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| # | Location | File | Last Modified |
|---|---|---|---|
| 1 | v2.0_Sprint_15_Build_5.zip\v2.0_Sprint_15_Build_5\Unredacted\ARS_Backend\ars_app\src\main\resources | ARS_DB.sql | Tue Apr 24 14:46:24 2018 UTC |
| 2 | v2.0_Sprint_15_Build_5..zip\v2.0_Sprint_15_Build_5\Unredacted\ARS_Backend\ars_app\src\main\resources | ARS_DB.sql | Thu Apr 26 16:20:46 2018 UTC |
| Description | Between Files 1 and 2 |
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| Changed | 17 | 60 |
| Inserted | 0 | 0 |
| Removed | 0 | 0 |
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| Character case | Differences in character case are significant |
| Line endings | Differences in line endings (CR and LF characters) are ignored |
| CR/LF characters | Not shown in the comparison detail |
No regular expressions were active.
| 1 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 2 | -- File c reated - T uesday-Mar ch-13-2018 | |
| 3 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 5 | -- DDL fo r View CLA IMATTACHME NTS_VIEW | |
| 6 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 7 | ||
| 8 | CREATE O R REPLACE FORCE VIEW "ARS277_R EQUEST_TRA CKING"."CL AIMATTACHM ENTS_VIEW" ("ID", "A TTACHMENT_ ID", "ATTA CHMENT_PAT H", "PROVI DER_NAME", "PROVIDER _FIRST_NAM E", "PROVI DER_IDENTI FIER", "PR OVIDER_NPI ", "ENTITY _TYPE_QUAL IFIER", "P ATIENT_FIR ST_NAME", "PATIENT_L AST_NAME", "PATIENT_ IDENTIFIER _NUMBER", "REPORT_CO DE", "PATI ENT_CONTRO L_NUMBER", "REF01", "MEDICAL_R ECORD_NUMB ER", "CLAI M_IDENTIFI ER", "EXTE RNAL_CLAIM _ID", "CLA IM_SERVICE _START_DAT E", "CLAIM _SERVICE_E ND_DATE", "ATTACHMEN T_NAME", " ATTACHMENT _TYPE", "A TTACHMENT_ CONTROL_NU MBER", "PA YER_CLAIM_ CONTROL_NU MBER", "ST ATUS") AS | |
| 9 | SELECT D ISTINCT | |
| 10 | a. attachment _id AS "ID ", | |
| 11 | a. attachment _id, | |
| 12 | p. path_strin g AS attac hment_path , | |
| 13 | a. nm103 AS p rovider_na me, | |
| 14 | a. nm104 AS p rovider_fi rst_name, | |
| 15 | a. nm109 AS p rovider_id entifier, | |
| 16 | a. nm109 AS p rovider_np i, | |
| 17 | a. nm102 AS e ntity_type _qualifier , | |
| 18 | b. nm104 AS p atient_fir st_name, | |
| 19 | b. nm103 AS p atient_las t_name, | |
| 20 | b. nm109 AS p atient_ide ntifier_nu mber, | |
| 21 | c. report_cod e, | |
| 22 | d. ref02 AS p atient_con trol_numbe r, | |
| 23 | e. ref01 AS r ef01, | |
| 24 | e. ref02 AS m edical_rec ord_number , | |
| 25 | a. claim_key AS claim_i dentifier, | |
| 26 | c. external_c laim_id AS external_ claim_id, | |
| 27 | CASE sub str( | |
| 28 | g.dt p03, | |
| 29 | 1, | |
| 30 | inst r(g.dtp03, '-') | |
| 31 | ) | |
| 32 | WHEN ' ' THE N g.dtp03 | |
| 33 | ELSE substr( | |
| 34 | g.dtp03, | |
| 35 | 1, | |
| 36 | instr(g.dt p03,'-') - 1 | |
| 37 | ) | |
| 38 | END | |
| 39 | AS claim_ser vice_start _date, | |
| 40 | su bstr( | |
| 41 | dtp03, | |
| 42 | instr(dt p03,'-') + 1, | |
| 43 | length(r trim(dtp03 ) ) | |
| 44 | ) AS claim_s ervice_end _date, | |
| 45 | c. attachment _name, | |
| 46 | c. attachment _type, | |
| 47 | h. trn02 AS a ttachment_ control_nu mber, | |
| 48 | c. payer_clai m_control_ number, | |
| 49 | c. status | |
| 50 | FROM | |
| 51 | en tityname a | |
| 52 | LE FT OUTER J OIN refere nce_identi fication e ON | |
| 53 | a.attach ment_id = e.attachme nt_id | |
| 54 | AN D | |
| 55 | e.ref01 = 'EA' | |
| 56 | LE FT OUTER J OIN trace_ number h O N a.attach ment_id = h.attachme nt_id | |
| 57 | IN NER JOIN p aths p ON a.attachme nt_id = p. attachment _id, | |
| 58 | en tityname b , | |
| 59 | tr ansactions c, | |
| 60 | re ference_id entificati on d, | |
| 61 | cl aim_date g | |
| 62 | WHERE | |
| 63 | a.attach ment_id = b.attachme nt_id | |
| 64 | AN D | |
| 65 | a.attach ment_id = c.attachme nt_id | |
| 66 | AN D | |
| 67 | a.attach ment_id = d.attachme nt_id | |
| 68 | AN D | |
| 69 | a.attach ment_id = g.attachme nt_id | |
| 70 | AN D | |
| 71 | a.nm101 = '1P' | |
| 72 | AN D | |
| 73 | b.nm101 = 'QC' | |
| 74 | AN D | |
| 75 | d.ref01 = 'EJ' | |
| 76 | AN D | |
| 77 | g.dtp01 = '472' | |
| 78 | ; | |
| 79 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 80 | -- DDL fo r Table AR SAUDITLOG | |
| 81 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 82 | ||
| 83 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."ARSAUDIT LOG" | |
| 84 | ( "I D" NUMBER( 10,0), | |
| 85 | "M ETHODNAME" VARCHAR2( 50 BYTE), | |
| 86 | "U SERID" VAR CHAR2(60 B YTE), | |
| 87 | "C LAIMATTACH MENTID" NU MBER(10,0) , | |
| 88 | "A CCESSDATE" TIMESTAMP (3), | |
| 89 | "R EQUESTARGS " VARCHAR2 (200 BYTE) , | |
| 90 | "A CTION" VAR CHAR2(60 B YTE), | |
| 91 | "S UCCESS" NU MBER(1,0), | |
| 92 | "V ER" NUMBER (10,0) DEF AULT 1 | |
| 93 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 94 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 95 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 96 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 97 | TABLESPA CE "SYSTEM " ; | |
| 98 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 99 | -- DDL fo r Table AR SREPORTTYP E | |
| 100 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 101 | ||
| 102 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."ARSREPOR TTYPE" | |
| 103 | ( "C ODE" VARCH AR2(20 BYT E), | |
| 104 | "D EFINITION" VARCHAR2( 90 BYTE) | |
| 105 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 106 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 107 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 108 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 109 | TABLESPA CE "SYSTEM " ; | |
| 110 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 111 | -- DDL fo r Table AR S_ROLE | |
| 112 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 113 | ||
| 114 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."ARS_ROLE " | |
| 115 | ( "A RS_ROLE_ID " NUMBER(1 5,0), | |
| 116 | "R OLE_NAME" VARCHAR2(3 0 BYTE), | |
| 117 | "D ESCRIPTION " VARCHAR2 (60 BYTE), | |
| 118 | "C REATED_BY" VARCHAR2( 30 BYTE), | |
| 119 | "D ATE_CREATE D" DATE | |
| 120 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 121 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 122 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 123 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 124 | TABLESPA CE "SYSTEM " ; | |
| 125 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 126 | -- DDL fo r Table AR S_ROLE_PER MISSIONS | |
| 127 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 128 | ||
| 129 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."ARS_ROLE _PERMISSIO NS" | |
| 130 | ( "P ERMISSION_ ID" NUMBER (15,0), | |
| 131 | "P AGE_NAME" VARCHAR2(3 0 BYTE), | |
| 132 | "P ERMISSION_ NAME" VARC HAR2(40 BY TE), | |
| 133 | "A RS_ROLE_ID " NUMBER(1 5,0), | |
| 134 | "E NABLED" VA RCHAR2(1 B YTE), | |
| 135 | "C REATED_BY" VARCHAR2( 30 BYTE), | |
| 136 | "D ATE_CREATE D" DATE | |
| 137 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 138 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 139 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 140 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 141 | TABLESPA CE "SYSTEM " ; | |
| 142 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 143 | -- DDL fo r Table AR S_USER | |
| 144 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 145 | ||
| 146 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."ARS_USER " | |
| 147 | ( "A RS_USER_ID " NUMBER(1 5,0), | |
| 148 | "U SER_NAME" VARCHAR2(3 0 BYTE), | |
| 149 | "E NABLED" VA RCHAR2(1 B YTE), | |
| 150 | "L AST_NAME" VARCHAR2(3 0 BYTE), | |
| 151 | "F IRST_NAME" VARCHAR2( 30 BYTE), | |
| 152 | "M IDDLE_NAME " VARCHAR2 (30 BYTE), | |
| 153 | "P HONE_NUMBE R" VARCHAR 2(15 BYTE) , | |
| 154 | "E MAIL_ADDRE SS" VARCHA R2(100 BYT E), | |
| 155 | "L AST_LOGIN_ DATE" DATE , | |
| 156 | "D EACTIVATIO N_REASON_C D" NUMBER( 10,0), | |
| 157 | "D EACTIVATIO N_COMMENTS " VARCHAR2 (200 BYTE) , | |
| 158 | "C REATED_BY" VARCHAR2( 30 BYTE), | |
| 159 | "D ATE_CREATE D" DATE, | |
| 160 | "M ODIFIED_BY " VARCHAR2 (30 BYTE), | |
| 161 | "D ATE_MODIFI ED" DATE | |
| 162 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 163 | PCTFREE 0 PCTUSED 0 INITRANS 1 MAXTRAN S 255 NOCO MPRESS LOG GING | |
| 164 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 165 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 166 | TABLESPA CE "SYSTEM " | |
| 167 | PARALLEL 2 ; | |
| 168 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 169 | -- DDL fo r Table AR S_USER_ROL E_USAGES | |
| 170 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 171 | ||
| 172 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."ARS_USER _ROLE_USAG ES" | |
| 173 | ( "A RS_ROLE_ID " NUMBER(1 5,0), | |
| 174 | "A RS_USER_ID " NUMBER(1 5,0), | |
| 175 | "C REATED_BY" VARCHAR2( 30 BYTE), | |
| 176 | "D ATE_CREATE D" DATE | |
| 177 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 178 | PCTFREE 0 PCTUSED 0 INITRANS 1 MAXTRAN S 255 NOCO MPRESS LOG GING | |
| 179 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 180 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 181 | TABLESPA CE "SYSTEM " | |
| 182 | PARALLEL 2 ; | |
| 183 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 184 | -- DDL fo r Table BI NARY275 | |
| 185 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 186 | ||
| 187 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."BINARY27 5" | |
| 188 | ( "A TTACHMENT_ ID" NUMBER (10,0), | |
| 189 | "B IN01" NUMB ER(10,0), | |
| 190 | "B INARY275ID " NUMBER | |
| 191 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 192 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 193 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 194 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 195 | TABLESPA CE "SYSTEM " ; | |
| 196 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 197 | -- DDL fo r Table CL AIMATTACHM ENTS | |
| 198 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 199 | ||
| 200 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."CLAIMATT ACHMENTS" | |
| 201 | ( "I D" NUMBER( 10,0), | |
| 202 | "P ROVIDER_NA ME" VARCHA R2(132 BYT E), | |
| 203 | "P ROVIDER_ID ENTIFIER_N UMBER" VAR CHAR2(20 B YTE), | |
| 204 | "P ATIENT_FIR ST_NAME" V ARCHAR2(60 BYTE), | |
| 205 | "P ATIENT_LAS T_NAME" VA RCHAR2(60 BYTE), | |
| 206 | "R EPORT_CODE " VARCHAR2 (20 BYTE), | |
| 207 | "P ATIENT_CON TROL_NUMBE R" VARCHAR 2(20 BYTE) , | |
| 208 | "M EDICAL_REC ORD_NUMBER " VARCHAR2 (20 BYTE), | |
| 209 | "P ATIENT_IDE NTIFIER_NU MBER" VARC HAR2(20 BY TE), | |
| 210 | "P ROVIDER_NP I" VARCHAR 2(20 BYTE) , | |
| 211 | "C LAIM_IDENT IFIER" VAR CHAR2(20 B YTE), | |
| 212 | "C LAIM_SERVI CE_DATE" D ATE, | |
| 213 | "P AYER_CLAIM _CONTROL_N UMBER" VAR CHAR2(20 B YTE), | |
| 214 | "A TTACHMENT_ CONTROL_NU MBER" VARC HAR2(20 BY TE), | |
| 215 | "A TTACHMENT_ NAME" VARC HAR2(60 BY TE), | |
| 216 | "A TTACHMENT_ TYPE" VARC HAR2(10 BY TE), | |
| 217 | "L OINC_CODE" VARCHAR2( 100 BYTE), | |
| 218 | "S TATUS" VAR CHAR2(10 B YTE), | |
| 219 | "V ER" NUMBER (10,0) DEF AULT 1 | |
| 220 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 221 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 222 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 223 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 224 | TABLESPA CE "SYSTEM " ; | |
| 225 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 226 | -- DDL fo r Table CL AIM_CONTAC T | |
| 227 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 228 | ||
| 229 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."CLAIM_CO NTACT" | |
| 230 | ( "C ONTACTUSER ID" NUMBER , | |
| 231 | "C ONTACTEMAI L" VARCHAR 2(350 BYTE ), | |
| 232 | "D ATECREATED " DATE, | |
| 233 | "D ATEMODIFIE D" DATE | |
| 234 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 235 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 236 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 237 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 238 | TABLESPA CE "SYSTEM " ; | |
| 239 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 240 | -- DDL fo r Table CL AIM_DATE | |
| 241 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 242 | ||
| 243 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."CLAIM_DA TE" | |
| 244 | ( "A TTACHMENT_ ID" NUMBER (10,0), | |
| 245 | "L OOP_ID" VA RCHAR2(60 BYTE), | |
| 246 | "C LAIM_KEY" VARCHAR2(6 0 BYTE), | |
| 247 | "B ATCH_ID" V ARCHAR2(30 0 BYTE), | |
| 248 | "R EC_NUM" NU MBER(10,0) , | |
| 249 | "D TP01" VARC HAR2(60 BY TE), | |
| 250 | "D TP02" VARC HAR2(60 BY TE), | |
| 251 | "D TP03" VARC HAR2(60 BY TE), | |
| 252 | "C LAIM_DATE_ ID" NUMBER | |
| 253 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 254 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 255 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 256 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 257 | TABLESPA CE "SYSTEM " ; | |
| 258 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 259 | -- DDL fo r Table CL AIM_SUBMIS SION | |
| 260 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 261 | ||
| 262 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."CLAIM_SU BMISSION" | |
| 263 | ( "S UBMISSIONI D" NUMBER, | |
| 264 | "C ONTACTUSER ID" NUMBER , | |
| 265 | "H CCS_ID" NU MBER, | |
| 266 | "L OINC_ID" N UMBER, | |
| 267 | "L OINC_MOD_I D" NUMBER, | |
| 268 | "T RN02CPE_PD I" VARCHAR 2(15 CHAR) , | |
| 269 | "T RN02FPPS_C LAIM_ID" N UMBER, | |
| 270 | "H L1NM103PYR _NM" VARCH AR2(250 BY TE), | |
| 271 | "H L1NM109PYR _ID" VARCH AR2(350 BY TE), | |
| 272 | "H L2NM103INF _RCVR" VAR CHAR2(250 BYTE), | |
| 273 | "H L1PER04VAM CCNTEM" VA RCHAR2(250 BYTE), | |
| 274 | "H L3NM103SVC BILLPRVNM" VARCHAR2( 250 BYTE), | |
| 275 | "H L3NM109PRV NPI" VARCH AR2(350 BY TE), | |
| 276 | "H L2NM109SVC PRVTIN" VA RCHAR2(350 BYTE), | |
| 277 | "H L4NM103PTL STNM" VARC HAR2(250 B YTE), | |
| 278 | "H L4NM104PTF TNM" VARCH AR2(150 BY TE), | |
| 279 | "H L4NM109PTI D" VARCHAR 2(350 BYTE ), | |
| 280 | "R EF102PTCTR LNMBR" VAR CHAR2(200 BYTE), | |
| 281 | "T RN02PYRCLM CTRLNMBR" VARCHAR2(2 50 BYTE), | |
| 282 | "R EF202BILLT YPE" VARCH AR2(250 BY TE), | |
| 283 | "R EF402CLRNG HSID" VARC HAR2(250 B YTE), | |
| 284 | "R EF302MEDRE CNMBR" VAR CHAR2(250 BYTE), | |
| 285 | "D TP203RESPO NSEDUEDATE " DATE, | |
| 286 | "D TP103SVCFR MDT" DATE, | |
| 287 | "D TP103SVCTO DT" DATE, | |
| 288 | "S UBMISSION_ STATUS" VA RCHAR2(50 BYTE), | |
| 289 | "G ENERATE277 _STATUS" V ARCHAR2(50 BYTE), | |
| 290 | "D ATECREATED " DATE, | |
| 291 | "D ATESUBMITT ED" DATE, | |
| 292 | "D ATEMODIFIE D" DATE, | |
| 293 | "N 3RSPCNTADD RSLN" VARC HAR2(350 B YTE), | |
| 294 | "N 3RSPCNTADD LADDRLN" V ARCHAR2(35 0 BYTE), | |
| 295 | "N 4RSPCNTCIT Y" VARCHAR 2(200 BYTE ), | |
| 296 | "N 4RSPCNTSTC D" VARCHAR 2(10 BYTE) , | |
| 297 | "N 4RSPCNTZPC D" VARCHAR 2(50 BYTE) , | |
| 298 | "N 4RSPCNTCTR YCD" VARCH AR2(200 BY TE) | |
| 299 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 300 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 301 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 302 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 303 | TABLESPA CE "SYSTEM " ; | |
| 304 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 305 | -- DDL fo r Table CL AIM_SUBMIS SION_NOTE | |
| 306 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 307 | ||
| 308 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."CLAIM_SU BMISSION_N OTE" | |
| 309 | ( "C LAIM_SUBMI SSION_NOTE _ID" NUMBE R, | |
| 310 | "C LAIM_SUBMI SSION_ID" NUMBER, | |
| 311 | "C LAIM_SUBMI SSION_NOTE " VARCHAR2 (1000 BYTE ), | |
| 312 | "C LAIM_SUBMI SSION_OLD_ STATUS" VA RCHAR2(50 CHAR), | |
| 313 | "C LAIM_SUBMI SSION_NEW_ STATUS" VA RCHAR2(50 CHAR), | |
| 314 | "C REATED_BY" VARCHAR2( 30 CHAR), | |
| 315 | "D ATE_CREATE D" DATE | |
| 316 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 317 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 318 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 319 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 320 | TABLESPA CE "SYSTEM " ; | |
| 321 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 322 | -- DDL fo r Table CL AIM_SVC_LI NES | |
| 323 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 324 | ||
| 325 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."CLAIM_SV C_LINES" | |
| 326 | ( "S UBMISSIONS VCLINEID" NUMBER, | |
| 327 | "S UBMISSIONI D" NUMBER, | |
| 328 | "R EF02SVCLNN MBR" VARCH AR2(200 BY TE), | |
| 329 | "D TP03SVCFRM DT" DATE, | |
| 330 | "D TP03SVCTOD T" DATE, | |
| 331 | "S VC01REVCD" VARCHAR2( 200 BYTE), | |
| 332 | "S VC01PROCCD " VARCHAR2 (200 BYTE) , | |
| 333 | "S VC01MOD" V ARCHAR2(11 BYTE), | |
| 334 | "S VC02CHRGAM T" NUMBER( 19,4), | |
| 335 | "D ATECREATED " DATE, | |
| 336 | "D ATEMODIFIE D" DATE | |
| 337 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 338 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 339 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 340 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 341 | TABLESPA CE "SYSTEM " ; | |
| 342 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 343 | -- DDL fo r Table CO NTACT | |
| 344 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 345 | ||
| 346 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."CONTACT" | |
| 347 | ( "A TTACHMENT_ ID" NUMBER (10,0), | |
| 348 | "L OOP_ID" VA RCHAR2(60 BYTE), | |
| 349 | "C LAIM_KEY" VARCHAR2(6 0 BYTE), | |
| 350 | "B ATCH_ID" V ARCHAR2(30 0 BYTE), | |
| 351 | "P ER01" VARC HAR2(60 BY TE), | |
| 352 | "P ER02" VARC HAR2(60 BY TE), | |
| 353 | "P ER03" VARC HAR2(60 BY TE), | |
| 354 | "P ER04" VARC HAR2(60 BY TE), | |
| 355 | "P ER05" VARC HAR2(60 BY TE), | |
| 356 | "P ER06" VARC HAR2(60 BY TE), | |
| 357 | "P ER07" VARC HAR2(60 BY TE), | |
| 358 | "P ER08" VARC HAR2(60 BY TE), | |
| 359 | "C ONTACT_ID" NUMBER | |
| 360 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 361 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 362 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 363 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 364 | TABLESPA CE "SYSTEM " ; | |
| 365 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 366 | -- DDL fo r Table DO CUMENT_CAT EGORY | |
| 367 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 368 | ||
| 369 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."DOCUMENT _CATEGORY" | |
| 370 | ( "A TTACHMENT_ ID" NUMBER (10,0), | |
| 371 | "L OOP_ID" VA RCHAR2(60 BYTE), | |
| 372 | "C LAIM_KEY" VARCHAR2(6 0 BYTE), | |
| 373 | "B ATCH_ID" V ARCHAR2(30 0 BYTE), | |
| 374 | "C AT01" VARC HAR2(60 BY TE), | |
| 375 | "C AT02" VARC HAR2(60 BY TE), | |
| 376 | "C AT03" VARC HAR2(60 BY TE), | |
| 377 | "E F101" VARC HAR2(60 BY TE), | |
| 378 | "D OCUMENT_CA TEGORYID" NUMBER | |
| 379 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 380 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 381 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 382 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 383 | TABLESPA CE "SYSTEM " ; | |
| 384 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 385 | -- DDL fo r Table EM AIL_TEMPLA TES | |
| 386 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 387 | ||
| 388 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."EMAIL_TE MPLATES" | |
| 389 | ( "E MAIL_TEMPL ATE_ID" NU MBER, | |
| 390 | "E MAIL_TEMPL ATE_HEADER " VARCHAR2 (250 BYTE) , | |
| 391 | "E MAIL_TEMPL ATE_BODY" VARCHAR2(2 50 BYTE), | |
| 392 | "E MAIL_TEMPL ATE_TYPE" VARCHAR2(2 50 BYTE), | |
| 393 | "D ATEMODIFIE D" DATE, | |
| 394 | "M ODIFIEDBY" VARCHAR2( 50 BYTE) | |
| 395 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 396 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 397 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 398 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 399 | TABLESPA CE "SYSTEM " ; | |
| 400 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 401 | -- DDL fo r Table EN TITYADDRES S | |
| 402 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 403 | ||
| 404 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."ENTITYAD DRESS" | |
| 405 | ( "A TTACHMENT_ ID" NUMBER (10,0), | |
| 406 | "L OOP_ID" VA RCHAR2(60 BYTE), | |
| 407 | "C LAIM_KEY" VARCHAR2(6 0 BYTE), | |
| 408 | "B ATCH_ID" V ARCHAR2(30 0 BYTE), | |
| 409 | "N 301" VARCH AR2(60 BYT E), | |
| 410 | "N 302" VARCH AR2(60 BYT E), | |
| 411 | "N 401" VARCH AR2(60 BYT E), | |
| 412 | "N 402" VARCH AR2(60 BYT E), | |
| 413 | "N 403" VARCH AR2(60 BYT E), | |
| 414 | "N 404" VARCH AR2(60 BYT E), | |
| 415 | "N 407" VARCH AR2(60 BYT E), | |
| 416 | "E NTITYADDRE SSID" NUMB ER | |
| 417 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 418 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 419 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 420 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 421 | TABLESPA CE "SYSTEM " ; | |
| 422 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 423 | -- DDL fo r Table EN TITYNAME | |
| 424 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 425 | ||
| 426 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."ENTITYNA ME" | |
| 427 | ( "A TTACHMENT_ ID" NUMBER (10,0), | |
| 428 | "L OOP_ID" VA RCHAR2(60 BYTE), | |
| 429 | "C LAIM_KEY" VARCHAR2(6 0 BYTE), | |
| 430 | "B ATCH_ID" V ARCHAR2(30 0 BYTE), | |
| 431 | "N M101" VARC HAR2(60 BY TE), | |
| 432 | "N M102" VARC HAR2(60 BY TE), | |
| 433 | "N M103" VARC HAR2(60 BY TE), | |
| 434 | "N M104" VARC HAR2(60 BY TE), | |
| 435 | "N M105" VARC HAR2(60 BY TE), | |
| 436 | "N M106" VARC HAR2(60 BY TE), | |
| 437 | "N M107" VARC HAR2(60 BY TE), | |
| 438 | "N M108" VARC HAR2(60 BY TE), | |
| 439 | "N M109" VARC HAR2(60 BY TE), | |
| 440 | "P RV01" VARC HAR2(2 BYT E), | |
| 441 | "P RV02" VARC HAR2(3 BYT E), | |
| 442 | "P RV03" VARC HAR2(50 BY TE), | |
| 443 | "E NTITYNAMEI D" NUMBER | |
| 444 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 445 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 446 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 447 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 448 | TABLESPA CE "SYSTEM " ; | |
| 449 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 450 | -- DDL fo r Table ER EPOSDATA | |
| 451 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 452 | ||
| 453 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."EREPOSDA TA" | |
| 454 | ( "D EBUG" CHAR (1 BYTE), | |
| 455 | "A TTACHMENT_ ID" NUMBER , | |
| 456 | "C LAIM_KEY" VARCHAR2(3 00 BYTE), | |
| 457 | "R EPORTCODE" VARCHAR2( 20 BYTE), | |
| 458 | "P AYERCLAIMC ONTROLNUMB ER" VARCHA R2(200 BYT E), | |
| 459 | "E XTERNALCLA IMID" VARC HAR2(200 B YTE), | |
| 460 | "E REPOSDATA_ ID" NUMBER | |
| 461 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 462 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 463 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 464 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 465 | TABLESPA CE "SYSTEM " ; | |
| 466 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 467 | -- DDL fo r Table HC CS_CD | |
| 468 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 469 | ||
| 470 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."HCCS_CD" | |
| 471 | ( "H CCS_ID" NU MBER, | |
| 472 | "S TCHCCSTATU SCAT_CD" V ARCHAR2(35 BYTE), | |
| 473 | "S TCHCCSTATU SCAT_CD_DE SC" VARCHA R2(2000 BY TE), | |
| 474 | "I SACTIVE" C HAR(1 BYTE ) DEFAULT '1', | |
| 475 | "D ATECREATED " DATE, | |
| 476 | "D ATEMODIFIE D" DATE | |
| 477 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 478 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 479 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 480 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 481 | TABLESPA CE "SYSTEM " ; | |
| 482 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 483 | -- DDL fo r Table LO INC_CD | |
| 484 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 485 | ||
| 486 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."LOINC_CD " | |
| 487 | ( "L OINC_ID" N UMBER, | |
| 488 | "S TCLOINC_CD " VARCHAR2 (35 BYTE), | |
| 489 | "S TCLOINC_CD _DESC" VAR CHAR2(2000 BYTE), | |
| 490 | "I SACTIVE" C HAR(1 BYTE ) DEFAULT '1', | |
| 491 | "D ATECREATED " DATE, | |
| 492 | "D ATEMODIFIE D" DATE | |
| 493 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 494 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 495 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 496 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 497 | TABLESPA CE "SYSTEM " ; | |
| 498 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 499 | -- DDL fo r Table LO INC_MOD_CD | |
| 500 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 501 | ||
| 502 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."LOINC_MO D_CD" | |
| 503 | ( "L OINC_MOD_I D" NUMBER, | |
| 504 | "S TCLOINC_CD _MOD" VARC HAR2(35 BY TE), | |
| 505 | "S TCLOINC_CD _MOD_DESC" VARCHAR2( 2000 BYTE) , | |
| 506 | "I SACTIVE" C HAR(1 BYTE ) DEFAULT '1', | |
| 507 | "D ATECREATED " DATE, | |
| 508 | "D ATEMODIFIE D" DATE | |
| 509 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 510 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 511 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 512 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 513 | TABLESPA CE "SYSTEM " ; | |
| 514 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 515 | -- DDL fo r Table OA UTH_CLIENT _AUTHORITI ES | |
| 516 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 517 | ||
| 518 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."OAUTH_CL IENT_AUTHO RITIES" | |
| 519 | ( "U SERNAME" V ARCHAR2(50 BYTE), | |
| 520 | "A UTHORITY" VARCHAR2(5 0 BYTE) | |
| 521 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 522 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 523 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 524 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 525 | TABLESPA CE "SYSTEM " ; | |
| 526 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 527 | -- DDL fo r Table OA UTH_CLIENT _INFO | |
| 528 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 529 | ||
| 530 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."OAUTH_CL IENT_INFO" | |
| 531 | ( "U SERNAME" V ARCHAR2(50 BYTE), | |
| 532 | "P ASSWORD" V ARCHAR2(50 BYTE), | |
| 533 | "E NABLED" NU MBER(1,0), | |
| 534 | "C REATED_BY" VARCHAR2( 30 BYTE), | |
| 535 | "D ATE_CREATE D" TIMESTA MP (6), | |
| 536 | "D ESCRIPTION " VARCHAR2 (60 BYTE) | |
| 537 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 538 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 539 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 540 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 541 | TABLESPA CE "SYSTEM " ; | |
| 542 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 543 | -- DDL fo r Table PA THS | |
| 544 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 545 | ||
| 546 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."PATHS" | |
| 547 | ( "P ATH_ID" NU MBER, | |
| 548 | "A TTACHMENT_ ID" NUMBER , | |
| 549 | "P ATH_STRING " VARCHAR2 (1200 BYTE ) | |
| 550 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 551 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 552 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 553 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 554 | TABLESPA CE "SYSTEM " ; | |
| 555 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 556 | -- DDL fo r Table RE FERENCE_ID ENTIFICATI ON | |
| 557 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 558 | ||
| 559 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."REFERENC E_IDENTIFI CATION" | |
| 560 | ( "A TTACHMENT_ ID" NUMBER (10,0), | |
| 561 | "L OOP_ID" VA RCHAR2(60 BYTE), | |
| 562 | "C LAIM_KEY" VARCHAR2(6 0 BYTE), | |
| 563 | "B ATCH_ID" V ARCHAR2(30 0 BYTE), | |
| 564 | "R EC_NUM" NU MBER(10,0) , | |
| 565 | "R EF01" VARC HAR2(60 BY TE), | |
| 566 | "R EF02" VARC HAR2(60 BY TE), | |
| 567 | "R EF03" VARC HAR2(60 BY TE), | |
| 568 | "R EF04" VARC HAR2(60 BY TE), | |
| 569 | "R EFERENCE_I DENTIFICAT ION_ID" NU MBER | |
| 570 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 571 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 572 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 573 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 574 | TABLESPA CE "SYSTEM " ; | |
| 575 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 576 | -- DDL fo r Table SS O_AUTHENTI CATION | |
| 577 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 578 | ||
| 579 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."SSO_AUTH ENTICATION " | |
| 580 | ( "G UID" VARCH AR2(36 BYT E), | |
| 581 | "S ESSIONID" VARCHAR2(5 0 BYTE), | |
| 582 | "N TNAME" VAR CHAR2(20 B YTE) | |
| 583 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 584 | PCTFREE 0 PCTUSED 0 INITRANS 1 MAXTRAN S 255 NOCO MPRESS LOG GING | |
| 585 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 586 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 587 | TABLESPA CE "SYSTEM " | |
| 588 | PARALLEL 2 ; | |
| 589 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 590 | -- DDL fo r Table ST ATUS_INFOR MATION | |
| 591 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 592 | ||
| 593 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."STATUS_I NFORMATION " | |
| 594 | ( "A TTACHMENT_ ID" NUMBER (10,0), | |
| 595 | "L OOP_ID" VA RCHAR2(60 BYTE), | |
| 596 | "C LAIM_KEY" VARCHAR2(6 0 BYTE), | |
| 597 | "B ATCH_ID" V ARCHAR2(30 0 BYTE), | |
| 598 | "S TC01_1" VA RCHAR2(60 BYTE), | |
| 599 | "S TC01_2" VA RCHAR2(60 BYTE), | |
| 600 | "S TC01_3" VA RCHAR2(60 BYTE), | |
| 601 | "S TC01_4" VA RCHAR2(60 BYTE), | |
| 602 | "S TC10_1" VA RCHAR2(60 BYTE), | |
| 603 | "S TC10_2" VA RCHAR2(60 BYTE), | |
| 604 | "S TC10_3" VA RCHAR2(60 BYTE), | |
| 605 | "S TC10_4" VA RCHAR2(60 BYTE), | |
| 606 | "S TC11_1" VA RCHAR2(60 BYTE), | |
| 607 | "S TC11_2" VA RCHAR2(60 BYTE), | |
| 608 | "S TC11_3" VA RCHAR2(60 BYTE), | |
| 609 | "S TC11_4" VA RCHAR2(60 BYTE), | |
| 610 | "S TATUS_INFO RMATION_ID " NUMBER | |
| 611 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 612 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 613 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 614 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 615 | TABLESPA CE "SYSTEM " ; | |
| 616 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 617 | -- DDL fo r Table TR ACE_NUMBER | |
| 618 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 619 | ||
| 620 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."TRACE_NU MBER" | |
| 621 | ( "A TTACHMENT_ ID" NUMBER (10,0), | |
| 622 | "T RN01" VARC HAR2(60 BY TE), | |
| 623 | "T RN02" VARC HAR2(60 BY TE), | |
| 624 | "T RACENUMBER ID" NUMBER | |
| 625 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 626 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 627 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 628 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 629 | TABLESPA CE "SYSTEM " ; | |
| 630 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 631 | -- DDL fo r Table TR ANSACTIONS | |
| 632 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 633 | ||
| 634 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."TRANSACT IONS" | |
| 635 | ( "A TTACHMENT_ ID" NUMBER (10,0), | |
| 636 | "L OOP_ID" VA RCHAR2(60 BYTE), | |
| 637 | "C LAIM_KEY" VARCHAR2(6 0 BYTE), | |
| 638 | "B ATCH_ID" V ARCHAR2(30 0 BYTE), | |
| 639 | "A TTACHMENT_ MOVED" NUM BER(10,0), | |
| 640 | "R EPORT_CODE " VARCHAR2 (20 BYTE), | |
| 641 | "A TTACHMENT_ NAME" VARC HAR2(120 B YTE), | |
| 642 | "A TTACHMENT_ TYPE" VARC HAR2(20 BY TE), | |
| 643 | "E XTERNAL_CL AIM_ID" VA RCHAR2(60 BYTE), | |
| 644 | "P AYER_CLAIM _CONTROL_N UMBER" VAR CHAR2(50 B YTE), | |
| 645 | "S TATUS" VAR CHAR2(60 B YTE), | |
| 646 | "S T01" VARCH AR2(60 BYT E), | |
| 647 | "S T02" VARCH AR2(60 BYT E), | |
| 648 | "S T03" VARCH AR2(60 BYT E), | |
| 649 | "S E01" VARCH AR2(60 BYT E), | |
| 650 | "S E02" VARCH AR2(60 BYT E), | |
| 651 | "B GN01" VARC HAR2(60 BY TE), | |
| 652 | "B GN02" VARC HAR2(60 BY TE), | |
| 653 | "B GN03" VARC HAR2(60 BY TE), | |
| 654 | "T RANS_TIMES TMP" TIMES TAMP (3), | |
| 655 | "L X01" VARCH AR2(10 BYT E), | |
| 656 | "P ATIENT_DOB " DATE, | |
| 657 | "V A_FACILITY _CD" VARCH AR2(12 BYT E), | |
| 658 | "T RANSACTION S_ID" NUMB ER | |
| 659 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 660 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 661 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 662 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 663 | TABLESPA CE "SYSTEM " ; | |
| 664 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 665 | -- DDL fo r Table ZI PCODE | |
| 666 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 667 | ||
| 668 | CREATE T ABLE "ARS2 77_REQUEST _TRACKING" ."ZIPCODE" | |
| 669 | ( "Z IP_CODE" V ARCHAR2(10 BYTE), | |
| 670 | "F IPS_STATE_ CODE" VARC HAR2(2 BYT E), | |
| 671 | "F IPS_COUNTY _CODE" VAR CHAR2(3 BY TE), | |
| 672 | "U RBAN_INDIC ATOR" VARC HAR2(10 BY TE), | |
| 673 | "A CTIVE_FLAG " VARCHAR2 (1 BYTE), | |
| 674 | "V A_FACILITY _CD" VARCH AR2(12 BYT E), | |
| 675 | "C REATED_BY" VARCHAR2( 30 BYTE), | |
| 676 | "D ATE_CREATE D" TIMESTA MP (3), | |
| 677 | "M ODIFIED_BY " VARCHAR2 (30 BYTE), | |
| 678 | "D ATE_MODIFI ED" TIMEST AMP (3) | |
| 679 | ) SEGME NT CREATIO N IMMEDIAT E | |
| 680 | PCTFREE 10 PCTUSED 40 INITRA NS 1 MAXTR ANS 255 NO COMPRESS L OGGING | |
| 681 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 682 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 683 | TABLESPA CE "SYSTEM " ; | |
| 684 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 685 | -- DDL fo r Sequence ARS_ROLE_ PERMISSION S_SEQ | |
| 686 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 687 | ||
| 688 | CREATE SEQUENCE "ARS277_RE QUEST_TRAC KING"."ARS _ROLE_PERM ISSIONS_SE Q" MINVAL UE 1 MAXVA LUE 999999 999999999 INCREMENT BY 1 START WITH 117 NOCACHE O RDER NOCY CLE ; | |
| 689 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 690 | -- DDL fo r Sequence ARS_ROLE_ SEQ | |
| 691 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 692 | ||
| 693 | CREATE SEQUENCE "ARS277_RE QUEST_TRAC KING"."ARS _ROLE_SEQ" MINVALUE 1 MAXVALU E 99999999 9999999 IN CREMENT BY 1 START W ITH 102 NO CACHE ORD ER NOCYCL E ; | |
| 694 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 695 | -- DDL fo r Sequence ARS_USER_ SEQ | |
| 696 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 697 | ||
| 698 | CREATE SEQUENCE "ARS277_RE QUEST_TRAC KING"."ARS _USER_SEQ" MINVALUE 1 MAXVALU E 99999999 9999999 IN CREMENT BY 1 START W ITH 102 NO CACHE ORD ER NOCYCL E ; | |
| 699 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 700 | -- DDL fo r Sequence ATTACHMEN T_ID_SEQ | |
| 701 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 702 | ||
| 703 | CREATE SEQUENCE "ARS277_RE QUEST_TRAC KING"."ATT ACHMENT_ID _SEQ" MIN VALUE -922 3372036854 775808 MAX VALUE 9223 3720368547 75807 INCR EMENT BY 1 START WIT H 620 CACH E 20 NOORD ER NOCYCL E ; | |
| 704 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 705 | -- DDL fo r Sequence BINARY_27 5_SEQ | |
| 706 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 707 | ||
| 708 | CREATE SEQUENCE "ARS277_RE QUEST_TRAC KING"."BIN ARY_275_SE Q" MINVAL UE -922337 2036854775 808 MAXVAL UE 9223372 0368547758 07 INCREME NT BY 1 ST ART WITH 2 21 CACHE 2 0 NOORDER NOCYCLE ; | |
| 709 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 710 | -- DDL fo r Sequence CLAIM_CON TACT_SEQ | |
| 711 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 712 | ||
| 713 | CREATE SEQUENCE "ARS277_RE QUEST_TRAC KING"."CLA IM_CONTACT _SEQ" MIN VALUE 1 MA XVALUE 999 9999999999 9999999999 9999 INCRE MENT BY 1 START WITH 309 NOCAC HE ORDER NOCYCLE ; | |
| 714 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 715 | -- DDL fo r Sequence CLAIM_DAT E_SEQ | |
| 716 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 717 | ||
| 718 | CREATE SEQUENCE "ARS277_RE QUEST_TRAC KING"."CLA IM_DATE_SE Q" MINVAL UE -922337 2036854775 808 MAXVAL UE 9223372 0368547758 07 INCREME NT BY 1 ST ART WITH 9 00 CACHE 2 0 NOORDER NOCYCLE ; | |
| 719 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 720 | -- DDL fo r Sequence CLAIM_SUB MISSION_NO TE_SEQ | |
| 721 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 722 | ||
| 723 | CREATE SEQUENCE "ARS277_RE QUEST_TRAC KING"."CLA IM_SUBMISS ION_NOTE_S EQ" MINVA LUE 1 MAXV ALUE 99999 9999999999 9999999999 999 INCREM ENT BY 1 S TART WITH 176 NOCACH E ORDER NOCYCLE ; | |
| 724 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 725 | -- DDL fo r Sequence CLAIM_SUB MISSION_SE Q | |
| 726 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 727 | ||
| 728 | CREATE SEQUENCE "ARS277_RE QUEST_TRAC KING"."CLA IM_SUBMISS ION_SEQ" MINVALUE 1 MAXVALUE 9999999999 9999999999 99999999 I NCREMENT B Y 1 START WITH 941 N OCACHE OR DER NOCYC LE ; | |
| 729 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 730 | -- DDL fo r Sequence CLAIM_SUB MISSION_SU BMISSIONID | |
| 731 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 732 | ||
| 733 | CREATE SEQUENCE "ARS277_RE QUEST_TRAC KING"."CLA IM_SUBMISS ION_SUBMIS SIONID" M INVALUE 1 MAXVALUE 9 9999999999 9999999999 9999999 IN CREMENT BY 1 START W ITH 1 NOCA CHE ORDER NOCYCLE ; | |
| 734 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 735 | -- DDL fo r Sequence CLAIM_SVC _LINES_SUB MISSIONSVC L | |
| 736 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 737 | ||
| 738 | CREATE SEQUENCE "ARS277_RE QUEST_TRAC KING"."CLA IM_SVC_LIN ES_SUBMISS IONSVCL" MINVALUE 1 MAXVALUE 9999999999 9999999999 99999999 I NCREMENT B Y 1 START WITH 862 N OCACHE OR DER NOCYC LE ; | |
| 739 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 740 | -- DDL fo r Sequence CONTACT_S EQ | |
| 741 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 742 | ||
| 743 | CREATE SEQUENCE "ARS277_RE QUEST_TRAC KING"."CON TACT_SEQ" MINVALUE -922337203 6854775808 MAXVALUE 9223372036 854775807 INCREMENT BY 1 START WITH 400 CACHE 20 N OORDER NO CYCLE ; | |
| 744 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 745 | -- DDL fo r Sequence DOCUMENT_ CATEGORY_S EQ | |
| 746 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 747 | ||
| 748 | CREATE SEQUENCE "ARS277_RE QUEST_TRAC KING"."DOC UMENT_CATE GORY_SEQ" MINVALUE -922337203 6854775808 MAXVALUE 9223372036 854775807 INCREMENT BY 1 START WITH 620 CACHE 20 N OORDER NO CYCLE ; | |
| 749 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 750 | -- DDL fo r Sequence EMAIL_TEM PLATE_ID_S EQ | |
| 751 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 752 | ||
| 753 | CREATE SEQUENCE "ARS277_RE QUEST_TRAC KING"."EMA IL_TEMPLAT E_ID_SEQ" MINVALUE 1 MAXVALUE 999999999 9999999999 999999999 INCREMENT BY 1 START WITH 7 NO CACHE ORD ER NOCYCL E ; | |
| 754 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 755 | -- DDL fo r Sequence ENTITY_AD DRESS_SEQ | |
| 756 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 757 | ||
| 758 | CREATE SEQUENCE "ARS277_RE QUEST_TRAC KING"."ENT ITY_ADDRES S_SEQ" MI NVALUE -92 2337203685 4775808 MA XVALUE 922 3372036854 775807 INC REMENT BY 1 START WI TH 620 CAC HE 20 NOOR DER NOCYC LE ; | |
| 759 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 760 | -- DDL fo r Sequence ENTITY_NA ME_SEQ | |
| 761 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 762 | ||
| 763 | CREATE SEQUENCE "ARS277_RE QUEST_TRAC KING"."ENT ITY_NAME_S EQ" MINVA LUE -92233 7203685477 5808 MAXVA LUE 922337 2036854775 807 INCREM ENT BY 1 S TART WITH 1260 CACHE 20 NOORDE R NOCYCLE ; | |
| 764 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 765 | -- DDL fo r Sequence EREPOSDAT A_SEQ | |
| 766 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 767 | ||
| 768 | CREATE SEQUENCE "ARS277_RE QUEST_TRAC KING"."ERE POSDATA_SE Q" MINVAL UE 1 MAXVA LUE 999999 9999999999 9999999999 99 INCREME NT BY 1 ST ART WITH 1 NOCACHE NOORDER N OCYCLE ; | |
| 769 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 770 | -- DDL fo r Sequence HCCS_CD_H CCS_ID_SEQ | |
| 771 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 772 | ||
| 773 | CREATE SEQUENCE "ARS277_RE QUEST_TRAC KING"."HCC S_CD_HCCS_ ID_SEQ" M INVALUE 1 MAXVALUE 9 9999999999 9999999999 9999999 IN CREMENT BY 1 START W ITH 141 NO CACHE ORD ER NOCYCL E ; | |
| 774 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 775 | -- DDL fo r Sequence LOINC_CD_ LOINC_ID_S EQ | |
| 776 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 777 | ||
| 778 | CREATE SEQUENCE "ARS277_RE QUEST_TRAC KING"."LOI NC_CD_LOIN C_ID_SEQ" MINVALUE 1 MAXVALUE 999999999 9999999999 999999999 INCREMENT BY 1 START WITH 138 NOCACHE O RDER NOCY CLE ; | |
| 779 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 780 | -- DDL fo r Sequence LOINC_MOD _CD_LOINC_ MOD_ID_SEQ | |
| 781 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 782 | ||
| 783 | CREATE SEQUENCE "ARS277_RE QUEST_TRAC KING"."LOI NC_MOD_CD_ LOINC_MOD_ ID_SEQ" M INVALUE 1 MAXVALUE 9 9999999999 9999999999 9999999 IN CREMENT BY 1 START W ITH 122 NO CACHE ORD ER NOCYCL E ; | |
| 784 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 785 | -- DDL fo r Sequence PATH_SEQ | |
| 786 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 787 | ||
| 788 | CREATE SEQUENCE "ARS277_RE QUEST_TRAC KING"."PAT H_SEQ" MI NVALUE 1 M AXVALUE 99 9999999999 9999999999 999999 INC REMENT BY 1 START WI TH 240 NOC ACHE NOOR DER NOCYC LE ; | |
| 789 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 790 | -- DDL fo r Sequence REFERENCE _IDENTIFIC ATION_SEQ | |
| 791 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 792 | ||
| 793 | CREATE SEQUENCE "ARS277_RE QUEST_TRAC KING"."REF ERENCE_IDE NTIFICATIO N_SEQ" MI NVALUE -92 2337203685 4775808 MA XVALUE 922 3372036854 775807 INC REMENT BY 1 START WI TH 1080 CA CHE 20 NOO RDER NOCY CLE ; | |
| 794 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 795 | -- DDL fo r Sequence STATUS_IN FORMATION_ SEQ | |
| 796 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 797 | ||
| 798 | CREATE SEQUENCE "ARS277_RE QUEST_TRAC KING"."STA TUS_INFORM ATION_SEQ" MINVALUE -92233720 3685477580 8 MAXVALUE 922337203 6854775807 INCREMENT BY 1 STAR T WITH 400 CACHE 20 NOORDER N OCYCLE ; | |
| 799 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 800 | -- DDL fo r Sequence TRACE_NUM BER_SEQ | |
| 801 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 802 | ||
| 803 | CREATE SEQUENCE "ARS277_RE QUEST_TRAC KING"."TRA CE_NUMBER_ SEQ" MINV ALUE -9223 3720368547 75808 MAXV ALUE 92233 7203685477 5807 INCRE MENT BY 1 START WITH 640 CACHE 20 NOORDE R NOCYCLE ; | |
| 804 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 805 | -- DDL fo r Sequence TRANSACTI ONS_SEQ | |
| 806 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 807 | ||
| 808 | CREATE SEQUENCE "ARS277_RE QUEST_TRAC KING"."TRA NSACTIONS_ SEQ" MINV ALUE -9223 3720368547 75808 MAXV ALUE 92233 7203685477 5807 INCRE MENT BY 1 START WITH 620 CACHE 20 NOORDE R NOCYCLE ; | |
| 809 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.ARSAUDI TLOG | |
| 810 | SET DEFINE OFF; | |
| 811 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.ARSREPO RTTYPE | |
| 812 | SET DEFINE OFF; | |
| 813 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.ARS_ROL E | |
| 814 | SET DEFINE OFF; | |
| 815 | Insert int o ARS277_R EQUEST_TRA CKING.ARS_ ROLE (ARS_ ROLE_ID,RO LE_NAME,DE SCRIPTION, CREATED_BY ,DATE_CREA TED) value s (100,'BA SE_USER',' Regular Us er of Appl ication',' ARS_ADMIN' ,to_date(' 07-FEB-18' ,'DD-MON-R R')); | |
| 816 | Insert int o ARS277_R EQUEST_TRA CKING.ARS_ ROLE (ARS_ ROLE_ID,RO LE_NAME,DE SCRIPTION, CREATED_BY ,DATE_CREA TED) value s (101,'AD MIN','Admi nistrator' ,'ARS_ADMI N',to_date ('07-FEB-1 8','DD-MON -RR')); | |
| 817 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.ARS_ROL E_PERMISSI ONS | |
| 818 | SET DEFINE OFF; | |
| 819 | Insert int o ARS277_R EQUEST_TRA CKING.ARS_ ROLE_PERMI SSIONS (PE RMISSION_I D,PAGE_NAM E,PERMISSI ON_NAME,AR S_ROLE_ID, ENABLED,CR EATED_BY,D ATE_CREATE D) values (100,'addi tionalInfo rmation',' populateIn fo',100,'Y ','ARS_ADM IN',to_dat e('07-FEB- 18','DD-MO N-RR')); | |
| 820 | Insert int o ARS277_R EQUEST_TRA CKING.ARS_ ROLE_PERMI SSIONS (PE RMISSION_I D,PAGE_NAM E,PERMISSI ON_NAME,AR S_ROLE_ID, ENABLED,CR EATED_BY,D ATE_CREATE D) values (101,'addi tionalInfo rmation',' populateIn fo',101,'Y ','ARS_ADM IN',to_dat e('07-FEB- 18','DD-MO N-RR')); | |
| 821 | Insert int o ARS277_R EQUEST_TRA CKING.ARS_ ROLE_PERMI SSIONS (PE RMISSION_I D,PAGE_NAM E,PERMISSI ON_NAME,AR S_ROLE_ID, ENABLED,CR EATED_BY,D ATE_CREATE D) values (102,'addi tionalInfo rmation',' submitInfo ',100,'Y', 'ARS_ADMIN ',to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 822 | Insert int o ARS277_R EQUEST_TRA CKING.ARS_ ROLE_PERMI SSIONS (PE RMISSION_I D,PAGE_NAM E,PERMISSI ON_NAME,AR S_ROLE_ID, ENABLED,CR EATED_BY,D ATE_CREATE D) values (103,'addi tionalInfo rmation',' submitInfo ',101,'Y', 'ARS_ADMIN ',to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 823 | Insert int o ARS277_R EQUEST_TRA CKING.ARS_ ROLE_PERMI SSIONS (PE RMISSION_I D,PAGE_NAM E,PERMISSI ON_NAME,AR S_ROLE_ID, ENABLED,CR EATED_BY,D ATE_CREATE D) values (104,'look up','searc h',100,'Y' ,'ARS_ADMI N',to_date ('07-FEB-1 8','DD-MON -RR')); | |
| 824 | Insert int o ARS277_R EQUEST_TRA CKING.ARS_ ROLE_PERMI SSIONS (PE RMISSION_I D,PAGE_NAM E,PERMISSI ON_NAME,AR S_ROLE_ID, ENABLED,CR EATED_BY,D ATE_CREATE D) values (105,'look up','searc h',101,'Y' ,'ARS_ADMI N',to_date ('07-FEB-1 8','DD-MON -RR')); | |
| 825 | Insert int o ARS277_R EQUEST_TRA CKING.ARS_ ROLE_PERMI SSIONS (PE RMISSION_I D,PAGE_NAM E,PERMISSI ON_NAME,AR S_ROLE_ID, ENABLED,CR EATED_BY,D ATE_CREATE D) values (106,'look up','viewS ubmission' ,100,'Y',' ARS_ADMIN' ,to_date(' 07-FEB-18' ,'DD-MON-R R')); | |
| 826 | Insert int o ARS277_R EQUEST_TRA CKING.ARS_ ROLE_PERMI SSIONS (PE RMISSION_I D,PAGE_NAM E,PERMISSI ON_NAME,AR S_ROLE_ID, ENABLED,CR EATED_BY,D ATE_CREATE D) values (107,'look up','viewS ubmission' ,101,'Y',' ARS_ADMIN' ,to_date(' 07-FEB-18' ,'DD-MON-R R')); | |
| 827 | Insert int o ARS277_R EQUEST_TRA CKING.ARS_ ROLE_PERMI SSIONS (PE RMISSION_I D,PAGE_NAM E,PERMISSI ON_NAME,AR S_ROLE_ID, ENABLED,CR EATED_BY,D ATE_CREATE D) values (108,'view Submission ','updateR fai',100,' Y','ARS_AD MIN',to_da te('07-FEB -18','DD-M ON-RR')); | |
| 828 | Insert int o ARS277_R EQUEST_TRA CKING.ARS_ ROLE_PERMI SSIONS (PE RMISSION_I D,PAGE_NAM E,PERMISSI ON_NAME,AR S_ROLE_ID, ENABLED,CR EATED_BY,D ATE_CREATE D) values (109,'view Submission ','updateR fai',101,' Y','ARS_AD MIN',to_da te('07-FEB -18','DD-M ON-RR')); | |
| 829 | Insert int o ARS277_R EQUEST_TRA CKING.ARS_ ROLE_PERMI SSIONS (PE RMISSION_I D,PAGE_NAM E,PERMISSI ON_NAME,AR S_ROLE_ID, ENABLED,CR EATED_BY,D ATE_CREATE D) values (110,'view Submission ','saveUpd ates',100, 'Y','ARS_A DMIN',to_d ate('07-FE B-18','DD- MON-RR')); | |
| 830 | Insert int o ARS277_R EQUEST_TRA CKING.ARS_ ROLE_PERMI SSIONS (PE RMISSION_I D,PAGE_NAM E,PERMISSI ON_NAME,AR S_ROLE_ID, ENABLED,CR EATED_BY,D ATE_CREATE D) values (111,'view Submission ','saveUpd ates',101, 'Y','ARS_A DMIN',to_d ate('07-FE B-18','DD- MON-RR')); | |
| 831 | Insert int o ARS277_R EQUEST_TRA CKING.ARS_ ROLE_PERMI SSIONS (PE RMISSION_I D,PAGE_NAM E,PERMISSI ON_NAME,AR S_ROLE_ID, ENABLED,CR EATED_BY,D ATE_CREATE D) values (112,'view Submission ','printRf ai',100,'Y ','ARS_ADM IN',to_dat e('07-FEB- 18','DD-MO N-RR')); | |
| 832 | Insert int o ARS277_R EQUEST_TRA CKING.ARS_ ROLE_PERMI SSIONS (PE RMISSION_I D,PAGE_NAM E,PERMISSI ON_NAME,AR S_ROLE_ID, ENABLED,CR EATED_BY,D ATE_CREATE D) values (113,'view Submission ','printRf ai',101,'Y ','ARS_ADM IN',to_dat e('07-FEB- 18','DD-MO N-RR')); | |
| 833 | Insert int o ARS277_R EQUEST_TRA CKING.ARS_ ROLE_PERMI SSIONS (PE RMISSION_I D,PAGE_NAM E,PERMISSI ON_NAME,AR S_ROLE_ID, ENABLED,CR EATED_BY,D ATE_CREATE D) values (116,'admi n','submit Changes',1 01,'Y','AR S_ADMIN',t o_date('07 -FEB-18',' DD-MON-RR' )); | |
| 834 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.ARS_USE R | |
| 835 | SET DEFINE OFF; | |
| 836 | Insert int o ARS277_R EQUEST_TRA CKING.ARS_ USER (ARS_ USER_ID,US ER_NAME,EN ABLED,LAST _NAME,FIRS T_NAME,MID DLE_NAME,P HONE_NUMBE R,EMAIL_AD DRESS,LAST _LOGIN_DAT E,DEACTIVA TION_REASO N_CD,DEACT IVATION_CO MMENTS,CRE ATED_BY,DA TE_CREATED ,MODIFIED_ BY,DATE_MO DIFIED) va lues (100, '
|
|
| 837 | Insert int o ARS277_R EQUEST_TRA CKING.ARS_ USER (ARS_ USER_ID,US ER_NAME,EN ABLED,LAST _NAME,FIRS T_NAME,MID DLE_NAME,P HONE_NUMBE R,EMAIL_AD DRESS,LAST _LOGIN_DAT E,DEACTIVA TION_REASO N_CD,DEACT IVATION_CO MMENTS,CRE ATED_BY,DA TE_CREATED ,MODIFIED_ BY,DATE_MO DIFIED) va lues (101, '
|
|
| 838 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.ARS_USE R_ROLE_USA GES | |
| 839 | SET DEFINE OFF; | |
| 840 | Insert int o ARS277_R EQUEST_TRA CKING.ARS_ USER_ROLE_ USAGES (AR S_ROLE_ID, ARS_USER_I D,CREATED_ BY,DATE_CR EATED) val ues (100,1 00,'ARS_AD MIN',to_da te('07-FEB -18','DD-M ON-RR')); | |
| 841 | Insert int o ARS277_R EQUEST_TRA CKING.ARS_ USER_ROLE_ USAGES (AR S_ROLE_ID, ARS_USER_I D,CREATED_ BY,DATE_CR EATED) val ues (100,1 01,'ARS_AD MIN',to_da te('07-FEB -18','DD-M ON-RR')); | |
| 842 | Insert int o ARS277_R EQUEST_TRA CKING.ARS_ USER_ROLE_ USAGES (AR S_ROLE_ID, ARS_USER_I D,CREATED_ BY,DATE_CR EATED) val ues (101,1 01,'ARS_AD MIN',to_da te('07-FEB -18','DD-M ON-RR')); | |
| 843 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.BINARY2 75 | |
| 844 | SET DEFINE OFF; | |
| 845 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (55 2,7888,153 ); | |
| 846 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (55 3,7404,154 ); | |
| 847 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (55 4,116144,1 55); | |
| 848 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (55 5,26275,15 6); | |
| 849 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (55 6,26270,15 7); | |
| 850 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (55 7,26275,15 8); | |
| 851 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (55 8,26275,15 9); | |
| 852 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (55 9,936843,1 60); | |
| 853 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (56 0,26275,16 1); | |
| 854 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (56 1,114024,1 62); | |
| 855 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (56 2,478202,1 63); | |
| 856 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (56 3,355562,1 64); | |
| 857 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (56 4,26275,16 5); | |
| 858 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (55 0,7888,151 ); | |
| 859 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (55 1,7888,152 ); | |
| 860 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (56 5,7888,166 ); | |
| 861 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (56 6,7888,167 ); | |
| 862 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (56 7,7888,168 ); | |
| 863 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (56 8,7404,169 ); | |
| 864 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (56 9,116144,1 70); | |
| 865 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (57 0,26275,17 1); | |
| 866 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (57 1,26270,17 2); | |
| 867 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (57 2,26275,17 3); | |
| 868 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (57 3,26275,17 4); | |
| 869 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (57 4,936843,1 75); | |
| 870 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (57 5,26275,17 6); | |
| 871 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (57 6,114024,1 77); | |
| 872 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (57 7,478202,1 78); | |
| 873 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (57 8,355562,1 79); | |
| 874 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (57 9,26275,18 0); | |
| 875 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (58 0,237289,1 81); | |
| 876 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (58 1,71531,18 2); | |
| 877 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (58 2,7888,183 ); | |
| 878 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (58 3,7888,184 ); | |
| 879 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (58 4,7888,185 ); | |
| 880 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (58 5,7404,186 ); | |
| 881 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (58 6,116144,1 87); | |
| 882 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (58 7,26275,18 8); | |
| 883 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (58 8,26270,18 9); | |
| 884 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (58 9,26275,19 0); | |
| 885 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (59 0,26275,19 1); | |
| 886 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (59 1,936843,1 92); | |
| 887 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (59 2,26275,19 3); | |
