Data Field Descriptions for Form, Form Enhanced, and Label Templates

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Data Field Formats

The following table explains the available data field format options for the data fields that have multiple formatting options: Data Field Icon Data Fields Format Description Appointment Information Appointment Resource This data field displays the resource name, if there is one attached to the appointment. However, if more than one resource is attached to the appointment, then the terminology Multiple Resources prints on the form or label (all of the resources attached to the appointment do not print). In addition, the appointment resource information will print only when you print a form or label using one of the following access paths: Appt Book toolbar button > Highlight the applicable appointment > Right-click > Print > Select Forms… or Labels… Appt List toolbar button > Enter the applicable search criteria > Find button > Select the applicable appointments > Right-click > Print > Select Forms… or Labels… Appointment/Encounter Information Location Name This data field displays eit

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Data Field Descriptions for Form, Form Enhanced, and Label Templates

Tables in the the following sections list the available data fields in the Data Repository that you can use to customize your form templates and label templates. The * icon indicates that there is more than one data field format option to choose from for this data field. Refer to the table in the following section for the exact data fields that have multiple format options and an explanation of each format. The + icon indicates that any user-defined patient providers that you set up for use in the Provider Practice Preferences will be added to and will appear in the data repository. The ++ icon indicates that any user-defined fields that you set up for use in the Practice Preferences window will be added to and will appear in the data repository. Account Information Data Field Descriptions for Form and Label Templates Data Repository data fields description for Account Information. Appointment Information Data Field Descriptions for Form and Label Templates Data Repository data fields

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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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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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Case Management Information Data Field Descriptions

The following table describes the Data Repository fields for Case Management information. Data Fields Description Accident Description Accident description Auth Number Authorization number Case Contact Address 1 Address of case contact Case Contact Address 2 Address of case contact Case Contact City City of case contact Case Contact Name Case contact's name Case Contact Phone Case contact's number Case Contact Phone Ext Extension of case contact's address Case Contact State State associated with case contact's address Case Contact Zip ZIP code associated with case contact's address Case Description Case description Case Employer Full Name Full name of the case employer Case Number Case number Case Status Case status Cond Related to Emp Cond related to employer Disabled From Disabled from Disabled To Disabled to Effective Date Effective date Expiration Date Expiration date Guarantor Name of the guarantor Guarantor with Prefix/Suffix Name of the guarantor with prefix, such as Mr. and suf

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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

Data Field Descriptions for Form, Form Enhanced, and Label Templates

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Data Field Descriptions for Form, Form Enhanced, and Label Templates

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

Encounter Information Data Field Descriptions for Form and Label Templates

Case Management Information Data Field Descriptions

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