| Name | Description | Type | Additional information |
|---|---|---|---|
| grptotal | string |
None. |
|
| gdistotal | string |
None. |
|
| rounding | string |
None. |
|
| totalbill | string |
None. |
|
| deposit | string |
None. |
|
| msh | Message_Header |
None. |
|
| prd | provider_Data_Segment |
None. |
|
| pid | Patient_Data_Segment |
None. |
|
| pv1 | Patient_Visit_Segment |
None. |
|
| ps1 | Payor_Segment |
None. |
|
| db1 | Details_Data_Segment |
None. |