| 888 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (59 3,114024,1 94); | |
| 889 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (59 4,478202,1 95); | |
| 890 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (59 5,355562,1 96); | |
| 891 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (59 6,26275,19 7); | |
| 892 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (59 7,7888,198 ); | |
| 893 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (59 8,7888,199 ); | |
| 894 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (59 9,7888,200 ); | |
| 895 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (60 0,7404,201 ); | |
| 896 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (60 1,116144,2 02); | |
| 897 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (60 2,26275,20 3); | |
| 898 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (60 3,26270,20 4); | |
| 899 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (60 4,26275,20 5); | |
| 900 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (60 5,26275,20 6); | |
| 901 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (60 6,936843,2 07); | |
| 902 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (60 7,26275,20 8); | |
| 903 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (60 8,114024,2 09); | |
| 904 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (60 9,478202,2 10); | |
| 905 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (61 0,355562,2 11); | |
| 906 | Insert int o ARS277_R EQUEST_TRA CKING.BINA RY275 (ATT ACHMENT_ID ,BIN01,BIN ARY275ID) values (61 1,26275,21 2); | |
| 907 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.CLAIMAT TACHMENTS | |
| 908 | SET DEFINE OFF; | |
| 909 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.CLAIM_C ONTACT | |
| 910 | SET DEFINE OFF; | |
| 911 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values PII ',to_date( '11-JAN-18 ','DD-MON- RR'),to_da te('11-JAN -18','DD-M ON-RR')); | |
| 912 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values PII ',to_date( '11-JAN-18 ','DD-MON- RR'),to_da te('11-JAN -18','DD-M ON-RR')); | |
| 913 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (2,'test@ nowhere.co m',to_date ('11-JAN-1 8','DD-MON -RR'),to_d ate('11-JA N-18','DD- MON-RR')); | |
| 914 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values PII ',to_date( '11-JAN-18 ','DD-MON- RR'),to_da te('11-JAN -18','DD-M ON-RR')); | |
| 915 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values PII ',to_date( '11-JAN-18 ','DD-MON- RR'),to_da te('11-JAN -18','DD-M ON-RR')); | |
| 916 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values PII ',to_date( '11-JAN-18 ','DD-MON- RR'),to_da te('11-JAN -18','DD-M ON-RR')); | |
| 917 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values PII ',to_date( '11-JAN-18 ','DD-MON- RR'),to_da te('11-JAN -18','DD-M ON-RR')); | |
| 918 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values PII ',to_date( '11-JAN-18 ','DD-MON- RR'),to_da te('11-JAN -18','DD-M ON-RR')); | |
| 919 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values PII ',to_date( '11-JAN-18 ','DD-MON- RR'),to_da te('11-JAN -18','DD-M ON-RR')); | |
| 920 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values PII ',to_date( '11-JAN-18 ','DD-MON- RR'),to_da te('11-JAN -18','DD-M ON-RR')); | |
| 921 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values PII ',to_date( '11-JAN-18 ','DD-MON- RR'),to_da te('11-JAN -18','DD-M ON-RR')); | |
| 922 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values PII ',to_date( '11-JAN-18 ','DD-MON- RR'),to_da te('11-JAN -18','DD-M ON-RR')); | |
| 923 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (62,'test 3@nowhere. com',to_da te('11-JAN -18','DD-M ON-RR'),to _date('11- JAN-18','D D-MON-RR') ); | |
| 924 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (63,'test 2@nowhere. com',to_da te('11-JAN -18','DD-M ON-RR'),to _date('11- JAN-18','D D-MON-RR') ); | |
| 925 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values PII ',to_date( '12-JAN-18 ','DD-MON- RR'),to_da te('12-JAN -18','DD-M ON-RR')); | |
| 926 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (114,'tes t@test.gov ',to_date( '16-JAN-18 ','DD-MON- RR'),to_da te('16-JAN -18','DD-M ON-RR')); | |
| 927 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (115,'q@q .com',to_d ate('16-JA N-18','DD- MON-RR'),t o_date('16 -JAN-18',' DD-MON-RR' )); | |
| 928 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (116,'con tact',to_d ate('16-JA N-18','DD- MON-RR'),t o_date('16 -JAN-18',' DD-MON-RR' )); | |
| 929 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (117,'tes t@test1.go v',to_date ('16-JAN-1 8','DD-MON -RR'),to_d ate('16-JA N-18','DD- MON-RR')); | |
| 930 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (118,'Tes t@test.com ',to_date( '16-JAN-18 ','DD-MON- RR'),to_da te('16-JAN -18','DD-M ON-RR')); | |
| 931 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (119,'con ta',to_dat e('16-JAN- 18','DD-MO N-RR'),to_ date('16-J AN-18','DD -MON-RR')) ; | |
| 932 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (120,'q@q .in',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 933 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (121,'q@q .us',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 934 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (122,'q@q .nz',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 935 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (123,'q@q .mn',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 936 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (124,'a@a .com',to_d ate('16-JA N-18','DD- MON-RR'),t o_date('16 -JAN-18',' DD-MON-RR' )); | |
| 937 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (125,'a@a .in',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 938 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (126,'sdd fgsdf',to_ date('16-J AN-18','DD -MON-RR'), to_date('1 6-JAN-18', 'DD-MON-RR ')); | |
| 939 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (127,'fhs fhsfgh',to _date('16- JAN-18','D D-MON-RR') ,to_date(' 16-JAN-18' ,'DD-MON-R R')); | |
| 940 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (128,'a@a .us',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 941 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (129,'a@a .nz',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 942 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (130,'a@a .mn',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 943 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (131,'b@b .com',to_d ate('16-JA N-18','DD- MON-RR'),t o_date('16 -JAN-18',' DD-MON-RR' )); | |
| 944 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (132,'b@b .in',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 945 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (133,'Tes t@Test.com ',to_date( '16-JAN-18 ','DD-MON- RR'),to_da te('16-JAN -18','DD-M ON-RR')); | |
| 946 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (134,'we@ we',to_dat e('16-JAN- 18','DD-MO N-RR'),to_ date('16-J AN-18','DD -MON-RR')) ; | |
| 947 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (135,'b@b .us',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 948 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (136,'b@b .nz',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 949 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (137,'b@b .mn',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 950 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (138,'c@c .com',to_d ate('16-JA N-18','DD- MON-RR'),t o_date('16 -JAN-18',' DD-MON-RR' )); | |
| 951 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (139,'c@c .in',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 952 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (140,'c@c .mn',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 953 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (141,'c@c .us',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 954 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (142,'dra gon@vamsij son.gov',t o_date('16 -JAN-18',' DD-MON-RR' ),to_date( '16-JAN-18 ','DD-MON- RR')); | |
| 955 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (143,'c@c .nz',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 956 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (144,'d@d .com',to_d ate('16-JA N-18','DD- MON-RR'),t o_date('16 -JAN-18',' DD-MON-RR' )); | |
| 957 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (145,'d@d .in',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 958 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (146,'d@d .us',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 959 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (147,'d@d .mn',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 960 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (148,'d@d .nz',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 961 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (149,'e@e .com',to_d ate('16-JA N-18','DD- MON-RR'),t o_date('16 -JAN-18',' DD-MON-RR' )); | |
| 962 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (150,'e@e .in',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 963 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (151,'e@e .us',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 964 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (152,'e@e .nz',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 965 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (153,'f@f .com',to_d ate('16-JA N-18','DD- MON-RR'),t o_date('16 -JAN-18',' DD-MON-RR' )); | |
| 966 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (154,'f@f .in',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 967 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (155,'f@f .us',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 968 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (156,'f@f .mn',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 969 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (157,'f@f .nz',to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ); | |
| 970 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (158,'Tes t2@test.co m',to_date ('16-JAN-1 8','DD-MON -RR'),to_d ate('16-JA N-18','DD- MON-RR')); | |
| 971 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (159,'Tes t3@test.co m',to_date ('16-JAN-1 8','DD-MON -RR'),to_d ate('16-JA N-18','DD- MON-RR')); | |
| 972 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (160,'g@g .com',to_d ate('17-JA N-18','DD- MON-RR'),t o_date('17 -JAN-18',' DD-MON-RR' )); | |
| 973 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values PII ',to_date( '17-JAN-18 ','DD-MON- RR'),to_da te('17-JAN -18','DD-M ON-RR')); | |
| 974 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (162,'g@g .in',to_da te('17-JAN -18','DD-M ON-RR'),to _date('17- JAN-18','D D-MON-RR') ); | |
| 975 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (163,'g@g .us',to_da te('18-JAN -18','DD-M ON-RR'),to _date('18- JAN-18','D D-MON-RR') ); | |
| 976 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (164,'dra gontest@th is.again', to_date('1 9-JAN-18', 'DD-MON-RR '),to_date ('19-JAN-1 8','DD-MON -RR')); | |
| 977 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (165,'g@g .nz',to_da te('19-JAN -18','DD-M ON-RR'),to _date('19- JAN-18','D D-MON-RR') ); | |
| 978 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (166,'g@g .mn',to_da te('25-JAN -18','DD-M ON-RR'),to _date('25- JAN-18','D D-MON-RR') ); | |
| 979 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (167,null ,to_date(' 25-JAN-18' ,'DD-MON-R R'),to_dat e('25-JAN- 18','DD-MO N-RR')); | |
| 980 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (168,'s@s .us',to_da te('25-JAN -18','DD-M ON-RR'),to _date('25- JAN-18','D D-MON-RR') ); | |
| 981 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (169,'s@s .in',to_da te('25-JAN -18','DD-M ON-RR'),to _date('25- JAN-18','D D-MON-RR') ); | |
| 982 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (170,'s@s .com',to_d ate('25-JA N-18','DD- MON-RR'),t o_date('25 -JAN-18',' DD-MON-RR' )); | |
| 983 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (171,'r@r .mn',to_da te('25-JAN -18','DD-M ON-RR'),to _date('25- JAN-18','D D-MON-RR') ); | |
| 984 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (172,'h@h .com',to_d ate('25-JA N-18','DD- MON-RR'),t o_date('25 -JAN-18',' DD-MON-RR' )); | |
| 985 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (173,'h@h .in',to_da te('25-JAN -18','DD-M ON-RR'),to _date('25- JAN-18','D D-MON-RR') ); | |
| 986 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (174,'h@h .us',to_da te('25-JAN -18','DD-M ON-RR'),to _date('25- JAN-18','D D-MON-RR') ); | |
| 987 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (175,'h@h .nz',to_da te('25-JAN -18','DD-M ON-RR'),to _date('25- JAN-18','D D-MON-RR') ); | |
| 988 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (176,'h@h .mn',to_da te('25-JAN -18','DD-M ON-RR'),to _date('25- JAN-18','D D-MON-RR') ); | |
| 989 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (177,'i@i .com',to_d ate('25-JA N-18','DD- MON-RR'),t o_date('25 -JAN-18',' DD-MON-RR' )); | |
| 990 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (178,'i@i .in',to_da te('25-JAN -18','DD-M ON-RR'),to _date('25- JAN-18','D D-MON-RR') ); | |
| 991 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (179,'i@i .us',to_da te('26-JAN -18','DD-M ON-RR'),to _date('26- JAN-18','D D-MON-RR') ); | |
| 992 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (180,'i@i .mn',to_da te('26-JAN -18','DD-M ON-RR'),to _date('26- JAN-18','D D-MON-RR') ); | |
| 993 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (181,'i@i .nz',to_da te('26-JAN -18','DD-M ON-RR'),to _date('26- JAN-18','D D-MON-RR') ); | |
| 994 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (182,'j@j .com',to_d ate('30-JA N-18','DD- MON-RR'),t o_date('30 -JAN-18',' DD-MON-RR' )); | |
| 995 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (183,'j@j .in',to_da te('30-JAN -18','DD-M ON-RR'),to _date('30- JAN-18','D D-MON-RR') ); | |
| 996 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (184,'j@j .us',to_da te('30-JAN -18','DD-M ON-RR'),to _date('30- JAN-18','D D-MON-RR') ); | |
| 997 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (185,'j@j .mn',to_da te('30-JAN -18','DD-M ON-RR'),to _date('30- JAN-18','D D-MON-RR') ); | |
| 998 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (186,'j@j .nz',to_da te('30-JAN -18','DD-M ON-RR'),to _date('30- JAN-18','D D-MON-RR') ); | |
| 999 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values PII ',to_date( '30-JAN-18 ','DD-MON- RR'),to_da te('30-JAN -18','DD-M ON-RR')); | |
| 1000 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (188,'k@k .com',to_d ate('31-JA N-18','DD- MON-RR'),t o_date('31 -JAN-18',' DD-MON-RR' )); | |
| 1001 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (189,'k@k .in',to_da te('31-JAN -18','DD-M ON-RR'),to _date('31- JAN-18','D D-MON-RR') ); | |
| 1002 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (190,'k@k .us',to_da te('01-FEB -18','DD-M ON-RR'),to _date('01- FEB-18','D D-MON-RR') ); | |
| 1003 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (191,'k@k .nz',to_da te('01-FEB -18','DD-M ON-RR'),to _date('01- FEB-18','D D-MON-RR') ); | |
| 1004 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (192,'k@k .mn',to_da te('01-FEB -18','DD-M ON-RR'),to _date('01- FEB-18','D D-MON-RR') ); | |
| 1005 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (193,'l@l .com',to_d ate('07-FE B-18','DD- MON-RR'),t o_date('07 -FEB-18',' DD-MON-RR' )); | |
| 1006 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (194,'l@l .in',to_da te('08-FEB -18','DD-M ON-RR'),to _date('08- FEB-18','D D-MON-RR') ); | |
| 1007 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (195,'l@l .us',to_da te('08-FEB -18','DD-M ON-RR'),to _date('08- FEB-18','D D-MON-RR') ); | |
| 1008 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (196,'l@l .nz',to_da te('08-FEB -18','DD-M ON-RR'),to _date('08- FEB-18','D D-MON-RR') ); | |
| 1009 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (197,'l@l .mn',to_da te('08-FEB -18','DD-M ON-RR'),to _date('08- FEB-18','D D-MON-RR') ); | |
| 1010 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (198,'m@m .com',to_d ate('08-FE B-18','DD- MON-RR'),t o_date('08 -FEB-18',' DD-MON-RR' )); | |
| 1011 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (199,'cha rlie.stone @ftc.com', to_date('0 8-FEB-18', 'DD-MON-RR '),to_date ('08-FEB-1 8','DD-MON -RR')); | |
| 1012 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (200,'m@m .in',to_da te('08-FEB -18','DD-M ON-RR'),to _date('08- FEB-18','D D-MON-RR') ); | |
| 1013 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (201,'m@m .us',to_da te('08-FEB -18','DD-M ON-RR'),to _date('08- FEB-18','D D-MON-RR') ); | |
| 1014 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (202,'m@m .nz',to_da te('08-FEB -18','DD-M ON-RR'),to _date('08- FEB-18','D D-MON-RR') ); | |
| 1015 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (203,'m@m .mn',to_da te('08-FEB -18','DD-M ON-RR'),to _date('08- FEB-18','D D-MON-RR') ); | |
| 1016 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (204,'n@n .com',to_d ate('08-FE B-18','DD- MON-RR'),t o_date('08 -FEB-18',' DD-MON-RR' )); | |
| 1017 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (205,'n@n .in',to_da te('08-FEB -18','DD-M ON-RR'),to _date('08- FEB-18','D D-MON-RR') ); | |
| 1018 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (206,'n@n .mn',to_da te('08-FEB -18','DD-M ON-RR'),to _date('08- FEB-18','D D-MON-RR') ); | |
| 1019 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (207,'TES TER@TEST.C OM',to_dat e('08-FEB- 18','DD-MO N-RR'),to_ date('08-F EB-18','DD -MON-RR')) ; | |
| 1020 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (208,'n@n .us',to_da te('08-FEB -18','DD-M ON-RR'),to _date('08- FEB-18','D D-MON-RR') ); | |
| 1021 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (209,'n@n .nz',to_da te('08-FEB -18','DD-M ON-RR'),to _date('08- FEB-18','D D-MON-RR') ); | |
| 1022 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (210,'o@o .com',to_d ate('08-FE B-18','DD- MON-RR'),t o_date('08 -FEB-18',' DD-MON-RR' )); | |
| 1023 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (211,'tes t@test.COM ',to_date( '08-FEB-18 ','DD-MON- RR'),to_da te('08-FEB -18','DD-M ON-RR')); | |
| 1024 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (212,'TES T@test.COM ',to_date( '08-FEB-18 ','DD-MON- RR'),to_da te('08-FEB -18','DD-M ON-RR')); | |
| 1025 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (213,'tes ting',to_d ate('08-FE B-18','DD- MON-RR'),t o_date('08 -FEB-18',' DD-MON-RR' )); | |
| 1026 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (214,'o@o .in',to_da te('08-FEB -18','DD-M ON-RR'),to _date('08- FEB-18','D D-MON-RR') ); | |
| 1027 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (215,'o@o .us',to_da te('08-FEB -18','DD-M ON-RR'),to _date('08- FEB-18','D D-MON-RR') ); | |
| 1028 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (216,'TeS t',to_date ('09-FEB-1 8','DD-MON -RR'),to_d ate('09-FE B-18','DD- MON-RR')); | |
| 1029 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (217,'tes t',to_date ('09-FEB-1 8','DD-MON -RR'),to_d ate('09-FE B-18','DD- MON-RR')); | |
| 1030 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (218,'TES T',to_date ('09-FEB-1 8','DD-MON -RR'),to_d ate('09-FE B-18','DD- MON-RR')); | |
| 1031 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (219,'o@o .nz',to_da te('09-FEB -18','DD-M ON-RR'),to _date('09- FEB-18','D D-MON-RR') ); | |
| 1032 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (220,'o@o .mn',to_da te('09-FEB -18','DD-M ON-RR'),to _date('09- FEB-18','D D-MON-RR') ); | |
| 1033 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (221,'p@p .com',to_d ate('09-FE B-18','DD- MON-RR'),t o_date('09 -FEB-18',' DD-MON-RR' )); | |
| 1034 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (222,'tes t@testing1 23.com',to _date('09- FEB-18','D D-MON-RR') ,to_date(' 09-FEB-18' ,'DD-MON-R R')); | |
| 1035 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (223,'p@p .in',to_da te('09-FEB -18','DD-M ON-RR'),to _date('09- FEB-18','D D-MON-RR') ); | |
| 1036 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (224,'p@p .us',to_da te('11-FEB -18','DD-M ON-RR'),to _date('11- FEB-18','D D-MON-RR') ); | |
| 1037 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (225,'p@p .nz',to_da te('11-FEB -18','DD-M ON-RR'),to _date('11- FEB-18','D D-MON-RR') ); | |
| 1038 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (226,'p@p .mn',to_da te('11-FEB -18','DD-M ON-RR'),to _date('11- FEB-18','D D-MON-RR') ); | |
| 1039 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (227,'gre en.maroon@ gmail.com' ,to_date(' 11-FEB-18' ,'DD-MON-R R'),to_dat e('11-FEB- 18','DD-MO N-RR')); | |
| 1040 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (228,'r@r .com',to_d ate('12-FE B-18','DD- MON-RR'),t o_date('12 -FEB-18',' DD-MON-RR' )); | |
| 1041 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (229,'tes ting.new@g mail.com', to_date('1 2-FEB-18', 'DD-MON-RR '),to_date ('12-FEB-1 8','DD-MON -RR')); | |
| 1042 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (230,'r@r .in',to_da te('12-FEB -18','DD-M ON-RR'),to _date('12- FEB-18','D D-MON-RR') ); | |
| 1043 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (231,'r@r .us',to_da te('12-FEB -18','DD-M ON-RR'),to _date('12- FEB-18','D D-MON-RR') ); | |
| 1044 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (232,'r@r .nz',to_da te('12-FEB -18','DD-M ON-RR'),to _date('12- FEB-18','D D-MON-RR') ); | |
| 1045 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (233,'xxx xxxxxxxxxx xxxxxxxxxx xxxxxx',to _date('12- FEB-18','D D-MON-RR') ,to_date(' 12-FEB-18' ,'DD-MON-R R')); | |
| 1046 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (234,'xxx xxxxxxxxxx xxxxxxxxxx xxxxxxxxxx xx',to_dat e('12-FEB- 18','DD-MO N-RR'),to_ date('12-F EB-18','DD -MON-RR')) ; | |
| 1047 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (235,'tes t@test.com ',to_date( '12-FEB-18 ','DD-MON- RR'),to_da te('12-FEB -18','DD-M ON-RR')); | |
| 1048 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (236,'s@s .mn',to_da te('12-FEB -18','DD-M ON-RR'),to _date('12- FEB-18','D D-MON-RR') ); | |
| 1049 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (237,'e@e .mn',to_da te('12-FEB -18','DD-M ON-RR'),to _date('12- FEB-18','D D-MON-RR') ); | |
| 1050 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (238,'qwe r@qw.com', to_date('1 2-FEB-18', 'DD-MON-RR '),to_date ('12-FEB-1 8','DD-MON -RR')); | |
| 1051 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (239,'hel lo@test.co m',to_date ('12-FEB-1 8','DD-MON -RR'),to_d ate('12-FE B-18','DD- MON-RR')); | |
| 1052 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (240,null ,to_date(' 12-FEB-18' ,'DD-MON-R R'),to_dat e('12-FEB- 18','DD-MO N-RR')); | |
| 1053 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (241,null ,to_date(' 12-FEB-18' ,'DD-MON-R R'),to_dat e('12-FEB- 18','DD-MO N-RR')); | |
| 1054 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (242,null ,to_date(' 12-FEB-18' ,'DD-MON-R R'),to_dat e('12-FEB- 18','DD-MO N-RR')); | |
| 1055 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (243,'con tact@infor mation.com ',to_date( '13-FEB-18 ','DD-MON- RR'),to_da te('13-FEB -18','DD-M ON-RR')); | |
| 1056 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (244,'con tactinfo@i nfo.com',t o_date('13 -FEB-18',' DD-MON-RR' ),to_date( '13-FEB-18 ','DD-MON- RR')); | |
| 1057 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (245,null ,to_date(' 13-FEB-18' ,'DD-MON-R R'),to_dat e('13-FEB- 18','DD-MO N-RR')); | |
| 1058 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (246,null ,to_date(' 13-FEB-18' ,'DD-MON-R R'),to_dat e('13-FEB- 18','DD-MO N-RR')); | |
| 1059 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (247,null ,to_date(' 13-FEB-18' ,'DD-MON-R R'),to_dat e('13-FEB- 18','DD-MO N-RR')); | |
| 1060 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (248,'dom ain@email. com',to_da te('14-FEB -18','DD-M ON-RR'),to _date('14- FEB-18','D D-MON-RR') ); | |
| 1061 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (249,'dsd fdsfgd',to _date('14- FEB-18','D D-MON-RR') ,to_date(' 14-FEB-18' ,'DD-MON-R R')); | |
| 1062 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (250,null ,to_date(' 14-FEB-18' ,'DD-MON-R R'),to_dat e('14-FEB- 18','DD-MO N-RR')); | |
| 1063 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (251,null ,to_date(' 14-FEB-18' ,'DD-MON-R R'),to_dat e('14-FEB- 18','DD-MO N-RR')); | |
| 1064 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (252,null ,to_date(' 14-FEB-18' ,'DD-MON-R R'),to_dat e('14-FEB- 18','DD-MO N-RR')); | |
| 1065 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (253,null ,to_date(' 14-FEB-18' ,'DD-MON-R R'),to_dat e('14-FEB- 18','DD-MO N-RR')); | |
| 1066 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (254,null ,to_date(' 14-FEB-18' ,'DD-MON-R R'),to_dat e('14-FEB- 18','DD-MO N-RR')); | |
| 1067 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values PII ',to_date( '15-FEB-18 ','DD-MON- RR'),to_da te('15-FEB -18','DD-M ON-RR')); | |
| 1068 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (256,null ,to_date(' 15-FEB-18' ,'DD-MON-R R'),to_dat e('15-FEB- 18','DD-MO N-RR')); | |
| 1069 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (257,null ,to_date(' 15-FEB-18' ,'DD-MON-R R'),to_dat e('15-FEB- 18','DD-MO N-RR')); | |
| 1070 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (258,null ,to_date(' 15-FEB-18' ,'DD-MON-R R'),to_dat e('15-FEB- 18','DD-MO N-RR')); | |
| 1071 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (259,null ,to_date(' 15-FEB-18' ,'DD-MON-R R'),to_dat e('15-FEB- 18','DD-MO N-RR')); | |
| 1072 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (260,null ,to_date(' 15-FEB-18' ,'DD-MON-R R'),to_dat e('15-FEB- 18','DD-MO N-RR')); | |
| 1073 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (261,'ccx c',to_date ('15-FEB-1 8','DD-MON -RR'),to_d ate('15-FE B-18','DD- MON-RR')); | |
| 1074 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (262,null ,to_date(' 16-FEB-18' ,'DD-MON-R R'),to_dat e('16-FEB- 18','DD-MO N-RR')); | |
| 1075 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (263,null ,to_date(' 16-FEB-18' ,'DD-MON-R R'),to_dat e('16-FEB- 18','DD-MO N-RR')); | |
| 1076 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (264,null ,to_date(' 16-FEB-18' ,'DD-MON-R R'),to_dat e('16-FEB- 18','DD-MO N-RR')); | |
| 1077 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values PII ',to_date( '16-FEB-18 ','DD-MON- RR'),to_da te('16-FEB -18','DD-M ON-RR')); | |
| 1078 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values PII ',to_date( '16-FEB-18 ','DD-MON- RR'),to_da te('16-FEB -18','DD-M ON-RR')); | |
| 1079 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (267,'zzz @zzz.com', to_date('1 6-FEB-18', 'DD-MON-RR '),to_date ('16-FEB-1 8','DD-MON -RR')); | |
| 1080 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values PII ',to_date( '16-FEB-18 ','DD-MON- RR'),to_da te('16-FEB -18','DD-M ON-RR')); | |
| 1081 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (269,null ,to_date(' 16-FEB-18' ,'DD-MON-R R'),to_dat e('16-FEB- 18','DD-MO N-RR')); | |
| 1082 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (270,null ,to_date(' 16-FEB-18' ,'DD-MON-R R'),to_dat e('16-FEB- 18','DD-MO N-RR')); | |
| 1083 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (271,null ,to_date(' 16-FEB-18' ,'DD-MON-R R'),to_dat e('16-FEB- 18','DD-MO N-RR')); | |
| 1084 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (272,null ,to_date(' 16-FEB-18' ,'DD-MON-R R'),to_dat e('16-FEB- 18','DD-MO N-RR')); | |
| 1085 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (273,null ,to_date(' 16-FEB-18' ,'DD-MON-R R'),to_dat e('16-FEB- 18','DD-MO N-RR')); | |
| 1086 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (274,null ,to_date(' 16-FEB-18' ,'DD-MON-R R'),to_dat e('16-FEB- 18','DD-MO N-RR')); | |
| 1087 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values PII ',to_date( '16-FEB-18 ','DD-MON- RR'),to_da te('16-FEB -18','DD-M ON-RR')); | |
| 1088 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (276,'va@ va.com',to _date('16- FEB-18','D D-MON-RR') ,to_date(' 16-FEB-18' ,'DD-MON-R R')); | |
| 1089 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (277,'tes t120@test. com',to_da te('16-FEB -18','DD-M ON-RR'),to _date('16- FEB-18','D D-MON-RR') ); | |
| 1090 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (278,null ,to_date(' 16-FEB-18' ,'DD-MON-R R'),to_dat e('16-FEB- 18','DD-MO N-RR')); | |
| 1091 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (279,null ,to_date(' 16-FEB-18' ,'DD-MON-R R'),to_dat e('16-FEB- 18','DD-MO N-RR')); | |
| 1092 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (280,null ,to_date(' 16-FEB-18' ,'DD-MON-R R'),to_dat e('16-FEB- 18','DD-MO N-RR')); | |
| 1093 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (281,null ,to_date(' 16-FEB-18' ,'DD-MON-R R'),to_dat e('16-FEB- 18','DD-MO N-RR')); | |
| 1094 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (282,'va@ test.gov', to_date('1 6-FEB-18', 'DD-MON-RR '),to_date ('16-FEB-1 8','DD-MON -RR')); | |
| 1095 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (283,'va@ gov',to_da te('20-FEB -18','DD-M ON-RR'),to _date('20- FEB-18','D D-MON-RR') ); | |
| 1096 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (284,'tes t@gov',to_ date('20-F EB-18','DD -MON-RR'), to_date('2 0-FEB-18', 'DD-MON-RR ')); | |
| 1097 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (285,'cxv xc',to_dat e('20-FEB- 18','DD-MO N-RR'),to_ date('20-F EB-18','DD -MON-RR')) ; | |
| 1098 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (286,'xfb vxc',to_da te('20-FEB -18','DD-M ON-RR'),to _date('20- FEB-18','D D-MON-RR') ); | |
| 1099 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (287,'hel lo1@test.c om',to_dat e('20-FEB- 18','DD-MO N-RR'),to_ date('20-F EB-18','DD -MON-RR')) ; | |
| 1100 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (288,'xxx ',to_date( '20-FEB-18 ','DD-MON- RR'),to_da te('20-FEB -18','DD-M ON-RR')); | |
| 1101 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (289,'tes t@test.tes t',to_date ('20-FEB-1 8','DD-MON -RR'),to_d ate('20-FE B-18','DD- MON-RR')); | |
| 1102 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (290,'va@ tesr',to_d ate('21-FE B-18','DD- MON-RR'),t o_date('21 -FEB-18',' DD-MON-RR' )); | |
| 1103 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (291,'v@r ',to_date( '21-FEB-18 ','DD-MON- RR'),to_da te('21-FEB -18','DD-M ON-RR')); | |
| 1104 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (292,'v@t ',to_date( '21-FEB-18 ','DD-MON- RR'),to_da te('21-FEB -18','DD-M ON-RR')); | |
| 1105 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (293,'v@e ',to_date( '22-FEB-18 ','DD-MON- RR'),to_da te('22-FEB -18','DD-M ON-RR')); | |
| 1106 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (294,'c@w ',to_date( '22-FEB-18 ','DD-MON- RR'),to_da te('22-FEB -18','DD-M ON-RR')); | |
| 1107 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (295,null ,to_date(' 22-FEB-18' ,'DD-MON-R R'),to_dat e('22-FEB- 18','DD-MO N-RR')); | |
| 1108 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (296,null ,to_date(' 22-FEB-18' ,'DD-MON-R R'),to_dat e('22-FEB- 18','DD-MO N-RR')); | |
| 1109 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (297,null ,to_date(' 22-FEB-18' ,'DD-MON-R R'),to_dat e('22-FEB- 18','DD-MO N-RR')); | |
| 1110 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (298,'r@g b',to_date ('22-FEB-1 8','DD-MON -RR'),to_d ate('22-FE B-18','DD- MON-RR')); | |
| 1111 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (299,'tes t@123test. com',to_da te('22-FEB -18','DD-M ON-RR'),to _date('22- FEB-18','D D-MON-RR') ); | |
| 1112 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (300,'tes t@thisisat est.com',t o_date('23 -FEB-18',' DD-MON-RR' ),to_date( '23-FEB-18 ','DD-MON- RR')); | |
| 1113 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values PII ',to_date( '23-FEB-18 ','DD-MON- RR'),to_da te('23-FEB -18','DD-M ON-RR')); | |
| 1114 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (302,'tes t@testcont act.com',t o_date('26 -FEB-18',' DD-MON-RR' ),to_date( '26-FEB-18 ','DD-MON- RR')); | |
| 1115 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values PII ',to_date( '26-FEB-18 ','DD-MON- RR'),to_da te('26-FEB -18','DD-M ON-RR')); | |
| 1116 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (304,'tes tuser@test .test',to_ date('26-F EB-18','DD -MON-RR'), to_date('2 6-FEB-18', 'DD-MON-RR ')); | |
| 1117 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (305,'tes t@testuser .test',to_ date('26-F EB-18','DD -MON-RR'), to_date('2 6-FEB-18', 'DD-MON-RR ')); | |
| 1118 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values PII ',to_date( '26-FEB-18 ','DD-MON- RR'),to_da te('26-FEB -18','DD-M ON-RR')); | |
| 1119 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values PII ',to_date( '26-FEB-18 ','DD-MON- RR'),to_da te('26-FEB -18','DD-M ON-RR')); | |
| 1120 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_CONTACT (CONTACTUS ERID,CONTA CTEMAIL,DA TECREATED, DATEMODIFI ED) values (308,'ann a.singh@va .com',to_d ate('27-FE B-18','DD- MON-RR'),t o_date('27 -FEB-18',' DD-MON-RR' )); | |
| 1121 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.CLAIM_D ATE | |
| 1122 | SET DEFINE OFF; | |
| 1123 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (55 0,'1000D', null,'275_ TEST_572_T SET.txt',1 ,'472','D8 ','2013081 1',754); | |
| 1124 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (55 1,'2100B', null,'275_ TEST_572_T SET.txt',3 ,'368','D8 ','2016060 4',755); | |
| 1125 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (55 1,'1000D', null,'275_ TEST_572_T SET.txt',1 ,'472','D8 ','2013082 7',756); | |
| 1126 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (55 1,'2100A', null,'275_ TEST_572_T SET.txt',2 ,'472','D8 ','2016030 3',757); | |
| 1127 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (55 2,'2100A', null,'275_ TEST_572_T SET.txt',2 ,'472','D8 ','2016060 1',758); | |
| 1128 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (55 2,'1000D', null,'275_ TEST_572_T SET.txt',1 ,'472','RD 8','201605 31-2016060 8',759); | |
| 1129 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (55 2,'2100B', null,'275_ TEST_572_T SET.txt',3 ,'368','D8 ','2016070 8',760); | |
| 1130 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (55 3,'1000D', null,'275_ TEST_572_T SET.txt',1 ,'472','RD 8','201605 08-2016050 8',761); | |
| 1131 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (55 3,'2100B', null,'275_ TEST_572_T SET.txt',2 ,'368','D8 ','2016080 7',762); | |
| 1132 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (55 4,'2100B', null,'275_ TEST_572_T SET.txt',2 ,'368','D8 ','2016060 6',763); | |
| 1133 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (55 4,'1000D', null,'275_ TEST_572_T SET.txt',1 ,'472','RD 8','201605 05-2016050 6',764); | |
| 1134 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (55 5,'1000D', null,'275_ TEST_572_T SET.txt',1 ,'472','RD 8','201606 08-2016060 8',765); | |
| 1135 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (55 5,'2100B', null,'275_ TEST_572_T SET.txt',2 ,'368','D8 ','2015041 5',766); | |
| 1136 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (55 6,'2100B', null,'275_ TEST_572_T SET.txt',2 ,'368','D8 ','2016071 2',767); | |
| 1137 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (55 6,'1000D', null,'275_ TEST_572_T SET.txt',1 ,'472','D8 ','2016061 3',768); | |
| 1138 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (55 7,'1000D', null,'275_ TEST_572_T SET.txt',1 ,'472','D8 ','2016051 1',769); | |
| 1139 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (55 7,'2100B', null,'275_ TEST_572_T SET.txt',2 ,'368','D8 ','2016061 0',770); | |
| 1140 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (55 8,'2100B', null,'275_ TEST_572_T SET.txt',2 ,'368','D8 ','2016071 4',771); | |
| 1141 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (55 8,'1000D', null,'275_ TEST_572_T SET.txt',1 ,'472','RD 8','201706 14-2017061 4',772); | |
| 1142 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (55 9,'2100A', null,'275_ TEST_572_T SET.txt',1 ,'472','D8 ','2016060 6',773); | |
| 1143 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (55 9,'2100B', null,'275_ TEST_572_T SET.txt',2 ,'368','D8 ','2016070 5',774); | |
| 1144 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (56 0,'1000D', null,'275_ TEST_572_T SET.txt',1 ,'472','RD 8','201705 12-2017051 2',775); | |
| 1145 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (56 0,'2100B', null,'275_ TEST_572_T SET.txt',2 ,'368','D8 ','2016061 2',776); | |
| 1146 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (56 1,'2100B', null,'275_ TEST_572_T SET.txt',2 ,'368','D8 ','2016071 2',777); | |
| 1147 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (56 1,'1000D', null,'275_ TEST_572_T SET.txt',1 ,'472','RD 8','201706 12-2017061 2',778); | |
| 1148 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (56 2,'1000D', null,'275_ TEST_572_T SET.txt',1 ,'472','D8 ','2016061 3',779); | |
| 1149 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (56 2,'2100B', null,'275_ TEST_572_T SET.txt',3 ,'368','D8 ','2016071 5',780); | |
| 1150 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (56 2,'2100B', null,'275_ TEST_572_T SET.txt',2 ,'368','D8 ','2016071 5',781); | |
| 1151 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (56 3,'1000D', null,'275_ TEST_572_T SET.txt',1 ,'472','D8 ','2016061 3',782); | |
| 1152 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (56 3,'2100B', null,'275_ TEST_572_T SET.txt',3 ,'368','D8 ','2016071 5',783); | |
| 1153 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (56 3,'2100B', null,'275_ TEST_572_T SET.txt',2 ,'368','D8 ','2016071 5',784); | |
| 1154 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (56 4,'2100B', null,'275_ TEST_572_T SET.txt',2 ,'368','D8 ','2016090 2',785); | |
| 1155 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (56 4,'1000D', null,'275_ TEST_572_T SET.txt',1 ,'472','D8 ','2016030 3',786); | |
| 1156 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (55 0,'2100A', null,'275_ TEST_572_T SET.txt',2 ,'472','D8 ','2016040 5',752); | |
| 1157 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (55 0,'2100B', null,'275_ TEST_572_T SET.txt',3 ,'368','D8 ','2016060 4',753); | |
| 1158 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (56 5,'2100A', null,'Drag on1.txt',2 ,'472','D8 ','2016040 5',787); | |
| 1159 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (56 5,'1000D', null,'Drag on1.txt',1 ,'472','D8 ','2013081 1',788); | |
| 1160 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (56 5,'2100B', null,'Drag on1.txt',3 ,'368','D8 ','2016060 4',789); | |
| 1161 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (56 6,'2100B', null,'Drag on1.txt',3 ,'368','D8 ','2016060 4',790); | |
| 1162 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (56 6,'1000D', null,'Drag on1.txt',1 ,'472','D8 ','2013082 7',791); | |
| 1163 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (56 6,'2100A', null,'Drag on1.txt',2 ,'472','D8 ','2016030 3',792); | |
| 1164 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (56 7,'2100B', null,'Drag on1.txt',3 ,'368','D8 ','2016070 8',793); | |
| 1165 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (56 7,'2100A', null,'Drag on1.txt',2 ,'472','D8 ','2016060 1',794); | |
| 1166 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (56 7,'1000D', null,'Drag on1.txt',1 ,'472','RD 8','201605 31-2016060 8',795); | |
| 1167 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (56 8,'2100B', null,'Drag on1.txt',2 ,'368','D8 ','2016080 7',796); | |
| 1168 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (56 8,'1000D', null,'Drag on1.txt',1 ,'472','RD 8','201605 08-2016050 8',797); | |
| 1169 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (56 9,'1000D', null,'Drag on1.txt',1 ,'472','RD 8','201605 05-2016050 6',798); | |
| 1170 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (56 9,'2100B', null,'Drag on1.txt',2 ,'368','D8 ','2016060 6',799); | |
| 1171 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (57 0,'1000D', null,'Drag on1.txt',1 ,'472','RD 8','201606 08-2016060 8',800); | |
| 1172 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (57 0,'2100B', null,'Drag on1.txt',2 ,'368','D8 ','2015041 5',801); | |
| 1173 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (57 1,'2100B', null,'Drag on1.txt',2 ,'368','D8 ','2016071 2',802); | |
| 1174 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (57 1,'1000D', null,'Drag on1.txt',1 ,'472','D8 ','2016061 3',803); | |
| 1175 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (57 2,'2100B', null,'Drag on1.txt',2 ,'368','D8 ','2016061 0',804); | |
| 1176 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (57 2,'1000D', null,'Drag on1.txt',1 ,'472','D8 ','2016051 1',805); | |
| 1177 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (57 3,'1000D', null,'Drag on1.txt',1 ,'472','RD 8','201706 14-2017061 4',806); | |
| 1178 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (57 3,'2100B', null,'Drag on1.txt',2 ,'368','D8 ','2016071 4',807); | |
| 1179 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (57 4,'2100A', null,'Drag on1.txt',1 ,'472','D8 ','2016060 6',808); | |
| 1180 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (57 4,'2100B', null,'Drag on1.txt',2 ,'368','D8 ','2016070 5',809); | |
| 1181 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (57 5,'1000D', null,'Drag on1.txt',1 ,'472','RD 8','201705 12-2017051 2',810); | |
| 1182 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (57 5,'2100B', null,'Drag on1.txt',2 ,'368','D8 ','2016061 2',811); | |
| 1183 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (57 6,'1000D', null,'Drag on1.txt',1 ,'472','RD 8','201706 12-2017061 2',812); | |
| 1184 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (57 6,'2100B', null,'Drag on1.txt',2 ,'368','D8 ','2016071 2',813); | |
| 1185 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (57 7,'2100B', null,'Drag on1.txt',2 ,'368','D8 ','2016071 5',814); | |
| 1186 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (57 7,'1000D', null,'Drag on1.txt',1 ,'472','D8 ','2016061 3',815); | |
| 1187 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (57 7,'2100B', null,'Drag on1.txt',3 ,'368','D8 ','2016071 5',816); | |
| 1188 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (57 8,'2100B', null,'Drag on1.txt',2 ,'368','D8 ','2016071 5',817); | |
| 1189 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (57 8,'1000D', null,'Drag on1.txt',1 ,'472','D8 ','2016061 3',818); | |
| 1190 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (57 8,'2100B', null,'Drag on1.txt',3 ,'368','D8 ','2016071 5',819); | |
| 1191 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (57 9,'1000D', null,'Drag on1.txt',1 ,'472','D8 ','2016030 3',820); | |
| 1192 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (57 9,'2100B', null,'Drag on1.txt',2 ,'368','D8 ','2016090 2',821); | |
| 1193 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (58 0,'1000D', null,'Drag on2.txt',1 ,'472','D8 ','2018011 1',822); | |
| 1194 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (58 0,'2100B', null,'Drag on2.txt',2 ,'368','D8 ','2018022 1',823); | |
| 1195 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (58 1,'1000D', null,'Drag on2.txt',1 ,'472','D8 ','2018011 0',824); | |
| 1196 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (58 1,'2100B', null,'Drag on2.txt',2 ,'368','D8 ','2018022 1',825); | |
| 1197 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (58 2,'2100A', null,'Drag on3.txt',2 ,'472','D8 ','2016040 5',826); | |
| 1198 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (58 2,'2100B', null,'Drag on3.txt',3 ,'368','D8 ','2016060 4',827); | |
| 1199 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (58 2,'1000D', null,'Drag on3.txt',1 ,'472','D8 ','2013081 1',828); | |
| 1200 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (58 3,'2100B', null,'Drag on3.txt',3 ,'368','D8 ','2016060 4',829); | |
| 1201 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (58 3,'1000D', null,'Drag on3.txt',1 ,'472','D8 ','2013082 7',830); | |
| 1202 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (58 3,'2100A', null,'Drag on3.txt',2 ,'472','D8 ','2016030 3',831); | |
| 1203 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (58 4,'2100A', null,'Drag on3.txt',2 ,'472','D8 ','2016060 1',832); | |
| 1204 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (58 4,'1000D', null,'Drag on3.txt',1 ,'472','RD 8','201605 31-2016060 8',833); | |
| 1205 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (58 4,'2100B', null,'Drag on3.txt',3 ,'368','D8 ','2016070 8',834); | |
| 1206 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (58 5,'1000D', null,'Drag on3.txt',1 ,'472','RD 8','201605 08-2016050 8',835); | |
| 1207 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (58 5,'2100B', null,'Drag on3.txt',2 ,'368','D8 ','2016080 7',836); | |
| 1208 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (58 6,'2100B', null,'Drag on3.txt',2 ,'368','D8 ','2016060 6',837); | |
| 1209 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (58 6,'1000D', null,'Drag on3.txt',1 ,'472','RD 8','201605 05-2016050 6',838); | |
| 1210 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (58 7,'1000D', null,'Drag on3.txt',1 ,'472','RD 8','201606 08-2016060 8',839); | |
| 1211 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (58 7,'2100B', null,'Drag on3.txt',2 ,'368','D8 ','2015041 5',840); | |
| 1212 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (58 8,'2100B', null,'Drag on3.txt',2 ,'368','D8 ','2016071 2',841); | |
| 1213 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (58 8,'1000D', null,'Drag on3.txt',1 ,'472','D8 ','2016061 3',842); | |
| 1214 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (58 9,'1000D', null,'Drag on3.txt',1 ,'472','D8 ','2016051 1',843); | |
| 1215 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (58 9,'2100B', null,'Drag on3.txt',2 ,'368','D8 ','2016061 0',844); | |
| 1216 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (59 0,'2100B', null,'Drag on3.txt',2 ,'368','D8 ','2016071 4',845); | |
| 1217 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (59 0,'1000D', null,'Drag on3.txt',1 ,'472','RD 8','201706 14-2017061 4',846); | |
| 1218 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (59 1,'2100A', null,'Drag on3.txt',1 ,'472','D8 ','2016060 6',847); | |
| 1219 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (59 1,'2100B', null,'Drag on3.txt',2 ,'368','D8 ','2016070 5',848); | |
| 1220 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (59 2,'1000D', null,'Drag on3.txt',1 ,'472','RD 8','201705 12-2017051 2',849); | |
| 1221 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (59 2,'2100B', null,'Drag on3.txt',2 ,'368','D8 ','2016061 2',850); | |
| 1222 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (59 3,'2100B', null,'Drag on3.txt',2 ,'368','D8 ','2016071 2',851); | |
| 1223 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (59 3,'1000D', null,'Drag on3.txt',1 ,'472','RD 8','201706 12-2017061 2',852); | |
| 1224 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (59 4,'1000D', null,'Drag on3.txt',1 ,'472','D8 ','2016061 3',853); | |
| 1225 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (59 4,'2100B', null,'Drag on3.txt',3 ,'368','D8 ','2016071 5',854); | |
| 1226 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (59 4,'2100B', null,'Drag on3.txt',2 ,'368','D8 ','2016071 5',855); | |
| 1227 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (59 5,'1000D', null,'Drag on3.txt',1 ,'472','D8 ','2016061 3',856); | |
| 1228 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (59 5,'2100B', null,'Drag on3.txt',3 ,'368','D8 ','2016071 5',857); | |
| 1229 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (59 5,'2100B', null,'Drag on3.txt',2 ,'368','D8 ','2016071 5',858); | |
| 1230 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (59 6,'2100B', null,'Drag on3.txt',2 ,'368','D8 ','2016090 2',859); | |
| 1231 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (59 6,'1000D', null,'Drag on3.txt',1 ,'472','D8 ','2016030 3',860); | |
| 1232 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (59 7,'1000D', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',1,' 472','D8', '20130811' ,861); | |
| 1233 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (59 7,'2100B', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',3,' 368','D8', '20160604' ,862); | |
| 1234 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (59 7,'2100A', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',2,' 472','D8', '20160405' ,863); | |
| 1235 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (59 8,'1000D', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',1,' 472','D8', '20130827' ,864); | |
| 1236 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (59 8,'2100A', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',2,' 472','D8', '20160303' ,865); | |
| 1237 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (59 8,'2100B', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',3,' 368','D8', '20160604' ,866); | |
| 1238 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (59 9,'2100B', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',3,' 368','D8', '20160708' ,867); | |
| 1239 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (59 9,'2100A', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',2,' 472','D8', '20160601' ,868); | |
| 1240 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (59 9,'1000D', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',1,' 472','RD8' ,'20160531 -20160608' ,869); | |
| 1241 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (60 0,'2100B', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',2,' 368','D8', '20160807' ,870); | |
| 1242 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (60 0,'1000D', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',1,' 472','RD8' ,'20160508 -20160508' ,871); | |
| 1243 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (60 1,'1000D', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',1,' 472','RD8' ,'20160505 -20160506' ,872); | |
| 1244 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (60 1,'2100B', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',2,' 368','D8', '20160606' ,873); | |
| 1245 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (60 2,'1000D', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',1,' 472','RD8' ,'20160608 -20160608' ,874); | |
| 1246 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (60 2,'2100B', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',2,' 368','D8', '20150415' ,875); | |
| 1247 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (60 3,'1000D', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',1,' 472','D8', '20160613' ,876); | |
| 1248 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (60 3,'2100B', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',2,' 368','D8', '20160712' ,877); | |
| 1249 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (60 4,'1000D', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',1,' 472','D8', '20160511' ,878); | |
| 1250 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (60 4,'2100B', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',2,' 368','D8', '20160610' ,879); | |
| 1251 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (60 5,'1000D', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',1,' 472','RD8' ,'20170614 -20170614' ,880); | |
| 1252 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (60 5,'2100B', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',2,' 368','D8', '20160714' ,881); | |
| 1253 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (60 6,'2100B', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',2,' 368','D8', '20160705' ,882); | |
| 1254 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (60 6,'2100A', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',1,' 472','D8', '20160606' ,883); | |
| 1255 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (60 7,'2100B', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',2,' 368','D8', '20160612' ,884); | |
| 1256 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (60 7,'1000D', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',1,' 472','RD8' ,'20170512 -20170512' ,885); | |
| 1257 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (60 8,'2100B', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',2,' 368','D8', '20160712' ,886); | |
