GLOBAL MAP DATA DICTIONARY #355.5 -- INSURANCE CLAIMS YEAR TO DATE FILE                                           9/29/25    PAGE 1
STORED IN ^IBA(355.5,  *** NO DATA STORED YET ***   SITE: WWW.BMIRWIN.COM   UCI: VISTA,VISTA                       (VERSION 2.0)   
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This file will contain the claim to date information about a patient's health insurance claims to a specific carrier for a specific
year.  This will allow estimate of receivables based on whether claims exceed deductibles or other maximum benefits.  
 
Per VHA Directive 10-93-142, this file definition should not be modified.  


CROSS
REFERENCED BY: PATIENT(APPY), POLICY(APPY1), BENEFIT YEAR BEGINNING ON(APPY2), PATIENT POLICY POINTER(APPY3), POLICY(B), 
               PATIENT(C)



^IBA(355.5,D0,0)= (#.01) POLICY [1P:355.3] ^ (#.02) PATIENT [2P:2] ^ (#.03) BENEFIT YEAR BEGINNING ON [3D] ^ (#.04) DEDUCTIBLE 
               ==>MET? [4S] ^ (#.05) AMOUNT OF DEDUCTIBLE MET [5N] ^ (#.06) DEDUCTIBLE (INPT) MET? [6S] ^ (#.07) AMOUNT OF 
               ==>DEDUCTIBLE (INP) MET [7N] ^ (#.08) DEDUCTIBLE (OPT) MET? [8S] ^ (#.09) AMOUNT OF DEDUCTIBLE (OPT) MET [9N] ^ 
               ==>(#.1) AMT LIFETIME MAX USED (OPT) [10N] ^ (#.11) MH DEDUCTIBLE (INP) MET? [11S] ^ (#.12) AMOUNT OF MH (INP) DED 
               ==>MET [12N] ^ (#.13) MH DEDUCTIBLE (OPT) MET? [13S] ^ (#.14) AMOUNT OF MH (OPT) DED MET [14N] ^ (#.15) 
               ==>PRE-EXISTING CONDITIONS [15F] ^ (#.16) COORDINATION OF BENEFITS DATA [16F] ^ (#.17) PATIENT POLICY POINTER 
               ==>[17N] ^ (#.18) AMT. MH LIFET. MAX USED (INPT) [18N] ^ (#.19) AMT LIFETIME MAX USED (INPT) [19N] ^ (#.2) AMT MH 
               ==>LIFET MAX USED (OPT) [20N] ^ 
^IBA(355.5,D0,1)= (#1.01) DATE ENTERED [1D] ^ (#1.02) ENTERED BY [2P:200] ^ (#1.03) DATE LAST VERIFIED [3D] ^ (#1.04) VERIFIED BY 
               ==>[4P:200] ^ (#1.05) DATE LAST EDITED [5D] ^ (#1.06) EDITED BY [6P:200] ^ (#1.07) PERSON CONTACTED [7F] ^ (#1.08) 
               ==>COMMENT - CLAIMS FILED [8F] ^ (#1.09) CONTACT'S PHONE NUMBER [9F] ^ 


INPUT TEMPLATE(S):
^DIE(567)= IBCN BU ADD COM    
^DIE(571)= IBCN BU ED AL    
^DIE(568)= IBCN BU INPT    
^DIE(569)= IBCN BU OPT    
^DIE(570)= IBCN BU POL    

PRINT TEMPLATE(S):

SORT TEMPLATE(S):

FORM(S)/BLOCK(S):