RX+111 |
| IBARR( | RX+111 |
| IBBI | RX+16~, RATEPRIC+3*, RATEPRIC+4, RATEPRIC+11, RATEPRIC+12 |
| IBCHG | RX+16~, RATEPRIC+25*, RATEPRIC+26 |
| IBCHNM | SETINSUR+23~, SETINSUR+45*, SETINSUR+58, SETINSUR+59 |
| IBCNT | SETINSUR+17~, SETINSUR+87*, SETINSUR+91, SETINSUR+98 |
| IBD | RX~, RX+70, RX+86, RX+106, RX+120, RX+124, RATEPRIC+19, SETINSUR~, RXPCT~ |
| IBD( | RX+112, RX+113 |
| IBD("ACT DTY | OVR" , RX+109 |
| IBD("COST" | RATEPRIC+19*, RATEPRIC+25, RATEPRIC+34 |
| IBD("DOS" | RX+28 |
| IBD("DRUG" | RX+120, RX+124, RX+128, RXPCT+4 |
| IBD("FILL NUM | BER" , RX+75, RXPCT+4 |
| IBD("IEN" | RX+74, RX+106, RXPCT+4 |
| IBD("INS" | RX+14!, RX+124, RX+128, RATEPRIC+48*, SETINSUR+15!, SETINSUR+34, SETINSUR+71*, SETINSUR+82*, SETINSUR+92, SETINSUR+93 , SETINSUR+104, SETINSUR+105 |
| IBD("NDC" | RATEPRIC+7, RATEPRIC+12, RXPCT+4 |
| IBD("NO ECME | INSURANCE" , RX+87, RX+95*, RX+100*, GETINS+3, RXQ+5, SETINSUR+15!, SETINSUR+104*, SETINSUR+105* |
| IBD("PATIENT | TYPE" , RXQ+7* |
| IBD("PLAN" | RX+54*, RX+61, SETINSUR+28, SETINSUR+34 |
| IBD("QTY" | RX+76*, RATEPRIC+15, RATEPRIC+25, RATEPRIC+34 |
| IBD("RELEASE | DATE" , RX+156, RATEPRIC+51 |
| IBD("RTYPE" | RX+53*, RX+61, RX+62, RX+63 |
| IBD("RX ACTIO | N" , RX+23 |
| IBD("RXCOB" | RX+40, RX+90, CT+1, SETINSUR+101 |
| IBD("SC/EI NO | ANSW" , RX+14!, RX+115* |
| IBD("SC/EI OV | R" , RX+109 |
| IBDAT | SETINSUR+23~, SETINSUR+50*, SETINSUR+51*, SETINSUR+52*, SETINSUR+53*, SETINSUR+54*, SETINSUR+55*, SETINSUR+56*, SETINSUR+57*, SETINSUR+58* , SETINSUR+59*, SETINSUR+60*, SETINSUR+61*, SETINSUR+62*, SETINSUR+63*, SETINSUR+64*, SETINSUR+65*, SETINSUR+66*, SETINSUR+67*, SETINSUR+68* , SETINSUR+69*, SETINSUR+70*, SETINSUR+71, SETINSUR+73*, SETINSUR+74*, SETINSUR+75*, SETINSUR+76*, SETINSUR+77*, SETINSUR+78*, SETINSUR+79* , SETINSUR+80*, SETINSUR+81*, SETINSUR+82 |
| IBDEA | RX+16~ |
| IBDIEN | RXPCT+3~, RXPCT+4*, RXPCT+24 |
| IBDISPFEE | RX+16~, RATEPRIC+27*, RATEPRIC+39, RATEPRIC+41 |
| IBDQUO | RXPCT+3~, RXPCT+11*, RXPCT+26 |
| IBDRFL | RXPCT+3~, RXPCT+4*, RXPCT+24 |
| IBDRUG | RXPCT+3~ |
| IBDRX | RXPCT+3~, RXPCT+4*, RXPCT+6, RXPCT+8, RXPCT+9, RXPCT+10, RXPCT+14, RXPCT+15, RXPCT+16, RXPCT+17 |
| IBELIG | RX+17~, RX+23*, RX+68, RX+70, RX+86, RXQ+9, SETINSUR~, SETINSUR+39 |
| IBERMSG | SETINSUR+17~ |
| IBERMSG( | SETINSUR+34*, SETINSUR+37*, SETINSUR+40*, SETINSUR+43*, SETINSUR+104 |
| IBERMSG(0 | SETINSUR+93 |
| IBFEE | RX+17~, RATEPRIC+25, RATEPRIC+27, RATEPRIC+28 |