| 1258 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (60 8,'1000D', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',1,' 472','RD8' ,'20170612 -20170612' ,887); | |
| 1259 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (60 9,'2100B', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',2,' 368','D8', '20160715' ,888); | |
| 1260 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (60 9,'1000D', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',1,' 472','D8', '20160613' ,889); | |
| 1261 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (60 9,'2100B', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',3,' 368','D8', '20160715' ,890); | |
| 1262 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (61 0,'2100B', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',2,' 368','D8', '20160715' ,891); | |
| 1263 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (61 0,'1000D', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',1,' 472','D8', '20160613' ,892); | |
| 1264 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (61 0,'2100B', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',3,' 368','D8', '20160715' ,893); | |
| 1265 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (61 1,'1000D', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',1,' 472','D8', '20160303' ,894); | |
| 1266 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_DATE (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,R EC_NUM,DTP 01,DTP02,D TP03,CLAIM _DATE_ID) values (61 1,'2100B', null,'275s Correspond ingTo837Pa nd837_TEST 5.txt',2,' 368','D8', '20160902' ,895); | |
| 1267 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.CLAIM_S UBMISSION | |
| 1268 | SET DEFINE OFF; | |
| 1269 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (1,1, 1,1,1,null ,10084,'pa yerName',' 12115','in foReceiver ',null,'pr oviderInfo ','2345678 90','76543 2109','pat ientLastna me','first Name','999 999999','1 23','234', 'type','Dr agonCleari ngHouseId' ,'123',to_ date('01-A PR-18','DD -MON-RR'), null,null, 'PENDING', 'GENERATED ',null,nul l,to_date( '07-FEB-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1270 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (52,1 ,2,4,1,nul l,10086,'p ayerName', '12115','i nfoReceive r',null,'p roviderInf o','123456 789','8765 43210','pa tientLastn ame','firs tName','99 9999999',' 519','222' ,'billType ','DragonC learingHou seId','123 ',to_date( '12-DEC-17 ','DD-MON- RR'),null, null,'SUBM ITTED','GE NERATED',n ull,null,n ull,null,n ull,null,n ull,null,n ull); | |
| 1271 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (59,1 ,1,2,3,nul l,10087,'D ragonPayer Name','121 15','infor mationRece iver',null ,'DragonPr oviderInfo rmation',' 345678901' ,'98765432 1','Dragon ','Whosa', '888888888 ','1231212 34','Drago nPayerClai mControlNu mber','Dra gonBillTyp e','cleari ngHouse',' DragonMedi calRecordN umber',to_ date('31-J AN-18','DD -MON-RR'), null,null, 'SUBMITTED ','GENERAT ED',to_dat e('11-JAN- 18','DD-MO N-RR'),nul l,to_date( '11-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1272 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (60,1 ,1,2,3,nul l,10087,'D ragonPayer Name','121 15','infor mationRece iver',null ,'DragonPr oviderInfo rmation',' 456789012' ,'87654321 0','Dragon ','Whosa', '888888888 ','1231212 34','Drago nPayerClai mControlNu mber','Dra gonBillTyp e','Dragon ClearingHo useId','Dr agonMedica lRecordNum ber',to_da te('31-JAN -18','DD-M ON-RR'),nu ll,null,'P ENDING','G ENERATED', to_date('1 1-JAN-18', 'DD-MON-RR '),null,to _date('13- FEB-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1273 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (64,1 ,3,4,1,nul l,10088,'p ayerName', '12115','i nfoReceive r',null,'p roviderInf o','678901 234','1111 11118','pa tientLastn ame','firs tName','99 9999999',' 519','222' ,'billType ','clearin gHouse','1 23',to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('11 -JAN-18',' DD-MON-RR' ),null,to_ date('11-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1274 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (57,1 ,1,2,3,nul l,10087,'D ragonPayer Name','121 15','infor mationRece iver',null ,'DragonPr oviderInfo rmation',' 012345678' ,'98765432 1','Dragon ','Whosa', '888888888 ','1231212 34','Drago nPayerClai mControlNu mber','Dra gonBillTyp e','Dragon ClearingHo useId','Dr agonMedica lRecordNum ber',to_da te('01-APR -18','DD-M ON-RR'),nu ll,null,'P ENDING','G ENERATED', null,null, null,null, null,null, null,null, null); | |
| 1275 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (58,1 ,1,2,3,nul l,10087,'D ragonPayer Name','121 15','infor mationRece iver',null ,'DragonPr oviderInfo rmation',' 123456789' ,'09876543 2','Dragon ','Whosa', '888888888 ','1231212 34','Drago nPayerClai mControlNu mber','Dra gonBillTyp e','Dragon ClearingHo useId','Dr agonMedica lRecordNum ber',to_da te('31-JAN -18','DD-M ON-RR'),nu ll,null,'P ENDING','G ENERATED', null,null, null,null, null,null, null,null, null); | |
| 1276 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (65,1 ,1,2,3,nul l,10087,'D ragonPayer Name','121 15','infor mationRece iver',null ,'DragonPr oviderInfo rmation',' 234567890' ,'10987654 3','Dragon ','Whosa', '888888888 ','1231212 34','Drago nPayerClai mControlNu mber','Dra gonBillTyp e','Dragon ClearingHo useId','Dr agonMedica lRecordNum ber',to_da te('31-JAN -18','DD-M ON-RR'),nu ll,null,'P ENDING','G ENERATED', to_date('1 1-JAN-18', 'DD-MON-RR '),null,to _date('11- JAN-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1277 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (115, 1,1,2,3,nu ll,10087,' DragonPaye rName','12 115','info rmationRec eiver',nul l,'DragonP roviderInf ormation', '345678901 ','2109876 54','Drago n','Whosa' ,'88888888 8','123121 234','Drag onPayerCla imControlN umber','Dr agonBillTy pe','Drago nClearingH ouseId','D ragonMedic alRecordNu mber',to_d ate('31-JA N-18','DD- MON-RR'),n ull,null,' SUBMITTED' ,'SUBMITTE D',to_date ('11-JAN-1 8','DD-MON -RR'),to_d ate('11-JA N-18','DD- MON-RR'),t o_date('11 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1278 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (116, 1,1,2,3,nu ll,10087,' DragonPaye rName','12 115','info rmationRec eiver',nul l,'DragonP roviderInf ormation', '456789012 ','3210987 65','Drago n','Whosa' ,'88888888 8','123121 234','Drag onPayerCla imControlN umber','Dr agonBillTy pe','Drago nClearingH ouseId','D ragonMedic alRecordNu mber',to_d ate('31-JA N-18','DD- MON-RR'),n ull,null,' SUBMITTED' ,'SUBMITTE D',to_date ('11-JAN-1 8','DD-MON -RR'),to_d ate('11-JA N-18','DD- MON-RR'),t o_date('11 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1279 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (117, 1,1,2,3,nu ll,10087,' DragonPaye rName','12 115','info Receiver', null,'Drag onProvider Informatio n','789012 345','4321 09876','Dr agon','Who sa','88888 8888','123 121234','D ragonPayer ClaimContr olNumber', 'DragonBil lType','cl earingHous e','Dragon MedicalRec ordNumber' ,to_date(' 31-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('11-JA N-18','DD- MON-RR'),n ull,to_dat e('11-JAN- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1280 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (69,1 ,4,4,1,nul l,10089,'p ayerName', '12115','i nfoReceive r',null,'p roviderInf o','901234 567','1111 11113','pa tientLastn ame','firs tName','99 9999999',' 519','222' ,'billType ','clearin gHouse','1 23',to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('11 -JAN-18',' DD-MON-RR' ),null,to_ date('11-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1281 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (119, 1,1,2,3,nu ll,10087,' DragonPaye rName','12 115','info rmationRec eiver',nul l,'DragonP roviderInf ormation', '890123456 ','5432109 87','Drago n','Whosa' ,'88888888 8','123121 234','Drag onPayerCla imControlN umber','Dr agonBillTy pe','clear ingHouse', 'DragonMed icalRecord Number',to _date('31- JAN-18','D D-MON-RR') ,null,null ,'PENDING' ,'GENERATE D',to_date ('11-JAN-1 8','DD-MON -RR'),null ,to_date(' 11-JAN-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1282 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (71,1 ,4,4,1,nul l,10090,'p ayerName', '12115','i nfoReceive r',null,'p roviderInf o','345678 901','1111 11113','pa tientLastn ame','firs tName','99 9999999',' 519','222' ,'billType ','clearin gHouse','1 23',to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('11 -JAN-18',' DD-MON-RR' ),null,to_ date('11-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1283 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (122, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nfoReceive r',null,'V ECTOR REHA BILITAT',' 1000000010 ','1111111 13','Dunca n','Ester' ,'00010000 6','100000 00','10000 ','231','1 0000','123 456',to_da te('12-DEC -17','DD-M ON-RR'),nu ll,null,'S UBMITTED', 'SUBMITTED ',to_date( '12-JAN-18 ','DD-MON- RR'),to_da te('12-JAN -18','DD-M ON-RR'),to _date('12- JAN-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1284 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (125, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '10000000' ,'10000',' 231','1000 0','123456 ',to_date( '12-DEC-17 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('12-J AN-18','DD -MON-RR'), null,to_da te('12-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1285 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (145, 1,1,2,3,nu ll,10087,' DragonPaye rName','12 115','info rmationRec eiver',nul l,'DragonP roviderInf ormation', '901234567 ','6543210 98','Drago n','Whosa' ,'88888888 8','123121 234','Drag onPayerCla imControlN umber','Dr agonBillTy pe','Drago nClearingH ouseId','D ragonMedic alRecordNu mber',to_d ate('31-JA N-18','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 12-JAN-18' ,'DD-MON-R R'),null,t o_date('12 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1286 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (148, 1,2,4,1,nu ll,10087,' payerName' ,'12115',' informatio nReceiver' ,null,'pro viderInfo' ,'78901234 5','987654 321','pati entLastnam e','firstN ame','9999 99999','51 9','222',' billType', 'clearingH ouse','123 ',to_date( '12-DEC-17 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('12-J AN-18','DD -MON-RR'), null,to_da te('12-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1287 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (150, 1,2,4,1,nu ll,10087,' payerName' ,'12115',' informatio nReceiver' ,null,'pro viderInfo' ,'45678901 2','654321 098','pati entLastnam e','firstN ame','9999 99999','51 9','222',' billType', 'clearingH ouse','123 ',to_date( '12-DEC-17 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('12-J AN-18','DD -MON-RR'), null,to_da te('12-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1288 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (156, 1,1,2,3,nu ll,10087,' DragonPaye rName','12 115','info Receiver', null,'Drag onProvider Informatio n','678901 234','0987 65432','Dr agon','Who sa','88888 8888','123 121234','D ragonPayer ClaimContr olNumber', 'DragonBil lType','Dr agonCleari ngHouseId' ,'DragonMe dicalRecor dNumber',t o_date('31 -JAN-18',' DD-MON-RR' ),null,nul l,'PENDING ','GENERAT ED',to_dat e('12-JAN- 18','DD-MO N-RR'),nul l,to_date( '12-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1289 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (164, 1,2,4,1,nu ll,10087,' payerName' ,'12115',' infoReceiv er',null,' providerIn fo','01234 5678','654 321098','p atientLast name','fir stName','9 99999999', '519','222 ','billTyp e','Dragon ClearingHo useId','12 3',to_date ('12-DEC-1 7','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('12- JAN-18','D D-MON-RR') ,null,to_d ate('12-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1290 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (166, 1,1,2,3,nu ll,10000,' Veteran''s Affairs', '12115','i nfoReceive r',null,'V ECTOR REHA BILITAT',' 1000000010 ','1111111 18','Dunca n','Ester' ,'00010000 6','100000 00','10000 ','231','1 0000','123 456',to_da te('20-JAN -18','DD-M ON-RR'),nu ll,null,'M anually Cl osed','SUB MITTED',to _date('12- JAN-18','D D-MON-RR') ,to_date(' 12-JAN-18' ,'DD-MON-R R'),to_dat e('16-FEB- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1291 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (169, 1,1,2,3,nu ll,10087,' DragonPaye rName','12 115','info Receiver', null,'Drag onProvider Informatio n','567890 123','7654 32109','Dr agon','Who sa','88888 8888','123 121234','D ragonPayer ClaimContr olNumber', 'DragonBil lType','Dr agonCleari ngHouseId' ,'DragonMe dicalRecor dNumber',t o_date('31 -JAN-18',' DD-MON-RR' ),null,nul l,'PENDING ','GENERAT ED',to_dat e('12-JAN- 18','DD-MO N-RR'),nul l,to_date( '12-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1292 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (170, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '10000000' ,'10000',' 231','1000 0','10000' ,to_date(' 12-DEC-17' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('12-JA N-18','DD- MON-RR'),n ull,to_dat e('12-JAN- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1293 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (171, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nfoReceive r',null,'R IVERSIDE M ETH HOS',' 1000000004 ','1111111 13','Dunca n','Ester' ,'00010000 6','100000 00','10000 ','name',' 123456','1 0000',to_d ate('12-DE C-17','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 12-JAN-18' ,'DD-MON-R R'),null,t o_date('12 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1294 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (172, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nfoReceive r',null,'R IVERSIDE M ETH HOS',' 1000000004 ','1111111 13','Dunca n','Ester' ,'00010000 6','100000 00','10000 ','name',' 123456','1 0000',to_d ate('12-DE C-17','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 12-JAN-18' ,'DD-MON-R R'),null,t o_date('12 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1295 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (175, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nfoReceive r',null,'R IVERSIDE M ETH HOS',' 1000000004 ','1111111 13','Dunca n','Ester' ,'00010000 6','100000 00','10000 ','231','1 0000','123 456',to_da te('12-DEC -17','DD-M ON-RR'),nu ll,null,'P ENDING','G ENERATED', to_date('1 2-JAN-18', 'DD-MON-RR '),null,to _date('12- JAN-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1296 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (176, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '10000000' ,'10000',' type','123 4567','100 00',to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('12 -JAN-18',' DD-MON-RR' ),null,to_ date('12-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1297 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (177, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '10000000' ,'10000',' type','123 4567','123 456',to_da te('12-DEC -17','DD-M ON-RR'),nu ll,null,'P ENDING','G ENERATED', to_date('1 2-JAN-18', 'DD-MON-RR '),null,to _date('12- JAN-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1298 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (178, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '10000000' ,'10000',' name','cle aringHouse ','123456' ,to_date(' 12-DEC-17' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('12-JA N-18','DD- MON-RR'),n ull,to_dat e('12-JAN- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1299 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (179, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '10000000' ,'10000',' 231','clea ringHouse' ,'10000',t o_date('12 -DEC-17',' DD-MON-RR' ),null,nul l,'PENDING ','GENERAT ED',to_dat e('12-JAN- 18','DD-MO N-RR'),nul l,to_date( '12-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1300 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (185, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 123456','D uncan','Es ter','0001 00006','10 000000','1 0000','231 ','DragonC learingHou seId','123 456',to_da te('12-DEC -17','DD-M ON-RR'),nu ll,null,'P ENDING','G ENERATED', to_date('1 2-JAN-18', 'DD-MON-RR '),null,to _date('12- JAN-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1301 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (188, 1,1,1,1,nu ll,10000,' Veteran''s Affairs', '84146','i nfoReceive r',null,'R IVERSIDE M ETH HOS',' 1000000004 ','1111111 13','Dunca n','Ester' ,'00010000 6','100000 00','10000 ','231','1 0000','123 456',to_da te('17-JAN -19','DD-M ON-RR'),to _date('10- SEP-17','D D-MON-RR') ,to_date(' 16-SEP-17' ,'DD-MON-R R'),'Compl ete','SUBM ITTED',to_ date('12-J AN-18','DD -MON-RR'), to_date('1 2-JAN-18', 'DD-MON-RR '),to_date ('07-FEB-1 8','DD-MON -RR'),null ,null,null ,null,null ,null); | |
| 1302 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (189, 1,1,1,1,nu ll,10000,' Veteran''s Affairs', '84146','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '10000000' ,'10000',' 231','1000 0','123456 ',to_date( '17-JAN-18 ','DD-MON- RR'),to_da te('10-SEP -17','DD-M ON-RR'),to _date('16- SEP-17','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('12-JAN-1 8','DD-MON -RR'),null ,to_date(' 12-JAN-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1303 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (190, 1,17,1,1,n ull,10000, 'Veteran'' s Affairs' ,'84146',' informatio nReceiver' ,null,'RIV ERSIDE MET H HOS','10 00000004', '111111113 ','Duncan' ,'Ester',' 000100006' ,'10000000 ','10000', 'name','12 3456','100 00',to_dat e('17-JAN- 18','DD-MO N-RR'),to_ date('10-S EP-17','DD -MON-RR'), to_date('1 6-SEP-17', 'DD-MON-RR '),'PENDIN G','GENERA TED',to_da te('12-JAN -18','DD-M ON-RR'),nu ll,to_date ('12-JAN-1 8','DD-MON -RR'),null ,null,null ,null,null ,null); | |
| 1304 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (191, 1,17,1,1,n ull,10001, 'Veteran'' s Affairs' ,'84146',' infoReceiv er',null,' ROCK VALLE Y PHYSICAL THERAPY', '100000000 3','111111 116','Cham bers','Atk ins','0001 00082','10 000001','1 0001','231 ','10000', '123456',t o_date('17 -JAN-18',' DD-MON-RR' ),null,nul l,'PENDING ','GENERAT ED',to_dat e('12-JAN- 18','DD-MO N-RR'),nul l,to_date( '12-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1305 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (192, 1,1,1,2,nu ll,123456, 'Veteran A ffair''s', '12115','1 2345',null ,'loyola', '112233445 56677','99 0088776655 ','Dunn',' Deirdre',' 21','21',' 11','211', '123456789 0','123456 789',to_da te('17-JAN -18','DD-M ON-RR'),to _date('01- JAN-18','D D-MON-RR') ,to_date(' 12-FEB-18' ,'DD-MON-R R'),'PENDI NG','GENER ATED',to_d ate('12-JA N-18','DD- MON-RR'),n ull,to_dat e('12-JAN- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1306 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (194, 1,1,2,2,nu ll,2006172 99000160,' Veteran''s Affairs', '84146','1 0244',null ,'WMHS SPE CIALTY SER VICES','11 84769952', '520591531 ','RANI',' MN','00000 0005','111 10000223', '200617299 000160','2 21','05181 7242879014 ','EI05181 7242879014 -07',to_da te('17-JAN -18','DD-M ON-RR'),to _date('30- JAN-11','D D-MON-RR') ,to_date(' 30-JAN-11' ,'DD-MON-R R'),'PENDI NG','GENER ATED',to_d ate('12-JA N-18','DD- MON-RR'),n ull,to_dat e('12-JAN- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1307 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (195, 1,1,1,1,nu ll,543216, 'Vamsi','1 23456','In formation' ,null,'XXX X','567890 123','1001 11','Last' ,'First',' 123456','1 23456','12 3456','jhg jhgjh','78 9456','789 456',to_da te('12-JAN -18','DD-M ON-RR'),nu ll,null,'P ENDING','G ENERATED', to_date('1 2-JAN-18', 'DD-MON-RR '),null,to _date('12- JAN-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1308 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (196, 113,1,2,2, null,20061 7299000160 ,'Veteran' 's Affairs ','84146', '10244',nu ll,'WMHS S PECIALTY S ERVICES',' 1184769952 ','5205915 31','RANI' ,'MN','000 000005','1 1110000223 ','2006172 99000160', '221','201 6111610016 16','EI051 8172428790 14-07',to_ date('17-J AN-18','DD -MON-RR'), to_date('3 0-JAN-11', 'DD-MON-RR '),to_date ('30-JAN-1 1','DD-MON -RR'),'PEN DING','GEN ERATED',to _date('12- JAN-18','D D-MON-RR') ,null,to_d ate('12-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1309 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (198, 1,1,8,3,nu ll,10241,' DragonPaye rName','12 115','info Receiver', null,'Drag onProvider Informatio n','789012 345','8765 43210','Dr agon','Who sa','88888 8888','100 00241','Dr agonPayerC laimContro lNumber',' DragonBill Type','cle aringHouse ','DragonM edicalReco rdNumber', to_date('2 0-JAN-18', 'DD-MON-RR '),null,nu ll,'SUBMIT TED','SUBM ITTED',to_ date('15-J AN-18','DD -MON-RR'), to_date('1 5-JAN-18', 'DD-MON-RR '),to_date ('15-JAN-1 8','DD-MON -RR'),null ,null,null ,null,null ,null); | |
| 1310 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (199, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nfoReceive r',null,'R IVERSIDE M ETH HOS',' 1000000004 ','123456' ,'Duncan', 'Ester','0 00100006', '10000000' ,'10000',' 231','Drag onClearing HouseId',' 10000',to_ date('12-D EC-17','DD -MON-RR'), null,null, 'PENDING', 'GENERATED ',to_date( '15-JAN-18 ','DD-MON- RR'),null, to_date('1 5-JAN-18', 'DD-MON-RR '),null,nu ll,null,nu ll,null,nu ll); | |
| 1311 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (201, 1,1,2,2,nu ll,12345,' Veteran''s Affairs', '84146','1 0242',null ,'UNIV OF SOUTH ALAB AMA HEA',' 1000000003 ','1111111 21','Dunn' ,'Deirdre' ,'00010001 0','100002 42','10242 ','231','E I051817242 879014-09' ,'EI051817 242879014- 09',to_dat e('20-JAN- 18','DD-MO N-RR'),to_ date('13-S EP-17','DD -MON-RR'), to_date('1 5-SEP-17', 'DD-MON-RR '),'SUBMIT TED','SUBM ITTED',to_ date('15-J AN-18','DD -MON-RR'), to_date('1 5-JAN-18', 'DD-MON-RR '),to_date ('15-JAN-1 8','DD-MON -RR'),null ,null,null ,null,null ,null); | |
| 1312 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (202, 1,5,7,2,nu ll,10241,' DragonPaye rName','12 115','info rmationRec eiver',nul l,'DragonP roviderInf ormation', '345678901 ','6543210 98','Drago n','Whosa' ,'88888888 8','100002 41','Drago nPayerClai mControlNu mber','Dra gonBillTyp e','cleari ngHouse',' DragonMedi calRecordN umber',to_ date('20-J AN-18','DD -MON-RR'), to_date('1 4-SEP-17', 'DD-MON-RR '),to_date ('15-SEP-1 7','DD-MON -RR'),'PEN DING','GEN ERATED',to _date('15- JAN-18','D D-MON-RR') ,null,to_d ate('15-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1313 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (203, 1,2,2,5,nu ll,10242,' Veteran''s Affairs', '84146','1 0242',null ,'UNIV OF SOUTH ALAB AMA HEA',' 1000000003 ','1111111 21','Dunn' ,'Deirdre' ,'00010001 0','100002 42','10242 ','231','E I051817242 879014-09' ,'EI051817 242879014- 09',to_dat e('21-JAN- 18','DD-MO N-RR'),to_ date('13-S EP-17','DD -MON-RR'), to_date('1 5-SEP-17', 'DD-MON-RR '),'PENDIN G','GENERA TED',to_da te('16-JAN -18','DD-M ON-RR'),nu ll,to_date ('16-JAN-1 8','DD-MON -RR'),null ,null,null ,null,null ,null); | |
| 1314 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (205, 1,2,1,1,nu ll,10000,' Veteran''s Affairs', '84146','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '10000000' ,'10000',' name','123 456','1234 56',to_dat e('21-JAN- 18','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('16 -JAN-18',' DD-MON-RR' ),null,to_ date('16-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1315 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (206, 1,2,1,1,nu ll,10000,' Veteran''s Affairs', '84146','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '10000000' ,'10000',' 231','1000 0','10000' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('16-JA N-18','DD- MON-RR'),n ull,to_dat e('16-JAN- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1316 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (207, 1,1,2,1,nu ll,10000,' Veteran''s Affairs', '84146','i nfoReceive r',null,'R IVERSIDE M ETH HOS',' 1000000004 ','1111111 13','Dunca n','Ester' ,'00010000 6','100000 00','10000 ','name',' 123456','1 0000',to_d ate('21-JA N-18','DD- MON-RR'),t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '16-SEP-17 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('16-J AN-18','DD -MON-RR'), null,to_da te('16-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1317 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (208, 1,1,2,1,nu ll,10000,' Veteran''s Affairs', '84146','i nfoReceive r',null,'R IVERSIDE M ETH HOS',' 1000000004 ','1111111 13','Dunca n','Ester' ,'00010000 6','100000 00','10000 ','name',' 123456','1 0000',to_d ate('21-JA N-18','DD- MON-RR'),t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '16-SEP-17 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('16-J AN-18','DD -MON-RR'), null,to_da te('16-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1318 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (209, 114,4,5,5, null,11223 ,'name','1 23123','11 223',null, 'provider name','121 2121212',' 000000012' ,'last nam e','first name','121 21212','12 1212122',' 12121212', '221','123 123123','1 2121212',t o_date('21 -JAN-18',' DD-MON-RR' ),to_date( '01-JAN-16 ','DD-MON- RR'),to_da te('01-FEB -16','DD-M ON-RR'),'S UBMITTED', 'SUBMITTED ',to_date( '16-JAN-18 ','DD-MON- RR'),to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1319 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (210, 1,4,4,5,nu ll,10242,' Veteran''s Affairs', '84146','1 0242',null ,'UNIV OF SOUTH ALAB AMA HEA',' 1000000003 ','1111111 21','Dunn' ,'Deirdre' ,'00010001 0','100002 42','10242 ','231','E I051817242 879014-09' ,'EI051817 242879014- 09',to_dat e('21-JAN- 18','DD-MO N-RR'),to_ date('13-S EP-17','DD -MON-RR'), to_date('1 5-SEP-17', 'DD-MON-RR '),'PENDIN G','GENERA TED',to_da te('16-JAN -18','DD-M ON-RR'),nu ll,to_date ('16-JAN-1 8','DD-MON -RR'),null ,null,null ,null,null ,null); | |
| 1320 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (211, 114,4,4,5, null,10242 ,'Veteran' 's Affairs ','84146', '10242',nu ll,'UNIV O F SOUTH AL ABAMA HEA' ,'10000000 03','11111 1121','Dun n','Deirdr e','000100 010','1000 0242','102 42','231', 'EI0518172 42879014-0 9','EI0518 1724287901 4-09',to_d ate('21-JA N-18','DD- MON-RR'),t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '15-SEP-17 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('16-J AN-18','DD -MON-RR'), null,to_da te('16-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1321 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (212, 114,4,4,5, null,10242 ,'Veteran' 's Affairs ','84146', '10242',nu ll,'UNIV O F SOUTH AL ABAMA HEA' ,'10000000 03','11111 1121','Dun n','Deirdr e','000100 010','1000 0242','102 42','231', 'EI0518172 42879014-0 9','EI0518 1724287901 4-09',to_d ate('21-JA N-18','DD- MON-RR'),t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '15-SEP-17 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('16-J AN-18','DD -MON-RR'), null,to_da te('16-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1322 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (213, 114,4,4,5, null,10242 ,'Veteran' 's Affairs ','84146', '10242',nu ll,'UNIV O F SOUTH AL ABAMA HEA' ,'10000000 03','11111 1121','Dun n','Deirdr e','000100 010','1000 0242','102 42','231', 'EI0518172 42879014-0 9','EI0518 1724287901 4-09',to_d ate('21-JA N-18','DD- MON-RR'),t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '15-SEP-17 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('16-J AN-18','DD -MON-RR'), null,to_da te('16-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1323 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (214, 114,4,4,5, null,10242 ,'Veteran' 's Affairs ','84146', '10242',nu ll,'UNIV O F SOUTH AL ABAMA HEA' ,'10000000 03','11111 1121','Dun n','Deirdr e','000100 010','1000 0242','102 42','231', 'EI0518172 42879014-0 9','EI0518 1724287901 4-09',to_d ate('21-JA N-18','DD- MON-RR'),t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '15-SEP-17 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('16-J AN-18','DD -MON-RR'), null,to_da te('16-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1324 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (215, 114,4,4,5, null,10242 ,'Veteran' 's Affairs ','84146', '10242',nu ll,'UNIV O F SOUTH AL ABAMA HEA' ,'10000000 03','11111 1121','Dun n','Deirdr e','000100 010','1000 0242','102 42','231', 'EI0518172 42879014-0 9','EI0518 1724287901 4-09',to_d ate('21-JA N-18','DD- MON-RR'),t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '15-SEP-17 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('16-J AN-18','DD -MON-RR'), null,to_da te('16-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1325 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (217, 114,4,4,5, null,10242 ,'Veteran' 's Affairs ','84146', '10242',nu ll,'UNIV O F SOUTH AL ABAMA HEA' ,'10000000 03','11111 1121','Dun n','Deirdr e','000100 010','1000 0242','102 42','231', 'EI0518172 42879014-0 9','EI0518 1724287901 4-09',to_d ate('21-JA N-18','DD- MON-RR'),t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '15-SEP-17 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('16-J AN-18','DD -MON-RR'), null,to_da te('16-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1326 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (218, 114,4,4,5, null,10242 ,'Veteran' 's Affairs ','84146', '10242',nu ll,'UNIV O F SOUTH AL ABAMA HEA' ,'10000000 03','11111 1121','Dun n','Deirdr e','000100 010','1000 0242','102 42','231', 'EI0518172 42879014-0 9','EI0518 1724287901 4-09',to_d ate('21-JA N-18','DD- MON-RR'),t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '15-SEP-17 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('16-J AN-18','DD -MON-RR'), null,to_da te('16-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1327 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (219, 114,4,4,5, null,10242 ,'Veteran' 's Affairs ','84146', '10242',nu ll,'UNIV O F SOUTH AL ABAMA HEA' ,'10000000 03','11111 1121','Dun n','Deirdr e','000100 010','1000 0242','102 42','231', 'EI0518172 42879014-0 9','EI0518 1724287901 4-09',to_d ate('21-JA N-18','DD- MON-RR'),t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '15-SEP-17 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('16-J AN-18','DD -MON-RR'), null,to_da te('16-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1328 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (220, 1,4,4,1,nu ll,10095,' name','123 456','info Receiver', null,'name ','123456' ,'123456', 'name','na me','00010 0006','123 456','1234 56','name' ,'DragonCl earingHous eId','1234 56',to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('16 -JAN-18',' DD-MON-RR' ),null,to_ date('16-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1329 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (221, 1,4,4,1,nu ll,10095,' name','123 456','name ',null,'na me','12345 6','123456 ','name',' name','000 100006','1 23456','12 3456','nam e','10000' ,'123456', to_date('1 2-DEC-17', 'DD-MON-RR '),null,nu ll,'PENDIN G','GENERA TED',to_da te('16-JAN -18','DD-M ON-RR'),nu ll,to_date ('16-JAN-1 8','DD-MON -RR'),null ,null,null ,null,null ,null); | |
| 1330 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (223, 1,6,5,7,nu ll,10004,' Veteran''s Affairs', '12115','i nformation Receiver', null,'ROCK VALLEY PH YSICAL THE RAPY','100 0000003',' 111111116' ,'Chambers ','Atkins' ,'00010008 2','100000 01','10001 ','231','1 234567','1 23456',to_ date('21-J AN-18','DD -MON-RR'), to_date('1 3-SEP-17', 'DD-MON-RR '),to_date ('16-SEP-1 7','DD-MON -RR'),'PEN DING','GEN ERATED',to _date('16- JAN-18','D D-MON-RR') ,null,to_d ate('16-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1331 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (225, 1,4,4,1,nu ll,10095,' name','123 456','name ',null,'na me','12345 6','111111 113','name ','name',' 000100006' ,'123456', '123456',' name','123 456','1234 56',to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('16 -JAN-18',' DD-MON-RR' ),null,to_ date('16-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1332 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (226, 115,5,4,6, null,10000 ,'Veteran' 's Affairs ','12115', 'infoRecei ver',null, 'RIVERSIDE METH HOS' ,'10000000 04','11111 1113','Dun can','Este r','000100 006','1000 0000','100 00','231', '10000','1 23456',to_ date('21-J AN-18','DD -MON-RR'), null,null, 'PENDING', 'GENERATED ',to_date( '16-JAN-18 ','DD-MON- RR'),null, to_date('1 6-JAN-18', 'DD-MON-RR '),null,nu ll,null,nu ll,null,nu ll); | |
| 1333 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (228, 115,4,6,7, null,10000 ,'Veteran' 's Affairs ','12115', 'infoRecei ver',null, 'RIVERSIDE METH HOS' ,'10000000 04','11111 1113','Dun can','Este r','000100 006','1000 0000','100 00','231', '10000','1 23456',to_ date('21-J AN-18','DD -MON-RR'), null,null, 'PENDING', 'GENERATED ',to_date( '16-JAN-18 ','DD-MON- RR'),null, to_date('1 6-JAN-18', 'DD-MON-RR '),null,nu ll,null,nu ll,null,nu ll); | |
| 1334 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (229, 116,1,1,1, null,12345 6454444444 ,'name','1 23','4654' ,null,'nam e','12313' ,'12321',' name','nam e','6541', '654','123 12','654', '654','654 ',to_date( '16-JAN-18 ','DD-MON- RR'),to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('16-JAN-1 8','DD-MON -RR'),null ,to_date(' 16-JAN-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1335 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (230, 116,1,1,1, null,12345 4165465465 ,'name','1 23','4654' ,null,'nam e','12313' ,'12321',' name','nam e','6541', '654','123 12','654', '654','654 ',to_date( '16-JAN-18 ','DD-MON- RR'),to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('16-JAN-1 8','DD-MON -RR'),null ,to_date(' 16-JAN-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1336 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (231, 116,1,1,1, null,12345 4165465465 ,'name','1 23','4654' ,null,'nam e','12313' ,'12321',' name','nam e','6541', '654','123 12','654', '654','654 ',to_date( '16-JAN-18 ','DD-MON- RR'),to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('16-JAN-1 8','DD-MON -RR'),null ,to_date(' 16-JAN-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1337 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (232, 116,1,1,1, null,56456 4654654654 ,'name','1 23','4654' ,null,'nam e','12313' ,'12321',' name','nam e','6541', '654','123 12','654', 'EI0518172 42879014-0 9','654',t o_date('16 -JAN-18',' DD-MON-RR' ),to_date( '16-JAN-18 ','DD-MON- RR'),to_da te('16-JAN -18','DD-M ON-RR'),'P ENDING','G ENERATED', to_date('1 6-JAN-18', 'DD-MON-RR '),null,to _date('16- JAN-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1338 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (233, 116,1,1,1, null,56456 46546546,' name','123 ','4654',n ull,'name' ,'12313',' 12321','na me','name' ,'6541','6 54','12312 ','654','6 54','654', to_date('1 6-JAN-18', 'DD-MON-RR '),to_date ('16-JAN-1 8','DD-MON -RR'),to_d ate('16-JA N-18','DD- MON-RR'),' PENDING',' GENERATED' ,to_date(' 16-JAN-18' ,'DD-MON-R R'),null,t o_date('16 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1339 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (234, 116,1,1,1, null,51475 4,'name',' 123','4654 ',null,'na me','12313 ','12321', 'name','na me','6541' ,'654','12 312','654' ,'654','65 4',to_date ('16-JAN-1 8','DD-MON -RR'),to_d ate('16-JA N-18','DD- MON-RR'),t o_date('16 -JAN-18',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('16-JAN- 18','DD-MO N-RR'),nul l,to_date( '16-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1340 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (235, 116,1,1,1, null,51475 47777,'nam e','123',' 4654',null ,'name','1 2313','123 21','name' ,'name','6 541','654' ,'12312',' 654','654' ,'654',to_ date('16-J AN-18','DD -MON-RR'), to_date('1 6-JAN-18', 'DD-MON-RR '),to_date ('16-JAN-1 8','DD-MON -RR'),'PEN DING','GEN ERATED',to _date('16- JAN-18','D D-MON-RR') ,null,to_d ate('16-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1341 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (236, 116,1,1,1, null,51475 47777,'nam e','123',' 4654',null ,'name','1 2313','123 21','name' ,'name','6 541','654' ,'12312',' 654','654' ,'654',to_ date('16-J AN-18','DD -MON-RR'), to_date('1 6-JAN-18', 'DD-MON-RR '),to_date ('16-JAN-1 8','DD-MON -RR'),'PEN DING','GEN ERATED',to _date('16- JAN-18','D D-MON-RR') ,null,to_d ate('16-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1342 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (237, 116,1,1,1, null,51475 47777,'nam e','123',' 4654',null ,'name','1 2313','123 21','name' ,'name','6 541','654' ,'12312',' 654','654' ,'654',to_ date('16-J AN-18','DD -MON-RR'), to_date('1 6-JAN-18', 'DD-MON-RR '),to_date ('16-JAN-1 8','DD-MON -RR'),'PEN DING','GEN ERATED',to _date('16- JAN-18','D D-MON-RR') ,null,to_d ate('16-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1343 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (238, 116,1,1,1, null,56465 4654654654 ,'name','1 23','4654' ,null,'nam e','12313' ,'12321',' name','nam e','6541', '654','123 12','654', '654','654 ',to_date( '16-JAN-18 ','DD-MON- RR'),to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('16-JAN-1 8','DD-MON -RR'),null ,to_date(' 16-JAN-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1344 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (240, 114,3,4,3, null,11223 ,'1','1',' 1',null,'1 ','1','1', '1','1','1 ','1','1', '1','1','1 ',to_date( '21-JAN-18 ','DD-MON- RR'),to_da te('01-JAN -16','DD-M ON-RR'),to _date('01- FEB-16','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('16-JAN-1 8','DD-MON -RR'),null ,to_date(' 16-JAN-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1345 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (241, 117,6,8,1, null,12345 ,'1','1',' 1',null,'1 ','1','1', '1','1','1 ','1','1', '1','1','1 ',to_date( '21-JAN-18 ','DD-MON- RR'),to_da te('01-JAN -16','DD-M ON-RR'),to _date('01- FEB-16','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('16-JAN-1 8','DD-MON -RR'),null ,to_date(' 16-JAN-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1346 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (242, 118,5,4,4, null,12345 6,'VA','12 115','Test @test.com' ,null,'Bil ling Provi der','1234 56789','99 9999999',' Patient La st Name',' Patient Fi rst Name', '123121234 ','1111111 11','12345 6','137',' 123123123' ,'55555555 5',to_date ('20-JAN-1 7','DD-MON -RR'),to_d ate('01-AU G-17','DD- MON-RR'),t o_date('02 -AUG-17',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('16-JAN- 18','DD-MO N-RR'),nul l,to_date( '16-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1347 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (243, 118,5,4,4, null,12345 6,'VA','12 115','Test @test.com' ,null,'Bil ling Provi der','1234 56789','99 9999999',' Patient La st Name',' Patient Fi rst Name', '123121234 ','1111111 11','12345 6','137',' 123123123' ,'55555555 5',to_date ('20-JAN-1 7','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('16- JAN-18','D D-MON-RR') ,null,to_d ate('16-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1348 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (245, 118,5,4,4, null,12345 6,'VA','12 115','Test @test.com' ,null,'Bil ling Provi der','1234 56789','99 9999999',' Patient La st Name',' Patient Fi rst Name', '123121234 ','1111111 11','12345 6','137',' 123123123' ,'55555555 5',to_date ('20-JAN-1 7','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('16- JAN-18','D D-MON-RR') ,null,to_d ate('16-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1349 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (246, 118,5,4,4, null,12345 6,'VA','12 115','Test @test.com' ,null,'Bil ling Provi der','1234 56789','99 9999999',' Patient La st Name',' Patient Fi rst Name', '123121234 ','1111111 11','12345 6','137',' 123123123' ,'55555555 5',to_date ('20-JAN-1 7','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('16- JAN-18','D D-MON-RR') ,null,to_d ate('16-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1350 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (247, 118,5,4,4, null,12345 6,'VA','12 115','Test @test.com' ,null,'Bil ling Provi der','1234 56789','99 9999999',' Patient La st Name',' Patient Fi rst Name', '123121234 ','1111111 11','12345 6','137',' 123123123' ,'55555555 5',to_date ('20-JAN-1 7','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('16- JAN-18','D D-MON-RR') ,null,to_d ate('16-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1351 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (248, 118,5,4,4, null,10244 ,'Veteran' 's Affairs ','12115', '10244',nu ll,'SKAGIT RADIOLOGY INC','100 0000005',' 111111111' ,'Ortega', 'Michael', '000100091 ','1000024 4','10244' ,'221','EI 0518172428 79014-07', 'EI0518172 42879014-0 7',to_date ('21-JAN-1 8','DD-MON -RR'),to_d ate('13-SE P-17','DD- MON-RR'),t o_date('15 -SEP-17',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('16-JAN- 18','DD-MO N-RR'),nul l,to_date( '16-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1352 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (250, 119,7,3,4, null,10240 ,'vam','10 000','smnb n',null,'n ame','3217 8','111111 116','Madd i','Vamsi' ,'123455', '10000240' ,'10001',' type','123 456','1234 56',to_dat e('21-JAN- 18','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('16 -JAN-18',' DD-MON-RR' ),null,to_ date('16-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1353 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (251, 11,1,1,1,n ull,10001, 'vam','100 00','smnbn ',null,'na me','32178 ','244566' ,'Maddi',' Vamsi','12 3455','109 99','10001 ','type',' 123456','1 0000',to_d ate('01-JA N-18','DD- MON-RR'),t o_date('01 -JAN-18',' DD-MON-RR' ),to_date( '16-JAN-18 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('16-J AN-18','DD -MON-RR'), null,to_da te('16-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1354 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (252, 118,3,4,3, null,10245 ,'Veteran' 's Affairs ','12115', '10245',nu ll,'PLAZA MED CTR OF FW','1000 000008','1 11111118', 'Turner',' Patrick',' 000100031' ,'10000245 ','10245', '221','102 45','10245 ',to_date( '21-JAN-18 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('16-J AN-18','DD -MON-RR'), null,to_da te('09-FEB -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1355 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (253, 11,1,1,1,n ull,10001, 'vam','100 00','smnbn ',null,'na me','32178 ','244566' ,'Maddi',' Vamsi','12 3455','109 99','10001 ','type',' 123456','1 23456',to_ date('01-J AN-18','DD -MON-RR'), to_date('0 1-JAN-18', 'DD-MON-RR '),to_date ('16-JAN-1 8','DD-MON -RR'),'SUB MITTED','S UBMITTED', to_date('1 6-JAN-18', 'DD-MON-RR '),to_date ('16-JAN-1 8','DD-MON -RR'),to_d ate('16-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1356 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (255, 115,2,1,2, null,10240 ,'Veteran' 's Affairs ','12115', 'infoRecei ver',null, 'ROCK VALL EY PHYSICA L THERAPY' ,'10000000 03','11111 1119','Cha mbers','At kins','000 100082','1 0000240',' 10001','na me','10000 ','123456' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),to_dat e('10-SEP- 17','DD-MO N-RR'),to_ date('15-S EP-17','DD -MON-RR'), 'PENDING', 'GENERATED ',to_date( '16-JAN-18 ','DD-MON- RR'),null, to_date('1 6-JAN-18', 'DD-MON-RR '),null,nu ll,null,nu ll,null,nu ll); | |
| 1357 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (257, 120,1,1,1, null,10240 ,'Veteran' 's Affairs ','84146', 'infoRecei ver',null, 'ROCK VALL EY PHYSICA L THERAPY' ,'10000000 03','11111 1120','Cha mbers','At kins','000 100082','1 23456','10 001','231' ,'10000',' 123456',to _date('01- JAN-18','D D-MON-RR') ,to_date(' 01-JAN-18' ,'DD-MON-R R'),to_dat e('16-JAN- 18','DD-MO N-RR'),'PE NDING','GE NERATED',t o_date('16 -JAN-18',' DD-MON-RR' ),null,to_ date('16-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1358 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (258, 11,4,3,4,n ull,10245, 'Veteran'' s Affairs' ,'12115',' 10245',nul l,'PLAZA M ED CTR OF FW','10000 00008','11 1111118',' Turner','P atrick','0 00100031', '10000245' ,'10245',' 221','1024 5','10245' ,to_date(' 21-FEB-18' ,'DD-MON-R R'),null,n ull,'Aband oned','GEN ERATED',to _date('16- JAN-18','D D-MON-RR') ,null,to_d ate('11-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1359 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (259, 11,2,2,2,n ull,85951, 'Veteran'' s Affairs' ,'12115',' 1629129747 ',null,'MA RY HITCHCO CK MEMORIA L HOSPITAL ','1023092 053','0202 22140','GG GGGG','XXX XXX','0375 6','H65994 65803','85 951','137' ,'05181724 2879014',' 50218131 6 ',to_date( '21-JAN-18 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('16-J AN-18','DD -MON-RR'), null,to_da te('16-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1360 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (260, 121,4,5,5, null,10244 ,'Veteran' 's Affairs ','12115', '10244',nu ll,'SKAGIT RADIOLOGY INC','100 0000005',' 111111111' ,'Ortega', 'Michael', '000100091 ','1000024 4','10244' ,'221','EI 0518172428 79014-07', 'EI0518172 42879014-0 7',to_date ('21-JAN-1 8','DD-MON -RR'),to_d ate('13-SE P-17','DD- MON-RR'),t o_date('15 -SEP-17',' DD-MON-RR' ),'SUBMITT ED','SUBMI TTED',to_d ate('16-JA N-18','DD- MON-RR'),t o_date('16 -JAN-18',' DD-MON-RR' ),to_date( '16-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1361 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (261, 11,2,2,2,n ull,10240, 'Veteran'' s Affairs' ,'12115',' informatio nReceiver' ,null,'HUM ANA VETERA NS HEALTHC ARE SERVIC ES','10000 00003','11 1111112',' David','We aver','000 100046','1 0000240',' 10002','na me','10000 ','10000', to_date('2 1-JAN-18', 'DD-MON-RR '),null,nu ll,'PENDIN G','GENERA TED',to_da te('16-JAN -18','DD-M ON-RR'),nu ll,to_date ('16-JAN-1 8','DD-MON -RR'),null ,null,null ,null,null ,null); | |
| 1362 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (262, 11,2,2,2,n ull,10240, 'Veteran'' s Affairs' ,'12115',' informatio nReceiver' ,null,'HUM ANA VETERA NS HEALTHC ARE SERVIC ES','10000 00003','76 5432109',' David','We aver','000 100046','1 0000240',' 10002','na me','12345 67','12345 6',to_date ('21-JAN-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('16- JAN-18','D D-MON-RR') ,null,to_d ate('16-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1363 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (264, 123,6,8,5, null,10244 ,'Veteran' 's Affairs ','12115', '10244',nu ll,'SKAGIT RADIOLOGY INC','100 0000005',' 111111111' ,'Ortega', 'Michael', '000100091 ','1000024 4','10244' ,'221','EI 0518172428 79014-07', 'EI0518172 42879014-0 7',to_date ('21-JAN-1 8','DD-MON -RR'),to_d ate('13-SE P-17','DD- MON-RR'),t o_date('15 -SEP-17',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('16-JAN- 18','DD-MO N-RR'),nul l,to_date( '16-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1364 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (266, 125,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', 'informati onReceiver ',null,'RO CK VALLEY PHYSICAL T HERAPY','1 000000003' ,'87654321 0','Chambe rs','Atkin s','000100 082','2312 3','10001' ,'231','12 34567','12 3456',to_d ate('01-JA N-18','DD- MON-RR'),t o_date('01 -JAN-18',' DD-MON-RR' ),to_date( '16-JAN-18 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('16-J AN-18','DD -MON-RR'), null,to_da te('16-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1365 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (267, 11,2,2,2,n ull,10000, 'Veteran'' s Affairs' ,'12115',' informatio nReceiver' ,null,'RIV ERSIDE MET H HOS','10 00000004', '111111113 ','Duncan' ,'Ester',' 000100006' ,'10000000 ','10000', 'type','12 34567','10 000',to_da te('21-JAN -18','DD-M ON-RR'),to _date('10- SEP-17','D D-MON-RR') ,to_date(' 16-SEP-17' ,'DD-MON-R R'),'PENDI NG','GENER ATED',to_d ate('16-JA N-18','DD- MON-RR'),n ull,to_dat e('16-JAN- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1366 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (268, 126,3,5,6, null,10000 ,'Veteran' 's Affairs ','12115', 'informati onReceiver ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'type','1 234567','1 23456',to_ date('21-J AN-18','DD -MON-RR'), null,null, 'PENDING', 'GENERATED ',to_date( '16-JAN-18 ','DD-MON- RR'),null, to_date('1 6-JAN-18', 'DD-MON-RR '),null,nu ll,null,nu ll,null,nu ll); | |
| 1367 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (269, 127,5,6,8, null,10000 ,'Veteran' 's Affairs ','12115', 'informati onReceiver ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'name','c learingHou se','12345 6',to_date ('21-JAN-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('16- JAN-18','D D-MON-RR') ,null,to_d ate('16-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1368 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (270, 128,6,6,7, null,10000 ,'Veteran' 's Affairs ','12115', 'informati onReceiver ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','cl earingHous e','10000' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('16-JA N-18','DD- MON-RR'),n ull,to_dat e('16-JAN- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1369 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (271, 129,5,5,7, null,10243 ,'Veteran' 's Affairs ','12115', '10243',nu ll,'UNIV O F WASHINGT ON PHYSICI ANS','1000 000003','1 11111121', 'Gomez','E stela','00 0100003',' 10000243', '10243','2 21','EI051 8172428790 14-08','EI 0518172428 79014-09', to_date('2 1-JAN-18', 'DD-MON-RR '),to_date ('13-SEP-1 7','DD-MON -RR'),to_d ate('15-SE P-17','DD- MON-RR'),' PENDING',' GENERATED' ,to_date(' 16-JAN-18' ,'DD-MON-R R'),null,t o_date('16 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1370 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (272, 130,2,2,5, null,20061 7203000156 ,'Veteran' 's Affairs ','12115', '10243',nu ll,'UNIV O F WASHINGT ON PHYSICI ANS','1000 000003','1 11111121', 'Gomez','E stela','00 0100003',' 10000243', '10243','2 21','EI051 8172428790 14-08','EI 0518172428 79014-08', to_date('2 1-JAN-18', 'DD-MON-RR '),to_date ('13-SEP-1 7','DD-MON -RR'),to_d ate('15-SE P-17','DD- MON-RR'),' PENDING',' GENERATED' ,to_date(' 16-JAN-18' ,'DD-MON-R R'),null,t o_date('16 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1371 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (273, 131,2,2,5, null,20061 7270000158 ,'Veteran' 's Affairs ','84146', '10242',nu ll,'HEDGES CLINIC SE RVICE CORP ','1326111 600','3627 48681','JO HN','GA',' 000000003' ,'11110000 225','2006 1727000015 8','231',' EI05181724 2879014-09 ','EI05181 7242879014 -09',to_da te('21-JAN -18','DD-M ON-RR'),to _date('13- SEP-17','D D-MON-RR') ,to_date(' 15-SEP-17' ,'DD-MON-R R'),'PENDI NG','GENER ATED',to_d ate('16-JA N-18','DD- MON-RR'),n ull,to_dat e('16-JAN- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1372 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (274, 132,4,6,6, null,21352 35235,'rwr werwqer',' 5125323523 5','123521 35213',nul l,'2352352 135','2352 35235','25 235235','1 235235235' ,'12352352 135','1235 21352135', '235235213 5','213523 5235','123 512351235' ,'12352135 2135','213 5235235',t o_date('01 -JAN-19',' DD-MON-RR' ),to_date( '01-JAN-18 ','DD-MON- RR'),to_da te('16-JAN -18','DD-M ON-RR'),'P ENDING','G ENERATED', to_date('1 6-JAN-18', 'DD-MON-RR '),null,to _date('16- JAN-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1373 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (275, 133,3,3,4, null,10240 ,'Veteran' 's Affairs ','12115', 'informati onReceiver ',null,'HU MANA VETER ANS HEALTH CARE SERVI CES','1000 000001','5 43210987', 'Kennedy', 'Vonda','0 00100086', '10000240' ,'10009',' 231','Drag onClearing HouseId',' 10000',to_ date('21-J AN-18','DD -MON-RR'), null,null, 'PENDING', 'GENERATED ',to_date( '16-JAN-18 ','DD-MON- RR'),null, to_date('1 6-JAN-18', 'DD-MON-RR '),null,nu ll,null,nu ll,null,nu ll); | |
