hippo_eyeDoc 0.0.1

data/lib/hippo_eyeDoc/segments/CAS.rb

@@ -0,0 +1,159 @@
+module Hippo_eyeDoc::Segments
+  class CAS < Hippo_eyeDoc::Segments::Base
+
+    segment_identifier 'CAS'
+
+    field :name                 => 'ClaimAdjustmentGroupCode',
+          :sequence             => 1,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 2,
+          :required             => true,
+          :data_element_number  => 1033
+
+    field :name                 => 'ClaimAdjustmentReasonCode',
+          :sequence             => 2,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 5,
+          :required             => true,
+          :data_element_number  => 1034
+
+    field :name                 => 'MonetaryAmount',
+          :sequence             => 3,
+          :datatype             => :decimal,
+          :minimum              => 1,
+          :maximum              => 18,
+          :required             => true,
+          :data_element_number  => 782
+
+    field :name                 => 'Quantity',
+          :sequence             => 4,
+          :datatype             => :decimal,
+          :minimum              => 1,
+          :maximum              => 15,
+          :required             => false,
+          :data_element_number  => 380
+
+    field :name                 => 'ClaimAdjustmentReasonCode',
+          :sequence             => 5,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 5,
+          :required             => false,
+          :data_element_number  => 1034
+
+    field :name                 => 'MonetaryAmount',
+          :sequence             => 6,
+          :datatype             => :decimal,
+          :minimum              => 1,
+          :maximum              => 18,
+          :required             => false,
+          :data_element_number  => 782
+
+    field :name                 => 'Quantity',
+          :sequence             => 7,
+          :datatype             => :decimal,
+          :minimum              => 1,
+          :maximum              => 15,
+          :required             => false,
+          :data_element_number  => 380
+
+    field :name                 => 'ClaimAdjustmentReasonCode',
+          :sequence             => 8,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 5,
+          :required             => false,
+          :data_element_number  => 1034
+
+    field :name                 => 'MonetaryAmount',
+          :sequence             => 9,
+          :datatype             => :decimal,
+          :minimum              => 1,
+          :maximum              => 18,
+          :required             => false,
+          :data_element_number  => 782
+
+    field :name                 => 'Quantity',
+          :sequence             => 10,
+          :datatype             => :decimal,
+          :minimum              => 1,
+          :maximum              => 15,
+          :required             => false,
+          :data_element_number  => 380
+
+    field :name                 => 'ClaimAdjustmentReasonCode',
+          :sequence             => 11,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 5,
+          :required             => false,
+          :data_element_number  => 1034
+
+    field :name                 => 'MonetaryAmount',
+          :sequence             => 12,
+          :datatype             => :decimal,
+          :minimum              => 1,
+          :maximum              => 18,
+          :required             => false,
+          :data_element_number  => 782
+
+    field :name                 => 'Quantity',
+          :sequence             => 13,
+          :datatype             => :decimal,
+          :minimum              => 1,
+          :maximum              => 15,
+          :required             => false,
+          :data_element_number  => 380
+
+    field :name                 => 'ClaimAdjustmentReasonCode',
+          :sequence             => 14,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 5,
+          :required             => false,
+          :data_element_number  => 1034
+
+    field :name                 => 'MonetaryAmount',
+          :sequence             => 15,
+          :datatype             => :decimal,
+          :minimum              => 1,
+          :maximum              => 18,
+          :required             => false,
+          :data_element_number  => 782
+
+    field :name                 => 'Quantity',
+          :sequence             => 16,
+          :datatype             => :decimal,
+          :minimum              => 1,
+          :maximum              => 15,
+          :required             => false,
+          :data_element_number  => 380
+
+    field :name                 => 'ClaimAdjustmentReasonCode',
+          :sequence             => 17,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 5,
+          :required             => false,
+          :data_element_number  => 1034
+
+    field :name                 => 'MonetaryAmount',
+          :sequence             => 18,
+          :datatype             => :decimal,
+          :minimum              => 1,
+          :maximum              => 18,
+          :required             => false,
+          :data_element_number  => 782
+
+    field :name                 => 'Quantity',
+          :sequence             => 19,
+          :datatype             => :decimal,
+          :minimum              => 1,
+          :maximum              => 15,
+          :required             => false,
+          :data_element_number  => 380
+
+  end
+end