| IBFIL | RX+17~, RX+75*, RX+83, RX+97, RX+114, RX+136, RXQ+10, CT+3 |
| IBFRM | RXPCT+3~, RXPCT+5*, RXPCT+25 |
| IBINGCOST | RX+17~, RATEPRIC+34*, RATEPRIC+35*, RATEPRIC+41, RATEPRIC+44 |
| IBINS | RX+17~, RX+31, RX+40, RX+58, RX+70, RX+86, SETINSUR~ |
| IBINS( | SETINSUR+24, SETINSUR+33, SETINSUR+46, SETINSUR+55, SETINSUR+70, SETINSUR+74 |
| IBINS("S" | SETINSUR+21, SETINSUR+22 |
| IBINSN | SETINSUR+23~, SETINSUR+44*, SETINSUR+64 |
| IBINSXRES | RX+17~, RX+87*, GETINS+3 |
| IBIT | RX+17~, RATEPRIC+12*, RATEPRIC+13, RATEPRIC+15 |
| IBNBR | RX+144~, RX+145*, RX+146 |
| IBNBRT | RX+144~, RX+146*, RX+150, RX+156, RX+161, RX+166, RX+171 |
| IBNDC | RXPCT+3~, RXPCT+4*, RXPCT+16 |
| IBNEEDS | RX+17~, RX+108*, RX+114*, RX+116 |
| IBPDISP | RXPCT+3~, RXPCT+10*, RXPCT+11, RXPCT+20*, RXPCT+21 |
| IBPIEN | SETINSUR+23~, SETINSUR+36*, SETINSUR+37, SETINSUR+39, SETINSUR+76, SETINSUR+81 |
| IBPL | SETINSUR+23~, SETINSUR+25*, SETINSUR+26, SETINSUR+27, SETINSUR+28, SETINSUR+36, SETINSUR+44, SETINSUR+51, SETINSUR+78 |
| IBPLNTYP | SETINSUR+23~, SETINSUR+33*, SETINSUR+34, SETINSUR+77 |
| IBPORD | RXPCT+3~, RXPCT+9*, RXPCT+11, RXPCT+19*, RXPCT+21 |
| IBPRDATA | RX+17~, RATEPRIC+38*, RATEPRIC+39*, RATEPRIC+40*, RATEPRIC+41*, RATEPRIC+42*, RATEPRIC+43*, RATEPRIC+44*, RATEPRIC+45*, RATEPRIC+48 |
| IBPRICE | RX+18~, RATEPRIC+15*, RATEPRIC+26*, RATEPRIC+30, RATEPRIC+35*, RATEPRIC+41, RATEPRIC+42, RATEPRIC+45 |
| IBPSUF | RXPCT+3~, RXPCT+17*, RXPCT+18, RXPCT+19, RXPCT+20 |
| IBPTYP | RX+18~, RX+58, RX+64, RXQ+5, RXQ+6, RXQ+7 |
| IBQUO | RXPCT+3~, RXPCT+5*, RXPCT+11*, RXPCT+21*, RXPCT+26*, RXPCT+28*, RXPCTQ+1 |
| IBREL | SETINSUR+23~, SETINSUR+46*, SETINSUR+48*, SETINSUR+57 |
| IBRES | RX+18~, RX+25*, RX+27*, RX+69*, RX+70, RX+74*, RX+75*, RX+76*, RX+86, RX+87 , RX+94*, RX+100*, RX+117*, RX+120*, RX+132*, RX+174*, GETINS+3*, RATEPRIC+2*, RATEPRIC+4*, RATEPRIC+7* , RATEPRIC+13*, RATEPRIC+30*, RATEPRIC+50*, RATEPRIC+51, RXQ+2*, RXQ+6*, RXQ+10, RXQ+11, RXQ+14, SETINSUR~ , SETINSUR+104*, SETINSUR+105* |
| IBRMARK | RX+18~, RX+100*, RX+113*, RX+116*, RX+117, RX+120, RX+131*, RX+137!, RX+139, RX+171* , RX+174, RATEPRIC+50, RATEPRIC+51*, CT+3 |
| IBROIMAIBRS | RX+18~ |
| >> IBRS | RATEPRIC+3, RATEPRIC+11*, RATEPRIC+25 |
| >> IBRS( | RATEPRIC+11 |
| IBRT | RX+18~, RX+58*, RX+62*, RX+63*, RX+64*, RX+70, RX+86, RX+104, RX+120, RATEPRIC+2 , RATEPRIC+3, RATEPRIC+12, RATEPRIC+13, RATEPRIC+15, RATEPRIC+19, RATEPRIC+25, RATEPRIC+26, RATEPRIC+40, RATEPRIC+41, RXQ+2 , RXQ+10, SETINSUR~, SETINSUR+34 |