| 1374 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (276, 118,5,3,4, null,20061 7203000156 ,'Veteran' 's Affairs ','84146', '10240',nu ll,'LMH HE ALTH PROFE SSIONALS', '150808655 4','311425 530','JACK ','CC','00 0000001',' 1111000022 3','200617 203000156' ,'211','05 1817242879 014','0518 1724287901 4',to_date ('21-JAN-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('16- JAN-18','D D-MON-RR') ,null,to_d ate('16-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1375 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (277, 134,1,1,1, null,12345 67,'asd',' 12','12',n ull,'12',' 12','12',' we','we',' 12','12',' 12','211', '12','12', to_date('2 1-JAN-18', 'DD-MON-RR '),to_date ('03-JAN-1 8','DD-MON -RR'),to_d ate('05-JA N-18','DD- MON-RR'),' PENDING',' GENERATED' ,to_date(' 16-JAN-18' ,'DD-MON-R R'),null,t o_date('16 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1376 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (278, 135,4,4,6, null,45674 57645,'364 576425745' ,'45743573 475','3457 4357',null ,'34574357 ','3457345 7','457435 7457','435 73457','34 574357','4 3573457',' 6756735676 57','45674 57645','34 57457','56 56754687', '567456875 6',to_date ('01-JAN-1 9','DD-MON -RR'),to_d ate('01-JA N-18','DD- MON-RR'),t o_date('16 -JAN-18',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('16-JAN- 18','DD-MO N-RR'),nul l,to_date( '16-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1377 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (279, 133,3,3,3, null,20006 7070767,'P ayer Name' ,'12115',' Informatio n Receiver ',null,'Bi lling Prov ider','111 111111','2 22222222', 'Patient L ast Name', 'First Nam e','555555 555','1231 21234','20 0067070767 ','137','9 99999999', '000000000 ',to_date( '18-JAN-18 ','DD-MON- RR'),to_da te('01-JAN -18','DD-M ON-RR'),to _date('02- JAN-18','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('16-JAN-1 8','DD-MON -RR'),null ,to_date(' 16-JAN-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1378 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (280, 134,1,1,1, null,10243 ,'Veteran' 's Affairs ','12115', '10243',nu ll,'UNIV O F WASHINGT ON PHYSICI ANS','1000 000003','1 11111121', 'Gomez','E stela','00 0100003',' 10000243', '10243','2 21','EI051 8172428790 14-08','EI 0518172428 79014-09', to_date('2 1-JAN-18', 'DD-MON-RR '),to_date ('13-SEP-1 7','DD-MON -RR'),to_d ate('15-SE P-17','DD- MON-RR'),' PENDING',' GENERATED' ,to_date(' 16-JAN-18' ,'DD-MON-R R'),null,t o_date('16 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1379 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (281, 136,1,1,1, null,10243 ,'Veteran' 's Affairs ','12115', '10243',nu ll,'UNIV O F WASHINGT ON PHYSICI ANS','1000 000003','1 11111121', 'Gomez','E stela','00 0100003',' 10000243', '10243','2 21','EI051 8172428790 14-08','EI 0518172428 79014-09', to_date('2 1-JAN-18', 'DD-MON-RR '),to_date ('13-SEP-1 7','DD-MON -RR'),to_d ate('15-SE P-17','DD- MON-RR'),' SUBMITTED' ,'SUBMITTE D',to_date ('16-JAN-1 8','DD-MON -RR'),to_d ate('16-JA N-18','DD- MON-RR'),t o_date('16 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1380 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (282, 137,1,1,1, null,10243 ,'Veteran' 's Affairs ','12115', '10243',nu ll,'UNIV O F WASHINGT ON PHYSICI ANS','1000 000003','1 11111121', 'Gomez','E stela','00 0100003',' 10000243', '10243','2 21','EI051 8172428790 14-08','EI 0518172428 79014-09', to_date('2 1-JAN-18', 'DD-MON-RR '),to_date ('13-SEP-1 7','DD-MON -RR'),to_d ate('15-SE P-17','DD- MON-RR'),' PENDING',' GENERATED' ,to_date(' 16-JAN-18' ,'DD-MON-R R'),null,t o_date('16 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1381 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (283, 138,1,1,1, null,10243 ,'Veteran' 's Affairs ','12115', '10243',nu ll,'UNIV O F WASHINGT ON PHYSICI ANS','1000 000003','1 11111121', 'Gomez','E stela','00 0100003',' 10000243', '10243','2 21','EI051 8172428790 14-08','EI 0518172428 79014-08', to_date('2 1-JAN-18', 'DD-MON-RR '),to_date ('13-SEP-1 7','DD-MON -RR'),to_d ate('15-SE P-17','DD- MON-RR'),' PENDING',' GENERATED' ,to_date(' 16-JAN-18' ,'DD-MON-R R'),null,t o_date('16 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1382 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (284, 139,1,1,1, null,10243 ,'Veteran' 's Affairs ','12115', '10243',nu ll,'UNIV O F WASHINGT ON PHYSICI ANS','1000 000003','1 11111121', 'Gomez','E stela','00 0100003',' 10000243', '10243','2 21','EI051 8172428790 14-08','EI 0518172428 79014-09', to_date('2 1-JAN-18', 'DD-MON-RR '),to_date ('13-SEP-1 7','DD-MON -RR'),to_d ate('15-SE P-17','DD- MON-RR'),' SUBMITTED' ,'SUBMITTE D',to_date ('16-JAN-1 8','DD-MON -RR'),to_d ate('16-JA N-18','DD- MON-RR'),t o_date('16 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1383 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (285, 133,4,4,3, null,99999 9999,'Paye r Name','1 2115','Inf ormation R eceiver',n ull,'Billi ng Provide r','000000 000','1111 11111','La st Name',' First Name ','8888888 88','12312 1234','999 999999','1 37','12345 6789','123 121234',to _date('20- JAN-17','D D-MON-RR') ,null,null ,'PENDING' ,'GENERATE D',to_date ('16-JAN-1 8','DD-MON -RR'),null ,to_date(' 16-JAN-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1384 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (286, 140,4,5,4, null,10242 ,'Veteran' 's Affairs ','12115', '10242',nu ll,'UNIV O F SOUTH AL ABAMA HEA' ,'10000000 03','11111 1121','Dun n','Deirdr e','000100 010','1000 0242','102 42','231', 'EI0518172 42879014-0 9','EI0518 1724287901 4-09',to_d ate('21-JA N-18','DD- MON-RR'),t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '15-SEP-17 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('16-J AN-18','DD -MON-RR'), null,to_da te('16-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1385 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (287, 141,1,4,1, null,10242 ,'Veteran' 's Affairs ','12115', '10242',nu ll,'UNIV O F SOUTH AL ABAMA HEA' ,'10000000 03','11111 1121','Dun n','Deirdr e','000100 010','1000 0242','102 42','231', 'EI0518172 42879014-0 9','EI0518 1724287901 4-09',to_d ate('21-JA N-18','DD- MON-RR'),t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '15-SEP-17 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('16-J AN-18','DD -MON-RR'), null,to_da te('16-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1386 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (288, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', 'informati onReceiver ',null,'GE NETIVA HEA LTH SVC',' 1000000009 ','4321098 76','Hende rson','Yvo nne','0001 00022','10 000240','1 0020','231 ','DragonC learingHou seId','100 00',to_dat e('21-JAN- 18','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('16 -JAN-18',' DD-MON-RR' ),null,to_ date('16-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1387 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (289, 143,1,4,1, null,10242 ,'Veteran' 's Affairs ','12115', '10242',nu ll,'UNIV O F SOUTH AL ABAMA HEA' ,'10000000 03','11111 1121','Dun n','Deirdr e','000100 010','1000 0242','102 42','231', 'EI0518172 42879014-0 9','EI0518 1724287901 4-09',to_d ate('21-JA N-18','DD- MON-RR'),t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '15-SEP-17 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('16-J AN-18','DD -MON-RR'), null,to_da te('16-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1388 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (290, 144,1,4,1, null,10242 ,'Veteran' 's Affairs ','12115', '10242',nu ll,'UNIV O F SOUTH AL ABAMA HEA' ,'10000000 03','11111 1121','Dun n','Deirdr e','000100 010','1000 0242','102 42','231', 'EI0518172 42879014-0 9','EI0518 1724287901 4-09',to_d ate('21-JA N-18','DD- MON-RR'),t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '15-SEP-17 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('16-J AN-18','DD -MON-RR'), null,to_da te('16-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1389 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (291, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', 'infoRecei ver',null, 'RIVERSIDE METH HOS' ,'10000000 07','98765 4321','Stu art','Howe ','0001700 01','10000 240','1002 1','type', 'DragonCle aringHouse Id','10000 ',to_date( '21-JAN-18 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('16-J AN-18','DD -MON-RR'), null,to_da te('16-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1390 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (292, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','1 00001111', null,'RIVE RSIDE METH HOS','100 0000004',' 244566','D uncan','Es ter','0001 00006','10 000000','1 0000','231 ','123456' ,'10000',t o_date('12 -DEC-17',' DD-MON-RR' ),null,nul l,'PENDING ','GENERAT ED',to_dat e('16-JAN- 18','DD-MO N-RR'),nul l,to_date( '16-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1391 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (293, 145,1,3,4, null,10242 ,'Veteran' 's Affairs ','12115', '10242',nu ll,'UNIV O F SOUTH AL ABAMA HEA' ,'10000000 03','11111 1121','Dun n','Deirdr e','000100 010','1000 0242','102 42','231', 'EI0518172 42879014-0 9','EI0518 1724287901 4-09',to_d ate('21-JA N-18','DD- MON-RR'),t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '15-SEP-17 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('16-J AN-18','DD -MON-RR'), null,to_da te('16-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1392 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (294, 146,1,3,4, null,10242 ,'Veteran' 's Affairs ','12115', '10242',nu ll,'UNIV O F SOUTH AL ABAMA HEA' ,'10000000 03','11111 1121','Dun n','Deirdr e','000100 010','1000 0242','102 42','231', 'EI0518172 42879014-0 9','EI0518 1724287901 4-09',to_d ate('21-JA N-18','DD- MON-RR'),t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '15-SEP-17 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('16-J AN-18','DD -MON-RR'), null,to_da te('16-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1393 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (295, 147,1,3,4, null,10242 ,'Veteran' 's Affairs ','12115', '10242',nu ll,'UNIV O F SOUTH AL ABAMA HEA' ,'10000000 03','11111 1121','Dun n','Deirdr e','000100 010','1000 0242','102 42','231', 'EI0518172 42879014-0 9','EI0518 1724287901 4-09',to_d ate('21-JA N-18','DD- MON-RR'),t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '15-SEP-17 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('16-J AN-18','DD -MON-RR'), null,to_da te('16-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1394 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (296, 142,1,2,3, null,10240 ,'payerNam e','12115' ,'infoRece iver',null ,'provider Info','234 567890','8 76543210', 'patientLa stname','f irstName', '999999999 ','1000024 0','234',' type','Dra gonClearin gHouseId', '123',to_d ate('21-JA N-18','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 16-JAN-18' ,'DD-MON-R R'),null,t o_date('16 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1395 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (297, 148,1,1,1, null,10242 ,'Veteran' 's Affairs ','12115', '10242',nu ll,'UNIV O F SOUTH AL ABAMA HEA' ,'10000000 03','11111 1121','Dun n','Deirdr e','000100 010','1000 0242','102 42','231', 'EI0518172 42879014-0 9','EI0518 1724287901 4-09',to_d ate('21-JA N-18','DD- MON-RR'),t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '15-SEP-17 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('16-J AN-18','DD -MON-RR'), null,to_da te('16-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1396 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (298, 149,1,1,1, null,10242 ,'payerNam e','12115' ,'infoRece iver',null ,'provider Info','012 345678','0 98765432', 'patientLa stname','f irstName', '999999999 ','1000024 2','222',' billType', 'DragonCle aringHouse Id','123', to_date('2 1-JAN-18', 'DD-MON-RR '),to_date ('13-SEP-1 7','DD-MON -RR'),to_d ate('15-SE P-17','DD- MON-RR'),' PENDING',' GENERATED' ,to_date(' 16-JAN-18' ,'DD-MON-R R'),null,t o_date('16 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1397 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (299, 150,1,1,1, null,10242 ,'DragonPa yerName',' 12115','in foReceiver ',null,'Dr agonProvid erInformat ion','6789 01234','10 9876543',' Dragon','W hosa','888 888888','1 0000242',' DragonPaye rClaimCont rolNumber' ,'DragonBi llType','D ragonClear ingHouseId ','DragonM edicalReco rdNumber', to_date('2 1-JAN-18', 'DD-MON-RR '),to_date ('13-SEP-1 7','DD-MON -RR'),to_d ate('15-SE P-17','DD- MON-RR'),' PENDING',' GENERATED' ,to_date(' 16-JAN-18' ,'DD-MON-R R'),null,t o_date('16 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1398 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (300, 151,1,1,1, null,10242 ,'payerNam e','12115' ,'informat ionReceive r',null,'p roviderInf o','456789 012','2109 87654','pa tientLastn ame','firs tName','99 9999999',' 10000242', '222','bil lType','cl earingHous e','123',t o_date('21 -JAN-18',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),to_da te('15-SEP -17','DD-M ON-RR'),'P ENDING','G ENERATED', to_date('1 6-JAN-18', 'DD-MON-RR '),null,to _date('16- JAN-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1399 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (301, 152,1,1,1, null,10242 ,'DragonPa yerName',' 12115','in formationR eceiver',n ull,'Drago nProviderI nformation ','9012345 67','65432 1098','Dra gon','Whos a','888888 888','1000 0242','Dra gonPayerCl aimControl Number','D ragonBillT ype','Drag onClearing HouseId',' DragonMedi calRecordN umber',to_ date('21-J AN-18','DD -MON-RR'), to_date('1 3-SEP-17', 'DD-MON-RR '),to_date ('15-SEP-1 7','DD-MON -RR'),'SUB MITTED','S UBMITTED', to_date('1 6-JAN-18', 'DD-MON-RR '),to_date ('16-JAN-1 8','DD-MON -RR'),to_d ate('16-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1400 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (302, 153,1,1,1, null,10240 ,'payerNam e','12115' ,'infoRece iver',null ,'provider Info','123 456789','6 54321098', 'patientLa stname','f irstName', '999999999 ','1000024 0','222',' billType', 'DragonCle aringHouse Id','123', to_date('2 1-JAN-18', 'DD-MON-RR '),to_date ('10-SEP-1 7','DD-MON -RR'),to_d ate('15-SE P-17','DD- MON-RR'),' PENDING',' GENERATED' ,to_date(' 16-JAN-18' ,'DD-MON-R R'),null,t o_date('16 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1401 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (303, 154,1,1,1, null,10240 ,'DragonPa yerName',' 12115','in formationR eceiver',n ull,'Drago nProviderI nformation ','8901234 56','98765 4321','Dra gon','Whos a','888888 888','1000 0240','Dra gonPayerCl aimControl Number','D ragonBillT ype','clea ringHouse' ,'DragonMe dicalRecor dNumber',t o_date('21 -JAN-18',' DD-MON-RR' ),null,nul l,'PENDING ','GENERAT ED',to_dat e('16-JAN- 18','DD-MO N-RR'),nul l,to_date( '16-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1402 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (304, 155,1,1,1, null,10242 ,'payerNam e','12115' ,'informat ionReceive r',null,'p roviderInf o','789012 345','7654 32109','pa tientLastn ame','firs tName','99 9999999',' 10000242', '222','bil lType','cl earingHous e','123',t o_date('21 -JAN-18',' DD-MON-RR' ),null,nul l,'SUBMITT ED','SUBMI TTED',to_d ate('16-JA N-18','DD- MON-RR'),t o_date('16 -JAN-18',' DD-MON-RR' ),to_date( '16-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1403 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (305, 156,2,1,2, null,10240 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 6','Duncan ','Ester', '000100006 ','519','1 0000','231 ','123456' ,'10000',t o_date('21 -JAN-18',' DD-MON-RR' ),to_date( '10-SEP-17 ','DD-MON- RR'),to_da te('15-SEP -17','DD-M ON-RR'),'S UBMITTED', 'SUBMITTED ',to_date( '16-JAN-18 ','DD-MON- RR'),to_da te('16-JAN -18','DD-M ON-RR'),to _date('16- JAN-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1404 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (306, 157,1,1,1, null,10240 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 6','Duncan ','Ester', '000100006 ','519','1 0000','231 ','123456' ,'10000',t o_date('21 -JAN-18',' DD-MON-RR' ),null,nul l,'SUBMITT ED','SUBMI TTED',to_d ate('16-JA N-18','DD- MON-RR'),t o_date('16 -JAN-18',' DD-MON-RR' ),to_date( '16-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1405 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (307, 118,6,2,4, null,20061 7203000156 ,'Veteran' 's Affairs ','84146', '10240',nu ll,'LMH HE ALTH PROFE SSIONALS', '150808655 4','311425 530','JACK ','CC','00 0000001',' 1111000022 3','200617 203000156' ,'211','05 1817242871 234','0518 1724287901 4',to_date ('21-JAN-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('16- JAN-18','D D-MON-RR') ,null,to_d ate('16-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1406 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (308, 158,1,8,1, null,85951 ,'Veteran' 's Affairs ','12115', '162912974 7',null,'M ARY HITCHC OCK MEMORI AL HOSPITA L','102309 2053','020 222140','G GGGGG','XX XXXX','037 56','H6599 465803','8 5951','137 ','0518172 42879014', '50218131 6',to_date ('21-JAN-1 8','DD-MON -RR'),null ,null,'SUB MITTED','S UBMITTED', to_date('1 6-JAN-18', 'DD-MON-RR '),to_date ('17-JAN-1 8','DD-MON -RR'),to_d ate('16-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1407 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (309, 159,5,5,18 ,null,2222 22222,'Pay er Name',' 111111111' ,'Informat ion Receiv er',null,' Billing Pr ovider Nam e','333333 333','4444 44444','Pa tient Last Name','Pa tient Firs t Name','5 55555555', '666666666 ','2222222 22','77777 7777','888 888888','9 99999999', to_date('2 0-JAN-18', 'DD-MON-RR '),to_date ('01-AUG-1 7','DD-MON -RR'),to_d ate('02-AU G-17','DD- MON-RR'),' PENDING',' GENERATED' ,to_date(' 16-JAN-18' ,'DD-MON-R R'),null,t o_date('16 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1408 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (310, 160,3,1,2, null,10002 ,'Veteran' 's Affairs ','12115', 'informati onReceiver ',null,'HU MANA VETER ANS HEALTH CARE SERVI CES','1000 000003','1 11111112', 'David','W eaver','00 0100046',' 10000002', '10002','n ame','1234 567','1234 56',to_dat e('22-JAN- 18','DD-MO N-RR'),to_ date('10-S EP-17','DD -MON-RR'), to_date('1 6-SEP-17', 'DD-MON-RR '),'PENDIN G','GENERA TED',to_da te('17-JAN -18','DD-M ON-RR'),nu ll,to_date ('17-JAN-1 8','DD-MON -RR'),null ,null,null ,null,null ,null); | |
| 1409 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (313, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','1 00001111', null,'RIVE RSIDE METH HOS','100 0000004',' 111111116' ,'Duncan', 'Ester','0 00100006', '10000000' ,'10000',' 231','1000 0','10000' ,to_date(' 12-DEC-17' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('18-JA N-18','DD- MON-RR'),n ull,to_dat e('18-JAN- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1410 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (314, 1,4,4,1,nu ll,10095,' vam','1000 0','smnbn' ,null,'nam e','32178' ,'11111111 6','Maddi' ,'Vamsi',' 123455','1 0999','100 01','type' ,'123456', '10000',to _date('12- DEC-17','D D-MON-RR') ,null,null ,'PENDING' ,'GENERATE D',to_date ('18-JAN-1 8','DD-MON -RR'),null ,to_date(' 18-JAN-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1411 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (315, 1,4,4,1,nu ll,10095,' vam','1000 0','smnbn' ,null,'nam e','32178' ,'11111111 2','Maddi' ,'Vamsi',' 123455','1 0999','100 01','type' ,'123456', '123456',t o_date('12 -DEC-17',' DD-MON-RR' ),null,nul l,'PENDING ','GENERAT ED',to_dat e('18-JAN- 18','DD-MO N-RR'),nul l,to_date( '18-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1412 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (316, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nfoReceive r',null,'R OCK VALLEY PHYSICAL THERAPY',' 1000000003 ','1111111 12','Chamb ers','Atki ns','00010 0082','100 00001','10 001','name ','10000', '123456',t o_date('12 -DEC-17',' DD-MON-RR' ),null,nul l,'PENDING ','GENERAT ED',to_dat e('18-JAN- 18','DD-MO N-RR'),nul l,to_date( '18-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1413 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (322, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'GENE TIVA HEALT H SVC','10 00000009', '876543210 ','Henders on','Yvonn e','000100 022','1000 0020','100 20','231', 'DragonCle aringHouse Id','10000 ',to_date( '12-DEC-17 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('18-J AN-18','DD -MON-RR'), null,to_da te('18-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1414 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (323, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nfoReceive r',null,'R IVERSIDE M ETH HOS',' 1000000007 ','5432109 87','Stuar t','Howe', '000170001 ','1000002 1','10021' ,'type','D ragonClear ingHouseId ','10000', to_date('1 2-DEC-17', 'DD-MON-RR '),null,nu ll,'PENDIN G','GENERA TED',to_da te('18-JAN -18','DD-M ON-RR'),nu ll,to_date ('18-JAN-1 8','DD-MON -RR'),null ,null,null ,null,null ,null); | |
| 1415 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (327, 163,5,3,6, null,10242 ,'DragonPa yerName',' 12115','in formationR eceiver',n ull,'Drago nProviderI nformation ','4567890 12','09876 5432','Dra gon','Whos a','888888 888','1000 0242','Dra gonPayerCl aimControl Number','D ragonBillT ype','Drag onClearing HouseId',' DragonMedi calRecordN umber',to_ date('23-J AN-18','DD -MON-RR'), to_date('1 3-SEP-17', 'DD-MON-RR '),to_date ('15-SEP-1 7','DD-MON -RR'),'SUB MITTED','S UBMITTED', to_date('1 8-JAN-18', 'DD-MON-RR '),to_date ('19-JAN-1 8','DD-MON -RR'),to_d ate('18-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1416 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (328, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nfoReceive r',null,'V ECTOR REHA BILITAT',' 1000000010 ','1111111 18','Dunca n','Ester' ,'00010000 6','123121 234','1000 0','231',' 10000','12 3456',to_d ate('12-DE C-17','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 19-JAN-18' ,'DD-MON-R R'),null,t o_date('19 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1417 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (330, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '123121234 ','10000', '231','100 00','12345 6',to_date ('12-DEC-1 7','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('19- JAN-18','D D-MON-RR') ,null,to_d ate('19-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1418 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (333, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '519','100 00','name' ,'123456', '123456',t o_date('12 -DEC-17',' DD-MON-RR' ),null,nul l,'PENDING ','GENERAT ED',to_dat e('19-JAN- 18','DD-MO N-RR'),nul l,to_date( '19-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1419 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (335, 164,2,2,2, null,85951 ,'Veteran' 's Affairs ','12115', '162912974 7',null,'M ARY HITCHC OCK MEMORI AL HOSPITA L','102309 2053','020 222140','G GGGGG','XX XXXX','037 56','H6599 465803','8 5951','137 ','0518172 42879014', '50218131 6',to_date ('24-JAN-1 8','DD-MON -RR'),to_d ate('25-OC T-16','DD- MON-RR'),t o_date('25 -OCT-16',' DD-MON-RR' ),'SUBMITT ED','SUBMI TTED',to_d ate('19-JA N-18','DD- MON-RR'),t o_date('20 -JAN-18',' DD-MON-RR' ),to_date( '19-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1420 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (336, 164,2,2,2, null,85951 ,'Veteran' 's Affairs ','12115', '162912974 7',null,'M ARY HITCHC OCK MEMORI AL HOSPITA L','102309 2053','020 222140','G GGGGG','XX XXXX','037 56','H6599 465803','8 5951','137 ','0518172 42879014', '50218131 6',to_date ('24-JAN-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('19- JAN-18','D D-MON-RR') ,null,to_d ate('19-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1421 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (337, 164,2,2,2, null,85951 ,'Veteran' 's Affairs ','12115', '162912974 7',null,'M ARY HITCHC OCK MEMORI AL HOSPITA L','102309 2053','020 222140','G GGGGG','XX XXXX','037 56','H6599 465803','8 5951','137 ','0518172 42879014', '50218131 6',to_date ('24-JAN-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('19- JAN-18','D D-MON-RR') ,null,to_d ate('19-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1422 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (340, 165,2,2,3, null,10009 ,'Veteran' 's Affairs ','12115', 'informati onReceiver ',null,'HU MANA VETER ANS HEALTH CARE SERVI CES','1000 000001','1 11111119', 'Kennedy', 'Vonda','0 00100086', '10000009' ,'10009',' 231','Drag onClearing HouseId',' 10000',to_ date('24-J AN-18','DD -MON-RR'), to_date('1 2-SEP-17', 'DD-MON-RR '),to_date ('16-SEP-1 7','DD-MON -RR'),'PEN DING','GEN ERATED',to _date('19- JAN-18','D D-MON-RR') ,null,to_d ate('19-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1423 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (342, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nfoReceive r',null,'R IVERSIDE M ETH HOS',' 1000000004 ','1111111 13','Dunca n','Ester' ,'00010000 6','123121 234','1000 0','231',' 10000','12 3456',to_d ate('12-DE C-17','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 22-JAN-18' ,'DD-MON-R R'),null,t o_date('22 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1424 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (343, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '123121234 ','10000', '231','100 00','12345 6',to_date ('12-DEC-1 7','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('22- JAN-18','D D-MON-RR') ,null,to_d ate('22-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1425 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (345, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '123121234 ','10000', 'type','12 34567','10 000',to_da te('12-DEC -17','DD-M ON-RR'),nu ll,null,'P ENDING','G ENERATED', to_date('2 2-JAN-18', 'DD-MON-RR '),null,to _date('22- JAN-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1426 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (347, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '123121234 ','10000', 'name','cl earingHous e','123456 ',to_date( '12-DEC-17 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('23-J AN-18','DD -MON-RR'), null,to_da te('23-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1427 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (348, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '519','100 00','231', 'clearingH ouse','100 00',to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('23 -JAN-18',' DD-MON-RR' ),null,to_ date('23-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1428 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (350, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '519','100 00','231', 'DragonCle aringHouse Id','10000 ',to_date( '12-DEC-17 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('23-J AN-18','DD -MON-RR'), null,to_da te('23-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1429 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (356, 1,4,4,1,nu ll,10095,' name','123 456','name ',null,'na me','12345 6','123456 ','name',' name','000 100006','1 0000000',' 123456','n ame','1000 0','123456 ',to_date( '12-DEC-17 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('24-J AN-18','DD -MON-RR'), null,to_da te('24-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1430 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (357, 1,4,4,1,nu ll,10095,' name','123 456','name ',null,'na me','12345 6','123456 ','name',' name','123 456','1000 0000','123 456','name ','123456' ,'123456', to_date('1 2-DEC-17', 'DD-MON-RR '),null,nu ll,'PENDIN G','GENERA TED',to_da te('24-JAN -18','DD-M ON-RR'),nu ll,to_date ('24-JAN-1 8','DD-MON -RR'),null ,null,null ,null,null ,null); | |
| 1431 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (358, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 2','Duncan ','Ester', '000100006 ','1000024 0','10000' ,'231','10 000','1000 0',to_date ('21-JAN-1 8','DD-MON -RR'),null ,null,'SUB MITTED','S UBMITTED', to_date('2 4-JAN-18', 'DD-MON-RR '),to_date ('24-JAN-1 8','DD-MON -RR'),to_d ate('24-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1432 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (359, 142,1,2,3, null,10240 ,'vam','10 000','smnb n',null,'n ame','3217 8','111111 112','Madd i','Vamsi' ,'123455', '10000240' ,'10001',' type','123 456','1000 0',to_date ('21-JAN-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('24- JAN-18','D D-MON-RR') ,null,to_d ate('24-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1433 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (361, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','1 00001111', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '10000000' ,'10000',' 231','1234 56','10000 ',to_date( '12-DEC-17 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('25-J AN-18','DD -MON-RR'), null,to_da te('25-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1434 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (363, 166,1,2,1, null,10000 ,'Veteran' 's Affairs ','12115', 'informati onReceiver ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','Dr agonCleari ngHouseId' ,'10000',t o_date('30 -JAN-18',' DD-MON-RR' ),null,nul l,'PENDING ','GENERAT ED',to_dat e('25-JAN- 18','DD-MO N-RR'),nul l,to_date( '25-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1435 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (364, 167,1,1,1, null,10000 ,'Veteran' 's Affairs ','12115', 'infoRecei ver',null, 'RIVERSIDE METH HOS' ,'10000000 04','11111 1113','Dun can','Este r','000100 006','1000 0000','100 00','231', 'DragonCle aringHouse Id','10000 ',to_date( '30-JAN-18 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('25-J AN-18','DD -MON-RR'), null,to_da te('25-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1436 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (365, 168,1,1,1, null,12345 ,'name','1 2345','nam e',null,'n ame','1234 5','12345' ,'name','n ame','1234 5','12345' ,'12345',' type','123 45','12345 ',to_date( '01-JAN-17 ','DD-MON- RR'),to_da te('01-JAN -16','DD-M ON-RR'),to _date('01- JAN-16','D D-MON-RR') ,'SUBMITTE D','SUBMIT TED',to_da te('25-JAN -18','DD-M ON-RR'),to _date('26- JAN-18','D D-MON-RR') ,to_date(' 25-JAN-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1437 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (366, 169,1,1,1, null,10245 ,'Veterans Affair''s ','12115', '123456',n ull,'qwert y','123456 ','123456' ,'qwerty', 'qwerty',' 123456','1 23456','10 245','211' ,'123456', '123456',t o_date('02 -JAN-18',' DD-MON-RR' ),to_date( '09-JAN-18 ','DD-MON- RR'),to_da te('25-JAN -18','DD-M ON-RR'),'P ENDING','G ENERATED', to_date('2 5-JAN-18', 'DD-MON-RR '),null,to _date('25- JAN-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1438 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (367, 170,1,1,1, null,10245 ,'Veterans Affair''s ','12115', '123456',n ull,'qwert y','123456 ','123456' ,'qwerty', 'qwerty',' 123456','1 23456','10 245','211' ,'123456', '123456',t o_date('02 -JAN-18',' DD-MON-RR' ),to_date( '09-JAN-18 ','DD-MON- RR'),to_da te('25-JAN -18','DD-M ON-RR'),'P ENDING','G ENERATED', to_date('2 5-JAN-18', 'DD-MON-RR '),null,to _date('25- JAN-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1439 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (368, 171,1,1,1, null,10000 ,'name','1 23456','in foReceiver ',null,'na me','12345 6','123456 ','name',' name','000 100006','1 23456','12 3456','nam e','Dragon ClearingHo useId','12 3456',to_d ate('25-JA N-18','DD- MON-RR'),t o_date('01 -JAN-18',' DD-MON-RR' ),to_date( '25-JAN-18 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('25-J AN-18','DD -MON-RR'), null,to_da te('25-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1440 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (370, 173,1,1,1, null,10000 ,'name','1 23456','na me',null,' name','123 456','1234 56','name' ,'name','0 00100006', '123456',' 123456','n ame','1000 0','123456 ',to_date( '01-FEB-18 ','DD-MON- RR'),to_da te('01-JAN -18','DD-M ON-RR'),to _date('25- JAN-18','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('25-JAN-1 8','DD-MON -RR'),null ,to_date(' 25-JAN-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1441 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (371, 174,1,1,1, null,12345 ,'name','1 23456','na me',null,' name','123 456','1234 56','name' ,'name','1 23456','12 3456',null ,'123456', '123456',' 123456',to _date('01- JAN-18','D D-MON-RR') ,to_date(' 01-JAN-18' ,'DD-MON-R R'),to_dat e('25-JAN- 18','DD-MO N-RR'),'PE NDING','GE NERATED',t o_date('25 -JAN-18',' DD-MON-RR' ),null,to_ date('25-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1442 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (373, 176,1,1,1, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('30-JAN-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('25- JAN-18','D D-MON-RR') ,null,to_d ate('25-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1443 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (374, 177,1,1,1, null,10000 ,'name','1 23456','na me',null,' name','123 456','1234 56','name' ,'name','0 00100006', '123456',' 123456','n ame','1000 0','123456 ',to_date( '01-JAN-18 ','DD-MON- RR'),to_da te('01-JAN -18','DD-M ON-RR'),to _date('25- JAN-18','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('25-JAN-1 8','DD-MON -RR'),null ,to_date(' 25-JAN-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1444 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (375, 178,1,1,2, null,10000 ,'name','1 23456','na me',null,' name','123 456','1234 56','name' ,'name','1 23456','12 3456','123 456','name ','123456' ,'123456', to_date('2 5-FEB-18', 'DD-MON-RR '),to_date ('01-JAN-1 8','DD-MON -RR'),to_d ate('25-JA N-18','DD- MON-RR'),' PENDING',' GENERATED' ,to_date(' 25-JAN-18' ,'DD-MON-R R'),null,t o_date('25 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1445 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (376, 1,4,4,1,nu ll,10095,' vam','1000 0','smnbn' ,null,'nam e','32178' ,'244566', 'Maddi','V amsi','123 455','1000 0000','100 01','type' ,'123456', '10000',to _date('12- DEC-17','D D-MON-RR') ,null,null ,'PENDING' ,'GENERATE D',to_date ('25-JAN-1 8','DD-MON -RR'),null ,to_date(' 25-JAN-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1446 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (377, 1,4,4,1,nu ll,10095,' vam','1000 0','smnbn' ,null,'nam e','32178' ,'244566', 'Maddi','V amsi','123 455','1000 0000','100 01','type' ,'123456', '123456',t o_date('12 -DEC-17',' DD-MON-RR' ),null,nul l,'PENDING ','GENERAT ED',to_dat e('25-JAN- 18','DD-MO N-RR'),nul l,to_date( '25-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1447 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (378, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nfoReceive r',null,'R OCK VALLEY PHYSICAL THERAPY',' 1000000003 ','1111111 16','Chamb ers','Atki ns','00010 0082','100 00000','10 001','name ','10000', '123456',t o_date('12 -DEC-17',' DD-MON-RR' ),null,nul l,'PENDING ','GENERAT ED',to_dat e('25-JAN- 18','DD-MO N-RR'),nul l,to_date( '25-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1448 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (382, 179,6,4,8, null,10245 ,'Veteran' 's Affairs ','12115', '10245',nu ll,'PLAZA MED CTR OF FW','1000 000008','1 11111118', 'Turner',' Patrick',' 000100031' ,'10000245 ','10245', '221','102 45','10245 ',to_date( '31-JAN-18 ','DD-MON- RR'),null, null,'SUBM ITTED','SU BMITTED',t o_date('26 -JAN-18',' DD-MON-RR' ),to_date( '26-JAN-18 ','DD-MON- RR'),to_da te('26-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1449 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (385, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'HUMA NA VETERAN S HEALTHCA RE SERVICE S','100000 0001','111 111119','K ennedy','V onda','000 100086','1 0000000',' 10009','23 1','Dragon ClearingHo useId','10 000',to_da te('12-DEC -17','DD-M ON-RR'),nu ll,null,'P ENDING','G ENERATED', to_date('2 6-JAN-18', 'DD-MON-RR '),null,to _date('26- JAN-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1450 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (386, 181,5,4,7, null,10245 ,'1234','1 2345','1', null,'bill ing name', '123','111 11','last name','fir st name',' 1111','111 ','123','1 01','102', '103',to_d ate('31-JA N-18','DD- MON-RR'),t o_date('20 -OCT-17',' DD-MON-RR' ),to_date( '20-FEB-18 ','DD-MON- RR'),'SUBM ITTED','SU BMITTED',t o_date('26 -JAN-18',' DD-MON-RR' ),to_date( '26-JAN-18 ','DD-MON- RR'),to_da te('26-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1451 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (388, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nfoReceive r',null,'R IVERSIDE M ETH HOS',' 1000000007 ','1111111 12','Stuar t','Howe', '000170001 ','123456' ,'10021',' type','Dra gonClearin gHouseId', '10000',to _date('12- DEC-17','D D-MON-RR') ,null,null ,'PENDING' ,'GENERATE D',to_date ('26-JAN-1 8','DD-MON -RR'),null ,to_date(' 26-JAN-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1452 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (389, 1,4,4,1,nu ll,10095,' payerName' ,'12115',' infoReceiv er',null,' providerIn fo','23456 7890','765 432109','p atientLast name','fir stName','9 99999999', '123456',' 234','type ','DragonC learingHou seId','123 ',to_date( '12-DEC-17 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('26-J AN-18','DD -MON-RR'), null,to_da te('26-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1453 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (393, 1,4,4,1,nu ll,10095,' DragonPaye rName','12 115','info rmationRec eiver',nul l,'DragonP roviderInf ormation', '345678901 ','9876543 21','Drago n','Whosa' ,'88888888 8','123456 ','DragonP ayerClaimC ontrolNumb er','Drago nBillType' ,'clearing House','Dr agonMedica lRecordNum ber',to_da te('12-DEC -17','DD-M ON-RR'),nu ll,null,'P ENDING','G ENERATED', to_date('2 9-JAN-18', 'DD-MON-RR '),null,to _date('29- JAN-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1454 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (394, 1,4,4,1,nu ll,10095,' DragonPaye rName','12 115','info rmationRec eiver',nul l,'DragonP roviderInf ormation', '456789012 ','8765432 10','Drago n','Whosa' ,'88888888 8','100000 00','Drago nPayerClai mControlNu mber','Dra gonBillTyp e','Dragon ClearingHo useId','Dr agonMedica lRecordNum ber',to_da te('12-DEC -17','DD-M ON-RR'),nu ll,null,'P ENDING','G ENERATED', to_date('2 9-JAN-18', 'DD-MON-RR '),null,to _date('29- JAN-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1455 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (399, 1,4,4,1,nu ll,10095,' DragonPaye rName','12 115','info Receiver', null,'Drag onProvider Informatio n','678901 234','1111 11113','Dr agon','Who sa','88888 8888','100 00001','Dr agonPayerC laimContro lNumber',' DragonBill Type','Dra gonClearin gHouseId', 'DragonMed icalRecord Number',to _date('12- DEC-17','D D-MON-RR') ,null,null ,'PENDING' ,'GENERATE D',to_date ('29-JAN-1 8','DD-MON -RR'),null ,to_date(' 29-JAN-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1456 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (401, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nfoReceive r',null,'V ECTOR REHA BILITAT',' 1000000010 ','1111111 13','Dunca n','Ester' ,'00010000 6','100000 02','10000 ','231','1 0000','123 456',to_da te('12-DEC -17','DD-M ON-RR'),nu ll,null,'P ENDING','G ENERATED', to_date('2 9-JAN-18', 'DD-MON-RR '),null,to _date('29- JAN-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1457 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (403, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '10000001' ,'10000',' 231','1000 0','123456 ',to_date( '12-DEC-17 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('29-J AN-18','DD -MON-RR'), null,to_da te('29-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1458 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (406, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '10000021' ,'10000',' name','123 456','1234 56',to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('29 -JAN-18',' DD-MON-RR' ),null,to_ date('29-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1459 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (408, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nfoReceive r',null,'R IVERSIDE M ETH HOS',' 1000000004 ','1111111 13','Dunca n','Ester' ,'00010000 6','519',' 10000','na me','12345 6','10000' ,to_date(' 12-DEC-17' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('30-JA N-18','DD- MON-RR'),n ull,to_dat e('30-JAN- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1460 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (411, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '123121234 ','10000', '231','100 00','12345 6',to_date ('12-DEC-1 7','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('30- JAN-18','D D-MON-RR') ,null,to_d ate('30-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1461 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (413, 133,1,1,1, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','12 3456','100 00',to_dat e('04-FEB- 18','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('30 -JAN-18',' DD-MON-RR' ),null,to_ date('30-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1462 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (417, 133,1,1,1, null,22222 22222,'Pay er Name',' 111111111' ,'Informat ion Receiv er',null,' Billing Pr ovider Nam e','333333 3333','444 4444444',' Patient La st Name',' Patient Fi rst Name', '555555555 5','666666 6666','222 2222222',' Bill Type' ,'77777777 77','88888 88888',to_ date('15-F EB-18','DD -MON-RR'), to_date('0 1-JAN-18', 'DD-MON-RR '),to_date ('13-JAN-1 8','DD-MON -RR'),'PEN DING','GEN ERATED',to _date('30- JAN-18','D D-MON-RR') ,null,to_d ate('30-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1463 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (419, 186,6,8,3, null,10245 ,'Veteran' 's Affairs ','12115', '10245',nu ll,'PLAZA MED CTR OF FW','1000 000008','1 11111118', 'Turner',' Patrick',' 000100031' ,'10000245 ','10245', '221','102 45','10245 ',to_date( '04-FEB-18 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('30-J AN-18','DD -MON-RR'), null,to_da te('30-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1464 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (420, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '123121234 ','10000', 'type','12 34567','10 000',to_da te('12-DEC -17','DD-M ON-RR'),nu ll,null,'P ENDING','G ENERATED', to_date('3 0-JAN-18', 'DD-MON-RR '),null,to _date('30- JAN-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1465 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (421, 187,6,6,8, null,10002 ,'Veteran' 's Affairs ','12115', 'informati onReceiver ',null,'HU MANA VETER ANS HEALTH CARE SERVI CES','1000 000003','1 11111112', 'David','W eaver','00 0100046',' 10000002', '10002','n ame','1000 0','10000' ,to_date(' 04-FEB-18' ,'DD-MON-R R'),null,n ull,'SUBMI TTED','SUB MITTED',to _date('30- JAN-18','D D-MON-RR') ,to_date(' 30-JAN-18' ,'DD-MON-R R'),to_dat e('30-JAN- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1466 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (372, 175,1,1,1, null,12345 ,'name','1 23456','na me',null,' name','123 456','1234 56','name' ,'name','1 23456','12 3456',null ,'123456', '123456',' 123456',to _date('23- JAN-18','D D-MON-RR') ,to_date(' 01-JAN-18' ,'DD-MON-R R'),to_dat e('25-JAN- 18','DD-MO N-RR'),'PE NDING','GE NERATED',t o_date('25 -JAN-18',' DD-MON-RR' ),null,to_ date('25-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1467 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (423, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 123456','D uncan','Es ter','0001 00006','51 9','10000' ,'name','c learingHou se','12345 6',to_date ('12-DEC-1 7','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('30- JAN-18','D D-MON-RR') ,null,to_d ate('30-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1468 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (424, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 123456','D uncan','Es ter','0001 00006','51 9','10000' ,'231','cl earingHous e','10000' ,to_date(' 12-DEC-17' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('30-JA N-18','DD- MON-RR'),n ull,to_dat e('30-JAN- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1469 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (425, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 123456','D uncan','Es ter','0001 00006','12 3121234',' 10000','23 1','Dragon ClearingHo useId','12 3456',to_d ate('12-DE C-17','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 30-JAN-18' ,'DD-MON-R R'),null,t o_date('30 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1470 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (427, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nfoReceive r',null,'R IVERSIDE M ETH HOS',' 1000000004 ','123456' ,'Duncan', 'Ester','0 00100006', '123121234 ','10000', '231','Dra gonClearin gHouseId', '10000',to _date('12- DEC-17','D D-MON-RR') ,null,null ,'PENDING' ,'GENERATE D',to_date ('30-JAN-1 8','DD-MON -RR'),null ,to_date(' 30-JAN-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1471 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (430, 118,1,2,2, null,10020 ,'Veteran' 's Affairs ','12115', 'informati onReceiver ',null,'GE NETIVA HEA LTH SVC',' 1000000009 ','1111111 20','Hende rson','Yvo nne','0001 00022','10 000020','1 0020','231 ','DragonC learingHou seId','100 00',to_dat e('04-FEB- 18','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('30 -JAN-18',' DD-MON-RR' ),null,to_ date('30-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1472 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (431, 118,1,1,1, null,10021 ,'Veteran' 's Affairs ','12115', 'infoRecei ver',null, 'RIVERSIDE METH HOS' ,'10000000 07','11111 1112','Stu art','Howe ','0001700 01','10000 021','1002 1','type', 'DragonCle aringHouse Id','10000 ',to_date( '04-FEB-18 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('30-J AN-18','DD -MON-RR'), null,to_da te('30-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1473 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (432, 188,1,1,1, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','12 3456','100 00',to_dat e('05-FEB- 18','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('31 -JAN-18',' DD-MON-RR' ),null,to_ date('31-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1474 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (433, 189,16,7,2 ,null,1000 0,'Veteran ''s Affair s','12115' ,'10000111 1',null,'R IVERSIDE M ETH HOS',' 1000000004 ','1111111 13','Dunca n','Ester' ,'00010000 6','100000 00','10000 ','231','1 0000','100 00',to_dat e('05-FEB- 18','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('31 -JAN-18',' DD-MON-RR' ),null,to_ date('31-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1475 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (435, 1,4,4,1,nu ll,10095,' name','123 456','name ',null,'na me','12345 6','111111 113','name ','name',' 000100006' ,'12312123 4','123456 ','name',' 10000','12 3456',to_d ate('12-DE C-17','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 01-FEB-18' ,'DD-MON-R R'),null,t o_date('01 -FEB-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1476 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (441, 1,4,4,1,nu ll,10095,' name','123 456','name ',null,'na me','12345 6','244566 ','name',' name','000 100006','5 19','12345 6','name', '123456',' 123456',to _date('12- DEC-17','D D-MON-RR') ,null,null ,'PENDING' ,'GENERATE D',to_date ('02-FEB-1 8','DD-MON -RR'),null ,to_date(' 02-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1477 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (318, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'HUMA NA VETERAN S HEALTHCA RE SERVICE S','100000 0003','111 111119','D avid','Wea ver','0001 00046','10 000002','1 0002','nam e','10000' ,'10000',t o_date('12 -DEC-17',' DD-MON-RR' ),null,nul l,'PENDING ','GENERAT ED',to_dat e('18-JAN- 18','DD-MO N-RR'),nul l,to_date( '18-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1478 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (352, 1,4,4,1,nu ll,10095,' name','123 456','info Receiver', null,'name ','123456' ,'123456', 'name','na me','00010 0006','100 00000','12 3456','nam e','Dragon ClearingHo useId','12 3456',to_d ate('12-DE C-17','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 23-JAN-18' ,'DD-MON-R R'),null,t o_date('23 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1479 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (362, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','1 00001111', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '10000000' ,'10000',' 231','1000 0','10000' ,to_date(' 12-DEC-17' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('25-JA N-18','DD- MON-RR'),n ull,to_dat e('25-JAN- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1480 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (344, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nfoReceive r',null,'R IVERSIDE M ETH HOS',' 1000000004 ','1111111 13','Dunca n','Ester' ,'00010000 6','123121 234','1000 0','231',' 10000','12 3456',to_d ate('12-DE C-17','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 22-JAN-18' ,'DD-MON-R R'),null,t o_date('22 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1481 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (312, 162,3,3,5, null,10000 ,'Veteran' 's Affairs ','12115', 'informati onReceiver ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','Dr agonCleari ngHouseId' ,'123456', to_date('2 2-JAN-18', 'DD-MON-RR '),to_date ('10-SEP-1 7','DD-MON -RR'),to_d ate('16-SE P-17','DD- MON-RR'),' PENDING',' GENERATED' ,to_date(' 17-JAN-18' ,'DD-MON-R R'),null,t o_date('17 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1482 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (429, 133,1,1,1, null,10001 ,'Veteran' 's Affairs ','12115', 'infoRecei ver',null, 'ROCK VALL EY PHYSICA L THERAPY' ,'10000000 03','11111 1116','Cha mbers','At kins','000 100082','1 0000001',' 10001','na me','10000 ','123456' ,to_date(' 04-FEB-18' ,'DD-MON-R R'),to_dat e('13-SEP- 17','DD-MO N-RR'),to_ date('16-S EP-17','DD -MON-RR'), 'PENDING', 'GENERATED ',to_date( '30-JAN-18 ','DD-MON- RR'),null, to_date('3 0-JAN-18', 'DD-MON-RR '),null,nu ll,null,nu ll,null,nu ll); | |
| 1483 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (326, 1,4,4,1,nu ll,10095,' DragonPaye rName','12 115','info rmationRec eiver',nul l,'DragonP roviderInf ormation', '890123456 ','8765432 10','Drago n','Whosa' ,'88888888 8','123121 234','Drag onPayerCla imControlN umber','Dr agonBillTy pe','clear ingHouse', 'DragonMed icalRecord Number',to _date('12- DEC-17','D D-MON-RR') ,to_date(' 30-JAN-11' ,'DD-MON-R R'),to_dat e('30-JAN- 11','DD-MO N-RR'),'PE NDING','GE NERATED',t o_date('18 -JAN-18',' DD-MON-RR' ),null,to_ date('18-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1484 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (339, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nfoReceive r',null,'R IVERSIDE M ETH HOS',' 1000000004 ','1111111 13','Dunca n','Ester' ,'00010000 6','123121 234','1000 0','name', '123456',' 10000',to_ date('12-D EC-17','DD -MON-RR'), null,null, 'PENDING', 'GENERATED ',to_date( '19-JAN-18 ','DD-MON- RR'),null, to_date('1 9-JAN-18', 'DD-MON-RR '),null,nu ll,null,nu ll,null,nu ll); | |
