FB1 Record Entry Field Locations

Medical Segment 2

Number	Position	Field Name	Data Entry Screen
01	1-3	Record Type	(Auto Fill)
02	4-5	Sequence Number In Claims	(Auto Fill)
03	7-22	Patient ID	(See CAO Record Patient ID)
04	23-39	Line Item Control Number	(Auto Fill)
05	40-72	Place or Service Number	Setup > Lookup Lists > Facilities/Laboratories > [Change] > General tab > Name   and Patient List > Case/Diagnosis button > Case Information button > Inpatient tab > Facility Name
06	73-92	Ordering Provider Last Name	Setup > Lookup Lists > Outside Physicians > [Change] > General tab > Last Name
07	93-104	Ordering Provider First Name	Setup > Lookup Lists > Outside Physicians > [Change] > General tab > First Name
08	105	Ordering Provider Middle Initial	Setup > Lookup Lists > Outside Physicians > [Change] > General tab > MI
09	106-120	Ordering Provider UPIN	Setup > Lookup Lists > Outside Physicians > [Change] > General tab > UPIN
10	121-140	Referring Provider Last Name	Setup > Lookup Lists > Outside Physicians > [Change] > General tab > Last Name
11	141-152	Referring Provider First Name	Setup > Lookup Lists > Outside Physicians > [Change] > General tab > First Name
12	153	Referring Provider Middle Initial	Setup > Lookup Lists > Outside Physicians > [Change] > General tab > MI
13	154-168	Referring Provider UPIN	Setup > Lookup Lists > Outside Physicians > [Change] > General tab > NPI or UPIN
14	169-188	Rendering Provider Last Name	Setup > Preferences > Provider Preferences > [Change] > General tab > Last Name
15	189-200	Rendering Provider First Name	Setup > Preferences > Provider Preferences > [Change] > First Name
16	201	Rendering Provider Middle Initial	Setup > Preferences > Provider Preferences > [Change] > General tab > MI
17	202-216	Rendering Provider UPIN	Setup > Preferences > Provider Preferences > [Change] > Misc Tab > ID Numbers button > National Provider ID (NPI) or Universal Provider ID (UPIN)
18	217-236	Supervising Provider Last Name	Setup > Preferences > Provider Preferences > [Change] > General tab > Last Name
19	237-248	Supervising Provider First Name	Setup > Preferences > Provider Preferences > [Change] > General tab > First Name
20	249	Supervising Provider Middle Initial	Setup > Preferences > Provider Preferences > [Change] > General tab > MI
21	250-264	Supervising Provider NPI	Setup > Preferences > Provider Preferences > [Change] > ID Numbers tab > [Change NPI]
22	265-279	Supervising Provider UPIN	Setup > Preferences > Provider Preferences > [Change] > ID Numbers tab > [Change UPIN]
23	280-320	Filler National	(Not Supported)