STANDARD DATA DICTIONARY #354.75 -- IB COPAY CAPS FILE 3/24/25 PAGE 1
STORED IN ^IBAM(354.75, (22 ENTRIES) SITE: WWW.BMIRWIN.COM UCI: VISTA,VISTA (VERSION 2.0)
DATA NAME GLOBAL DATA
ELEMENT TITLE LOCATION TYPE
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DO NOT delete entries in this file. DO NOT edit data in this file with VA File Manager.
This file comes populated with data. The data in this file should not be edited, added, or deleted locally. The information
stored here is the cap amounts for outpatient medication copayment. Once a patient has reached his cap, billing will stop for the
remainder of the period indicated.
Per VHA Directive 10-93-142, this file definition should not be modified.
DD ACCESS: @
RD ACCESS: @
WR ACCESS: @
DEL ACCESS: @
LAYGO ACCESS: @
AUDIT ACCESS: @
CROSS
REFERENCED BY: EFFECTIVE DATE(B)
INDEXED BY: PRIORITY LEVEL & EFFECTIVE DATE (AC)
LAST MODIFIED: DEC 20,2016@15:22:52
354.75,.01 EFFECTIVE DATE 0;1 DATE (Required)
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: JUN 05, 2001
HELP-PROMPT: Answer with an effective date.
DESCRIPTION: This is the effective date of this cap entry. Based upon the date of the transaction, this will be
used to determine if a billing transaction is above the cap or not.
CROSS-REFERENCE: 354.75^B
1)= S ^IBAM(354.75,"B",$E(X,1,30),DA)=""
2)= K ^IBAM(354.75,"B",$E(X,1,30),DA)
RECORD INDEXES: AC (#106)
354.75,.02 PRIORITY LEVEL 0;2 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>8)!(X<1)!(X?.E1"."1.N) X
LAST EDITED: MAR 29, 2016
HELP-PROMPT: Answer with a priority level 1 through 8.
DESCRIPTION: This is the priority level of the cap. This will be used based upon the patient's priority level
to determine what their cap amount is.
RECORD INDEXES: AC (#106)
354.75,.03 MONTHLY CAP AMOUNT 0;3 NUMBER
INPUT TRANSFORM: S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>999999.99)!(X<0) X
LAST EDITED: JUN 05, 2001
HELP-PROMPT: Enter the rx copay monthly cap amount.
DESCRIPTION: This is the monthly cap amount that will be used to determine if the bill is above the cap or not.
This is a total monthly amount that can be billed to a patient for pharmacy copay.
354.75,.04 YEARLY CAP AMOUNT 0;4 NUMBER
INPUT TRANSFORM: S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>999999.99)!(X<0) X
LAST EDITED: JUN 05, 2001
HELP-PROMPT: Enter the rx copay yearly cap amount.
DESCRIPTION: This is the yearly cap amount that will be used to determine if the bill is above the cap or not
based on the year basis specified. This is the total yearly amount that can be billed to a patient
for pharmacy copay.
354.75,.05 TERMINATION DATE 0;5 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: JUN 05, 2001
HELP-PROMPT: Answer with the termination date of this cap amount.
DESCRIPTION:
This is the termination date of this cap amount. This is optional.
354.75,.06 YEAR BASIS 0;6 SET
'C' FOR CALENDAR YEAR;
'F' FOR FISCAL YEAR;
LAST EDITED: JUN 05, 2001
HELP-PROMPT: Answer with the year basis for this cap amount.
DESCRIPTION: This is the year basis for this cap amount. This will be used to determine the timeframe to
calculate the amounts billed to a patient.
File #354.75
Record Indexes:
AC (#106) RECORD REGULAR IR SORTING ONLY
Short Descr: Index for quick look up.
Description: This index will provide quick look up for a cap entry.
Set Logic: S ^IBAM(354.75,"AC",X(1),X(2),DA)=""
Kill Logic: K ^IBAM(354.75,"AC",X(1),X(2),DA)
Whole Kill: K ^IBAM(354.75,"AC")
X(1): PRIORITY LEVEL (354.75,.02) (Subscr 1) (forwards)
X(2): EFFECTIVE DATE (354.75,.01) (Subscr 2) (forwards)
INPUT TEMPLATE(S):
PRINT TEMPLATE(S):
SORT TEMPLATE(S):
FORM(S)/BLOCK(S):