data/lib/hippo_eyeDoc/segments/CL1.rb

@@ -0,0 +1,39 @@
+module Hippo_eyeDoc::Segments
+  class CL1 < Hippo_eyeDoc::Segments::Base
+
+    segment_identifier 'CL1'
+
+    field :name                 => 'AdmissionTypeCode',
+          :sequence             => 1,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 1,
+          :required             => false,
+          :data_element_number  => 1315
+
+    field :name                 => 'AdmissionSourceCode',
+          :sequence             => 2,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 1,
+          :required             => false,
+          :data_element_number  => 1314
+
+    field :name                 => 'PatientStatusCode',
+          :sequence             => 3,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 2,
+          :required             => false,
+          :data_element_number  => 1352
+
+    field :name                 => 'NursingHomeResidentialStatusCode',
+          :sequence             => 4,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 1,
+          :required             => false,
+          :data_element_number  => 1345
+
+  end
+end

data/lib/hippo_eyeDoc/segments/CLM.rb

@@ -0,0 +1,223 @@
+module Hippo_eyeDoc::Segments
+  class CLM < Hippo_eyeDoc::Segments::Base
+
+    segment_identifier 'CLM'
+
+    field :name                 => 'ClaimSubmitterSIdentifier',
+          :sequence             => 1,
+          :datatype             => :string,
+          :minimum              => 1,
+          :maximum              => 38,
+          :required             => true,
+          :data_element_number  => 1028
+
+    field :name                 => 'MonetaryAmount',
+          :sequence             => 2,
+          :datatype             => :decimal,
+          :minimum              => 1,
+          :maximum              => 18,
+          :required             => false,
+          :data_element_number  => 782
+
+    field :name                 => 'ClaimFilingIndicatorCode',
+          :sequence             => 3,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 2,
+          :required             => false,
+          :data_element_number  => 1032
+
+    field :name                 => 'NonInstitutionalClaimTypeCode',
+          :sequence             => 4,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 2,
+          :required             => false,
+          :data_element_number  => 1343
+
+    composite_field 'HealthCareServiceLocationInformation' do
+
+      field :name                 => 'FacilityCodeValue',
+            :sequence             => 1,
+            :datatype             => :string,
+            :minimum              => 1,
+            :maximum              => 2,
+            :required             => true,
+            :data_element_number  => 1331
+
+      field :name                 => 'FacilityCodeQualifier',
+            :sequence             => 2,
+            :datatype             => :list,
+            :minimum              => 1,
+            :maximum              => 2,
+            :required             => false,
+            :data_element_number  => 1332
+
+      field :name                 => 'ClaimFrequencyTypeCode',
+            :sequence             => 3,
+            :datatype             => :list,
+            :minimum              => 1,
+            :maximum              => 1,
+            :required             => false,
+            :data_element_number  => 1325
+
+    end
+
+    field :name                 => 'YesNoConditionOrResponseCode',
+          :sequence             => 6,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 1,
+          :required             => false,
+          :data_element_number  => 1073
+
+    field :name                 => 'ProviderAcceptAssignmentCode',
+          :sequence             => 7,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 1,
+          :required             => false,
+          :data_element_number  => 1359
+
+    field :name                 => 'YesNoConditionOrResponseCode',
+          :sequence             => 8,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 1,
+          :required             => false,
+          :data_element_number  => 1073
+
+    field :name                 => 'ReleaseOfInformationCode',
+          :sequence             => 9,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 1,
+          :required             => false,
+          :data_element_number  => 1363
+
+    field :name                 => 'PatientSignatureSourceCode',
+          :sequence             => 10,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 1,
+          :required             => false,
+          :data_element_number  => 1351
+
+    composite_field 'RelatedCausesInformation' do
+
+      field :name                 => 'RelatedCausesCode',
+            :sequence             => 1,
+            :datatype             => :list,
+            :minimum              => 2,
+            :maximum              => 3,
+            :required             => true,
+            :data_element_number  => 1362
+
+      field :name                 => 'RelatedCausesCode',
+            :sequence             => 2,
+            :datatype             => :list,
+            :minimum              => 2,
+            :maximum              => 3,
+            :required             => false,
+            :data_element_number  => 1362
+
+      field :name                 => 'RelatedCausesCode',
+            :sequence             => 3,
+            :datatype             => :list,
+            :minimum              => 2,
+            :maximum              => 3,
+            :required             => false,
+            :data_element_number  => 1362
+
+      field :name                 => 'StateOrProvinceCode',
+            :sequence             => 4,
+            :datatype             => :list,
+            :minimum              => 2,
+            :maximum              => 2,
+            :required             => false,
+            :data_element_number  => 156
+
+      field :name                 => 'CountryCode',
+            :sequence             => 5,
+            :datatype             => :list,
+            :minimum              => 2,
+            :maximum              => 3,
+            :required             => false,
+            :data_element_number  => 26
+
+    end
+
+    field :name                 => 'SpecialProgramCode',
+          :sequence             => 12,
+          :datatype             => :list,
+          :minimum              => 2,
+          :maximum              => 3,
+          :required             => false,
+          :data_element_number  => 1366
+
+    field :name                 => 'YesNoConditionOrResponseCode',
+          :sequence             => 13,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 1,
+          :required             => false,
+          :data_element_number  => 1073
+
+    field :name                 => 'LevelOfServiceCode',
+          :sequence             => 14,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 3,
+          :required             => false,
+          :data_element_number  => 1338
+
+    field :name                 => 'YesNoConditionOrResponseCode',
+          :sequence             => 15,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 1,
+          :required             => false,
+          :data_element_number  => 1073
+
+    field :name                 => 'ProviderAgreementCode',
+          :sequence             => 16,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 1,
+          :required             => false,
+          :data_element_number  => 1360
+
+    field :name                 => 'ClaimStatusCode',
+          :sequence             => 17,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 2,
+          :required             => false,
+          :data_element_number  => 1029
+
+    field :name                 => 'YesNoConditionOrResponseCode',
+          :sequence             => 18,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 1,
+          :required             => false,
+          :data_element_number  => 1073
+
+    field :name                 => 'ClaimSubmissionReasonCode',
+          :sequence             => 19,
+          :datatype             => :list,
+          :minimum              => 2,
+          :maximum              => 2,
+          :required             => false,
+          :data_element_number  => 1383
+
+    field :name                 => 'DelayReasonCode',
+          :sequence             => 20,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 2,
+          :required             => false,
+          :data_element_number  => 1514
+
+  end
+end