| 1485 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (381, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'HUMA NA VETERAN S HEALTHCA RE SERVICE S','100000 0003','111 111112','D avid','Wea ver','0001 00046','10 000000','1 0002','nam e','123456 7','123456 ',to_date( '12-DEC-17 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('26-J AN-18','DD -MON-RR'), null,to_da te('26-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1486 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (397, 1,4,4,1,nu ll,10095,' payerName' ,'12115',' informatio nReceiver' ,null,'pro viderInfo' ,'89012345 6','111111 113','pati entLastnam e','firstN ame','9999 99999','10 999','222' ,'billType ','clearin gHouse','1 23',to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('29 -JAN-18',' DD-MON-RR' ),null,to_ date('29-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1487 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (404, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '10000009' ,'10000',' name','123 456','1000 0',to_date ('12-DEC-1 7','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('29- JAN-18','D D-MON-RR') ,null,to_d ate('29-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1488 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (412, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nfoReceive r',null,'R IVERSIDE M ETH HOS',' 1000000004 ','1111111 13','Dunca n','Ester' ,'00010000 6','123121 234','1000 0','231',' 10000','12 3456',to_d ate('12-DE C-17','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 30-JAN-18' ,'DD-MON-R R'),null,t o_date('30 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1489 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (426, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '519','100 00','231', 'DragonCle aringHouse Id','10000 ',to_date( '12-DEC-17 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('30-J AN-18','DD -MON-RR'), null,to_da te('30-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1490 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (311, 161,11,5,1 5,null,102 42,'payerN ame','1211 5','inform ationRecei ver',null, 'providerI nfo','8901 23456','32 1098765',' patientLas tname','fi rstName',' 999999999' ,'10000242 ','222','b illType',' clearingHo use','123' ,to_date(' 22-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('17-JA N-18','DD- MON-RR'),n ull,to_dat e('17-JAN- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1491 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (174, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '10000000' ,'10000',' 231','1000 0','123456 ',to_date( '12-DEC-17 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('12-J AN-18','DD -MON-RR'), null,to_da te('12-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1492 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (325, 1,4,4,1,nu ll,10095,' payerName' ,'12115',' infoReceiv er',null,' providerIn fo','12345 6789','987 654321','p atientLast name','fir stName','9 99999999', '519','222 ','billTyp e','Dragon ClearingHo useId','12 3',to_date ('12-DEC-1 7','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('18- JAN-18','D D-MON-RR') ,null,to_d ate('18-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1493 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (331, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '123121234 ','10000', 'name','12 3456','100 00',to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('19 -JAN-18',' DD-MON-RR' ),null,to_ date('19-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1494 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (338, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '519','100 00','231', '10000','1 0000',to_d ate('12-DE C-17','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 19-JAN-18' ,'DD-MON-R R'),null,t o_date('19 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1495 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (353, 1,4,4,1,nu ll,10095,' name','123 456','info Receiver', null,'name ','123456' ,'123456', 'name','na me','00010 0006','100 00000','12 3456','nam e','Dragon ClearingHo useId','12 3456',to_d ate('12-DE C-17','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 23-JAN-18' ,'DD-MON-R R'),null,t o_date('23 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1496 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (380, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'HUMA NA VETERAN S HEALTHCA RE SERVICE S','100000 0003','111 111112','D avid','Wea ver','0001 00046','10 000000','1 0002','nam e','10000' ,'10000',t o_date('12 -DEC-17',' DD-MON-RR' ),null,nul l,'PENDING ','GENERAT ED',to_dat e('26-JAN- 18','DD-MO N-RR'),nul l,to_date( '26-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1497 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (390, 1,4,4,1,nu ll,10095,' payerName' ,'12115',' infoReceiv er',null,' providerIn fo','12345 6789','876 543210','p atientLast name','fir stName','9 99999999', '123456',' 222','bill Type','Dra gonClearin gHouseId', '123',to_d ate('12-DE C-17','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 26-JAN-18' ,'DD-MON-R R'),null,t o_date('26 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1498 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (396, 1,4,4,1,nu ll,10095,' payerName' ,'12115',' informatio nReceiver' ,null,'pro viderInfo' ,'78901234 5','111111 118','pati entLastnam e','firstN ame','9999 99999','10 000000','2 22','billT ype','clea ringHouse' ,'123',to_ date('12-D EC-17','DD -MON-RR'), null,null, 'PENDING', 'GENERATED ',to_date( '29-JAN-18 ','DD-MON- RR'),null, to_date('2 9-JAN-18', 'DD-MON-RR '),null,nu ll,null,nu ll,null,nu ll); | |
| 1499 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (405, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '10000020' ,'10000',' name','123 456','1234 56',to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('29 -JAN-18',' DD-MON-RR' ),null,to_ date('29-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1500 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (422, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '519','100 00','type' ,'1234567' ,'123456', to_date('1 2-DEC-17', 'DD-MON-RR '),null,nu ll,'PENDIN G','GENERA TED',to_da te('30-JAN -18','DD-M ON-RR'),nu ll,to_date ('30-JAN-1 8','DD-MON -RR'),null ,null,null ,null,null ,null); | |
| 1501 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (149, 1,2,4,1,nu ll,10087,' payerName' ,'12115',' informatio nReceiver' ,null,'pro viderInfo' ,'89012345 6','876543 210','pati entLastnam e','firstN ame','9999 99999','51 9','222',' billType', 'clearingH ouse','123 ',to_date( '12-DEC-17 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('12-J AN-18','DD -MON-RR'), null,to_da te('12-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1502 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (319, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'HUMA NA VETERAN S HEALTHCA RE SERVICE S','100000 0003','111 111120','D avid','Wea ver','0001 00046','10 000002','1 0002','nam e','123456 7','123456 ',to_date( '12-DEC-17 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('18-J AN-18','DD -MON-RR'), null,to_da te('18-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1503 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (341, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nfoReceive r',null,'R IVERSIDE M ETH HOS',' 1000000004 ','1111111 13','Dunca n','Ester' ,'00010000 6','519',' 10000','na me','12345 6','10000' ,to_date(' 12-DEC-17' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('22-JA N-18','DD- MON-RR'),n ull,to_dat e('22-JAN- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1504 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (355, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','1 00001111', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '10000000' ,'10000',' 231','1000 0','10000' ,to_date(' 12-DEC-17' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('24-JA N-18','DD- MON-RR'),n ull,to_dat e('24-JAN- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1505 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (398, 1,4,4,1,nu ll,10095,' payerName' ,'12115',' informatio nReceiver' ,null,'pro viderInfo' ,'45678901 2','111111 113','pati entLastnam e','firstN ame','9999 99999','10 999','222' ,'billType ','clearin gHouse','1 23',to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('29 -JAN-18',' DD-MON-RR' ),null,to_ date('29-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1506 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (428, 1,4,4,1,nu ll,10095,' name','123 456','info Receiver', null,'name ','123456' ,'123456', 'name','na me','00010 0006','123 121234','1 23456','na me','Drago nClearingH ouseId','1 23456',to_ date('12-D EC-17','DD -MON-RR'), null,null, 'PENDING', 'GENERATED ',to_date( '30-JAN-18 ','DD-MON- RR'),null, to_date('3 0-JAN-18', 'DD-MON-RR '),null,nu ll,null,nu ll,null,nu ll); | |
| 1507 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (123, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nfoReceive r',null,'R IVERSIDE M ETH HOS',' 1000000004 ','1111111 13','Dunca n','Ester' ,'00010000 6','100000 00','10000 ','231','1 0000','123 456',to_da te('12-DEC -17','DD-M ON-RR'),nu ll,null,'S UBMITTED', 'SUBMITTED ',to_date( '12-JAN-18 ','DD-MON- RR'),to_da te('12-JAN -18','DD-M ON-RR'),to _date('12- JAN-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1508 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (173, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nfoReceive r',null,'R IVERSIDE M ETH HOS',' 1000000004 ','1111111 13','Dunca n','Ester' ,'00010000 6','100000 00','10000 ','231','1 0000','123 456',to_da te('12-DEC -17','DD-M ON-RR'),nu ll,null,'P ENDING','G ENERATED', to_date('1 2-JAN-18', 'DD-MON-RR '),null,to _date('12- JAN-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1509 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (193, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 123456','D uncan','Es ter','0001 00006','10 000000','1 0000','231 ','DragonC learingHou seId','100 00',to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('12 -JAN-18',' DD-MON-RR' ),null,to_ date('12-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1510 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (317, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nfoReceive r',null,'R OCK VALLEY PHYSICAL THERAPY',' 1000000003 ','1111111 16','Chamb ers','Atki ns','00010 0082','100 00001','10 001','231' ,'10000',' 123456',to _date('12- DEC-17','D D-MON-RR') ,null,null ,'PENDING' ,'GENERATE D',to_date ('18-JAN-1 8','DD-MON -RR'),null ,to_date(' 18-JAN-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1511 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (332, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '519','100 00','name' ,'123456', '123456',t o_date('12 -DEC-17',' DD-MON-RR' ),null,nul l,'PENDING ','GENERAT ED',to_dat e('19-JAN- 18','DD-MO N-RR'),nul l,to_date( '19-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1512 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (346, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '123121234 ','10000', 'type','12 34567','12 3456',to_d ate('12-DE C-17','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 23-JAN-18' ,'DD-MON-R R'),null,t o_date('23 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1513 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (351, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nfoReceive r',null,'R IVERSIDE M ETH HOS',' 1000000004 ','1111111 13','Dunca n','Ester' ,'00010000 6','100000 00','10000 ','231','D ragonClear ingHouseId ','10000', to_date('1 2-DEC-17', 'DD-MON-RR '),null,nu ll,'PENDIN G','GENERA TED',to_da te('23-JAN -18','DD-M ON-RR'),nu ll,to_date ('23-JAN-1 8','DD-MON -RR'),null ,null,null ,null,null ,null); | |
| 1514 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (387, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'GENE TIVA HEALT H SVC','10 00000009', '111111120 ','Henders on','Yvonn e','000100 022','1000 0000','100 20','231', 'DragonCle aringHouse Id','10000 ',to_date( '12-DEC-17 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('26-J AN-18','DD -MON-RR'), null,to_da te('26-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1515 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (400, 1,4,4,1,nu ll,10095,' payerName' ,'12115',' infoReceiv er',null,' providerIn fo','01234 5678','111 111113','p atientLast name','fir stName','9 99999999', '10000001' ,'222','bi llType','D ragonClear ingHouseId ','123',to _date('12- DEC-17','D D-MON-RR') ,null,null ,'PENDING' ,'GENERATE D',to_date ('29-JAN-1 8','DD-MON -RR'),null ,to_date(' 29-JAN-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1516 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (409, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nfoReceive r',null,'R IVERSIDE M ETH HOS',' 1000000004 ','1111111 13','Dunca n','Ester' ,'00010000 6','123121 234','1000 0','name', '123456',' 10000',to_ date('12-D EC-17','DD -MON-RR'), null,null, 'PENDING', 'GENERATED ',to_date( '30-JAN-18 ','DD-MON- RR'),null, to_date('3 0-JAN-18', 'DD-MON-RR '),null,nu ll,null,nu ll,null,nu ll); | |
| 1517 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (439, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','1 00001111', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '123121234 ','10000', '231','100 00','10000 ',to_date( '12-DEC-17 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('01-F EB-18','DD -MON-RR'), null,to_da te('01-FEB -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1518 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (133, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '10000000' ,'10000',' name','123 456','1000 0',to_date ('12-DEC-1 7','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('12- JAN-18','D D-MON-RR') ,null,to_d ate('12-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1519 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (222, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','1 00001111', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '10000000' ,'10000',' 231','1000 0','10000' ,to_date(' 12-DEC-17' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('16-JA N-18','DD- MON-RR'),n ull,to_dat e('16-JAN- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1520 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (254, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','1 00001111', null,'RIVE RSIDE METH HOS','100 0000004',' 244566','D uncan','Es ter','0001 00006','10 000000','1 0000','231 ','123456' ,'10000',t o_date('12 -DEC-17',' DD-MON-RR' ),null,nul l,'PENDING ','GENERAT ED',to_dat e('16-JAN- 18','DD-MO N-RR'),nul l,to_date( '16-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1521 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (320, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'ROCK VALLEY PH YSICAL THE RAPY','100 0000003',' 111111112' ,'Chambers ','Atkins' ,'00010008 2','100000 01','10001 ','231','1 234567','1 23456',to_ date('12-D EC-17','DD -MON-RR'), null,null, 'PENDING', 'GENERATED ',to_date( '18-JAN-18 ','DD-MON- RR'),null, to_date('1 8-JAN-18', 'DD-MON-RR '),null,nu ll,null,nu ll,null,nu ll); | |
| 1522 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (354, 1,4,4,1,nu ll,10095,' name','123 456','name ',null,'na me','12345 6','123456 ','name',' name','000 100006','1 0000000',' 123456','n ame','1000 0','123456 ',to_date( '12-DEC-17 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('24-J AN-18','DD -MON-RR'), null,to_da te('24-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1523 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (379, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nfoReceive r',null,'R OCK VALLEY PHYSICAL THERAPY',' 1000000003 ','1111111 16','Chamb ers','Atki ns','00010 0082','100 00000','10 001','231' ,'10000',' 123456',to _date('12- DEC-17','D D-MON-RR') ,null,null ,'PENDING' ,'GENERATE D',to_date ('25-JAN-1 8','DD-MON -RR'),null ,to_date(' 25-JAN-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1524 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (395, 1,4,4,1,nu ll,10095,' DragonPaye rName','12 115','info rmationRec eiver',nul l,'DragonP roviderInf ormation', '901234567 ','6543210 98','Drago n','Whosa' ,'88888888 8','100000 00','Drago nPayerClai mControlNu mber','Dra gonBillTyp e','Dragon ClearingHo useId','Dr agonMedica lRecordNum ber',to_da te('12-DEC -17','DD-M ON-RR'),nu ll,null,'P ENDING','G ENERATED', to_date('2 9-JAN-18', 'DD-MON-RR '),null,to _date('29- JAN-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1525 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (434, 1,4,4,1,nu ll,10095,' name','123 456','info Receiver', null,'name ','123456' ,'11111111 3','name', 'name','00 0100006',' 123121234' ,'123456', 'name','Dr agonCleari ngHouseId' ,'123456', to_date('1 2-DEC-17', 'DD-MON-RR '),null,nu ll,'PENDIN G','GENERA TED',to_da te('01-FEB -18','DD-M ON-RR'),nu ll,to_date ('01-FEB-1 8','DD-MON -RR'),null ,null,null ,null,null ,null); | |
| 1526 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (135, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '10000000' ,'10000',' name','123 456','1234 56',to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('12 -JAN-18',' DD-MON-RR' ),null,to_ date('12-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1527 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (200, 1,4,4,1,nu ll,10095,' name','123 456','info Receiver', null,'name ','123456' ,'11111111 3','name', 'name','00 0100006',' 123456','1 23456','na me','Drago nClearingH ouseId','1 23456',to_ date('12-D EC-17','DD -MON-RR'), null,null, 'PENDING', 'GENERATED ',to_date( '15-JAN-18 ','DD-MON- RR'),null, to_date('1 5-JAN-18', 'DD-MON-RR '),null,nu ll,null,nu ll,null,nu ll); | |
| 1528 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (321, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'HUMA NA VETERAN S HEALTHCA RE SERVICE S','100000 0001','765 432109','K ennedy','V onda','000 100086','1 0000009',' 10009','23 1','Dragon ClearingHo useId','10 000',to_da te('12-DEC -17','DD-M ON-RR'),nu ll,null,'P ENDING','G ENERATED', to_date('1 8-JAN-18', 'DD-MON-RR '),null,to _date('18- JAN-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1529 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (384, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'ROCK VALLEY PH YSICAL THE RAPY','100 0000003',' 111111116' ,'Chambers ','Atkins' ,'00010008 2','100000 00','10001 ','231','1 234567','1 23456',to_ date('12-D EC-17','DD -MON-RR'), null,null, 'PENDING', 'GENERATED ',to_date( '26-JAN-18 ','DD-MON- RR'),null, to_date('2 6-JAN-18', 'DD-MON-RR '),null,nu ll,null,nu ll,null,nu ll); | |
| 1530 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (391, 1,4,4,1,nu ll,10095,' DragonPaye rName','12 115','info rmationRec eiver',nul l,'DragonP roviderInf ormation', '890123456 ','5432109 87','Drago n','Whosa' ,'88888888 8','100000 00','Drago nPayerClai mControlNu mber','Dra gonBillTyp e','cleari ngHouse',' DragonMedi calRecordN umber',to_ date('12-D EC-17','DD -MON-RR'), null,null, 'PENDING', 'GENERATED ',to_date( '29-JAN-18 ','DD-MON- RR'),null, to_date('2 9-JAN-18', 'DD-MON-RR '),null,nu ll,null,nu ll,null,nu ll); | |
| 1531 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (440, 1,4,4,1,nu ll,10095,' name','123 456','name ',null,'na me','12345 6','244566 ','name',' name','000 100006','1 23121234', '123456',' name','100 00','12345 6',to_date ('12-DEC-1 7','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('02- FEB-18','D D-MON-RR') ,null,to_d ate('02-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1532 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (204, 1,1,1,1,nu ll,10000,' Veteran''s Affairs', '84146','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '10000000' ,'10000',' name','123 456','1234 56',to_dat e('21-JAN- 17','DD-MO N-RR'),nul l,null,'Co mplete','G ENERATED', to_date('1 6-JAN-18', 'DD-MON-RR '),null,to _date('07- FEB-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1533 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (227, 115,2,3,6, null,10000 ,'Veteran' 's Affairs ','12115', 'informati onReceiver ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1234 56',to_dat e('21-JAN- 18','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('16 -JAN-18',' DD-MON-RR' ),null,to_ date('16-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1534 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (369, 172,1,1,1, null,10000 ,'name','1 23456','in foReceiver ',null,'na me','12345 6','123456 ','name',' name','000 100006','1 23456','12 3456','nam e','Dragon ClearingHo useId','12 3456',to_d ate('01-FE B-18','DD- MON-RR'),t o_date('01 -JAN-18',' DD-MON-RR' ),to_date( '25-JAN-18 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('25-J AN-18','DD -MON-RR'), null,to_da te('25-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1535 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (163, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '10000000' ,'10000',' name','123 456','1234 56',to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('12 -JAN-18',' DD-MON-RR' ),null,to_ date('12-J AN-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1536 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (224, 1,4,4,1,nu ll,10095,' name','123 456','name ',null,'na me','12345 6','111111 113','name ','name',' 000100006' ,'123456', '123456',' name','100 00','12345 6',to_date ('12-DEC-1 7','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('16- JAN-18','D D-MON-RR') ,null,to_d ate('16-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1537 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (324, 1,4,4,1,nu ll,10095,' payerName' ,'12115',' infoReceiv er',null,' providerIn fo','23456 7890','432 109876','p atientLast name','fir stName','9 99999999', '123','234 ','type',' DragonClea ringHouseI d','123',t o_date('12 -DEC-17',' DD-MON-RR' ),null,nul l,'PENDING ','GENERAT ED',to_dat e('18-JAN- 18','DD-MO N-RR'),nul l,to_date( '18-JAN-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1538 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (329, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nfoReceive r',null,'R IVERSIDE M ETH HOS',' 1000000004 ','1111111 13','Dunca n','Ester' ,'00010000 6','123121 234','1000 0','231',' 10000','12 3456',to_d ate('12-DE C-17','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 19-JAN-18' ,'DD-MON-R R'),null,t o_date('19 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1539 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (349, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '519','100 00','231', 'DragonCle aringHouse Id','12345 6',to_date ('12-DEC-1 7','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('23- JAN-18','D D-MON-RR') ,null,to_d ate('23-JA N-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1540 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (360, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','1 00001111', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '10000000' ,'10000',' 231','1234 56','10000 ',to_date( '12-DEC-17 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('24-J AN-18','DD -MON-RR'), null,to_da te('24-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1541 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (392, 1,4,4,1,nu ll,10095,' DragonPaye rName','12 115','info Receiver', null,'Drag onProvider Informatio n','789012 345','4321 09876','Dr agon','Who sa','88888 8888','123 456','Drag onPayerCla imControlN umber','Dr agonBillTy pe','clear ingHouse', 'DragonMed icalRecord Number',to _date('12- DEC-17','D D-MON-RR') ,null,null ,'PENDING' ,'GENERATE D',to_date ('29-JAN-1 8','DD-MON -RR'),null ,to_date(' 29-JAN-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1542 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (407, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nformation Receiver', null,'RIVE RSIDE METH HOS','100 0000004',' 111111113' ,'Duncan', 'Ester','0 00100006', '123','100 00','231', '10000','1 0000',to_d ate('12-DE C-17','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 29-JAN-18' ,'DD-MON-R R'),null,t o_date('29 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1543 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (410, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '12115','i nfoReceive r',null,'R IVERSIDE M ETH HOS',' 1000000004 ','1111111 13','Dunca n','Ester' ,'00010000 6','123121 234','1000 0','231',' 10000','12 3456',to_d ate('12-DE C-17','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 30-JAN-18' ,'DD-MON-R R'),null,t o_date('30 -JAN-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1544 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (216, 114,4,4,5, null,10242 ,'Veteran' 's Affairs ','84146', '10242',nu ll,'UNIV O F SOUTH AL ABAMA HEA' ,'10000000 03','11111 1121','Dun n','Deirdr e','000100 010','1000 0242','102 42','231', 'EI0518172 42879014-0 9','EI0518 1724287901 4-09',to_d ate('21-JA N-18','DD- MON-RR'),t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '15-SEP-17 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('16-J AN-18','DD -MON-RR'), null,to_da te('16-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1545 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (187, 1,1,1,1,nu ll,2006172 03000156,' Veteran''s Affairs', '84146','1 0240',null ,'LMH HEAL TH PROFESS IONALS','1 508086554' ,'31142553 0','JACK', 'CC','0000 00001','11 110000223' ,'20061720 3000156',' 211','0518 1724287901 4','EI0518 1724287901 4-08',to_d ate('17-JA N-18','DD- MON-RR'),t o_date('12 -APR-11',' DD-MON-RR' ),to_date( '12-APR-11 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('12-J AN-18','DD -MON-RR'), null,to_da te('12-JAN -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1546 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (197, 1,12,6,11, null,20061 7204000157 ,'Veteran' 's Affairs ','84146', '10241',nu ll,'MID OH IO EMERGEN CY SERVIC' ,'13866917 80','31160 3722','JAM E','CD','0 00000002', '111100002 23','20061 7204000157 ','211','2 0161116100 1616','EI0 5181724287 9014-08',t o_date('20 -JAN-18',' DD-MON-RR' ),to_date( '12-APR-11 ','DD-MON- RR'),to_da te('12-APR -11','DD-M ON-RR'),'P ENDING','G ENERATED', to_date('1 5-JAN-18', 'DD-MON-RR '),null,to _date('15- JAN-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1547 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (442, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','1 0242',null ,'UNIV OF SOUTH ALAB AMA HEA',' 1000000003 ','1111111 21','Dunn' ,'Deirdre' ,'00010001 0','100002 42','10242 ','231','E I051817242 879014-09' ,'EI051817 242879014- 09',to_dat e('20-JAN- 18','DD-MO N-RR'),to_ date('13-S EP-17','DD -MON-RR'), to_date('1 5-SEP-17', 'DD-MON-RR '),'PENDIN G','GENERA TED',to_da te('05-FEB -18','DD-M ON-RR'),to _date('15- JAN-18','D D-MON-RR') ,to_date(' 05-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1548 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (443, 1,4,4,1,nu ll,10095,' DragonPaye rName','12 115','info rmationRec eiver',nul l,'DragonP roviderInf ormation', '890123456 ','5432109 87','Drago n','Whosa' ,'88888888 8','100000 00','Drago nPayerClai mControlNu mber','Dra gonBillTyp e','cleari ngHouse',' DragonMedi calRecordN umber',to_ date('12-D EC-17','DD -MON-RR'), null,null, 'PENDING', 'GENERATED ',to_date( '05-FEB-18 ','DD-MON- RR'),null, to_date('0 5-FEB-18', 'DD-MON-RR '),null,nu ll,null,nu ll,null,nu ll); | |
| 1549 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (444, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('05 -FEB-18',' DD-MON-RR' ),null,to_ date('05-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1550 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (445, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('05 -FEB-18',' DD-MON-RR' ),null,to_ date('05-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1551 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (446, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('06 -FEB-18',' DD-MON-RR' ),null,to_ date('06-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1552 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (447, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('06 -FEB-18',' DD-MON-RR' ),null,to_ date('06-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1553 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (448, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('06 -FEB-18',' DD-MON-RR' ),null,to_ date('06-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1554 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (449, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('06 -FEB-18',' DD-MON-RR' ),null,to_ date('06-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1555 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (450, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('06 -FEB-18',' DD-MON-RR' ),null,to_ date('06-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1556 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (451, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('06 -FEB-18',' DD-MON-RR' ),null,to_ date('06-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1557 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (452, 1,1,1,1,nu ll,10084,' payerName' ,'12115',' infoReceiv er',null,' providerIn fo','23456 7890','765 432109','p atientLast name','fir stName','9 99999999', '123','234 ','type',' DragonClea ringHouseI d','123',t o_date('01 -APR-18',' DD-MON-RR' ),null,nul l,'PENDING ','GENERAT ED',null,n ull,null,n ull,null,n ull,null,n ull,null); | |
| 1558 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (453, 1,1,1,1,nu ll,10084,' payerName' ,'12115',' infoReceiv er',null,' providerIn fo','23456 7890','765 432109','p atientLast name','fir stName','9 99999999', '123','234 ','type',' DragonClea ringHouseI d','123',t o_date('01 -APR-18',' DD-MON-RR' ),null,nul l,'PENDING ','GENERAT ED',null,n ull,null,n ull,null,n ull,null,n ull,null); | |
| 1559 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (454, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('06 -FEB-18',' DD-MON-RR' ),null,to_ date('06-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1560 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (455, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('06 -FEB-18',' DD-MON-RR' ),null,to_ date('06-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1561 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (456, 1,1,1,1,nu ll,10084,' payerName' ,'12115',' infoReceiv er',null,' providerIn fo','23456 7890','765 432109','p atientLast name','fir stName','9 99999999', '123','234 ','type',' DragonClea ringHouseI d','123',t o_date('01 -APR-18',' DD-MON-RR' ),null,nul l,'PENDING ','GENERAT ED',null,n ull,null,n ull,null,n ull,null,n ull,null); | |
| 1562 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (457, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('06 -FEB-18',' DD-MON-RR' ),null,to_ date('06-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1563 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (458, 1,1,1,1,nu ll,10084,' payerName' ,'12115',' infoReceiv er',null,' providerIn fo','23456 7890','765 432109','p atientLast name','fir stName','9 99999999', '123','234 ','type',' DragonClea ringHouseI d','123',t o_date('01 -APR-18',' DD-MON-RR' ),null,nul l,'PENDING ','GENERAT ED',null,n ull,null,n ull,null,n ull,null,n ull,null); | |
| 1564 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (459, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('06 -FEB-18',' DD-MON-RR' ),null,to_ date('06-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1565 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (460, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('06 -FEB-18',' DD-MON-RR' ),null,to_ date('06-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1566 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (461, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('06 -FEB-18',' DD-MON-RR' ),null,to_ date('06-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1567 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (462, 1,1,1,1,nu ll,10084,' payerName' ,'12115',' infoReceiv er',null,' providerIn fo','23456 7890','765 432109','p atientLast name','fir stName','9 99999999', '123','234 ','type',' DragonClea ringHouseI d','123',t o_date('01 -APR-18',' DD-MON-RR' ),null,nul l,'PENDING ','GENERAT ED',null,n ull,null,n ull,null,n ull,null,n ull,null); | |
| 1568 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (463, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('06 -FEB-18',' DD-MON-RR' ),null,to_ date('06-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1569 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (464, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1570 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (465, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1571 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (466, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1572 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (467, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1573 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (468, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1574 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (469, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1575 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (471, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1576 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (472, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1577 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (473, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1578 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (474, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1579 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (475, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1580 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (476, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1581 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (477, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1582 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (478, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1583 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (479, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1584 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (480, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1585 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (481, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1586 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (482, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1587 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (483, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1588 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (484, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1589 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (485, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1590 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (486, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1591 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (487, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1592 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (488, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1593 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (489, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1594 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (490, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1595 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (491, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1596 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (492, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1597 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (493, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('07 -FEB-18',' DD-MON-RR' ),null,to_ date('07-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1598 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (494, 194,6,6,6, null,10245 ,'Veteran' 's Affairs ','12115', '10245',nu ll,'PLAZA MED CTR OF FW','1000 000008','1 11111118', 'Turner',' Patrick',' 000100031' ,'10000245 ','10245', '221','102 45','10245 ',to_date( '01-APR-18 ','DD-MON- RR'),to_da te('14-SEP -17','DD-M ON-RR'),to _date('15- SEP-17','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('08-FEB-1 8','DD-MON -RR'),null ,to_date(' 13-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1599 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (499, 199,2,2,2, null,10245 ,'Veteran' 's Affairs ','12115', '10245',nu ll,'PLAZA MED CTR OF FW','1000 000008','1 11111118', 'Turner',' Patrick',' 000100031' ,'10000245 ','10245', '221','102 45','10245 ',to_date( '13-FEB-18 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('08-F EB-18','DD -MON-RR'), null,to_da te('08-FEB -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1600 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (500, 200,4,4,5, null,10245 ,'Veteran' 's Affairs ','12115', '10245',nu ll,'PLAZA MED CTR OF FW','1000 000008','1 11111118', 'Turner',' Patrick',' 000100031' ,'10000245 ','10245', '221','102 45','10245 ',to_date( '13-FEB-18 ','DD-MON- RR'),to_da te('14-SEP -17','DD-M ON-RR'),to _date('15- SEP-17','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('08-FEB-1 8','DD-MON -RR'),null ,to_date(' 08-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1601 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (501, 201,4,4,5, null,10245 ,'Veteran' 's Affairs ','12115', '10245',nu ll,'PLAZA MED CTR OF FW','1000 000008','1 11111118', 'Turner',' Patrick',' 000100031' ,'10000245 ','10245', '221','102 45','10245 ',to_date( '13-FEB-18 ','DD-MON- RR'),to_da te('14-SEP -17','DD-M ON-RR'),to _date('15- SEP-17','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('08-FEB-1 8','DD-MON -RR'),null ,to_date(' 08-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1602 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (502, 202,8,4,2, null,10241 ,'Veteran' 's Affairs ','12115', '10241',nu ll,'PLAZA MED CTR OF FW','1000 000004','1 11111121', 'Burgess', 'Meyers',' 000100032' ,'10000241 ','10241', '211','201 6111610016 16','20161 1161001616 ',to_date( '13-FEB-18 ','DD-MON- RR'),to_da te('14-SEP -17','DD-M ON-RR'),to _date('15- SEP-17','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('08-FEB-1 8','DD-MON -RR'),null ,to_date(' 08-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1603 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (503, 203,5,5,5, null,10245 ,'Veteran' 's Affairs ','12115', '10245',nu ll,'PLAZA MED CTR OF FW','1000 000008','1 11111118', 'Turner',' Patrick',' 000100031' ,'10000245 ','10245', '221','102 45','10245 ',to_date( '13-FEB-18 ','DD-MON- RR'),to_da te('14-SEP -17','DD-M ON-RR'),to _date('15- SEP-17','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('08-FEB-1 8','DD-MON -RR'),null ,to_date(' 08-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1604 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (504, 204,6,6,5, null,10241 ,'Veteran' 's Affairs ','12115', '10241',nu ll,'PLAZA MED CTR OF FW','1000 000004','1 11111121', 'Burgess', 'Meyers',' 000100032' ,'10000241 ','10241', '211','201 6111610016 16','20161 1161001616 ',to_date( '13-FEB-18 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('08-F EB-18','DD -MON-RR'), null,to_da te('08-FEB -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1605 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (505, 205,5,5,5, null,10241 ,'Veteran' 's Affairs ','12115', '10241',nu ll,'PLAZA MED CTR OF FW','1000 000004','1 11111121', 'Burgess', 'Meyers',' 000100032' ,'10000241 ','10241', '211','201 6111610016 16','20161 1161001616 ',to_date( '13-FEB-18 ','DD-MON- RR'),to_da te('14-SEP -17','DD-M ON-RR'),to _date('15- SEP-17','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('08-FEB-1 8','DD-MON -RR'),null ,to_date(' 08-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1606 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (506, 206,8,4,5, null,10241 ,'Veteran' 's Affairs ','12115', '10241',nu ll,'PLAZA MED CTR OF FW','1000 000004','1 11111121', 'Burgess', 'Meyers',' 000100032' ,'10000241 ','10241', '211','201 6111610016 16','20161 1161001616 ',to_date( '13-FEB-18 ','DD-MON- RR'),to_da te('14-SEP -17','DD-M ON-RR'),to _date('15- SEP-17','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('08-FEB-1 8','DD-MON -RR'),null ,to_date(' 08-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1607 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (507, 207,4,5,7, null,10241 ,'Veteran' 's Affairs ','12115', '10241',nu ll,'PLAZA MED CTR OF FW','1000 000004','1 11111121', 'Burgess', 'Meyers',' 000100032' ,'10000241 ','10241', '211','201 6111610016 16','20161 1161001616 ',to_date( '13-FEB-18 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('08-F EB-18','DD -MON-RR'), null,to_da te('08-FEB -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1608 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (508, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('08 -FEB-18',' DD-MON-RR' ),null,to_ date('08-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1609 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (509, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('08 -FEB-18',' DD-MON-RR' ),null,to_ date('08-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1610 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (510, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('08 -FEB-18',' DD-MON-RR' ),null,to_ date('08-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1611 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (511, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('08 -FEB-18',' DD-MON-RR' ),null,to_ date('08-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1612 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (512, 208,6,8,6, null,10242 ,'Veteran' 's Affairs ','12115', '10242',nu ll,'UNIV O F SOUTH AL ABAMA HEA' ,'10000000 03','11111 1121','Dun n','Deirdr e','000100 010','1000 0242','102 42','231', 'EI0518172 42879014-0 9','EI0518 1724287901 4-09',to_d ate('13-FE B-18','DD- MON-RR'),t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '15-SEP-17 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('08-F EB-18','DD -MON-RR'), null,to_da te('08-FEB -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1613 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (513, 209,6,8,6, null,10241 ,'Veteran' 's Affairs ','12115', '10241',nu ll,'PLAZA MED CTR OF FW','1000 000004','1 11111121', 'Burgess', 'Meyers',' 000100032' ,'10000241 ','10241', '211','201 6111610016 16','20161 1161001616 ',to_date( '13-FEB-18 ','DD-MON- RR'),to_da te('14-SEP -17','DD-M ON-RR'),to _date('15- SEP-17','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('08-FEB-1 8','DD-MON -RR'),null ,to_date(' 08-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1614 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (514, 210,6,8,6, null,10241 ,'Veteran' 's Affairs ','12115', '10241',nu ll,'PLAZA MED CTR OF FW','1000 000004','1 11111121', 'Burgess', 'Meyers',' 000100032' ,'10000241 ','10241', '211','201 6111610016 16','20161 1161001616 ',to_date( '13-FEB-18 ','DD-MON- RR'),to_da te('14-SEP -17','DD-M ON-RR'),to _date('15- SEP-17','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('08-FEB-1 8','DD-MON -RR'),null ,to_date(' 08-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1615 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (515, 211,6,5,4, null,10241 ,'Veteran' 's Affairs ','12115', '10241',nu ll,'PLAZA MED CTR OF FW','1000 000004','1 11111121', 'Burgess', 'Meyers',' 000100032' ,'10000241 ','10241', '211','201 6111610016 16','20161 1161001616 ',to_date( '13-FEB-18 ','DD-MON- RR'),to_da te('14-SEP -17','DD-M ON-RR'),to _date('15- SEP-17','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('08-FEB-1 8','DD-MON -RR'),null ,to_date(' 08-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1616 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (516, 212,6,5,4, null,10241 ,'Veteran' 's Affairs ','12115', '10241',nu ll,'PLAZA MED CTR OF FW','1000 000004','1 11111121', 'Burgess', 'Meyers',' 000100032' ,'10000241 ','10241', '211','201 6111610016 16','20161 1161001616 ',to_date( '13-FEB-18 ','DD-MON- RR'),to_da te('14-SEP -17','DD-M ON-RR'),to _date('15- SEP-17','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('08-FEB-1 8','DD-MON -RR'),null ,to_date(' 08-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1617 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (517, 213,1,8,1, null,10242 ,'Veteran' 's Affairs ','12115', '10242',nu ll,'UNIV O F SOUTH AL ABAMA HEA' ,'10000000 03','11111 1121','Dun n','Deirdr e','000100 010','1000 0242','102 42','231', 'EI0518172 42879014-0 9','EI0518 1724287901 4-09',to_d ate('13-FE B-18','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 08-FEB-18' ,'DD-MON-R R'),null,t o_date('08 -FEB-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1618 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (518, 214,9,5,17 ,null,2006 1720400015 7,'Veteran ''s Affair s','84146' ,'10241',n ull,'MID O HIO EMERGE NCY SERVIC ','1386691 780','3116 03722','JA ME','CD',' 000000002' ,'11110000 223','2006 1720400015 7','211',' 2016111610 01616','20 1611161001 616',to_da te('13-FEB -18','DD-M ON-RR'),nu ll,null,'P ENDING','G ENERATED', to_date('0 8-FEB-18', 'DD-MON-RR '),null,to _date('08- FEB-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1619 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (519, 215,4,4,5, null,10245 ,'Veteran' 's Affairs ','12115', '10245',nu ll,'PLAZA MED CTR OF FW','1000 000008','1 11111118', 'Turner',' Patrick',' 000100031' ,'10000245 ','10245', '221','102 45','10245 ',to_date( '13-FEB-18 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('08-F EB-18','DD -MON-RR'), null,to_da te('08-FEB -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1620 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (520, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('08 -FEB-18',' DD-MON-RR' ),null,to_ date('08-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1621 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (521, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('08 -FEB-18',' DD-MON-RR' ),null,to_ date('08-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1622 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (522, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('08 -FEB-18',' DD-MON-RR' ),null,to_ date('08-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1623 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (523, 216,3,3,6, null,12345 ,'Payer na me','12345 ','info re ceiver',nu ll,'billin g provider Name','12 34567890', '123456',' last Name' ,'First Na me','12345 67','1234' ,'12345678 ','123',nu ll,null,to _date('01- FEB-18','D D-MON-RR') ,to_date(' 01-AUG-16' ,'DD-MON-R R'),to_dat e('01-SEP- 17','DD-MO N-RR'),'PE NDING','GE NERATED',t o_date('09 -FEB-18',' DD-MON-RR' ),null,to_ date('09-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1624 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (524, 216,3,3,6, null,12345 ,'Payer na me','12345 ','info re ceiver',nu ll,'billin g provider Name','12 34567890', '123456',' last Name' ,'First Na me','12345 67','1234' ,'12345678 ','123','1 11','222', to_date('0 1-FEB-18', 'DD-MON-RR '),null,nu ll,'PENDIN G','GENERA TED',to_da te('09-FEB -18','DD-M ON-RR'),nu ll,to_date ('09-FEB-1 8','DD-MON -RR'),null ,null,null ,null,null ,null); | |
| 1625 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (525, 217,2,2,2, null,10242 ,'Veteran' 's Affairs ','12115', '10242',nu ll,'UNIV O F SOUTH AL ABAMA HEA' ,'10000000 03','11111 1121','Dun n','Deirdr e','000100 010','1000 0242','102 42','231', 'EI0518172 42879014-0 9','EI0518 1724287901 4-09',to_d ate('14-FE B-18','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 09-FEB-18' ,'DD-MON-R R'),null,t o_date('09 -FEB-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1626 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (526, 218,1,2,3, null,11111 ,'Payer Na mes','1111 1','Inform ation Rece iver',null ,'Billing Provider N ame ','333 33','44444 ','Patient Last Name ','Patien t Last Nam e ','55555 ','12345', '22222','1 23','111', '222',to_d ate('25-FE B-18','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 09-FEB-18' ,'DD-MON-R R'),null,t o_date('09 -FEB-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1627 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (527, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('09-FE B-18','DD- MON-RR'),n ull,to_dat e('09-FEB- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1628 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (528, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('09 -FEB-18',' DD-MON-RR' ),null,to_ date('09-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1629 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (529, 217,10,5,5 ,null,2222 2,'payer n ame ','111 ','111',nu ll,'bill p rovider na me','111', '111','las t','first' ,'111','11 1','111',' 111','111' ,'111',to_ date('09-F EB-18','DD -MON-RR'), null,null, 'PENDING', 'GENERATED ',to_date( '09-FEB-18 ','DD-MON- RR'),null, to_date('0 9-FEB-18', 'DD-MON-RR '),null,nu ll,null,nu ll,null,nu ll); | |
| 1630 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (530, 217,10,5,5 ,null,2222 2,'payer n ame ','111 ','111',nu ll,'bill p rovider na me','111', '111','las t','first' ,'111','11 1','111',' 111','111' ,'111',to_ date('09-F EB-18','DD -MON-RR'), null,null, 'PENDING', 'GENERATED ',to_date( '09-FEB-18 ','DD-MON- RR'),null, to_date('0 9-FEB-18', 'DD-MON-RR '),null,nu ll,null,nu ll,null,nu ll); | |
| 1631 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (534, 219,7,8,6, null,10243 ,'Veteran' 's Affairs ','12115', '10243',nu ll,'UNIV O F WASHINGT ON PHYSICI ANS','1000 000003','1 11111121', 'Gomez','E stela','00 0100003',' 10000243', '10243','2 21','EI051 8172428790 14-08','EI 0518172428 79014-08', to_date('1 4-FEB-18', 'DD-MON-RR '),to_date ('13-SEP-1 7','DD-MON -RR'),to_d ate('15-SE P-17','DD- MON-RR'),' PENDING',' GENERATED' ,to_date(' 09-FEB-18' ,'DD-MON-R R'),null,t o_date('09 -FEB-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1632 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (535, 220,5,6,5, null,10243 ,'Veteran' 's Affairs ','12115', '10243',nu ll,'UNIV O F WASHINGT ON PHYSICI ANS','1000 000003','1 11111121', 'Gomez','E stela','00 0100003',' 10000243', '10243','2 21','EI051 8172428790 14-08','EI 0518172428 79014-08', to_date('1 4-FEB-18', 'DD-MON-RR '),to_date ('13-SEP-1 7','DD-MON -RR'),to_d ate('15-SE P-17','DD- MON-RR'),' PENDING',' GENERATED' ,to_date(' 09-FEB-18' ,'DD-MON-R R'),null,t o_date('09 -FEB-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1633 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (537, 221,4,4,7, null,10244 ,'Veteran' 's Affairs ','12115', '10244',nu ll,'SKAGIT RADIOLOGY INC','100 0000005',' 111111111' ,'Ortega', 'Michael', '000100091 ','1000024 4','10244' ,'221','EI 0518172428 79014-07', 'EI0518172 42879014-0 7',to_date ('14-FEB-1 8','DD-MON -RR'),to_d ate('13-SE P-17','DD- MON-RR'),t o_date('15 -SEP-17',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('09-FEB- 18','DD-MO N-RR'),nul l,to_date( '09-FEB-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1634 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (538, 217,4,4,7, null,10244 ,'Veteran' 's Affairs ','12115', '10244',nu ll,'SKAGIT RADIOLOGY INC','100 0000005',' 111111111' ,'Ortega', 'Michael', '000100091 ','1000024 4','10244' ,'221','EI 0518172428 79014-07', 'EI0518172 42879014-0 7',to_date ('14-FEB-1 8','DD-MON -RR'),to_d ate('13-SE P-17','DD- MON-RR'),t o_date('15 -SEP-17',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('09-FEB- 18','DD-MO N-RR'),nul l,to_date( '09-FEB-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1635 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (539, 217,4,4,7, null,10244 ,'Veteran' 's Affairs ','12115', '10244',nu ll,'SKAGIT RADIOLOGY INC','100 0000005',' 111111111' ,'Ortega', 'Michael', '000100091 ','1000024 4','10244' ,'221','EI 0518172428 79014-07', 'EI0518172 42879014-0 7',to_date ('14-FEB-1 8','DD-MON -RR'),to_d ate('13-SE P-17','DD- MON-RR'),t o_date('15 -SEP-17',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('09-FEB- 18','DD-MO N-RR'),nul l,to_date( '09-FEB-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1636 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (540, 222,4,4,7, null,10244 ,'Veteran' 's Affairs ','12115', '10244',nu ll,'SKAGIT RADIOLOGY INC','100 0000005',' 111111111' ,'Ortega', 'Michael', '000100091 ','1000024 4','10244' ,'221','EI 0518172428 79014-07', 'EI0518172 42879014-0 7',to_date ('14-FEB-1 8','DD-MON -RR'),to_d ate('13-SE P-17','DD- MON-RR'),t o_date('15 -SEP-17',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('09-FEB- 18','DD-MO N-RR'),nul l,to_date( '09-FEB-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1637 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (541, 164,4,4,7, null,10244 ,'Veteran' 's Affairs ','12115', '10244',nu ll,'SKAGIT RADIOLOGY INC','100 0000005',' 111111111' ,'Ortega', 'Michael', '000100091 ','1000024 4','10244' ,'221','EI 0518172428 79014-07', 'EI0518172 42879014-0 7',to_date ('14-FEB-1 8','DD-MON -RR'),to_d ate('13-SE P-17','DD- MON-RR'),t o_date('15 -SEP-17',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('09-FEB- 18','DD-MO N-RR'),nul l,to_date( '09-FEB-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1638 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (547, 113,1,8,11 ,null,1024 1,'Veteran ''s Affair s','12115' ,'10241',n ull,'PLAZA MED CTR O F FW','100 0000004',' 111111121' ,'Burgess' ,'Meyers', '000100032 ','1000024 1','10241' ,'211','20 1611161001 616','2016 1116100161 6',to_date ('14-FEB-1 8','DD-MON -RR'),to_d ate('14-SE P-17','DD- MON-RR'),t o_date('15 -SEP-17',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('09-FEB- 18','DD-MO N-RR'),nul l,to_date( '09-FEB-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1639 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (548, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('09 -FEB-18',' DD-MON-RR' ),null,to_ date('09-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1640 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (550, 1,1,1,2,nu ll,10084,' payerName' ,'payerId' ,'infoRece iver',null ,'provider Info','pro videNpi',n ull,'patie ntLastname ','firstNa me','inden tifier','1 23','234', 'billType' ,'clearing House','12 3',to_date ('12-DEC-1 7','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('09- FEB-18','D D-MON-RR') ,null,to_d ate('09-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1641 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (551, 1,4,4,1,nu ll,10087,' DragonPaye rName','12 115','info rmationRec eiver',nul l,'DragonP roviderInf ormation', '123456789 ',null,'Ja han','Kaws ar','inden tifier','5 19','222', 'billType' ,'clearing House','12 3',to_date ('12-DEC-1 7','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('09- FEB-18','D D-MON-RR') ,null,to_d ate('09-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1642 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (552, 1,4,4,1,nu ll,10087,' DragonPaye rName','12 115','info rmationRec eiver',nul l,'DragonP roviderInf ormation', '123456789 ',null,'Ja han','Kaws ar','inden tifier','5 19','222', 'billType' ,'clearing House','12 3',to_date ('12-DEC-1 7','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('09- FEB-18','D D-MON-RR') ,null,to_d ate('09-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1643 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (553, 1,4,4,1,nu ll,10087,' DragonPaye rName','12 115','info rmationRec eiver',nul l,'DragonP roviderInf ormation', '123456789 ',null,'Ja han','Kaws ar','inden tifier','5 19','222', 'billType' ,'clearing House','12 3',to_date ('12-DEC-1 7','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('09- FEB-18','D D-MON-RR') ,null,to_d ate('09-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1644 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (554, 1,4,4,1,nu ll,10087,' DragonPaye rName','12 115','info rmationRec eiver',nul l,'DragonP roviderInf ormation', '123456789 ',null,'Ja han','Kaws ar','inden tifier','5 19','222', 'billType' ,'clearing House','12 3',to_date ('12-DEC-1 7','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('09- FEB-18','D D-MON-RR') ,null,to_d ate('09-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1645 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (555, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('09 -FEB-18',' DD-MON-RR' ),null,to_ date('09-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1646 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (556, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('09 -FEB-18',' DD-MON-RR' ),null,to_ date('09-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1647 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (557, 217,1,1,1, null,22222 ,'1','1',' 1',null,'1 ','1','1', '1','1','1 ','1','1', '1','1','1 ',to_date( '09-FEB-18 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('09-F EB-18','DD -MON-RR'), null,to_da te('09-FEB -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1648 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (558, 217,1,1,1, null,33333 ,'1','1',' 1',null,'1 ','1','1', '1','1','1 ','1','1', '1','1','1 ',to_date( '14-FEB-18 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('09-F EB-18','DD -MON-RR'), null,to_da te('09-FEB -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1649 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (559, 223,4,4,5, null,10245 ,'Veteran' 's Affairs ','12115', '10245',nu ll,'PLAZA MED CTR OF FW','1000 000008','1 11111118', 'Turner',' Patrick',' 000100031' ,'10000245 ','10245', '221','102 45','10245 ',to_date( '14-FEB-18 ','DD-MON- RR'),to_da te('14-SEP -17','DD-M ON-RR'),to _date('15- SEP-17','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('09-FEB-1 8','DD-MON -RR'),null ,to_date(' 09-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1650 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (560, 1,4,4,1,nu ll,10087,' DragonPaye rName','12 115','info rmationRec eiver',nul l,'DragonP roviderInf ormation', '123456789 ',null,'Ja han','Kaws ar','inden tifier','5 19','222', 'billType' ,'clearing House','12 3',to_date ('12-DEC-1 7','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('09- FEB-18','D D-MON-RR') ,null,to_d ate('09-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1651 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (561, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('09 -FEB-18',' DD-MON-RR' ),null,to_ date('09-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1652 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (562, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('09 -FEB-18',' DD-MON-RR' ),null,to_ date('09-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1653 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (563, 217,3,2,1, null,10241 ,'Veteran' 's Affairs ','12115', '10241',nu ll,'PLAZA MED CTR OF FW','1000 000004','1 11111121', 'Burgess', 'Meyers',' 000100032' ,'10000241 ','10241', '211','201 6111610016 16','20161 1161001616 ',to_date( '28-FEB-18 ','DD-MON- RR'),null, null,'Erro r','GENERA TED',to_da te('09-FEB -18','DD-M ON-RR'),nu ll,to_date ('09-FEB-1 8','DD-MON -RR'),null ,null,null ,null,null ,null); | |