| IBRXN | RX+18~, RX+74*, RX+83, RX+97, RX+114, RX+136, RX+150, RXQ+10, CT+3 |
| IBRXPOL | SETINSUR+17~ |
| IBRXPOL( | SETINSUR+31*, SETINSUR+87 |
| IBSAVE | RX+18~ |
| >> IBSCRES( | RX+114 |
| IBSYN | RXPCT+3~, RXPCT+15*, RXPCT+16, RXPCT+17 |
| IBT | RX+18~, RX+111*, RX+112, RX+113, RX+115, SETINSUR+17~, SETINSUR+22*, SETINSUR+24, SETINSUR+31, SETINSUR+33 , SETINSUR+46, SETINSUR+55, SETINSUR+70, SETINSUR+74, SETINSUR+80 |
| IBTRKR | RX+19~, RX+79*, RX+81*, RX+100, CT+3 |
| IBTRKRN | RX+19~, RX+83*, RX+93, RX+136, RX+143, RX+145, RX+153, RX+158, RX+163, RX+168 |
| IBTRN | RX+19~ |
| IBUNIT | RXPCT+3~ |
| IBUNIT( | RXPCT+19, RXPCT+20 |
| IBUNIT(50 | RXPCT+9, RXPCT+10 |
| IBX | RX+19~, RX+111*, RATEPRIC+48*, SETINSUR+17~, SETINSUR+21*, SETINSUR+22, SETINSUR+31, SETINSUR+34, SETINSUR+37, SETINSUR+40 , SETINSUR+43, SETINSUR+71, SETINSUR+82, SETINSUR+87*, SETINSUR+92*, SETINSUR+93*, SETINSUR+98*, SETINSUR+101*, SETINSUR+104, SETINSUR+105 |
| IBY | SETINSUR+23~, SETINSUR+39! |
| IBY(1 | SETINSUR+40 |
| IBY(2 | SETINSUR+52 |
| IBY(3 | SETINSUR+53 |
| IBY(4 | SETINSUR+63 |
| IBY(5 | SETINSUR+54, SETINSUR+61, SETINSUR+62, SETINSUR+65, SETINSUR+66, SETINSUR+67, SETINSUR+68, SETINSUR+69 |
| IBY(6 | SETINSUR+40 |
| IBZ | SETINSUR+23~, SETINSUR+24*, SETINSUR+25, SETINSUR+45, SETINSUR+48, SETINSUR+56, SETINSUR+60, SETINSUR+75, SETINSUR+79 |
| INSIEN | RX+20~, RX+47*, RX+48*, RX+52, RX+53, RX+54 |
| POLNO | RX+20~, RX+46*, RX+52 |
| STOP | RX+20~, RX+41*, RX+43, RX+48, RX+55* |
| U | RX+62, RX+63, RX+64, RX+81, RX+100, RX+104, RX+112, RX+113, RX+115, RX+120 , RX+128, RX+145, RX+146, RATEPRIC+12, RATEPRIC+13, RATEPRIC+15, RATEPRIC+19, RATEPRIC+25, RATEPRIC+26, RATEPRIC+27 , RATEPRIC+28, RATEPRIC+39, RATEPRIC+40, RATEPRIC+41, RATEPRIC+42, RATEPRIC+43, RATEPRIC+44, RATEPRIC+45, RXQ+2, RXQ+6 , RXQ+10, SETINSUR+25, SETINSUR+33, SETINSUR+34, SETINSUR+44, SETINSUR+45, SETINSUR+46, SETINSUR+48, SETINSUR+51, SETINSUR+52 , SETINSUR+53, SETINSUR+54, SETINSUR+55, SETINSUR+56, SETINSUR+57, SETINSUR+58, SETINSUR+59, SETINSUR+60, SETINSUR+61, SETINSUR+62 , SETINSUR+63, SETINSUR+64, SETINSUR+65, SETINSUR+66, SETINSUR+67, SETINSUR+68, SETINSUR+69, SETINSUR+70, SETINSUR+74, SETINSUR+75 , SETINSUR+76, SETINSUR+77, SETINSUR+78, SETINSUR+79, SETINSUR+80, SETINSUR+81 |
| Name | Field # of Occurrence |
|---|---|
| $T(EXEMPT+IBX | RX+111 |
