| Name | Description | Type | Additional information |
|---|---|---|---|
| AdmissionDate | string |
None. |
|
| DischargeDate | string |
None. |
|
| NotifyDate | string |
None. |
|
| DocRcvDate | string |
None. |
|
| Center | string |
None. |
|
| Assesor | string |
None. |
|
| MsgId | string |
None. |
|
| ProcId | string |
None. |
|
| TerminalID | string |
None. |
|
| MerchantID | string |
None. |
|
| CardNo | string |
None. |
|
| Coverage | string |
None. |
|
| SystemTrace | string |
None. |
|
| Field63In | string |
None. |
|
| CoverageCd | string |
None. |
|
| ProviderCd | string |
None. |
|
| PlanCd | string |
None. |
|
| CorpCd | string |
None. |
|
| InvoiceNo | string |
None. |
|
| PreAuthId | string |
None. |
|
| IcdCd1 | string |
None. |
|
| IcdCd2 | string |
None. |
|
| McStartDt | string |
None. |
|
| McEndDt | string |
None. |
|
| McTakenDays | string |
None. |
|
| SysTrc | string |
None. |
|
| ProviderNm | string |
None. |
|
| ProviderType | string |
None. |
|
| ToTalBill | string |
None. |