| 1654 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (564, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('09 -FEB-18',' DD-MON-RR' ),null,to_ date('09-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1655 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (565, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('09 -FEB-18',' DD-MON-RR' ),null,to_ date('09-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1656 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (566, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('09 -FEB-18',' DD-MON-RR' ),null,to_ date('09-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1657 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (567, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('09 -FEB-18',' DD-MON-RR' ),null,to_ date('09-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1658 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (568, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('09 -FEB-18',' DD-MON-RR' ),null,to_ date('09-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1659 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (569, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('09 -FEB-18',' DD-MON-RR' ),null,to_ date('09-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1660 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (570, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('09 -FEB-18',' DD-MON-RR' ),null,to_ date('09-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1661 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (571, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('09 -FEB-18',' DD-MON-RR' ),null,to_ date('09-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1662 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (572, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('09 -FEB-18',' DD-MON-RR' ),null,to_ date('09-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1663 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (573, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('10 -FEB-18',' DD-MON-RR' ),null,to_ date('10-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1664 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (574, 224,4,4,6, null,10245 ,'Veteran' 's Affairs ','12115', '10245',nu ll,'PLAZA MED CTR OF FW','1000 000008','1 11111118', 'Turner',' Patrick',' 000100031' ,'10000245 ','10245', '221','102 45','10245 ',to_date( '16-FEB-18 ','DD-MON- RR'),to_da te('14-SEP -17','DD-M ON-RR'),to _date('15- SEP-17','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('11-FEB-1 8','DD-MON -RR'),null ,to_date(' 11-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1665 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (575, 225,3,4,6, null,10241 ,'Veteran' 's Affairs ','12115', '10241',nu ll,'PLAZA MED CTR OF FW','1000 000004','1 11111121', 'Burgess', 'Meyers',' 000100032' ,'10000241 ','10241', '211','201 6111610016 16','20161 1161001616 ',to_date( '16-FEB-18 ','DD-MON- RR'),to_da te('14-SEP -17','DD-M ON-RR'),to _date('15- SEP-17','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('11-FEB-1 8','DD-MON -RR'),null ,to_date(' 11-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1666 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (576, 226,6,5,4, null,10243 ,'Veteran' 's Affairs ','12115', '10243',nu ll,'UNIV O F WASHINGT ON PHYSICI ANS','1000 000003','1 11111121', 'Gomez','E stela','00 0100003',' 10000243', '10243','2 21','EI051 8172428790 14-08','EI 0518172428 79014-08', to_date('1 6-FEB-18', 'DD-MON-RR '),to_date ('13-SEP-1 7','DD-MON -RR'),to_d ate('15-SE P-17','DD- MON-RR'),' PENDING',' GENERATED' ,to_date(' 11-FEB-18' ,'DD-MON-R R'),null,t o_date('11 -FEB-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1667 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (577, 227,1,1,1, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('16-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('11- FEB-18','D D-MON-RR') ,null,to_d ate('11-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1668 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (578, 228,1,2,3, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('17-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('12- FEB-18','D D-MON-RR') ,null,to_d ate('12-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1669 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (579, 229,17,5,2 ,null,1000 0,'Veteran ''s Affair s','12115' ,'10000111 1',null,'R IVERSIDE M ETH HOS',' 1000000004 ','1111111 13','Dunca n','Ester' ,'00010000 6','100000 00','10000 ','231','1 0000','100 00',to_dat e('17-FEB- 18','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('12 -FEB-18',' DD-MON-RR' ),null,to_ date('12-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1670 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (580, 230,1,1,1, null,10000 ,'fdghfdhd ','10000', 'xxxxxxxxx xxxxxx',nu ll,'Njlkjk ljlkjlkjlk jl','89898 989',null, 'last','xx xxxxxxxxxx ','10000', '10000','1 9999','xxx xxxxxxxx', '999999999 9','999999 ',to_date( '12-FEB-19 ','DD-MON- RR'),to_da te('01-JAN -20','DD-M ON-RR'),to _date('01- JAN-20','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('12-FEB-1 8','DD-MON -RR'),null ,to_date(' 12-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1671 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (581, 231,4,4,6, null,10242 ,'Veteran' 's Affairs ','12115', '10242',nu ll,'UNIV O F SOUTH AL ABAMA HEA' ,'10000000 03','11111 1121','Dun n','Deirdr e','000100 010','1000 0242','102 42','231', 'EI0518172 42879014-0 9','EI0518 1724287901 4-09',to_d ate('17-FE B-18','DD- MON-RR'),t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '15-SEP-17 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('12-F EB-18','DD -MON-RR'), null,to_da te('12-FEB -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1672 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (582, 232,16,1,1 4,null,100 00,'xxxxxx x','123456 ','xxxxxxx ',null,'xx xxxxx','12 3456','123 456','xxxx xxx','xxxx xxx','1234 56','12345 6','123456 ','xxxxxxx ','123456' ,null,to_d ate('12-FE B-18','DD- MON-RR'),t o_date('01 -FEB-18',' DD-MON-RR' ),to_date( '12-FEB-18 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('12-F EB-18','DD -MON-RR'), null,to_da te('12-FEB -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1673 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (583, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('12 -FEB-18',' DD-MON-RR' ),null,to_ date('12-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1674 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (584, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('12 -FEB-18',' DD-MON-RR' ),null,to_ date('12-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1675 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (585, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('12 -FEB-18',' DD-MON-RR' ),null,to_ date('12-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1676 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (586, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('12 -FEB-18',' DD-MON-RR' ),null,to_ date('12-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1677 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (587, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('12 -FEB-18',' DD-MON-RR' ),null,to_ date('12-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1678 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (588, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('12 -FEB-18',' DD-MON-RR' ),null,to_ date('12-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1679 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (589, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('12 -FEB-18',' DD-MON-RR' ),null,to_ date('12-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1680 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (590, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('12 -FEB-18',' DD-MON-RR' ),null,to_ date('12-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1681 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (591, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('12 -FEB-18',' DD-MON-RR' ),null,to_ date('12-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1682 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (592, 233,1,2,1, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('17-FEB-1 8','DD-MON -RR'),to_d ate('10-SE P-17','DD- MON-RR'),t o_date('16 -SEP-17',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('12-FEB- 18','DD-MO N-RR'),nul l,to_date( '12-FEB-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1683 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (593, 234,2,1,1, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('12-FEB-2 2','DD-MON -RR'),to_d ate('10-SE P-17','DD- MON-RR'),t o_date('16 -SEP-17',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('12-FEB- 18','DD-MO N-RR'),nul l,to_date( '12-FEB-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1684 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (594, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('12 -FEB-18',' DD-MON-RR' ),null,to_ date('12-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1685 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (595, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('12 -FEB-18',' DD-MON-RR' ),null,to_ date('12-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1686 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (596, 235,3,2,1, null,10244 ,'Veteran' 's Affairs ','12115', '10244',nu ll,'SKAGIT RADIOLOGY INC','100 0000005',' 111111111' ,'Ortega', 'Michael', '000100091 ','1000024 4','10244' ,'221','EI 0518172428 79014-07', 'EI0518172 42879014-0 7',to_date ('25-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('12- FEB-18','D D-MON-RR') ,null,to_d ate('12-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1687 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (597, 236,14,7,1 4,null,102 42,'Vetera n''s Affai rs','12115 ','10242', null,'UNIV OF SOUTH ALABAMA HE A','100000 0003','111 111121','D unn','Deir dre','0001 00010','10 000242','1 0242','231 ','EI05181 7242879014 -09','EI05 1817242879 014-09',to _date('17- FEB-18','D D-MON-RR') ,null,null ,'PENDING' ,'GENERATE D',to_date ('12-FEB-1 8','DD-MON -RR'),null ,to_date(' 12-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1688 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (598, 235,1,1,1, null,22222 ,'payer na me','123', '555',null ,'billing provider n ame','111' ,'222','la st name',' first name ','333','4 44','22222 ','777','8 88','000', to_date('2 8-FEB-18', 'DD-MON-RR '),null,nu ll,'PENDIN G','GENERA TED',to_da te('12-FEB -18','DD-M ON-RR'),nu ll,to_date ('12-FEB-1 8','DD-MON -RR'),null ,null,null ,null,null ,null); | |
| 1689 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (599, 235,17,8,8 ,null,1234 5,'1','2', '11',null, '4','5','6 ','7','8', '9','10',' 3','12','1 3','14',to _date('01- MAR-18','D D-MON-RR') ,null,null ,'PENDING' ,'GENERATE D',to_date ('12-FEB-1 8','DD-MON -RR'),null ,to_date(' 12-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1690 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (600, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN', '100000000 6','111111 119','Hold en','Ines' ,'00010009 0','100002 40','10240 ','211','0 5181724287 9014','051 8172428790 14',to_dat e('21-JAN- 18','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('12 -FEB-18',' DD-MON-RR' ),null,to_ date('12-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1691 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (601, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN', '100000000 6','111111 119','Hold en','Ines' ,'00010009 0','100002 40','10240 ','211','0 5181724287 9014','051 8172428790 14',to_dat e('21-JAN- 18','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('12 -FEB-18',' DD-MON-RR' ),null,to_ date('12-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1692 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (602, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN', '100000000 6','111111 119','Hold en','Ines' ,'00010009 0','100002 40','10240 ','211','0 5181724287 9014','051 8172428790 14',to_dat e('21-JAN- 18','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('12 -FEB-18',' DD-MON-RR' ),null,to_ date('12-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1693 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (603, 237,1,1,2, null,10000 ,'XXXXXXX' ,'12345',n ull,null,' 12345','12 345','1234 5','XXXXXX X','XXXXXX X','12345' ,'12345',' 12345','XX XXXXX','12 345',null, to_date('1 2-FEB-18', 'DD-MON-RR '),null,nu ll,'PENDIN G','GENERA TED',to_da te('12-FEB -18','DD-M ON-RR'),nu ll,to_date ('12-FEB-1 8','DD-MON -RR'),null ,null,null ,null,null ,null); | |
| 1694 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (604, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('12 -FEB-18',' DD-MON-RR' ),null,to_ date('12-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1695 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (605, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('12 -FEB-18',' DD-MON-RR' ),null,to_ date('12-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1696 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (606, 238,4,1,6, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('12-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('12- FEB-18','D D-MON-RR') ,null,to_d ate('12-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1697 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (607, 239,5,5,7, null,10241 ,'Veteran' 's Affairs ','12115', '10241',nu ll,'PLAZA MED CTR OF FW','1000 000004','1 11111121', 'Burgess', 'Meyers',' 000100032' ,'10000241 ','10241', '211','201 6111610016 16','20161 1161001616 ',to_date( '25-FEB-18 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('12-F EB-18','DD -MON-RR'), null,to_da te('12-FEB -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1698 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (609, 239,6,4,7, null,10244 ,'Veteran' 's Affairs ','12115', '10244',nu ll,'SKAGIT RADIOLOGY INC','100 0000005',' 111111111' ,'Ortega', 'Michael', '000100091 ','1000024 4','10244' ,'221','EI 0518172428 79014-07', 'EI0518172 42879014-0 7',to_date ('01-MAR-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('12- FEB-18','D D-MON-RR') ,null,to_d ate('12-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1699 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (610, 240,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN', '100000000 6','111111 119','Hold en','Ines' ,'00010009 0','100002 40','10240 ','211','0 5181724287 9014','051 8172428790 14',to_dat e('21-JAN- 18','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('12 -FEB-18',' DD-MON-RR' ),null,to_ date('12-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1700 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (611, 239,4,4,5, null,10242 ,'Veteran' 's Affairs ','12115', '10242',nu ll,'UNIV O F SOUTH AL ABAMA HEA' ,'10000000 03','11111 1121','Dun n','Deirdr e','000100 010','1000 0242','102 42','231', 'EI0518172 42879014-0 9','EI0518 1724287901 4-09',to_d ate('15-MA Y-19','DD- MON-RR'),n ull,null,' Manually C losed','GE NERATED',t o_date('12 -FEB-18',' DD-MON-RR' ),null,to_ date('14-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1701 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (612, 239,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN', '100000000 6','111111 119','Hold en','Ines' ,'00010009 0','100002 40','10240 ','211','0 5181724287 9014','051 8172428790 14',to_dat e('21-JAN- 18','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('12 -FEB-18',' DD-MON-RR' ),null,to_ date('12-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1702 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (613, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('12 -FEB-18',' DD-MON-RR' ),null,to_ date('12-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1703 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (614, 241,1,1,1, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('17-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('12- FEB-18','D D-MON-RR') ,null,to_d ate('12-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1704 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (615, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('12 -FEB-18',' DD-MON-RR' ),null,to_ date('12-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1705 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (616, 238,4,1,6, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('28-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('12- FEB-18','D D-MON-RR') ,null,to_d ate('12-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1706 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (617, 242,2,3,4, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('01-JAN-2 0','DD-MON -RR'),to_d ate('10-SE P-17','DD- MON-RR'),t o_date('16 -SEP-17',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('12-FEB- 18','DD-MO N-RR'),nul l,to_date( '12-FEB-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1707 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (618, 239,1,1,1, null,11111 ,'1','1',' 1',null,'1 ','1','1', '1','1','1 ','1','1', '1','1','1 ',to_date( '27-FEB-17 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('12-F EB-18','DD -MON-RR'), null,to_da te('12-FEB -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1708 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (619, 239,1,1,1, null,11111 ,'1','1',' 1',null,'1 ','1','1', '1','1','1 ','1','1', '1','1','1 ',to_date( '27-OCT-17 ','DD-MON- RR'),null, null,'Erro r','GENERA TED',to_da te('12-FEB -18','DD-M ON-RR'),nu ll,to_date ('12-FEB-1 8','DD-MON -RR'),null ,null,null ,null,null ,null); | |
| 1709 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (620, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('13 -FEB-18',' DD-MON-RR' ),null,to_ date('13-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1710 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (402, 1,4,4,1,nu ll,10095,' Veteran''s Affairs', '84146','i nfoReceive r',null,'R IVERSIDE M ETH HOS',' 1000000004 ','1111111 13','Dunca n','Ester' ,'00010000 6','100000 02','10000 ','231','1 0000','123 456',to_da te('12-DEC -17','DD-M ON-RR'),nu ll,null,'P ENDING','G ENERATED', to_date('2 9-JAN-18', 'DD-MON-RR '),null,to _date('29- JAN-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1711 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (621, 243,1,1,1, null,22222 22222,'Pay erName','1 111111111' ,'Informat ionReceive r',null,'B illingProv iderName', '333333333 3','444444 4444','Pat ientLastNa me','Patie ntFirstNam e','555555 5555','666 6666666',' 2222222222 ','BillTyp e','777777 7777','888 8888888',t o_date('19 -FEB-17',' DD-MON-RR' ),null,nul l,'Complet e','GENERA TED',to_da te('13-FEB -18','DD-M ON-RR'),nu ll,to_date ('13-FEB-1 8','DD-MON -RR'),null ,null,null ,null,null ,null); | |
| 1712 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (622, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('13 -FEB-18',' DD-MON-RR' ),null,to_ date('13-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1713 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (623, 244,1,1,1, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('01-APR-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('13- FEB-18','D D-MON-RR') ,null,to_d ate('08-MA R-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1714 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (624, 245,2,1,1, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('13-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('13- FEB-18','D D-MON-RR') ,null,to_d ate('13-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1715 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (625, 246,2,1,1, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('13-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('13- FEB-18','D D-MON-RR') ,null,to_d ate('13-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1716 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (626, 247,2,1,1, null,10001 ,'Veteran' 's Affairs ','12115', null,null, 'ROCK VALL EY PHYSICA L THERAPY' ,'10000000 03','11111 1116','Cha mbers','At kins','000 100082','1 0000001',' 10001',nul l,null,nul l,to_date( '13-FEB-18 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('13-F EB-18','DD -MON-RR'), null,to_da te('13-FEB -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1717 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (627, 11,1,1,1,n ull,222222 2222,'Paye rName','11 11111111', 'Informati onReceiver ',null,'Bi llingProvi derName',' 3333333333 ','4444444 444','Pati entLastNam e','Patien tFirstName ','5555555 555','6666 666666','2 222222222' ,'BillType ','7777777 777','8888 888888',to _date('16- FEB-18','D D-MON-RR') ,null,null ,'PENDING' ,'GENERATE D',to_date ('14-FEB-1 8','DD-MON -RR'),null ,to_date(' 14-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1718 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (628, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('14 -FEB-18',' DD-MON-RR' ),null,to_ date('14-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1719 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (629, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('14 -FEB-18',' DD-MON-RR' ),null,to_ date('14-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1720 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (630, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('14 -FEB-18',' DD-MON-RR' ),null,to_ date('14-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1721 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (631, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('14 -FEB-18',' DD-MON-RR' ),null,to_ date('14-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1722 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (632, 248,1,1,1, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('14-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('14- FEB-18','D D-MON-RR') ,null,to_d ate('14-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1723 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (633, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('14 -FEB-18',' DD-MON-RR' ),null,to_ date('14-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1724 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (634, 249,1,1,1, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('14-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('14- FEB-18','D D-MON-RR') ,null,to_d ate('14-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1725 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (635, 250,1,1,1, null,10000 ,'VA','123 45','info' ,null,'VA' ,null,'123 45','last name','VA first name ','12345', '12345','1 0000','bil l type','1 2345','123 45',to_dat e('14-FEB- 20','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('14 -FEB-18',' DD-MON-RR' ),null,to_ date('14-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1726 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (636, 251,1,1,1, null,10000 ,'VA','123 45','info' ,null,'VA' ,null,'123 45','last name','VA first name ','12345', '12345','1 0000','bil l type','1 2345','123 45',to_dat e('14-FEB- 20','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('14 -FEB-18',' DD-MON-RR' ),null,to_ date('14-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1727 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (637, 252,1,1,1, null,10000 ,'VA','123 45','info' ,null,'VA' ,null,'123 45','last name','VA first name ','12345', '12345','1 0000','bil l type','1 2345','123 45',to_dat e('14-FEB- 20','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('14 -FEB-18',' DD-MON-RR' ),null,to_ date('14-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1728 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (638, 253,1,1,1, null,10000 ,'VA','123 45','info' ,null,'VA' ,null,'123 45','last name','VA first name ','12345', '12345','1 0000','bil l type','1 2345','123 45',to_dat e('14-FEB- 20','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('14 -FEB-18',' DD-MON-RR' ),null,to_ date('14-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1729 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (639, 254,1,1,1, null,10000 ,'VA','123 45','info' ,null,'VA' ,null,'123 45','last name','VA first name ','12345', '12345','1 0000','bil l type','1 2345','123 45',to_dat e('14-FEB- 20','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('14 -FEB-18',' DD-MON-RR' ),null,to_ date('14-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1730 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (640, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('14 -FEB-18',' DD-MON-RR' ),null,to_ date('14-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1731 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (641, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('14 -FEB-18',' DD-MON-RR' ),null,to_ date('14-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1732 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (642, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('14 -FEB-18',' DD-MON-RR' ),null,to_ date('14-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1733 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (643, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('14 -FEB-18',' DD-MON-RR' ),null,to_ date('14-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1734 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (644, 255,1,1,1, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('16-FEB-1 7','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('15- FEB-18','D D-MON-RR') ,null,to_d ate('15-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1735 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (645, 255,1,1,1, null,85951 ,'Veteran' 's Affairs ','12115', '162912974 7',null,'M ARY HITCHC OCK MEMORI AL HOSPITA L','102309 2053','020 222140','G GGGGG','XX XXXX','037 56','H6599 465803','8 5951','137 ','0518172 42879014', '50218131 6',to_date ('16-FEB-1 7','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('15- FEB-18','D D-MON-RR') ,null,to_d ate('15-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1736 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (646, 255,1,1,1, null,20061 7203000156 ,'Veteran' 's Affairs ','84146', '10240',nu ll,'LMH HE ALTH PROFE SSIONALS', '150808655 4','311425 530','JACK ','CC','00 0000001',' 1111000022 3','200617 203000156' ,'211','05 1817242871 234','0518 1724287901 4',to_date ('16-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('15- FEB-18','D D-MON-RR') ,null,to_d ate('15-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1737 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (647, 256,1,1,1, null,45632 1,'va','45 6321','inf o',null,'v a','456321 ','456321' ,'va','va' ,'456321', '456321',' 456321','t ype','4563 21','45632 1',to_date ('15-FEB-1 8','DD-MON -RR'),to_d ate('01-FE B-15','DD- MON-RR'),t o_date('01 -FEB-17',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('15-FEB- 18','DD-MO N-RR'),nul l,to_date( '15-FEB-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1738 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (648, 257,1,1,1, null,45632 1,'va','45 6321','inf o',null,'v a','456321 ','456321' ,'va','va' ,'456321', '456321',' 456321','t ype','4563 21','45632 1',to_date ('15-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('15- FEB-18','D D-MON-RR') ,null,to_d ate('15-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1739 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (649, 258,1,1,4, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('15-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('15- FEB-18','D D-MON-RR') ,null,to_d ate('15-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1740 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (650, 259,1,1,4, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('15-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('15- FEB-18','D D-MON-RR') ,null,to_d ate('15-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1741 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (651, 260,1,1,1, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('01-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('15- FEB-18','D D-MON-RR') ,null,to_d ate('15-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1742 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (652, 261,1,1,1, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('15-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('15- FEB-18','D D-MON-RR') ,null,to_d ate('15-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1743 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (653, 262,1,1,1, null,10310 ,'Veterans Affair''s ','12115', '765890342 ',null,'St Judes Hos pital','73 4562198',' 734562189' ,'Creek',' Troy','654 987','4563 28971','10 310','211' ,'76589034 1','765890 344',to_da te('16-FEB -18','DD-M ON-RR'),to _date('15- FEB-18','D D-MON-RR') ,to_date(' 16-FEB-18' ,'DD-MON-R R'),'PENDI NG','GENER ATED',to_d ate('16-FE B-18','DD- MON-RR'),n ull,to_dat e('16-FEB- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1744 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (654, 263,1,1,1, null,10310 ,'Veterans Affair''s ','12115', '765890341 ',null,'St Judes Hos pital','73 4562196',' 734562180' ,'Creek',' Jane','654 982','4563 28973','10 310','211' ,'76589034 8','765890 345',to_da te('16-FEB -18','DD-M ON-RR'),nu ll,null,'P ENDING','G ENERATED', to_date('1 6-FEB-18', 'DD-MON-RR '),null,to _date('16- FEB-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1745 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (655, 264,1,1,1, null,10311 ,'Veterans Affair''s ','12115', '765890341 ',null,'St Judes Hos pital','73 4562197',' 734562181' ,'Creek',' Dana','654 982','4563 28973','10 311','211' ,'76589034 8','765890 345',to_da te('16-FEB -18','DD-M ON-RR'),nu ll,null,'P ENDING','G ENERATED', to_date('1 6-FEB-18', 'DD-MON-RR '),null,to _date('16- FEB-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1746 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (656, 265,1,1,1, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('20-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('16- FEB-18','D D-MON-RR') ,null,to_d ate('16-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1747 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (659, 265,16,8,1 8,null,200 6172700001 58,'Vetera n''s Affai rs','84146 ','10242', null,'HEDG ES CLINIC SERVICE CO RP','13261 11600','36 2748681',' JOHN','GA' ,'00000000 3','111100 00225','20 0617270000 158','231' ,'EI051817 242879014- 09','EI051 8172428790 14-09',to_ date('20-F EB-18','DD -MON-RR'), null,null, 'PENDING', 'GENERATED ',to_date( '16-FEB-18 ','DD-MON- RR'),null, to_date('1 6-FEB-18', 'DD-MON-RR '),null,nu ll,null,nu ll,null,nu ll); | |
| 1748 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (660, 266,2,2,2, null,85951 ,'Veteran' 's Affairs ','12115', '162912974 7',null,'M ARY HITCHC OCK MEMORI AL HOSPITA L','102309 2053','020 222140','G GGGGG','XX XXXX','037 56','H6599 465803','8 5951','137 ','0518172 42879014', '50218131 6',to_date ('25-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('16- FEB-18','D D-MON-RR') ,null,to_d ate('16-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1749 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (661, 267,1,1,1, null,10245 ,'Veteran' 's Affairs ','12115', '10245',nu ll,'PLAZA MED CTR OF FW','1000 000008','1 11111118', 'Turner',' Patrick',' 000100031' ,'10000245 ','10245', '221','102 45','10245 ',to_date( '16-FEB-18 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('16-F EB-18','DD -MON-RR'), null,to_da te('16-FEB -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1750 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (662, 265,9,3,3, null,85951 ,'Veteran' 's Affairs ','12115', '162912974 7',null,'M ARY HITCHC OCK MEMORI AL HOSPITA L','102309 2053','020 222140','G GGGGG','XX XXXX','037 56','H6599 465803','8 5951','137 ','0518172 42879014', '50218131 6',to_date ('25-FEB-1 8','DD-MON -RR'),to_d ate('25-OC T-16','DD- MON-RR'),t o_date('25 -OCT-16',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('16-FEB- 18','DD-MO N-RR'),nul l,to_date( '16-FEB-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1751 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (664, 265,10,4,9 ,null,8595 1,'Veteran ''s Affair s','12115' ,'16291297 47',null,' MARY HITCH COCK MEMOR IAL HOSPIT AL','10230 92053','02 0222140',' GGGGGG','X XXXXX','03 756','H659 9465803',' 85951','13 7','051817 242879014' ,'50218131 6',to_dat e('25-FEB- 18','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('16 -FEB-18',' DD-MON-RR' ),null,to_ date('16-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1752 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (665, 268,1,1,3, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('20-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('16- FEB-18','D D-MON-RR') ,null,to_d ate('16-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1753 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (666, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('16 -FEB-18',' DD-MON-RR' ),null,to_ date('16-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1754 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (670, 272,1,1,1, null,12345 ,'va','123 45','Infor mation Rec eiver',nul l,'va','12 345','1234 5','va','v a','12345' ,'12345',' 12345','ty pe','12345 ','12345', to_date('1 6-FEB-18', 'DD-MON-RR '),to_date ('01-JAN-1 6','DD-MON -RR'),to_d ate('01-JA N-18','DD- MON-RR'),' PENDING',' GENERATED' ,to_date(' 16-FEB-18' ,'DD-MON-R R'),null,t o_date('16 -FEB-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1755 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (671, 273,3,2,2, null,10312 ,'Veterans Affairs', '12115','1 22333',nul l,'Biller' ,'12312312 3','321321 321','Pati ent','Joe' ,'112233', '123','103 12','211', '22223','3 3332',to_d ate('28-FE B-18','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 16-FEB-18' ,'DD-MON-R R'),null,t o_date('16 -FEB-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1756 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (672, 274,3,2,2, null,10312 ,'Veterans Affairs', '12115','1 22333',nul l,'Biller' ,'12312312 3','321321 321','Pati ent','Joe' ,'112233', '123','103 12','211', '22223','3 3332',to_d ate('28-FE B-18','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 16-FEB-18' ,'DD-MON-R R'),null,t o_date('16 -FEB-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1757 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (673, 275,1,1,1, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('16-FEB-1 8','DD-MON -RR'),to_d ate('10-SE P-17','DD- MON-RR'),t o_date('16 -SEP-17',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('16-FEB- 18','DD-MO N-RR'),nul l,to_date( '16-FEB-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1758 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (674, 276,1,1,1, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('16-FEB-1 8','DD-MON -RR'),to_d ate('10-SE P-17','DD- MON-RR'),t o_date('16 -SEP-17',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('16-FEB- 18','DD-MO N-RR'),nul l,to_date( '16-FEB-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1759 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (675, 277,1,1,1, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('16-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('16- FEB-18','D D-MON-RR') ,null,to_d ate('16-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1760 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (676, 278,1,1,1, null,12345 ,'name','1 2345','tes t',null,'n ame','1234 5','12345' ,'name','n ame','1234 5','12345' ,'12345',' 12345','12 345','1234 5',to_date ('01-FEB-1 8','DD-MON -RR'),to_d ate('01-FE B-18','DD- MON-RR'),t o_date('03 -FEB-18',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('16-FEB- 18','DD-MO N-RR'),nul l,to_date( '16-FEB-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1761 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (677, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('16 -FEB-18',' DD-MON-RR' ),null,to_ date('16-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1762 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (678, 279,1,1,1, null,12345 ,'name','1 2345','tes t',null,'n ame','1234 5','12345' ,'name','n ame','1234 5','12345' ,'12345',' 12345','12 345','1234 5',to_date ('01-FEB-1 8','DD-MON -RR'),to_d ate('01-FE B-18','DD- MON-RR'),t o_date('03 -FEB-18',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('16-FEB- 18','DD-MO N-RR'),nul l,to_date( '16-FEB-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1763 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (679, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('16 -FEB-18',' DD-MON-RR' ),null,to_ date('16-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1764 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (680, 280,1,1,1, null,12345 ,'name','1 2345','nam e',null,'n ame','1234 5','12345' ,'name','n ame','1234 5','12345' ,'12345',' name','123 45','12345 ',to_date( '01-FEB-18 ','DD-MON- RR'),to_da te('01-FEB -18','DD-M ON-RR'),to _date('01- FEB-18','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('16-FEB-1 8','DD-MON -RR'),null ,to_date(' 16-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1765 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (681, 161,2,3,2, null,85951 ,'Veteran' 's Affairs ','12115', '162912974 7',null,'M ARY HITCHC OCK MEMORI AL HOSPITA L','102309 2053','020 222140','G GGGGG','XX XXXX','037 56','H6599 465803','8 5951','137 ','0518172 42879014', '50218131 6',to_date ('20-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('16- FEB-18','D D-MON-RR') ,null,to_d ate('16-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1766 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (682, 281,1,2,2, null,12345 ,'name','1 23456','na me',null,' name','123 456','1234 56','name' ,'name','1 23456','12 3456','123 45','name' ,'123456', '123456',t o_date('16 -FEB-18',' DD-MON-RR' ),to_date( '01-JAN-18 ','DD-MON- RR'),to_da te('01-JAN -19','DD-M ON-RR'),'P ENDING','G ENERATED', to_date('1 6-FEB-18', 'DD-MON-RR '),null,to _date('16- FEB-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1767 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (683, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('16 -FEB-18',' DD-MON-RR' ),null,to_ date('16-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1768 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (684, 282,1,1,1, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('01-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('16- FEB-18','D D-MON-RR') ,null,to_d ate('16-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1769 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (685, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('16 -FEB-18',' DD-MON-RR' ),null,to_ date('16-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1770 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (686, 282,1,1,1, null,12345 ,'test','1 2345','tes t',null,'t est','1234 5','12345' ,'test','t est','1234 5','12345' ,'12345',' test','123 45','12345 ',to_date( '15-FEB-18 ','DD-MON- RR'),to_da te('01-FEB -18','DD-M ON-RR'),to _date('16- FEB-18','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('16-FEB-1 8','DD-MON -RR'),null ,to_date(' 16-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1771 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (687, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('16 -FEB-18',' DD-MON-RR' ),null,to_ date('16-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1772 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (688, 283,1,1,1, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('20-FEB-1 8','DD-MON -RR'),to_d ate('10-SE P-17','DD- MON-RR'),t o_date('16 -SEP-17',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('20-FEB- 18','DD-MO N-RR'),nul l,to_date( '20-FEB-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1773 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (689, 284,9,4,8, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('01-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('20- FEB-18','D D-MON-RR') ,null,to_d ate('20-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1774 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (690, 11,12,6,5, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('17-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('20- FEB-18','D D-MON-RR') ,null,to_d ate('20-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1775 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (691, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('20 -FEB-18',' DD-MON-RR' ),null,to_ date('20-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1776 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (692, 285,2,4,5, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('01-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('20- FEB-18','D D-MON-RR') ,null,to_d ate('20-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1777 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (693, 286,131,5, 5,null,100 00,'xx','1 21','xxxxx ',null,'xx xxx','121' ,'23424',' xxxxx','xx xxx','3434 ','12222', '10000','x xxxx','122 22','1221' ,to_date(' 01-FEB-18' ,'DD-MON-R R'),to_dat e('01-FEB- 18','DD-MO N-RR'),to_ date('20-F EB-18','DD -MON-RR'), 'PENDING', 'GENERATED ',to_date( '20-FEB-18 ','DD-MON- RR'),null, to_date('2 0-FEB-18', 'DD-MON-RR '),null,nu ll,null,nu ll,null,nu ll); | |
| 1778 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (694, 239,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN', '100000000 6','111111 119','Hold en','Ines' ,'00010009 0','100002 40','10240 ','211','0 5181724287 9014','051 8172428790 14',to_dat e('21-JAN- 18','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('20 -FEB-18',' DD-MON-RR' ),null,to_ date('20-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1779 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (695, 239,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN', '100000000 6','111111 119','Hold en','Ines' ,'00010009 0','100002 40','10240 ','211','0 5181724287 9014','051 8172428790 14',to_dat e('21-JAN- 18','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('20 -FEB-18',' DD-MON-RR' ),null,to_ date('20-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1780 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (696, 287,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN', '100000000 6','111111 119','Hold en','Ines' ,'00010009 0','100002 40','10240 ','211','0 5181724287 9014','051 8172428790 14',to_dat e('21-JAN- 18','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('20 -FEB-18',' DD-MON-RR' ),null,to_ date('20-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1781 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (697, 239,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN', '100000000 6','111111 119','Hold en','Ines' ,'00010009 0','100002 40','10240 ','211','0 5181724287 9014','051 8172428790 14',to_dat e('21-JAN- 18','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('20 -FEB-18',' DD-MON-RR' ),null,to_ date('20-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1782 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (698, 239,5,2,4, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('01-JAN-2 0','DD-MON -RR'),to_d ate('10-SE P-17','DD- MON-RR'),t o_date('16 -SEP-17',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('20-FEB- 18','DD-MO N-RR'),nul l,to_date( '20-FEB-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1783 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (699, 239,5,2,4, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('01-JAN-2 0','DD-MON -RR'),to_d ate('10-SE P-17','DD- MON-RR'),t o_date('16 -SEP-17',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('20-FEB- 18','DD-MO N-RR'),nul l,to_date( '20-FEB-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1784 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (700, 239,5,2,4, null,10002 ,'Veteran' 's Affairs ','12115', null,null, 'HUMANA VE TERANS HEA LTHCARE SE RVICES','1 000000003' ,'11111111 2','David' ,'Weaver', '000100046 ','1000000 2','10002' ,null,null ,null,to_d ate('01-JA N-20','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 20-FEB-18' ,'DD-MON-R R'),null,t o_date('20 -FEB-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1785 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (701, 239,5,2,2, null,12345 ,'xxxx','1 2345','xxx x',null,'x xxx','1234 5','12345' ,'xxxx','x xxx','1234 5','12345' ,'12345',' xxxx','123 45','12345 ',to_date( '01-FEB-18 ','DD-MON- RR'),to_da te('01-FEB -18','DD-M ON-RR'),to _date('20- FEB-18','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('20-FEB-1 8','DD-MON -RR'),null ,to_date(' 20-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1786 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (702, 288,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN', '100000000 6','111111 119','Hold en','Ines' ,'00010009 0','100002 40','10240 ','211','0 5181724287 9014','051 8172428790 14',to_dat e('21-JAN- 18','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('20 -FEB-18',' DD-MON-RR' ),null,to_ date('20-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1787 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (703, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('20 -FEB-18',' DD-MON-RR' ),null,to_ date('20-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1788 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (704, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('20 -FEB-18',' DD-MON-RR' ),null,to_ date('20-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1789 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (705, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('20 -FEB-18',' DD-MON-RR' ),null,to_ date('20-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1790 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (706, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('20 -FEB-18',' DD-MON-RR' ),null,to_ date('20-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1791 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (707, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('20 -FEB-18',' DD-MON-RR' ),null,to_ date('20-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1792 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (708, 289,3,2,1, null,10242 ,'Veteran' 's Affairs ','12115', '10242',nu ll,'UNIV O F SOUTH AL ABAMA HEA' ,'10000000 03','11111 1121','Dun n','Deirdr e','000100 010','1000 0242','102 42','231', 'EI0518172 42879014-0 9','EI0518 1724287901 4-09',to_d ate('25-FE B-18','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 20-FEB-18' ,'DD-MON-R R'),null,t o_date('20 -FEB-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1793 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (709, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('21 -FEB-18',' DD-MON-RR' ),null,to_ date('21-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1794 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (710, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('21 -FEB-18',' DD-MON-RR' ),null,to_ date('21-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1795 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (711, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('21 -FEB-18',' DD-MON-RR' ),null,to_ date('21-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1796 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (712, 290,4,1,3, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('01-JAN-1 8','DD-MON -RR'),to_d ate('10-SE P-17','DD- MON-RR'),t o_date('16 -SEP-17',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('21-FEB- 18','DD-MO N-RR'),nul l,to_date( '21-FEB-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1797 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (713, 291,3,2,4, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('01-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('21- FEB-18','D D-MON-RR') ,null,to_d ate('21-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1798 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (714, 292,3,3,5, null,12345 ,'xxxx','1 2345','xxx x',null,'x xxx','1234 5','12345' ,'xxxx','x xxx','1234 5','12345' ,'12345',' xxxx','123 45','12345 ',to_date( '01-FEB-18 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('21-F EB-18','DD -MON-RR'), null,to_da te('21-FEB -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1799 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (715, 292,6,4,5, null,12345 ,'text','1 2345','tex t',null,'t ext','1234 5','12345' ,'text','t ext','1234 5','12345' ,'12345',' text','123 45','12345 ',to_date( '21-FEB-18 ','DD-MON- RR'),to_da te('01-FEB -14','DD-M ON-RR'),to _date('01- FEB-18','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('21-FEB-1 8','DD-MON -RR'),null ,to_date(' 21-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1800 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (716, 292,1,4,3, null,12345 ,'text','1 2345','ter g',null,'t ex','12345 ','12345', 'text','te xt','12345 ','12345', '12345','t hrtfh','12 345','1234 5',to_date ('01-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('21- FEB-18','D D-MON-RR') ,null,to_d ate('21-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1801 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (717, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('21 -FEB-18',' DD-MON-RR' ),null,to_ date('21-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1802 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (718, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('21 -FEB-18',' DD-MON-RR' ),null,to_ date('21-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1803 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (719, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('21 -FEB-18',' DD-MON-RR' ),null,to_ date('21-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1804 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (720, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('21 -FEB-18',' DD-MON-RR' ),null,to_ date('21-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1805 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (721, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('21 -FEB-18',' DD-MON-RR' ),null,to_ date('21-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1806 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (722, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('21 -FEB-18',' DD-MON-RR' ),null,to_ date('21-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1807 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (723, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('22 -FEB-18',' DD-MON-RR' ),null,to_ date('22-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1808 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (724, 292,3,2,2, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('01-FEB-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('22- FEB-18','D D-MON-RR') ,null,to_d ate('22-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1809 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (725, 293,3,2,2, null,12345 ,'xxxx','1 2345','xxx x',null,'x xxx','1234 5','12345' ,'xxxx','x xxx','1234 5','12345' ,'12345',' xxxx','123 45','12345 ',to_date( '01-FEB-18 ','DD-MON- RR'),to_da te('01-FEB -18','DD-M ON-RR'),to _date('01- FEB-18','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('22-FEB-1 8','DD-MON -RR'),null ,to_date(' 22-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1810 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (726, 294,2,5,5, null,12345 ,'xxxx','1 2345','xxx x',null,'x xxx','1234 5','12345' ,'xxxx','x xxx','1234 5','12345' ,'12345',' xxxx','123 45','12345 ',to_date( '01-FEB-18 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('22-F EB-18','DD -MON-RR'), null,to_da te('22-FEB -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1811 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (727, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('22 -FEB-18',' DD-MON-RR' ),null,to_ date('22-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1812 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (728, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('22 -FEB-18',' DD-MON-RR' ),null,to_ date('22-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1813 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (729, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('22 -FEB-18',' DD-MON-RR' ),null,to_ date('22-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1814 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (730, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('22 -FEB-18',' DD-MON-RR' ),null,to_ date('22-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1815 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (731, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('22 -FEB-18',' DD-MON-RR' ),null,to_ date('22-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1816 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (732, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('22 -FEB-18',' DD-MON-RR' ),null,to_ date('22-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1817 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (733, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('22 -FEB-18',' DD-MON-RR' ),null,to_ date('22-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1818 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (734, 289,3,4,11 3,null,102 44,'Vetera n''s Affai rs','12115 ','10244', null,'SKAG IT RADIOLO GY INC','1 000000005' ,'11111111 1','Ortega ','Michael ','0001000 91','10000 244','1024 4','221',' EI05181724 2879014-07 ','EI05181 7242879014 -07',to_da te('01-MAR -18','DD-M ON-RR'),nu ll,null,'P ENDING','G ENERATED', to_date('2 2-FEB-18', 'DD-MON-RR '),null,to _date('22- FEB-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1819 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (735, 295,2,2,1, null,1,'1' ,'1','1',n ull,'1','1 ','1','1', '1','1','1 ','1','1', '1','1',to _date('03- MAR-18','D D-MON-RR') ,to_date(' 10-FEB-17' ,'DD-MON-R R'),to_dat e('20-FEB- 17','DD-MO N-RR'),'PE NDING','GE NERATED',t o_date('22 -FEB-18',' DD-MON-RR' ),null,to_ date('22-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1820 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (736, 296,2,2,1, null,11111 ,'1','1',' 1',null,'1 ','1','1', '1','1','1 ','12345', '11111','1 ','1','1', to_date('0 3-MAR-18', 'DD-MON-RR '),to_date ('10-FEB-1 7','DD-MON -RR'),to_d ate('20-FE B-17','DD- MON-RR'),' PENDING',' GENERATED' ,to_date(' 22-FEB-18' ,'DD-MON-R R'),null,t o_date('22 -FEB-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1821 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (737, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('22 -FEB-18',' DD-MON-RR' ),null,to_ date('22-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1822 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (738, 297,1,1,1, null,11001 ,'Veterans Affair''s ','12115', '845621373 ',null,'Ch ristus Spo hn Hospita l','845621 378','8456 21371','Bu tler','Ger ard','8456 21379','84 5621372',' 11001','21 1','845621 376','8456 21375',to_ date('27-F EB-18','DD -MON-RR'), null,null, 'PENDING', 'GENERATED ',to_date( '22-FEB-18 ','DD-MON- RR'),null, to_date('2 2-FEB-18', 'DD-MON-RR '),null,nu ll,null,nu ll,null,nu ll); | |
