Interface Information Data Fields for Form and Label Templates

Data Fields	Description
Encounter Integer ID	Creates a bar code that represents the unique encounter ID that is created for use by the Rosetta Interface. The bar code can be read by CodeScan ® software. The unique ID number is generated at time of encounter creation.

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System Information Data Fields for Form and Label Templates

Data Repository data fields for System Information. *System Date *System Date(mmddyy) System Date/Time System Esignature System Master File Text (Barcode) System Time System User Name System User-Defined Message Parent topic: Data Field Descriptions for Form, Form Enhanced, and Label Templates

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Appointment/Encounter Information Data Field Descriptions for Form and Label Templates

The following table lists the Data Repository data fields for appointment/encounter information. Appointment/Encounter Information is represented by the data field icon. Data Fields Description Encounter Appointment Date Encounter Appointment Date Location Address Appointment Location Location Address 2 Location Address 2 Location City, State Zip Appointment Location City, State Zip *Location Name Appointment Location Name Location Phone Appointment Location Phone Number Referring Physician Referring Physician Rendering Physician Rendering Physician Rendering Provider Address 1 Rendering Provider Address 1 Rendering Provider Address 2 Rendering Provider Address 2 Rendering Provider Business Phone Rendering Provider Business Phone Rendering Provider City, State Zip Rendering Provider City, State Zip Parent topic: Data Field Descriptions for Form, Form Enhanced, and Label Templates

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Interface Information Data Fields for Form and Label Templates

The following table lists the Data Repository data fields for Interface Information. Data Fields Description Encounter Integer ID Creates a bar code that represents the unique encounter ID that is created for use by the Rosetta Interface. The bar code can be read by CodeScan ® software. The unique ID number is generated at time of encounter creation. Parent topic: Data Field Descriptions for Form, Form Enhanced, and Label Templates

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Encounter UB-92 Data Field Descriptions for Form and Label Templates

Data Repository data fields for Encounter UB-92. Bill Class Frequency Hold Date Occur Code 32a Occur Code 32b Occur Code 33a Occur Code 33b Occur Code 34a Occur Code 34b Occur Code 35a Occur Code 35b Occur Date 32a Occur Date 32b Occur Date 33a Occur Date 33b Occur Date 34a Occur Date 34b Occur Date 35a Occur Date 35b Source of Admission Type of Facility Value Amount 39a Value Amount 39b Value Amount 39c Value Amount 39d Value Amount 40a Value Amount 40b Value Amount 40c Value Amount 40d Value Amount 41a Value Amount 41b Value Amount 41c Value Amount 41d Value Code 39a Value Code 39b Value Code 39c Value Code 39d Value Code 40a Value Code 40b Value Code 40c Value Code 40d Value Code 41a Value Code 41b Value Code 41c Value Code 41d Parent topic: Data Field Descriptions for Form, Form Enhanced, and Label Templates

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Encounter Information Data Field Descriptions for Form and Label Templates

The following table lists the Data Repository data fields and sub-data fields for encounter information. The sub-data fields are Encounter Primary, Encounter Secondary, and Encounter Tertiary. Encounter Information is represented by the data field icon. Data Fields Admitting Physician Enc Rendering Prov Address 1 Enc Rendering Prov Address 2 Enc Rendering Prov City Enc Rendering Prov City, State Zip Enc Rendering Prov State Enc Rendering Prov Zip Encounter Adjustments Encounter Admit Date Encounter Admit Time Encounter All Insurance Balance Encounter Attending Encounter Authorization Nbr Primary Encounter Authorization Nbr Secondary Encounter Authorization Nbr Tertiary Encounter Balance Encounter Balance (including unposted transactions) Encounter Charges Encounter Complaint Encounter Date Encounter Discharge Date Encounter Discharge Time Encounter Facility Address Encounter Facility Fax Number Encounter Facility Name Encounter Facility Phone Number Encounter ID (Barcode) Encounter Ins

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Practice Information Data Fields for Form and Label Templates

Data Repository data fields for Practice Information. Practice Address 1 Practice Address 2 Practice City Practice City, State Zip Practice Logo Practice Name Practice Phone Practice State Practice Tax ID # Practice Zip Parent topic: Data Field Descriptions for Form, Form Enhanced, and Label Templates

Interface Information Data Fields for Form and Label Templates

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