data/lib/hippo_eyeDoc/segments/CLP.rb

@@ -0,0 +1,119 @@
+module Hippo_eyeDoc::Segments
+  class CLP < Hippo_eyeDoc::Segments::Base
+
+    segment_identifier 'CLP'
+
+    field :name                 => 'ClaimSubmitterSIdentifier',
+          :sequence             => 1,
+          :datatype             => :string,
+          :minimum              => 1,
+          :maximum              => 38,
+          :required             => true,
+          :data_element_number  => 1028
+
+    field :name                 => 'ClaimStatusCode',
+          :sequence             => 2,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 2,
+          :required             => true,
+          :data_element_number  => 1029
+
+    field :name                 => 'MonetaryAmount',
+          :sequence             => 3,
+          :datatype             => :decimal,
+          :minimum              => 1,
+          :maximum              => 18,
+          :required             => true,
+          :data_element_number  => 782
+
+    field :name                 => 'MonetaryAmount',
+          :sequence             => 4,
+          :datatype             => :decimal,
+          :minimum              => 1,
+          :maximum              => 18,
+          :required             => true,
+          :data_element_number  => 782
+
+    field :name                 => 'MonetaryAmount',
+          :sequence             => 5,
+          :datatype             => :decimal,
+          :minimum              => 1,
+          :maximum              => 18,
+          :required             => false,
+          :data_element_number  => 782
+
+    field :name                 => 'ClaimFilingIndicatorCode',
+          :sequence             => 6,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 2,
+          :required             => false,
+          :data_element_number  => 1032
+
+    field :name                 => 'ReferenceIdentification',
+          :sequence             => 7,
+          :datatype             => :string,
+          :minimum              => 1,
+          :maximum              => 50,
+          :required             => false,
+          :data_element_number  => 127
+
+    field :name                 => 'FacilityCodeValue',
+          :sequence             => 8,
+          :datatype             => :string,
+          :minimum              => 1,
+          :maximum              => 2,
+          :required             => false,
+          :data_element_number  => 1331
+
+    field :name                 => 'ClaimFrequencyTypeCode',
+          :sequence             => 9,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 1,
+          :required             => false,
+          :data_element_number  => 1325
+
+    field :name                 => 'PatientStatusCode',
+          :sequence             => 10,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 2,
+          :required             => false,
+          :data_element_number  => 1352
+
+    field :name                 => 'DiagnosisRelatedGroupDrgCode',
+          :sequence             => 11,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 4,
+          :required             => false,
+          :data_element_number  => 1354
+
+    field :name                 => 'Quantity',
+          :sequence             => 12,
+          :datatype             => :decimal,
+          :minimum              => 1,
+          :maximum              => 15,
+          :required             => false,
+          :data_element_number  => 380
+
+    field :name                 => 'PercentageAsDecimal',
+          :sequence             => 13,
+          :datatype             => :decimal,
+          :minimum              => 1,
+          :maximum              => 10,
+          :required             => false,
+          :data_element_number  => 954
+
+    field :name                 => 'YesNoConditionOrResponseCode',
+          :sequence             => 14,
+          :datatype             => :list,
+          :minimum              => 1,
+          :maximum              => 1,
+          :required             => false,
+          :data_element_number  => 1073
+
+  end
+end