| 1823 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (739, 289,132,12 8,1,null,1 0243,'Vete ran''s Aff airs','121 15','10243 ',null,'UN IV OF WASH INGTON PHY SICIANS',' 1000000003 ','1111111 21','Gomez ','Estela' ,'00010000 3','100002 43','10243 ','221','E I051817242 879014-08' ,'EI051817 242879014- 08',to_dat e('28-FEB- 18','DD-MO N-RR'),to_ date('13-S EP-17','DD -MON-RR'), to_date('1 5-SEP-17', 'DD-MON-RR '),'PENDIN G','GENERA TED',to_da te('22-FEB -18','DD-M ON-RR'),nu ll,to_date ('22-FEB-1 8','DD-MON -RR'),null ,null,null ,null,null ,null); | |
| 1824 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (740, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('22 -FEB-18',' DD-MON-RR' ),null,to_ date('22-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1825 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (741, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('22 -FEB-18',' DD-MON-RR' ),null,to_ date('22-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1826 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (742, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('22 -FEB-18',' DD-MON-RR' ),null,to_ date('22-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1827 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (743, 298,2,2,4, null,12345 ,'xxxxx',' 12345','xx xxx',null, 'xxxxx','1 2345','123 45','xxxxx ','xxxxx', '12345','1 2345','123 45','xxxxx ','123456' ,'1233',to _date('01- FEB-18','D D-MON-RR') ,to_date(' 01-FEB-15' ,'DD-MON-R R'),to_dat e('01-FEB- 18','DD-MO N-RR'),'PE NDING','GE NERATED',t o_date('22 -FEB-18',' DD-MON-RR' ),null,to_ date('22-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1828 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (744, 289,1,1,1, null,12345 ,'1','1',' 1',null,'1 ','1','1', '1','1','1 ','1','123 45','1','1 ','1',to_d ate('27-FE B-18','DD- MON-RR'),t o_date('01 -JAN-17',' DD-MON-RR' ),to_date( '02-JAN-17 ','DD-MON- RR'),'PEND ING','GENE RATED',to_ date('22-F EB-18','DD -MON-RR'), null,to_da te('22-FEB -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1829 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (745, 299,1,128, 1,null,111 11,'1','1' ,'1',null, '1','1','1 ','1','1', '1','1','1 1111','1', '1','1',to _date('01- MAR-18','D D-MON-RR') ,to_date(' 01-JAN-17' ,'DD-MON-R R'),to_dat e('02-JAN- 17','DD-MO N-RR'),'PE NDING','GE NERATED',t o_date('22 -FEB-18',' DD-MON-RR' ),null,to_ date('22-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1830 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (746, 300,131,12 8,19,null, 22222,'1', '1','1',nu ll,'1','1' ,'1','1',' 1','1','1' ,'22222',' 1','1','1' ,to_date(' 05-MAR-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('23-FE B-18','DD- MON-RR'),n ull,to_dat e('23-FEB- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1831 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (747, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('23 -FEB-18',' DD-MON-RR' ),null,to_ date('23-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1832 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (748, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('23 -FEB-18',' DD-MON-RR' ),null,to_ date('23-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1833 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (749, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('23 -FEB-18',' DD-MON-RR' ),null,to_ date('23-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1834 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (750, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('23 -FEB-18',' DD-MON-RR' ),null,to_ date('23-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1835 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (751, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('23 -FEB-18',' DD-MON-RR' ),null,to_ date('23-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1836 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (752, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('23 -FEB-18',' DD-MON-RR' ),null,to_ date('23-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1837 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (753, 301,1,1,1, null,11002 ,'Veterans Affair''s ','12115', '326481934 ',null,'CH RISTUS SPO HN HOSPITA L','326481 939','3264 81931','Sa lvatore',' Stephen',' 326481932' ,'32648193 3','11002' ,'211','32 6481935',' 326481936' ,to_date(' 28-FEB-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('23-FE B-18','DD- MON-RR'),n ull,to_dat e('23-FEB- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1838 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (754, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('23 -FEB-18',' DD-MON-RR' ),null,to_ date('23-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1839 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (755, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('23 -FEB-18',' DD-MON-RR' ),null,to_ date('23-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1840 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (756, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('23 -FEB-18',' DD-MON-RR' ),null,to_ date('23-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1841 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (757, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('23 -FEB-18',' DD-MON-RR' ),null,to_ date('23-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1842 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (758, 301,1,1,1, null,10245 ,'Veteran' 's Affairs ','12115', '10245',nu ll,'PLAZA MED CTR OF FW','1000 000008','1 11111118', 'Turner',' Patrick',' 000100031' ,'10000245 ','10245', '221','102 45','10245 ',to_date( '03-MAR-18 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('25-F EB-18','DD -MON-RR'), null,to_da te('25-FEB -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1843 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (759, 302,1,2,3, null,44444 ,'1','1',' 1',null,'1 ','1','1', '1','1','1 ','1','444 44','1','1 ','1',to_d ate('10-MA R-18','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 26-FEB-18' ,'DD-MON-R R'),null,t o_date('26 -FEB-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1844 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (760, 303,1,2,3, null,10242 ,'Veteran' 's Affairs ','12115', '10242',nu ll,'UNIV O F SOUTH AL ABAMA HEA' ,'10000000 03','11111 1121','Dun n','Deirdr e','000100 010','1000 0242','102 42','231', 'EI0518172 42879014-0 9','EI0518 1724287901 4-09',to_d ate('10-MA R-18','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 26-FEB-18' ,'DD-MON-R R'),null,t o_date('26 -FEB-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1845 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (761, 303,5,5,19 ,null,5555 5,'payer n ame','123' ,'info rec eiver',nul l,'billing provider name','456 ','789','l ast name', 'first nam e','0123', '45678','5 5555','111 ','222','3 33',to_dat e('20-MAR- 18','DD-MO N-RR'),to_ date('01-J AN-17','DD -MON-RR'), to_date('0 2-FEB-17', 'DD-MON-RR '),'PENDIN G','GENERA TED',to_da te('26-FEB -18','DD-M ON-RR'),nu ll,to_date ('26-FEB-1 8','DD-MON -RR'),null ,null,null ,null,null ,null); | |
| 1846 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (762, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('26 -FEB-18',' DD-MON-RR' ),null,to_ date('26-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1847 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (763, 289,1,2,3, null,20061 7204000157 ,'Veteran' 's Affairs ','84146', '10241',nu ll,'MID OH IO EMERGEN CY SERVIC' ,'13866917 80','31160 3722','JAM E','CD','0 00000002', '111100002 23','20061 7204000157 ','211','2 0161116100 1616','201 6111610016 16',to_dat e('15-MAR- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('26 -FEB-18',' DD-MON-RR' ),null,to_ date('26-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1848 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (764, 304,4,4,5, null,77777 ,'payer na me','123', 'info rece iver',null ,'billing provider n ame','456' ,'789','la st name',' first name ','0123',' 45678','77 777','111' ,'222','33 3',to_date ('05-MAR-1 8','DD-MON -RR'),to_d ate('02-JA N-17','DD- MON-RR'),t o_date('04 -MAR-17',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('26-FEB- 18','DD-MO N-RR'),nul l,to_date( '26-FEB-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1849 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (765, 289,4,5,5, null,10244 ,'Veteran' 's Affairs ','12115', '10244',nu ll,'SKAGIT RADIOLOGY INC','100 0000005',' 111111111' ,'Ortega', 'Michael', '000100091 ','1000024 4','10244' ,'221','EI 0518172428 79014-07', 'EI0518172 42879014-0 7',to_date ('20-MAR-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('26- FEB-18','D D-MON-RR') ,null,to_d ate('26-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1850 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (766, 289,17,128 ,9,null,20 0617204000 157,'Veter an''s Affa irs','8414 6','10241' ,null,'MID OHIO EMER GENCY SERV IC','13866 91780','31 1603722',' JAME','CD' ,'00000000 2','111100 00223','20 0617204000 157','211' ,'20161116 1001616',' 2016111610 01616',to_ date('04-M AR-18','DD -MON-RR'), null,null, 'PENDING', 'GENERATED ',to_date( '26-FEB-18 ','DD-MON- RR'),null, to_date('2 6-FEB-18', 'DD-MON-RR '),null,nu ll,null,nu ll,null,nu ll); | |
| 1851 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (767, 305,5,5,3, null,10243 ,'Veteran' 's Affairs ','12115', '10243',nu ll,'UNIV O F WASHINGT ON PHYSICI ANS','1000 000003','1 11111121', 'Gomez','E stela','00 0100003',' 10000243', '10243','2 21','EI051 8172428790 14-08','EI 0518172428 79014-08', to_date('1 0-MAR-18', 'DD-MON-RR '),to_date ('13-SEP-1 7','DD-MON -RR'),to_d ate('15-SE P-17','DD- MON-RR'),' PENDING',' GENERATED' ,to_date(' 26-FEB-18' ,'DD-MON-R R'),null,t o_date('26 -FEB-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1852 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (768, 289,7,1,19 ,null,2222 2,'payer n ame','111' ,'777',nul l,'bill pr o name','3 33','444', 'last name ','first n ame','555' ,'666','22 222','888' ,'999','00 0',to_date ('15-MAR-1 8','DD-MON -RR'),to_d ate('11-NO V-17','DD- MON-RR'),t o_date('01 -DEC-17',' DD-MON-RR' ),'PENDING ','GENERAT ED',to_dat e('26-FEB- 18','DD-MO N-RR'),nul l,to_date( '26-FEB-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1853 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (769, 303,3,2,2, null,10241 ,'Veteran' 's Affairs ','12115', '10241',nu ll,'PLAZA MED CTR OF FW','1000 000004','1 11111121', 'Burgess', 'Meyers',' 000100032' ,'10000241 ','10241', '211','201 6111610016 16','20161 1161001616 ',to_date( '04-MAR-18 ','DD-MON- RR'),null, null,'PEND ING','GENE RATED',to_ date('26-F EB-18','DD -MON-RR'), null,to_da te('26-FEB -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1854 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (770, 306,10,7,1 1,null,111 11,'payer name','111 ','666',nu ll,'billin g provider name','22 2','333',' last name' ,'first na me','444', '55555','1 1111','777 ','888','9 99',to_dat e('10-MAR- 18','DD-MO N-RR'),to_ date('20-J AN-17','DD -MON-RR'), to_date('2 5-FEB-17', 'DD-MON-RR '),'PENDIN G','GENERA TED',to_da te('26-FEB -18','DD-M ON-RR'),nu ll,to_date ('26-FEB-1 8','DD-MON -RR'),null ,null,null ,null,null ,null); | |
| 1855 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (771, 307,10,6,7 ,null,9999 9,'PAYER n ame','999' ,'4444',nu ll,'bill p ro NAME',' 8888','777 7','last', 'first','6 666','5555 ','99999', '3333','22 22','1111' ,to_date(' 05-MAR-18' ,'DD-MON-R R'),to_dat e('10-MAY- 17','DD-MO N-RR'),to_ date('20-O CT-17','DD -MON-RR'), 'PENDING', 'GENERATED ',to_date( '26-FEB-18 ','DD-MON- RR'),null, to_date('2 6-FEB-18', 'DD-MON-RR '),null,nu ll,null,nu ll,null,nu ll); | |
| 1856 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (772, 303,13,4,6 ,null,2006 1720400015 7,'Veteran ''s Affair s','84146' ,'10241',n ull,'MID O HIO EMERGE NCY SERVIC ','1386691 780','3116 03722','JA ME','CD',' 000000002' ,'11110000 223','2006 1720400015 7','211',' 2016111610 01616','20 1611161001 616',to_da te('01-APR -18','DD-M ON-RR'),nu ll,null,'P ENDING','G ENERATED', to_date('2 6-FEB-18', 'DD-MON-RR '),null,to _date('26- FEB-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1857 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (773, 303,5,5,6, null,20061 7204000157 ,'Veteran' 's Affairs ','84146', '10241',nu ll,'MID OH IO EMERGEN CY SERVIC' ,'13866917 80','31160 3722','JAM E','CD','0 00000002', '111100002 23','20061 7204000157 ','211','2 0161116100 1616','201 6111610016 16',to_dat e('20-MAR- 18','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('26 -FEB-18',' DD-MON-RR' ),null,to_ date('26-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1858 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (774, 307,5,6,4, null,22222 ,'payer NA ME','111', '777',null ,'bill Nam e','333',' 444','last ','first', '555','666 ','22222', '888','999 ','1000',t o_date('01 -APR-18',' DD-MON-RR' ),to_date( '20-JAN-17 ','DD-MON- RR'),to_da te('15-NOV -17','DD-M ON-RR'),'P ENDING','G ENERATED', to_date('2 6-FEB-18', 'DD-MON-RR '),null,to _date('26- FEB-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1859 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (775, 306,10,6,1 2,null,102 44,'Vetera n''s Affai rs','12115 ','10244', null,'SKAG IT RADIOLO GY INC','1 000000005' ,'11111111 1','Ortega ','Michael ','0001000 91','10000 244','1024 4','221',' EI05181724 2879014-07 ','EI05181 7242879014 -07',to_da te('05-MAR -18','DD-M ON-RR'),nu ll,null,'P ENDING','G ENERATED', to_date('2 6-FEB-18', 'DD-MON-RR '),null,to _date('26- FEB-18','D D-MON-RR') ,null,null ,null,null ,null,null ); | |
| 1860 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (776, 303,1,2,3, null,12345 ,'payer na me','2','9 ',null,'bi ll provide r name','3 ','4','5', '6','7','8 ','12345', '10','11', '12',to_da te('05-MAR -18','DD-M ON-RR'),to _date('20- AUG-17','D D-MON-RR') ,to_date(' 11-NOV-17' ,'DD-MON-R R'),'PENDI NG','GENER ATED',to_d ate('27-FE B-18','DD- MON-RR'),n ull,to_dat e('27-FEB- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1861 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (777, 289,3,3,3, null,11111 ,'name','1 ','1',null ,'name','1 ','1','1', '1','1','1 ','11111', '1','1','1 ',to_date( '01-APR-18 ','DD-MON- RR'),to_da te('01-FEB -18','DD-M ON-RR'),to _date('02- FEB-18','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('27-FEB-1 8','DD-MON -RR'),null ,to_date(' 27-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1862 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (778, 303,1,1,1, null,12345 ,'1','1',' 1',null,'1 ','1','1', '1','1','1 ','1','123 45','1','1 ','1',to_d ate('04-AP R-18','DD- MON-RR'),n ull,null,' PENDING',' GENERATED' ,to_date(' 27-FEB-18' ,'DD-MON-R R'),null,t o_date('27 -FEB-18',' DD-MON-RR' ),null,nul l,null,nul l,null,nul l); | |
| 1863 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (779, 303,1,2,3, null,10243 ,'Veteran' 's Affairs ','12115', '10243',nu ll,'UNIV O F WASHINGT ON PHYSICI ANS','1000 000003','1 11111121', 'Gomez','E stela','00 0100003',' 10000243', '10243','2 21','EI051 8172428790 14-08','EI 0518172428 79014-08', to_date('0 2-APR-18', 'DD-MON-RR '),null,nu ll,'PENDIN G','GENERA TED',to_da te('27-FEB -18','DD-M ON-RR'),nu ll,to_date ('27-FEB-1 8','DD-MON -RR'),null ,null,null ,null,null ,null); | |
| 1864 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (782, 303,2,2,2, null,77777 ,'payer na me','111', '666',null ,'bill pro vider name ','222','3 33','last' ,'First',' 444','555' ,'77777',' 777','888' ,'999',to_ date('10-M AR-18','DD -MON-RR'), to_date('1 0-OCT-17', 'DD-MON-RR '),to_date ('15-NOV-1 7','DD-MON -RR'),'PEN DING','GEN ERATED',to _date('27- FEB-18','D D-MON-RR') ,null,to_d ate('27-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1865 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (783, 308,7,8,5, null,20061 7204000157 ,'Veteran' 's Affairs ','84146', '10241',nu ll,'MID OH IO EMERGEN CY SERVIC' ,'13866917 80','31160 3722','JAM E','CD','0 00000002', '111100002 23','20061 7204000157 ','211','2 0161116100 1616','201 6111610016 16',to_dat e('05-MAR- 18','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('27 -FEB-18',' DD-MON-RR' ),null,to_ date('27-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1866 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (784, 303,1,1,1, null,88888 ,'payer na me','1','7 ',null,'2' ,'3','4',' last','fir st','5','6 ','88888', '8','9','1 0',to_date ('15-MAR-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('27- FEB-18','D D-MON-RR') ,null,to_d ate('27-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1867 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (785, 293,3,2,3, null,12345 ,'xxxx','1 2345','xxx x',null,'x xxx','1234 5','12345' ,'xxxx','x xxx','1234 5','12345' ,'12345',' xxxx','122 34','12234 ',to_date( '01-FEB-18 ','DD-MON- RR'),to_da te('01-FEB -18','DD-M ON-RR'),to _date('27- FEB-18','D D-MON-RR') ,'PENDING' ,'GENERATE D',to_date ('27-FEB-1 8','DD-MON -RR'),null ,to_date(' 27-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1868 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (786, 161,2,3,5, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('05-MAR-1 8','DD-MON -RR'),null ,null,'COM PLETE','GE NERATED',t o_date('28 -FEB-18',' DD-MON-RR' ),null,to_ date('28-F EB-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1869 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (787, 161,2,1,9, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('05-MAR-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('28- FEB-18','D D-MON-RR') ,null,to_d ate('28-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1870 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (788, 161,1,1,1, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('05-MAR-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('28- FEB-18','D D-MON-RR') ,null,to_d ate('28-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1871 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (789, 161,3,1,9, null,10000 ,'Veteran' 's Affairs ','12115', '100001111 ',null,'RI VERSIDE ME TH HOS','1 000000004' ,'11111111 3','Duncan ','Ester', '000100006 ','1000000 0','10000' ,'231','10 000','1000 0',to_date ('31-MAY-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('28- FEB-18','D D-MON-RR') ,null,to_d ate('28-FE B-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1872 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (790, 303,1,2,2, null,1,'1' ,'1','1',n ull,'1','1 ','1','1', '1','1','1 ','1','1', '1','1',to _date('28- FEB-18','D D-MON-RR') ,null,null ,'PENDING' ,'GENERATE D',to_date ('28-FEB-1 8','DD-MON -RR'),null ,to_date(' 28-FEB-18' ,'DD-MON-R R'),null,n ull,null,n ull,null,n ull); | |
| 1873 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (791, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('01 -MAR-18',' DD-MON-RR' ),null,to_ date('01-M AR-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1874 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (792, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('02-MA R-18','DD- MON-RR'),n ull,to_dat e('02-MAR- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1875 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (793, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('02-MA R-18','DD- MON-RR'),n ull,to_dat e('02-MAR- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1876 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (794, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('02-MA R-18','DD- MON-RR'),n ull,to_dat e('02-MAR- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1877 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (795, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('02-MA R-18','DD- MON-RR'),n ull,to_dat e('02-MAR- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1878 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (796, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('02 -MAR-18',' DD-MON-RR' ),null,to_ date('02-M AR-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1879 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (797, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('02-MA R-18','DD- MON-RR'),n ull,to_dat e('02-MAR- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1880 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (798, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('02 -MAR-18',' DD-MON-RR' ),null,to_ date('02-M AR-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1881 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (799, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('05-MA R-18','DD- MON-RR'),n ull,to_dat e('05-MAR- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1882 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (800, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('05-MA R-18','DD- MON-RR'),n ull,to_dat e('05-MAR- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1883 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (801, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('05-MA R-18','DD- MON-RR'),n ull,to_dat e('05-MAR- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1884 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (802, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('05-MA R-18','DD- MON-RR'),n ull,to_dat e('05-MAR- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1885 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (803, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('05-MA R-18','DD- MON-RR'),n ull,to_dat e('05-MAR- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1886 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (804, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('05-MA R-18','DD- MON-RR'),n ull,to_dat e('05-MAR- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1887 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (805, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('05-MA R-18','DD- MON-RR'),n ull,to_dat e('05-MAR- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1888 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (806, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('05 -MAR-18',' DD-MON-RR' ),null,to_ date('05-M AR-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1889 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (807, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('05 -MAR-18',' DD-MON-RR' ),null,to_ date('05-M AR-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1890 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (808, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('05 -MAR-18',' DD-MON-RR' ),null,to_ date('05-M AR-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1891 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (809, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('05 -MAR-18',' DD-MON-RR' ),null,to_ date('05-M AR-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1892 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (810, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('06-MA R-18','DD- MON-RR'),n ull,to_dat e('06-MAR- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1893 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (811, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('06-MA R-18','DD- MON-RR'),n ull,to_dat e('06-MAR- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1894 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (812, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('06-MA R-18','DD- MON-RR'),n ull,to_dat e('06-MAR- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1895 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (813, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('06 -MAR-18',' DD-MON-RR' ),null,to_ date('06-M AR-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1896 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (814, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('06 -MAR-18',' DD-MON-RR' ),null,to_ date('06-M AR-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1897 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (815, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('06 -MAR-18',' DD-MON-RR' ),null,to_ date('06-M AR-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1898 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (816, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('06 -MAR-18',' DD-MON-RR' ),null,to_ date('06-M AR-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1899 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (817, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('06 -MAR-18',' DD-MON-RR' ),null,to_ date('06-M AR-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1900 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (818, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('06 -MAR-18',' DD-MON-RR' ),null,to_ date('06-M AR-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1901 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (819, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('06 -MAR-18',' DD-MON-RR' ),null,to_ date('06-M AR-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1902 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (820, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','GE NERATED',t o_date('06 -MAR-18',' DD-MON-RR' ),null,to_ date('06-M AR-18','DD -MON-RR'), null,null, null,null, null,null) ; | |
| 1903 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (821, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('06-MA R-18','DD- MON-RR'),n ull,to_dat e('06-MAR- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1904 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (822, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('06-MA R-18','DD- MON-RR'),n ull,to_dat e('06-MAR- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1905 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (823, 161,1,1,1, null,85951 ,'Veteran' 's Affairs ','12115', '162912974 7',null,'M ARY HITCHC OCK MEMORI AL HOSPITA L','102309 2053','020 222140','G GGGGG','XX XXXX','037 56','H6599 465803','8 5951','137 ','0518172 42879014', '50218131 6',to_date ('10-MAR-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('06- MAR-18','D D-MON-RR') ,null,to_d ate('06-MA R-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1906 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (824, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','GENER ATED',to_d ate('06-MA R-18','DD- MON-RR'),n ull,to_dat e('06-MAR- 18','DD-MO N-RR'),nul l,null,nul l,null,nul l,null); | |
| 1907 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (825, 161,14,4,8 ,null,2006 1720300015 6,'Veteran ''s Affair s','84146' ,'10240',n ull,'LMH H EALTH PROF ESSIONALS' ,'15080865 54','31142 5530','JAC K','CC','0 00000001', '111100002 23','20061 7203000156 ','211','0 5181724287 1234','051 8172428790 14',to_dat e('10-MAR- 18','DD-MO N-RR'),to_ date('18-A PR-11','DD -MON-RR'), to_date('1 8-APR-11', 'DD-MON-RR '),'PENDIN G','GENERA TED',to_da te('06-MAR -18','DD-M ON-RR'),nu ll,to_date ('06-MAR-1 8','DD-MON -RR'),null ,null,null ,null,null ,null); | |
| 1908 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (826, 161,1,1,1, null,85951 ,'Veteran' 's Affairs ','12115', '162912974 7',null,'M ARY HITCHC OCK MEMORI AL HOSPITA L','102309 2053','020 222140','G GGGGG','XX XXXX','037 56','H6599 465803','8 5951','137 ','0518172 42879014', '50218131 6',to_date ('10-MAR-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('06- MAR-18','D D-MON-RR') ,null,to_d ate('06-MA R-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1909 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (827, 161,5,5,8, null,20061 7203000156 ,'Veteran' 's Affairs ','84146', '10240',nu ll,'LMH HE ALTH PROFE SSIONALS', '150808655 4','311425 530','JACK ','CC','00 0000001',' 1111000022 3','200617 203000156' ,'211','05 1817242871 234','0518 1724287901 4',to_date ('10-OCT-1 8','DD-MON -RR'),null ,null,'PEN DING','GEN ERATED',to _date('06- MAR-18','D D-MON-RR') ,null,to_d ate('06-MA R-18','DD- MON-RR'),n ull,null,n ull,null,n ull,null); | |
| 1910 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (828, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('06-MAR- 18','DD-MO N-RR'),nul l,to_date( '06-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1911 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (829, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('06-MAR- 18','DD-MO N-RR'),nul l,to_date( '06-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1912 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (830, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('06-MAR- 18','DD-MO N-RR'),nul l,to_date( '06-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1913 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (831, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','PE NDING',to_ date('06-M AR-18','DD -MON-RR'), null,to_da te('06-MAR -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1914 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (832, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','PE NDING',to_ date('06-M AR-18','DD -MON-RR'), null,to_da te('06-MAR -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1915 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (833, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','PE NDING',to_ date('06-M AR-18','DD -MON-RR'), null,to_da te('06-MAR -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1916 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (834, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','PE NDING',to_ date('07-M AR-18','DD -MON-RR'), null,to_da te('07-MAR -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1917 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (835, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('07-MAR- 18','DD-MO N-RR'),nul l,to_date( '07-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1918 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (836, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('07-MAR- 18','DD-MO N-RR'),nul l,to_date( '07-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1919 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (837, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('07-MAR- 18','DD-MO N-RR'),nul l,to_date( '07-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1920 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (838, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('07-MAR- 18','DD-MO N-RR'),nul l,to_date( '07-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1921 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (839, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('07-MAR- 18','DD-MO N-RR'),nul l,to_date( '07-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1922 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (840, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('07-MAR- 18','DD-MO N-RR'),nul l,to_date( '07-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1923 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (841, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('07-MAR- 18','DD-MO N-RR'),nul l,to_date( '07-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1924 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (845, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('07-MAR- 18','DD-MO N-RR'),nul l,to_date( '07-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1925 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (842, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('07-MAR- 18','DD-MO N-RR'),nul l,to_date( '07-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1926 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (844, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('07-MAR- 18','DD-MO N-RR'),nul l,to_date( '07-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1927 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (843, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('07-MAR- 18','DD-MO N-RR'),nul l,to_date( '07-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1928 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (846, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('07-MAR- 18','DD-MO N-RR'),nul l,to_date( '07-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1929 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (847, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('07-MAR- 18','DD-MO N-RR'),nul l,to_date( '07-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1930 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (848, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('07-MAR- 18','DD-MO N-RR'),nul l,to_date( '07-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1931 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (849, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('07-MAR- 18','DD-MO N-RR'),nul l,to_date( '07-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1932 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (851, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('07-MAR- 18','DD-MO N-RR'),nul l,to_date( '07-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1933 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (850, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('07-MAR- 18','DD-MO N-RR'),nul l,to_date( '07-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1934 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (852, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('07-MAR- 18','DD-MO N-RR'),nul l,to_date( '07-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1935 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (853, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('07-MAR- 18','DD-MO N-RR'),nul l,to_date( '07-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1936 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (854, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','PE NDING',to_ date('07-M AR-18','DD -MON-RR'), null,to_da te('07-MAR -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1937 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (855, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','PE NDING',to_ date('07-M AR-18','DD -MON-RR'), null,to_da te('07-MAR -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1938 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (856, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','PE NDING',to_ date('07-M AR-18','DD -MON-RR'), null,to_da te('07-MAR -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1939 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (857, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','PE NDING',to_ date('08-M AR-18','DD -MON-RR'), null,to_da te('08-MAR -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1940 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (858, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','PE NDING',to_ date('08-M AR-18','DD -MON-RR'), null,to_da te('08-MAR -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1941 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (859, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','PE NDING',to_ date('08-M AR-18','DD -MON-RR'), null,to_da te('08-MAR -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1942 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (860, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','PE NDING',to_ date('08-M AR-18','DD -MON-RR'), null,to_da te('08-MAR -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1943 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (861, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','PE NDING',to_ date('08-M AR-18','DD -MON-RR'), null,to_da te('08-MAR -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1944 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (862, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','PE NDING',to_ date('08-M AR-18','DD -MON-RR'), null,to_da te('08-MAR -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 1945 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (863, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1946 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (864, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1947 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (865, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1948 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (866, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1949 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (867, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1950 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (868, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1951 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (869, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1952 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (870, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1953 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (871, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1954 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (872, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1955 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (873, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1956 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (874, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1957 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (875, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1958 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (876, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1959 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (877, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1960 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (878, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1961 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (879, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1962 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (880, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1963 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (881, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1964 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (882, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1965 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (883, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1966 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (884, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1967 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (885, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1968 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (886, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1969 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (887, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1970 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (888, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1971 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (889, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1972 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (890, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1973 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (891, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1974 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (892, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1975 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (893, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1976 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (894, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1977 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (895, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1978 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (896, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1979 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (897, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1980 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (898, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1981 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (899, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1982 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (900, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1983 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (901, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1984 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (902, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1985 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (903, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1986 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (904, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1987 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (905, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1988 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (906, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1989 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (907, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1990 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (908, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1991 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (909, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1992 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (910, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1993 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (911, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1994 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (912, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1995 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (913, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1996 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (914, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1997 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (915, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1998 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (916, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 1999 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (917, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 2000 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (918, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 2001 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (919, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 2002 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (920, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 2003 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (921, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 2004 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (922, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 2005 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (923, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 2006 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (924, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 2007 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (925, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 2008 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (926, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 2009 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (927, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 2010 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (928, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 2011 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (929, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 2012 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (930, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 2013 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (931, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 2014 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (932, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('08-MAR- 18','DD-MO N-RR'),nul l,to_date( '08-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 2015 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (933, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','PE NDING',to_ date('08-M AR-18','DD -MON-RR'), null,to_da te('08-MAR -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 2016 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (934, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','PE NDING',to_ date('09-M AR-18','DD -MON-RR'), null,to_da te('09-MAR -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 2017 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (935, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','PE NDING',to_ date('09-M AR-18','DD -MON-RR'), null,to_da te('09-MAR -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 2018 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (936, 142,1,2,3, null,10240 ,'Veteran' 's Affairs ','12115', '10240',nu ll,'JOHN M UIR TRAUMA PHYS','10 00000006', '111111119 ','Holden' ,'Ines','0 00100090', '10000240' ,'10240',' 211','0518 1724287901 4','051817 242879014' ,to_date(' 21-JAN-18' ,'DD-MON-R R'),null,n ull,'PENDI NG','PENDI NG',to_dat e('10-MAR- 18','DD-MO N-RR'),nul l,to_date( '10-MAR-18 ','DD-MON- RR'),null, null,null, null,null, null); | |
| 2019 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (937, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','PE NDING',to_ date('11-M AR-18','DD -MON-RR'), null,to_da te('11-MAR -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 2020 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (938, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','PE NDING',to_ date('12-M AR-18','DD -MON-RR'), null,to_da te('12-MAR -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 2021 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (939, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','PE NDING',to_ date('12-M AR-18','DD -MON-RR'), null,to_da te('12-MAR -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 2022 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON (SUBMIS SIONID,CON TACTUSERID ,HCCS_ID,L OINC_ID,LO INC_MOD_ID ,TRN02CPE_ PDI,TRN02F PPS_CLAIM_ ID,HL1NM10 3PYR_NM,HL 1NM109PYR_ ID,HL2NM10 3INF_RCVR, HL1PER04VA MCCNTEM,HL 3NM103SVCB ILLPRVNM,H L3NM109PRV NPI,HL2NM1 09SVCPRVTI N,HL4NM103 PTLSTNM,HL 4NM104PTFT NM,HL4NM10 9PTID,REF1 02PTCTRLNM BR,TRN02PY RCLMCTRLNM BR,REF202B ILLTYPE,RE F402CLRNGH SID,REF302 MEDRECNMBR ,DTP203RES PONSEDUEDA TE,DTP103S VCFRMDT,DT P103SVCTOD T,SUBMISSI ON_STATUS, GENERATE27 7_STATUS,D ATECREATED ,DATESUBMI TTED,DATEM ODIFIED,N3 RSPCNTADDR SLN,N3RSPC NTADDLADDR LN,N4RSPCN TCITY,N4RS PCNTSTCD,N 4RSPCNTZPC D,N4RSPCNT CTRYCD) va lues (940, 1,4,4,1,nu ll,10095,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,null,n ull,to_dat e('12-DEC- 17','DD-MO N-RR'),nul l,null,'PE NDING','PE NDING',to_ date('12-M AR-18','DD -MON-RR'), null,to_da te('12-MAR -18','DD-M ON-RR'),nu ll,null,nu ll,null,nu ll,null); | |
| 2023 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.CLAIM_S UBMISSION_ NOTE | |
| 2024 | SET DEFINE OFF; | |
| 2025 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (100,5 7,'Adding a Dragon N ote','PEND ING','Drag onStatus', null,to_da te('06-FEB -18','DD-M ON-RR')); | |
| 2026 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (101,4 52,'Adding a Dragon Note','PEN DING','Dra gonStatus' ,null,to_d ate('06-FE B-18','DD- MON-RR')); | |
| 2027 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (102,4 53,'Adding a Dragon Note','PEN DING','Dra gonStatus' ,null,to_d ate('06-FE B-18','DD- MON-RR')); | |
| 2028 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (103,4 56,'Adding a Dragon Note','PEN DING','Dra gonStatus' ,null,to_d ate('06-FE B-18','DD- MON-RR')); | |
| 2029 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (104,4 58,'Adding a Dragon Note','PEN DING','Dra gonStatus' ,null,to_d ate('06-FE B-18','DD- MON-RR')); | |
| 2030 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (105,4 62,'Adding a Dragon Note','PEN DING','Dra gonStatus' ,null,to_d ate('06-FE B-18','DD- MON-RR')); | |
| 2031 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (106,4 62,'Adding a Dragon Note','Dra gonStatus' ,'DragonSt atus2',nul l,to_date( '06-FEB-18 ','DD-MON- RR')); | |
| 2032 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (107,1 ,'Adding a Dragon No te','PENDI NG','Drago nStatus2', null,to_da te('06-FEB -18','DD-M ON-RR')); | |
| 2033 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (109,1 ,null,'Dra gonStatus2 ','DragonS tatus2',nu ll,to_date ('07-FEB-1 8','DD-MON -RR')); | |
| 2034 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (110,1 ,null,'Dra gonStatus2 ','DragonS tatus2',nu ll,to_date ('07-FEB-1 8','DD-MON -RR')); | |
| 2035 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (111,1 ,null,'Dra gonStatus2 ',null,nul l,to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2036 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (112,1 ,null,null ,'NEWSTATU S',null,to _date('07- FEB-18','D D-MON-RR') ); | |
| 2037 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (113,1 ,null,'NEW STATUS','N EWSTATUS', null,to_da te('07-FEB -18','DD-M ON-RR')); | |
| 2038 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (114,1 ,null,'NEW STATUS','N EWSTATUS', null,to_da te('07-FEB -18','DD-M ON-RR')); | |
| 2039 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (115,1 ,null,'NEW STATUS','N EWSTATUS', null,to_da te('07-FEB -18','DD-M ON-RR')); | |
| 2040 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (116,1 ,null,'NEW STATUS','N EWSTATUS2' ,null,to_d ate('07-FE B-18','DD- MON-RR')); | |
| 2041 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (117,1 66,'Test', 'SUBMITTED ','Complet e',null,to _date('07- FEB-18','D D-MON-RR') ); | |
| 2042 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (118,1 66,'Test', 'Complete' ,'Complete ',null,to_ date('07-F EB-18','DD -MON-RR')) ; | |
| 2043 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (119,1 88,'test', 'SUBMITTED ','Complet e',null,to _date('07- FEB-18','D D-MON-RR') ); | |
| 2044 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (120,1 66,'Notes' ,'Complete ','Closed' ,null,to_d ate('07-FE B-18','DD- MON-RR')); | |
| 2045 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (121,1 66,'notes' ,'Closed', 'Abandoned ',null,to_ date('07-F EB-18','DD -MON-RR')) ; | |
| 2046 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (122,1 66,'Notes' ,'Abandone d','Closed ',null,to_ date('07-F EB-18','DD -MON-RR')) ; | |
| 2047 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (123,1 66,'tests' ,'Closed', 'Error',nu ll,to_date ('07-FEB-1 8','DD-MON -RR')); | |
| 2048 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (124,2 04,'New up date','PEN DING','Com plete',nul l,to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2049 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (125,2 58,null,'P ENDING','E rror',null ,to_date(' 08-FEB-18' ,'DD-MON-R R')); | |
| 2050 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (126,2 58,null,'E rror','Pen ding Respo nse',null, to_date('0 8-FEB-18', 'DD-MON-RR ')); | |
| 2051 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (127,2 58,'notes' ,'Pending Response', 'Pending R esponse',n ull,to_dat e('08-FEB- 18','DD-MO N-RR')); | |
| 2052 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (128,4 94,'THIS I S A NOTE', null,'ABAN DONED',nul l,to_date( '08-FEB-18 ','DD-MON- RR')); | |
| 2053 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (129,4 94,'THIS I S A NOTE', 'ABANDONED ','ABANDON ED',null,t o_date('08 -FEB-18',' DD-MON-RR' )); | |
| 2054 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (130,4 94,'THIS I S A NOTE', 'ABANDONED ','ABANDON ED',null,t o_date('08 -FEB-18',' DD-MON-RR' )); | |
| 2055 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (131,4 94,'THIS I S A NOTE', 'ABANDONED ','ABANDON ED',null,t o_date('08 -FEB-18',' DD-MON-RR' )); | |
| 2056 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (132,1 66,'test', 'Error','C omplete',n ull,to_dat e('08-FEB- 18','DD-MO N-RR')); | |
| 2057 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (133,1 66,'Test', 'Complete' ,'Complete ',null,to_ date('08-F EB-18','DD -MON-RR')) ; | |
| 2058 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (134,1 66,'test', 'Complete' ,'Error',n ull,to_dat e('08-FEB- 18','DD-MO N-RR')); | |
| 2059 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (135,1 66,'Test', 'Error','C omplete',n ull,to_dat e('08-FEB- 18','DD-MO N-RR')); | |
| 2060 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (136,2 52,null,'P ENDING','P ENDING',nu ll,to_date ('09-FEB-1 8','DD-MON -RR')); | |
| 2061 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (137,2 52,null,'P ENDING','A bandoned', null,to_da te('09-FEB -18','DD-M ON-RR')); | |
| 2062 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (138,2 52,null,'A bandoned', 'Pending R esponse',n ull,to_dat e('09-FEB- 18','DD-MO N-RR')); | |
| 2063 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (139,5 63,null,nu ll,'Pendin g Response ',null,to_ date('09-F EB-18','DD -MON-RR')) ; | |
| 2064 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (140,5 63,null,'P ending Res ponse','Er ror',null, to_date('0 9-FEB-18', 'DD-MON-RR ')); | |
| 2065 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (141,5 63,'test c omments | |
| 2066 | ||
| 2067 | test comme nts 2','Er ror','Erro r',null,to _date('09- FEB-18','D D-MON-RR') ); | |
| 2068 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (142,2 58,null,'P ending Res ponse','Ab andoned',n ull,to_dat e('11-FEB- 18','DD-MO N-RR')); | |
| 2069 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (143,1 66,'Test', 'Complete' ,'Error',n ull,to_dat e('12-FEB- 18','DD-MO N-RR')); | |
| 2070 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (144,4 94,'THIS I S A NOTE', 'ABANDONED ','ABANDON ED',null,t o_date('12 -FEB-18',' DD-MON-RR' )); | |
| 2071 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (145,4 94,'THIS I S A NOTE', 'ABANDONED ','ABANDON ED',null,t o_date('12 -FEB-18',' DD-MON-RR' )); | |
| 2072 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (146,1 66,null,'E rror','Err or',null,t o_date('12 -FEB-18',' DD-MON-RR' )); | |
| 2073 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (147,6 03,'Test', 'PENDING', 'Complete' ,null,to_d ate('12-FE B-18','DD- MON-RR')); | |
| 2074 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (148,6 03,null,'C omplete',' Complete', null,to_da te('12-FEB -18','DD-M ON-RR')); | |
| 2075 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (149,6 03,'Abondo ned','Comp lete','Aba ndoned',nu ll,to_date ('12-FEB-1 8','DD-MON -RR')); | |
| 2076 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (150,6 11,'update d response due date TEST','PEN DING','PEN DING',null ,to_date(' 12-FEB-18' ,'DD-MON-R R')); | |
| 2077 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (151,6 11,'update d response due date TEST | |
| 2078 | updated to error TES T 2 | |
| 2079 | ','PENDING ','Error', null,to_da te('12-FEB -18','DD-M ON-RR')); | |
| 2080 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (152,6 06,'save 1 | |
| 2081 | ','PENDING ','PENDING ',null,to_ date('12-F EB-18','DD -MON-RR')) ; | |
| 2082 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (153,6 11,'write something' ,'Error',' Error',nul l,to_date( '12-FEB-18 ','DD-MON- RR')); | |
| 2083 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (154,6 11,'write something' ,'Error',' Error',nul l,to_date( '12-FEB-18 ','DD-MON- RR')); | |
| 2084 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (155,6 19,'commen t required ? test | |
| 2085 | ','PENDING ','Error', null,to_da te('12-FEB -18','DD-M ON-RR')); | |
| 2086 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (156,4 94,'THIS I S A NOTE', 'ABANDONED ','ABANDON ED',null,t o_date('13 -FEB-18',' DD-MON-RR' )); | |
| 2087 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (157,6 21,'Update d for Test ing','PEND ING','Manu ally Close d',null,to _date('13- FEB-18','D D-MON-RR') ); | |
| 2088 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (158,6 21,'Update d for Test ing','Manu ally Close d','Manual ly Closed' ,null,to_d ate('13-FE B-18','DD- MON-RR')); | |
| 2089 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (159,6 21,'Note', 'Manually Closed','C omplete',n ull,to_dat e('13-FEB- 18','DD-MO N-RR')); | |
| 2090 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (160,6 21,'Note', 'Complete' ,'Complete ',null,to_ date('13-F EB-18','DD -MON-RR')) ; | |
| 2091 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (161,6 21,'Note', 'Complete' ,'Complete ',null,to_ date('13-F EB-18','DD -MON-RR')) ; | |
| 2092 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (162,6 0,'alter', 'PENDING', 'PENDING', null,to_da te('13-FEB -18','DD-M ON-RR')); | |
| 2093 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (163,6 23,'THIS I S A NOTE', 'PENDING', 'ABANDONED ',null,to_ date('14-F EB-18','DD -MON-RR')) ; | |
| 2094 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (164,6 23,'THIS I S A NOTE', 'ABANDONED ','PENDING ',null,to_ date('14-F EB-18','DD -MON-RR')) ; | |
| 2095 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (165,6 23,'THIS I S A NOTE', 'PENDING', 'PENDING', null,to_da te('14-FEB -18','DD-M ON-RR')); | |
| 2096 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (166,6 23,'THIS I S A NOTE', 'PENDING', 'PENDING', null,to_da te('14-FEB -18','DD-M ON-RR')); | |
| 2097 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (167,6 11,'update d to manua lly closed ','Error', 'Manually Closed',nu ll,to_date ('14-FEB-1 8','DD-MON -RR')); | |
| 2098 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (168,1 66,'I rece ived this attachment via post and upload ed or prov ided here: ','Error' ,'Manually Closed',n ull,to_dat e('16-FEB- 18','DD-MO N-RR')); | |
| 2099 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (169,1 66,'I rece ived this attachment via post and upload ed or prov ided here: ','Manual ly Closed' ,'Manually Closed',n ull,to_dat e('16-FEB- 18','DD-MO N-RR')); | |
| 2100 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (170,6 23,'THIS I S A NOTE', 'PENDING', 'PENDING', null,to_da te('02-MAR -18','DD-M ON-RR')); | |
| 2101 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (171,6 23,'THIS I S A NOTE', 'PENDING', 'PENDING', null,to_da te('05-MAR -18','DD-M ON-RR')); | |
| 2102 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (172,6 23,'THIS I S A NOTE', 'PENDING', 'PENDING', null,to_da te('05-MAR -18','DD-M ON-RR')); | |
| 2103 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (173,6 23,'THIS I S A NOTE', 'PENDING', 'PENDING', null,to_da te('06-MAR -18','DD-M ON-RR')); | |
| 2104 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (174,6 23,'THIS I S A NOTE', 'PENDING', 'PENDING', null,to_da te('06-MAR -18','DD-M ON-RR')); | |
| 2105 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SUBMISSI ON_NOTE (C LAIM_SUBMI SSION_NOTE _ID,CLAIM_ SUBMISSION _ID,CLAIM_ SUBMISSION _NOTE,CLAI M_SUBMISSI ON_OLD_STA TUS,CLAIM_ SUBMISSION _NEW_STATU S,CREATED_ BY,DATE_CR EATED) val ues (175,6 23,'THIS I S A NOTE', 'PENDING', 'PENDING', null,to_da te('08-MAR -18','DD-M ON-RR')); | |
| 2106 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.CLAIM_S VC_LINES | |
| 2107 | SET DEFINE OFF; | |
| 2108 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (52, 440,'10087 ',to_date( '01-DEC-17 ','DD-MON- RR'),to_da te('02-DEC -17','DD-M ON-RR'),nu ll,'Dragon Procedurec ode','Drag onMod',3.5 ,null,null ); | |
| 2109 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (53, 59,'10087' ,to_date(' 01-DEC-17' ,'DD-MON-R R'),to_dat e('02-DEC- 17','DD-MO N-RR'),nul l,'DragonP rocedureco de','Drago nMod',3.5, to_date('1 1-JAN-18', 'DD-MON-RR '),to_date ('11-JAN-1 8','DD-MON -RR')); | |
| 2110 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (60, 60,'10087' ,to_date(' 01-DEC-17' ,'DD-MON-R R'),to_dat e('02-DEC- 17','DD-MO N-RR'),nul l,'DragonP rocedureco de','Drago nMod',3.5, to_date('1 1-JAN-18', 'DD-MON-RR '),to_date ('11-JAN-1 8','DD-MON -RR')); | |
| 2111 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (63, 64,'10088' ,to_date(' 11-SEP-17' ,'DD-MON-R R'),to_dat e('21-SEP- 17','DD-MO N-RR'),'16 ','aaa',nu ll,111,to_ date('11-J AN-18','DD -MON-RR'), to_date('1 1-JAN-18', 'DD-MON-RR ')); | |
| 2112 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (64, 65,'10087' ,to_date(' 01-DEC-17' ,'DD-MON-R R'),to_dat e('02-DEC- 17','DD-MO N-RR'),'Dr agonRevenu eCode','Dr agonProced urecode',' DragonMod' ,3.5,to_da te('11-JAN -18','DD-M ON-RR'),to _date('11- JAN-18','D D-MON-RR') ); | |
| 2113 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (114 ,115,'1008 7',to_date ('01-DEC-1 7','DD-MON -RR'),to_d ate('02-DE C-17','DD- MON-RR'),' DragonReve nueCode',' DragonProc edurecode' ,'DragonMo d',3.5,to_ date('11-J AN-18','DD -MON-RR'), to_date('1 1-JAN-18', 'DD-MON-RR ')); | |
| 2114 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (115 ,116,'1008 7',to_date ('01-DEC-1 7','DD-MON -RR'),to_d ate('02-DE C-17','DD- MON-RR'),' DragonReve nueCode',' DragonProc edurecode' ,'DragonMo d',3.5,to_ date('11-J AN-18','DD -MON-RR'), to_date('1 1-JAN-18', 'DD-MON-RR ')); | |
| 2115 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (116 ,117,'1008 7',to_date ('01-DEC-1 7','DD-MON -RR'),to_d ate('02-DE C-17','DD- MON-RR'),' DragonReve nueCode',' DragonProc edurecode' ,'DragonMo d',3.5,to_ date('11-J AN-18','DD -MON-RR'), to_date('1 1-JAN-18', 'DD-MON-RR ')); | |
| 2116 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (68, 69,'10089' ,to_date(' 11-SEP-17' ,'DD-MON-R R'),to_dat e('21-SEP- 17','DD-MO N-RR'),'16 ','aaa',nu ll,111,to_ date('11-J AN-18','DD -MON-RR'), to_date('1 1-JAN-18', 'DD-MON-RR ')); | |
| 2117 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (118 ,119,'1008 7',to_date ('01-DEC-1 7','DD-MON -RR'),to_d ate('02-DE C-17','DD- MON-RR'),' DragonReve nueCode',' DragonProc edurecode' ,'DragonMo d',3.5,to_ date('11-J AN-18','DD -MON-RR'), to_date('1 1-JAN-18', 'DD-MON-RR ')); | |
| 2118 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (70, 71,'10090' ,to_date(' 11-SEP-17' ,'DD-MON-R R'),to_dat e('21-SEP- 17','DD-MO N-RR'),'16 ','aaa',nu ll,111,to_ date('11-J AN-18','DD -MON-RR'), to_date('1 1-JAN-18', 'DD-MON-RR ')); | |
| 2119 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (121 ,122,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -JAN-18',' DD-MON-RR' ),to_date( '12-JAN-18 ','DD-MON- RR')); | |
| 2120 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (122 ,123,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -JAN-18',' DD-MON-RR' ),to_date( '12-JAN-18 ','DD-MON- RR')); | |
| 2121 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (123 ,125,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -JAN-18',' DD-MON-RR' ),to_date( '12-JAN-18 ','DD-MON- RR')); | |
| 2122 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (130 ,133,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -JAN-18',' DD-MON-RR' ),to_date( '12-JAN-18 ','DD-MON- RR')); | |
| 2123 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (131 ,135,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -JAN-18',' DD-MON-RR' ),to_date( '12-JAN-18 ','DD-MON- RR')); | |
| 2124 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (140 ,145,'1008 7',to_date ('01-DEC-1 7','DD-MON -RR'),to_d ate('02-DE C-17','DD- MON-RR'),' DragonReve nueCode',' DragonProc edurecode' ,'DragonMo d',3.5,to_ date('12-J AN-18','DD -MON-RR'), to_date('1 2-JAN-18', 'DD-MON-RR ')); | |
| 2125 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (143 ,148,'1008 7',to_date ('11-SEP-1 7','DD-MON -RR'),to_d ate('21-SE P-17','DD- MON-RR'),' 16','aaa', null,111,t o_date('12 -JAN-18',' DD-MON-RR' ),to_date( '12-JAN-18 ','DD-MON- RR')); | |
| 2126 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (144 ,149,'1008 7',to_date ('11-SEP-1 7','DD-MON -RR'),to_d ate('21-SE P-17','DD- MON-RR'),' 16','aaa', null,111,t o_date('12 -JAN-18',' DD-MON-RR' ),to_date( '12-JAN-18 ','DD-MON- RR')); | |
| 2127 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (145 ,150,'1008 7',to_date ('11-SEP-1 7','DD-MON -RR'),to_d ate('21-SE P-17','DD- MON-RR'),' 16','aaa', null,111,t o_date('12 -JAN-18',' DD-MON-RR' ),to_date( '12-JAN-18 ','DD-MON- RR')); | |
| 2128 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (156 ,156,'1008 7',to_date ('01-DEC-1 7','DD-MON -RR'),to_d ate('02-DE C-17','DD- MON-RR'),' DragonReve nueCode',' DragonProc edurecode' ,'DragonMo d',3.5,to_ date('12-J AN-18','DD -MON-RR'), to_date('1 2-JAN-18', 'DD-MON-RR ')); | |
| 2129 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (167 ,163,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -JAN-18',' DD-MON-RR' ),to_date( '12-JAN-18 ','DD-MON- RR')); | |
| 2130 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (168 ,164,'1008 7',to_date ('11-SEP-1 7','DD-MON -RR'),to_d ate('21-SE P-17','DD- MON-RR'),' 16','aaa', null,111,t o_date('12 -JAN-18',' DD-MON-RR' ),to_date( '12-JAN-18 ','DD-MON- RR')); | |
| 2131 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (171 ,166,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'12', '10000','J A,EE,QS,SG ',4829.52, to_date('1 2-JAN-18', 'DD-MON-RR '),to_date ('12-JAN-1 8','DD-MON -RR')); | |
| 2132 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (172 ,166,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'15', '10000','G 4,RT,LT,P3 ',17888.41 ,to_date(' 12-JAN-18' ,'DD-MON-R R'),to_dat e('12-JAN- 18','DD-MO N-RR')); | |
| 2133 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (176 ,169,'1008 7',to_date ('01-DEC-1 7','DD-MON -RR'),to_d ate('02-DE C-17','DD- MON-RR'),' DragonReve nueCode',' DragonProc edurecode' ,'DragonMo d',3.5,to_ date('12-J AN-18','DD -MON-RR'), to_date('1 2-JAN-18', 'DD-MON-RR ')); | |
| 2134 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (177 ,170,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -JAN-18',' DD-MON-RR' ),to_date( '12-JAN-18 ','DD-MON- RR')); | |
| 2135 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (178 ,171,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -JAN-18',' DD-MON-RR' ),to_date( '12-JAN-18 ','DD-MON- RR')); | |
| 2136 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (179 ,172,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -JAN-18',' DD-MON-RR' ),to_date( '12-JAN-18 ','DD-MON- RR')); | |
| 2137 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (180 ,173,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -JAN-18',' DD-MON-RR' ),to_date( '12-JAN-18 ','DD-MON- RR')); | |
| 2138 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (181 ,174,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -JAN-18',' DD-MON-RR' ),to_date( '12-JAN-18 ','DD-MON- RR')); | |
| 2139 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (182 ,175,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -JAN-18',' DD-MON-RR' ),to_date( '12-JAN-18 ','DD-MON- RR')); | |
| 2140 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (183 ,176,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -JAN-18',' DD-MON-RR' ),to_date( '12-JAN-18 ','DD-MON- RR')); | |
| 2141 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (184 ,177,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -JAN-18',' DD-MON-RR' ),to_date( '12-JAN-18 ','DD-MON- RR')); | |
| 2142 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (185 ,178,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -JAN-18',' DD-MON-RR' ),to_date( '12-JAN-18 ','DD-MON- RR')); | |
| 2143 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (186 ,179,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -JAN-18',' DD-MON-RR' ),to_date( '12-JAN-18 ','DD-MON- RR')); | |
| 2144 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (192 ,185,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -JAN-18',' DD-MON-RR' ),to_date( '12-JAN-18 ','DD-MON- RR')); | |
| 2145 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (194 ,187,'1',t o_date('18 -APR-11',' DD-MON-RR' ),to_date( '18-APR-11 ','DD-MON- RR'),'212' ,'99212',' 21,ac,14,2 1',60,to_d ate('12-JA N-18','DD- MON-RR'),t o_date('12 -JAN-18',' DD-MON-RR' )); | |
| 2146 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (195 ,191,'1000 1',to_date ('14-SEP-1 7','DD-MON -RR'),to_d ate('12-SE P-17','DD- MON-RR'),' 15','10001 ','G4,RT,A A,SG',8539 .97,to_dat e('12-JAN- 18','DD-MO N-RR'),to_ date('12-J AN-18','DD -MON-RR')) ; | |
| 2147 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (196 ,193,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -JAN-18',' DD-MON-RR' ),to_date( '12-JAN-18 ','DD-MON- RR')); | |
| 2148 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (197 ,195,'1234 5',to_date ('12-JAN-1 8','DD-MON -RR'),to_d ate('12-JA N-18','DD- MON-RR'),' 7890554',n ull,'gfhjg fh',12345, to_date('1 2-JAN-18', 'DD-MON-RR '),to_date ('12-JAN-1 8','DD-MON -RR')); | |
| 2149 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (198 ,198,'1024 1',to_date ('13-SEP-1 7','DD-MON -RR'),to_d ate('13-SE P-17','DD- MON-RR'),' 17','10241 ','JA,EE,Q S,EE',1036 5.13,to_da te('15-JAN -18','DD-M ON-RR'),to _date('15- JAN-18','D D-MON-RR') ); | |
| 2150 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (199 ,199,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('15 -JAN-18',' DD-MON-RR' ),to_date( '15-JAN-18 ','DD-MON- RR')); | |
| 2151 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (200 ,200,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('15 -JAN-18',' DD-MON-RR' ),to_date( '15-JAN-18 ','DD-MON- RR')); | |
| 2152 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (201 ,204,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'15', '10000','G 4,RT,LT,P3 ',17888.41 ,to_date(' 16-JAN-18' ,'DD-MON-R R'),to_dat e('16-JAN- 18','DD-MO N-RR')); | |
| 2153 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (202 ,205,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'15', '10000','G 4,RT,LT,P3 ',17888.41 ,to_date(' 16-JAN-18' ,'DD-MON-R R'),to_dat e('16-JAN- 18','DD-MO N-RR')); | |
| 2154 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (203 ,206,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'15', '10000','G 4,RT,LT,P3 ',17888.41 ,to_date(' 16-JAN-18' ,'DD-MON-R R'),to_dat e('16-JAN- 18','DD-MO N-RR')); | |
| 2155 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (204 ,220,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('16 -JAN-18',' DD-MON-RR' ),to_date( '16-JAN-18 ','DD-MON- RR')); | |
| 2156 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (205 ,221,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('16 -JAN-18',' DD-MON-RR' ),to_date( '16-JAN-18 ','DD-MON- RR')); | |
| 2157 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (206 ,222,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('16 -JAN-18',' DD-MON-RR' ),to_date( '16-JAN-18 ','DD-MON- RR')); | |
| 2158 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (207 ,224,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('16 -JAN-18',' DD-MON-RR' ),to_date( '16-JAN-18 ','DD-MON- RR')); | |
| 2159 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (208 ,225,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('16 -JAN-18',' DD-MON-RR' ),to_date( '16-JAN-18 ','DD-MON- RR')); | |
| 2160 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (209 ,226,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'12', '10000','J A,EE,QS,SG ',4829.52, to_date('1 6-JAN-18', 'DD-MON-RR '),to_date ('16-JAN-1 8','DD-MON -RR')); | |
| 2161 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (210 ,226,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'15', '10000','G 4,RT,LT,P3 ',17888.41 ,to_date(' 16-JAN-18' ,'DD-MON-R R'),to_dat e('16-JAN- 18','DD-MO N-RR')); | |
| 2162 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (211 ,227,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'12', '10000','J A,EE,QS,SG ',4829.52, to_date('1 6-JAN-18', 'DD-MON-RR '),to_date ('16-JAN-1 8','DD-MON -RR')); | |
| 2163 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (212 ,227,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'15', '10000','G 4,RT,LT,P3 ',17888.41 ,to_date(' 16-JAN-18' ,'DD-MON-R R'),to_dat e('16-JAN- 18','DD-MO N-RR')); | |
| 2164 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (213 ,228,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'12', '10000','J A,EE,QS,SG ',4829.52, to_date('1 6-JAN-18', 'DD-MON-RR '),to_date ('16-JAN-1 8','DD-MON -RR')); | |
| 2165 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (214 ,228,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'15', '10000','G 4,RT,LT,P3 ',17888.41 ,to_date(' 16-JAN-18' ,'DD-MON-R R'),to_dat e('16-JAN- 18','DD-MO N-RR')); | |
| 2166 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (216 ,243,'2',t o_date('07 -JUN-17',' DD-MON-RR' ),to_date( '08-JUN-17 ','DD-MON- RR'),'321' ,null,'005 56',333,to _date('16- JAN-18','D D-MON-RR') ,to_date(' 16-JAN-18' ,'DD-MON-R R')); | |
| 2167 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (217 ,243,'1',t o_date('06 -JUN-17',' DD-MON-RR' ),to_date( '07-JUN-17 ','DD-MON- RR'),'123' ,null,'890 ',123,to_d ate('16-JA N-18','DD- MON-RR'),t o_date('16 -JAN-18',' DD-MON-RR' )); | |
| 2168 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (219 ,245,'1',t o_date('06 -JUN-17',' DD-MON-RR' ),to_date( '07-JUN-17 ','DD-MON- RR'),'123' ,null,'890 ',123,to_d ate('16-JA N-18','DD- MON-RR'),t o_date('16 -JAN-18',' DD-MON-RR' )); | |
| 2169 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (220 ,245,'2',t o_date('07 -JUN-17',' DD-MON-RR' ),to_date( '08-JUN-17 ','DD-MON- RR'),'321' ,null,'005 56',333,to _date('16- JAN-18','D D-MON-RR') ,to_date(' 16-JAN-18' ,'DD-MON-R R')); | |
| 2170 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (221 ,246,'2',t o_date('07 -JUN-17',' DD-MON-RR' ),to_date( '08-JUN-17 ','DD-MON- RR'),'321' ,null,'005 56',333,to _date('16- JAN-18','D D-MON-RR') ,to_date(' 16-JAN-18' ,'DD-MON-R R')); | |
| 2171 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (222 ,246,'1',t o_date('06 -JUN-17',' DD-MON-RR' ),to_date( '07-JUN-17 ','DD-MON- RR'),'123' ,null,'890 ',123,to_d ate('16-JA N-18','DD- MON-RR'),t o_date('16 -JAN-18',' DD-MON-RR' )); | |
| 2172 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (223 ,247,'2',t o_date('07 -JUN-17',' DD-MON-RR' ),to_date( '08-JUN-17 ','DD-MON- RR'),'321' ,null,'005 56',333,to _date('16- JAN-18','D D-MON-RR') ,to_date(' 16-JAN-18' ,'DD-MON-R R')); | |
| 2173 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (224 ,247,'1',t o_date('06 -JUN-17',' DD-MON-RR' ),to_date( '07-JUN-17 ','DD-MON- RR'),'123' ,null,'890 ',123,to_d ate('16-JA N-18','DD- MON-RR'),t o_date('16 -JAN-18',' DD-MON-RR' )); | |
| 2174 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (226 ,250,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'GP,RT,AS, T5',9985.7 7,to_date( '16-JAN-18 ','DD-MON- RR'),to_da te('16-JAN -18','DD-M ON-RR')); | |
| 2175 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (227 ,252,'1',t o_date('11 -SEP-17',' DD-MON-RR' ),to_date( '12-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,EE,AA, AQ',16124. 57,to_date ('16-JAN-1 8','DD-MON -RR'),to_d ate('16-JA N-18','DD- MON-RR')); | |
| 2176 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (228 ,254,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('16 -JAN-18',' DD-MON-RR' ),to_date( '16-JAN-18 ','DD-MON- RR')); | |
| 2177 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (230 ,258,'1',t o_date('11 -SEP-17',' DD-MON-RR' ),to_date( '12-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,EE,AA, AQ',16124. 57,to_date ('16-JAN-1 8','DD-MON -RR'),to_d ate('16-JA N-18','DD- MON-RR')); | |
| 2178 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (231 ,259,'6',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0636 ','J9190', null,64.33 ,to_date(' 16-JAN-18' ,'DD-MON-R R'),to_dat e('16-JAN- 18','DD-MO N-RR')); | |
| 2179 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (232 ,259,'3',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0335 ','96409', null,507,t o_date('16 -JAN-18',' DD-MON-RR' ),to_date( '16-JAN-18 ','DD-MON- RR')); | |
| 2180 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (233 ,259,'5',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0636 ','J7050', null,8.6,t o_date('16 -JAN-18',' DD-MON-RR' ),to_date( '16-JAN-18 ','DD-MON- RR')); | |
| 2181 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (234 ,260,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '10-SEP-17 ','DD-MON- RR'),'0582 ','99509', 'GP,QS,LT, EE',1859.0 2,to_date( '16-JAN-18 ','DD-MON- RR'),to_da te('16-JAN -18','DD-M ON-RR')); | |
| 2182 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (235 ,261,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'GP,RT,AS, T5',9985.7 7,to_date( '16-JAN-18 ','DD-MON- RR'),to_da te('16-JAN -18','DD-M ON-RR')); | |
| 2183 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (236 ,262,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'GP,RT,AS, T5',9985.7 7,to_date( '16-JAN-18 ','DD-MON- RR'),to_da te('16-JAN -18','DD-M ON-RR')); | |
| 2184 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (237 ,268,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('16-JAN-1 8','DD-MON -RR'),to_d ate('16-JA N-18','DD- MON-RR')); | |
| 2185 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (238 ,268,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '16-JAN-18 ','DD-MON- RR'),to_da te('16-JAN -18','DD-M ON-RR')); | |
| 2186 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (239 ,269,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('16-JAN-1 8','DD-MON -RR'),to_d ate('16-JA N-18','DD- MON-RR')); | |
| 2187 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (240 ,269,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '16-JAN-18 ','DD-MON- RR'),to_da te('16-JAN -18','DD-M ON-RR')); | |
| 2188 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (241 ,270,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('16-JAN-1 8','DD-MON -RR'),to_d ate('16-JA N-18','DD- MON-RR')); | |
| 2189 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (242 ,270,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '16-JAN-18 ','DD-MON- RR'),to_da te('16-JAN -18','DD-M ON-RR')); | |
| 2190 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (243 ,273,'1',t o_date('22 -APR-11',' DD-MON-RR' ),to_date( '22-APR-11 ','DD-MON- RR'),null, '73610',nu ll,60,to_d ate('16-JA N-18','DD- MON-RR'),t o_date('16 -JAN-18',' DD-MON-RR' )); | |
| 2191 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (244 ,275,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'GP,RT,AS, T5',9985.7 7,to_date( '16-JAN-18 ','DD-MON- RR'),to_da te('16-JAN -18','DD-M ON-RR')); | |
| 2192 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (245 ,276,'1',t o_date('18 -APR-11',' DD-MON-RR' ),to_date( '18-APR-11 ','DD-MON- RR'),'212' ,'99212',' 21,ac,14,2 1',60,to_d ate('16-JA N-18','DD- MON-RR'),t o_date('16 -JAN-18',' DD-MON-RR' )); | |
| 2193 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (246 ,280,'1',t o_date('11 -SEP-17',' DD-MON-RR' ),to_date( '11-SEP-17 ','DD-MON- RR'),'0450 ','99285', 'JA,SG,AS, EE',11348. 29,to_date ('16-JAN-1 8','DD-MON -RR'),to_d ate('16-JA N-18','DD- MON-RR')); | |
| 2194 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (247 ,281,'1',t o_date('11 -SEP-17',' DD-MON-RR' ),to_date( '11-SEP-17 ','DD-MON- RR'),'0450 ','99285', 'JA,SG,AS, EE',11348. 29,to_date ('16-JAN-1 8','DD-MON -RR'),to_d ate('16-JA N-18','DD- MON-RR')); | |
| 2195 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (248 ,282,'1',t o_date('11 -SEP-17',' DD-MON-RR' ),to_date( '11-SEP-17 ','DD-MON- RR'),'0450 ','99285', 'JA,SG,AS, EE',11348. 29,to_date ('16-JAN-1 8','DD-MON -RR'),to_d ate('16-JA N-18','DD- MON-RR')); | |
| 2196 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (249 ,285,'1',t o_date('01 -JAN-17',' DD-MON-RR' ),to_date( '02-JAN-17 ','DD-MON- RR'),'123' ,null,'08, 05',100,t o_date('16 -JAN-18',' DD-MON-RR' ),to_date( '16-JAN-18 ','DD-MON- RR')); | |
| 2197 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (250 ,285,'2',t o_date('01 -JAN-17',' DD-MON-RR' ),to_date( '02-JAN-17 ','DD-MON- RR'),'456' ,null,'12, 500',300, to_date('1 6-JAN-18', 'DD-MON-RR '),to_date ('16-JAN-1 8','DD-MON -RR')); | |
| 2198 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (251 ,288,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'GP,RT,AS, T5',9985.7 7,to_date( '16-JAN-18 ','DD-MON- RR'),to_da te('16-JAN -18','DD-M ON-RR')); | |
| 2199 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (252 ,291,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'GP,RT,AS, T5',9985.7 7,to_date( '16-JAN-18 ','DD-MON- RR'),to_da te('16-JAN -18','DD-M ON-RR')); | |
| 2200 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (253 ,292,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('16 -JAN-18',' DD-MON-RR' ),to_date( '16-JAN-18 ','DD-MON- RR')); | |
| 2201 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (254 ,296,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'GP,RT,AS, T5',9985.7 7,to_date( '16-JAN-18 ','DD-MON- RR'),to_da te('16-JAN -18','DD-M ON-RR')); | |
| 2202 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (255 ,303,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'GP,RT,AS, T5',9985.7 7,to_date( '16-JAN-18 ','DD-MON- RR'),to_da te('16-JAN -18','DD-M ON-RR')); | |
| 2203 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (256 ,304,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0551 ','G0154', 'JA,RT,LT, SG',16564. 32,to_date ('16-JAN-1 8','DD-MON -RR'),to_d ate('16-JA N-18','DD- MON-RR')); | |
| 2204 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (257 ,306,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'GP,RT,AS, T5',9985.7 7,to_date( '16-JAN-18 ','DD-MON- RR'),to_da te('16-JAN -18','DD-M ON-RR')); | |
| 2205 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (258 ,307,'1',t o_date('18 -APR-11',' DD-MON-RR' ),to_date( '18-APR-11 ','DD-MON- RR'),'212' ,'99212',' 21,ac,14,2 1',60,to_d ate('16-JA N-18','DD- MON-RR'),t o_date('16 -JAN-18',' DD-MON-RR' )); | |
| 2206 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (259 ,308,'2',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0333 ','77386', null,3357, to_date('1 6-JAN-18', 'DD-MON-RR '),to_date ('16-JAN-1 8','DD-MON -RR')); | |
| 2207 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (260 ,308,'5',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0636 ','J7050', null,8.6,t o_date('16 -JAN-18',' DD-MON-RR' ),to_date( '16-JAN-18 ','DD-MON- RR')); | |
| 2208 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (261 ,311,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0551 ','G0154', 'JA,RT,LT, SG',16564. 32,to_date ('17-JAN-1 8','DD-MON -RR'),to_d ate('17-JA N-18','DD- MON-RR')); | |
| 2209 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (263 ,313,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('18 -JAN-18',' DD-MON-RR' ),to_date( '18-JAN-18 ','DD-MON- RR')); | |
| 2210 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (264 ,314,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('18 -JAN-18',' DD-MON-RR' ),to_date( '18-JAN-18 ','DD-MON- RR')); | |
| 2211 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (265 ,315,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('18 -JAN-18',' DD-MON-RR' ),to_date( '18-JAN-18 ','DD-MON- RR')); | |
| 2212 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (266 ,316,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('18 -JAN-18',' DD-MON-RR' ),to_date( '18-JAN-18 ','DD-MON- RR')); | |
| 2213 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (267 ,317,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('18 -JAN-18',' DD-MON-RR' ),to_date( '18-JAN-18 ','DD-MON- RR')); | |
| 2214 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (268 ,318,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('18 -JAN-18',' DD-MON-RR' ),to_date( '18-JAN-18 ','DD-MON- RR')); | |
| 2215 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (269 ,319,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('18 -JAN-18',' DD-MON-RR' ),to_date( '18-JAN-18 ','DD-MON- RR')); | |
| 2216 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (270 ,320,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('18 -JAN-18',' DD-MON-RR' ),to_date( '18-JAN-18 ','DD-MON- RR')); | |
| 2217 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (271 ,321,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('18 -JAN-18',' DD-MON-RR' ),to_date( '18-JAN-18 ','DD-MON- RR')); | |
| 2218 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (272 ,322,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('18 -JAN-18',' DD-MON-RR' ),to_date( '18-JAN-18 ','DD-MON- RR')); | |
| 2219 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (273 ,323,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('18 -JAN-18',' DD-MON-RR' ),to_date( '18-JAN-18 ','DD-MON- RR')); | |
| 2220 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (274 ,324,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('18 -JAN-18',' DD-MON-RR' ),to_date( '18-JAN-18 ','DD-MON- RR')); | |
| 2221 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (275 ,325,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('18 -JAN-18',' DD-MON-RR' ),to_date( '18-JAN-18 ','DD-MON- RR')); | |
| 2222 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (276 ,326,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('18 -JAN-18',' DD-MON-RR' ),to_date( '18-JAN-18 ','DD-MON- RR')); | |
| 2223 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (277 ,328,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('19 -JAN-18',' DD-MON-RR' ),to_date( '19-JAN-18 ','DD-MON- RR')); | |
| 2224 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (278 ,329,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('19 -JAN-18',' DD-MON-RR' ),to_date( '19-JAN-18 ','DD-MON- RR')); | |
| 2225 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (279 ,330,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('19 -JAN-18',' DD-MON-RR' ),to_date( '19-JAN-18 ','DD-MON- RR')); | |
| 2226 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (280 ,331,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('19 -JAN-18',' DD-MON-RR' ),to_date( '19-JAN-18 ','DD-MON- RR')); | |
| 2227 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (281 ,332,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('19 -JAN-18',' DD-MON-RR' ),to_date( '19-JAN-18 ','DD-MON- RR')); | |
| 2228 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (282 ,333,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('19 -JAN-18',' DD-MON-RR' ),to_date( '19-JAN-18 ','DD-MON- RR')); | |
| 2229 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (284 ,336,'8',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0636 ','J9280', null,802.9 5,to_date( '19-JAN-18 ','DD-MON- RR'),to_da te('19-JAN -18','DD-M ON-RR')); | |
| 2230 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (285 ,336,'6',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0636 ','J9190', null,64.33 ,to_date(' 19-JAN-18' ,'DD-MON-R R'),to_dat e('19-JAN- 18','DD-MO N-RR')); | |
| 2231 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (286 ,336,'4',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0352 ','77014', null,1372, to_date('1 9-JAN-18', 'DD-MON-RR '),to_date ('19-JAN-1 8','DD-MON -RR')); | |
| 2232 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (287 ,337,'8',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0636 ','J9280', null,802.9 5,to_date( '19-JAN-18 ','DD-MON- RR'),to_da te('19-JAN -18','DD-M ON-RR')); | |
| 2233 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (288 ,337,'4',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0352 ','77014', null,1372, to_date('1 9-JAN-18', 'DD-MON-RR '),to_date ('19-JAN-1 8','DD-MON -RR')); | |
| 2234 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (289 ,337,'6',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0636 ','J9190', null,64.33 ,to_date(' 19-JAN-18' ,'DD-MON-R R'),to_dat e('19-JAN- 18','DD-MO N-RR')); | |
| 2235 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (290 ,338,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('19 -JAN-18',' DD-MON-RR' ),to_date( '19-JAN-18 ','DD-MON- RR')); | |
| 2236 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (291 ,339,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('19 -JAN-18',' DD-MON-RR' ),to_date( '19-JAN-18 ','DD-MON- RR')); | |
| 2237 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (292 ,341,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('22 -JAN-18',' DD-MON-RR' ),to_date( '22-JAN-18 ','DD-MON- RR')); | |
| 2238 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (293 ,342,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('22 -JAN-18',' DD-MON-RR' ),to_date( '22-JAN-18 ','DD-MON- RR')); | |
| 2239 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (294 ,343,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('22 -JAN-18',' DD-MON-RR' ),to_date( '22-JAN-18 ','DD-MON- RR')); | |
| 2240 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (295 ,344,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('22 -JAN-18',' DD-MON-RR' ),to_date( '22-JAN-18 ','DD-MON- RR')); | |
| 2241 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (296 ,345,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('22 -JAN-18',' DD-MON-RR' ),to_date( '22-JAN-18 ','DD-MON- RR')); | |
| 2242 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (297 ,346,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('23 -JAN-18',' DD-MON-RR' ),to_date( '23-JAN-18 ','DD-MON- RR')); | |
| 2243 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (298 ,347,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('23 -JAN-18',' DD-MON-RR' ),to_date( '23-JAN-18 ','DD-MON- RR')); | |
| 2244 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (299 ,348,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('23 -JAN-18',' DD-MON-RR' ),to_date( '23-JAN-18 ','DD-MON- RR')); | |
| 2245 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (300 ,349,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('23 -JAN-18',' DD-MON-RR' ),to_date( '23-JAN-18 ','DD-MON- RR')); | |
| 2246 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (301 ,350,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('23 -JAN-18',' DD-MON-RR' ),to_date( '23-JAN-18 ','DD-MON- RR')); | |
| 2247 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (302 ,351,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('23 -JAN-18',' DD-MON-RR' ),to_date( '23-JAN-18 ','DD-MON- RR')); | |
| 2248 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (303 ,352,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('23 -JAN-18',' DD-MON-RR' ),to_date( '23-JAN-18 ','DD-MON- RR')); | |
| 2249 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (304 ,353,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('23 -JAN-18',' DD-MON-RR' ),to_date( '23-JAN-18 ','DD-MON- RR')); | |
| 2250 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (305 ,354,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('24 -JAN-18',' DD-MON-RR' ),to_date( '24-JAN-18 ','DD-MON- RR')); | |
| 2251 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (306 ,355,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('24 -JAN-18',' DD-MON-RR' ),to_date( '24-JAN-18 ','DD-MON- RR')); | |
| 2252 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (307 ,356,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('24 -JAN-18',' DD-MON-RR' ),to_date( '24-JAN-18 ','DD-MON- RR')); | |
| 2253 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (308 ,357,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('24 -JAN-18',' DD-MON-RR' ),to_date( '24-JAN-18 ','DD-MON- RR')); | |
| 2254 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (309 ,358,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'GP,RT,AS, T5',9985.7 7,to_date( '24-JAN-18 ','DD-MON- RR'),to_da te('24-JAN -18','DD-M ON-RR')); | |
| 2255 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (310 ,359,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'GP,RT,AS, T5',9985.7 7,to_date( '24-JAN-18 ','DD-MON- RR'),to_da te('24-JAN -18','DD-M ON-RR')); | |
| 2256 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (311 ,360,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('24 -JAN-18',' DD-MON-RR' ),to_date( '24-JAN-18 ','DD-MON- RR')); | |
| 2257 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (312 ,361,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('25 -JAN-18',' DD-MON-RR' ),to_date( '25-JAN-18 ','DD-MON- RR')); | |
| 2258 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (313 ,362,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('25 -JAN-18',' DD-MON-RR' ),to_date( '25-JAN-18 ','DD-MON- RR')); | |
| 2259 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (314 ,363,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('25-JAN-1 8','DD-MON -RR'),to_d ate('25-JA N-18','DD- MON-RR')); | |
| 2260 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (315 ,363,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '25-JAN-18 ','DD-MON- RR'),to_da te('25-JAN -18','DD-M ON-RR')); | |
| 2261 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (316 ,364,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('25-JAN-1 8','DD-MON -RR'),to_d ate('25-JA N-18','DD- MON-RR')); | |
| 2262 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (317 ,364,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '25-JAN-18 ','DD-MON- RR'),to_da te('25-JAN -18','DD-M ON-RR')); | |
| 2263 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (318 ,373,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('25-JAN-1 8','DD-MON -RR'),to_d ate('25-JA N-18','DD- MON-RR')); | |
| 2264 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (319 ,373,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '25-JAN-18 ','DD-MON- RR'),to_da te('25-JAN -18','DD-M ON-RR')); | |
| 2265 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (320 ,376,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('25 -JAN-18',' DD-MON-RR' ),to_date( '25-JAN-18 ','DD-MON- RR')); | |
| 2266 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (321 ,377,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('25 -JAN-18',' DD-MON-RR' ),to_date( '25-JAN-18 ','DD-MON- RR')); | |
| 2267 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (322 ,378,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('25 -JAN-18',' DD-MON-RR' ),to_date( '25-JAN-18 ','DD-MON- RR')); | |
| 2268 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (323 ,379,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('25 -JAN-18',' DD-MON-RR' ),to_date( '25-JAN-18 ','DD-MON- RR')); | |
| 2269 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (324 ,380,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('26 -JAN-18',' DD-MON-RR' ),to_date( '26-JAN-18 ','DD-MON- RR')); | |
| 2270 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (325 ,381,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('26 -JAN-18',' DD-MON-RR' ),to_date( '26-JAN-18 ','DD-MON- RR')); | |
| 2271 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (326 ,382,'1',t o_date('11 -SEP-17',' DD-MON-RR' ),to_date( '12-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,EE,AA, AQ',16124. 57,to_date ('26-JAN-1 8','DD-MON -RR'),to_d ate('26-JA N-18','DD- MON-RR')); | |
| 2272 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (328 ,384,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('26 -JAN-18',' DD-MON-RR' ),to_date( '26-JAN-18 ','DD-MON- RR')); | |
| 2273 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (329 ,385,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('26 -JAN-18',' DD-MON-RR' ),to_date( '26-JAN-18 ','DD-MON- RR')); | |
| 2274 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (330 ,387,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('26 -JAN-18',' DD-MON-RR' ),to_date( '26-JAN-18 ','DD-MON- RR')); | |
| 2275 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (331 ,388,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('26 -JAN-18',' DD-MON-RR' ),to_date( '26-JAN-18 ','DD-MON- RR')); | |
| 2276 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (332 ,389,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('26 -JAN-18',' DD-MON-RR' ),to_date( '26-JAN-18 ','DD-MON- RR')); | |
| 2277 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (333 ,390,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('26 -JAN-18',' DD-MON-RR' ),to_date( '26-JAN-18 ','DD-MON- RR')); | |
| 2278 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (334 ,391,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('29 -JAN-18',' DD-MON-RR' ),to_date( '29-JAN-18 ','DD-MON- RR')); | |
| 2279 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (335 ,392,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('29 -JAN-18',' DD-MON-RR' ),to_date( '29-JAN-18 ','DD-MON- RR')); | |
| 2280 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (336 ,393,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('29 -JAN-18',' DD-MON-RR' ),to_date( '29-JAN-18 ','DD-MON- RR')); | |
| 2281 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (337 ,394,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('29 -JAN-18',' DD-MON-RR' ),to_date( '29-JAN-18 ','DD-MON- RR')); | |
| 2282 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (338 ,395,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('29 -JAN-18',' DD-MON-RR' ),to_date( '29-JAN-18 ','DD-MON- RR')); | |
| 2283 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (339 ,396,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('29 -JAN-18',' DD-MON-RR' ),to_date( '29-JAN-18 ','DD-MON- RR')); | |
| 2284 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (340 ,397,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('29 -JAN-18',' DD-MON-RR' ),to_date( '29-JAN-18 ','DD-MON- RR')); | |
| 2285 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (341 ,398,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('29 -JAN-18',' DD-MON-RR' ),to_date( '29-JAN-18 ','DD-MON- RR')); | |
| 2286 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (342 ,399,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('29 -JAN-18',' DD-MON-RR' ),to_date( '29-JAN-18 ','DD-MON- RR')); | |
| 2287 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (343 ,400,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('29 -JAN-18',' DD-MON-RR' ),to_date( '29-JAN-18 ','DD-MON- RR')); | |
| 2288 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (344 ,401,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('29 -JAN-18',' DD-MON-RR' ),to_date( '29-JAN-18 ','DD-MON- RR')); | |
| 2289 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (345 ,402,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('29 -JAN-18',' DD-MON-RR' ),to_date( '29-JAN-18 ','DD-MON- RR')); | |
| 2290 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (346 ,403,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('29 -JAN-18',' DD-MON-RR' ),to_date( '29-JAN-18 ','DD-MON- RR')); | |
| 2291 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (347 ,404,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('29 -JAN-18',' DD-MON-RR' ),to_date( '29-JAN-18 ','DD-MON- RR')); | |
| 2292 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (348 ,405,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('29 -JAN-18',' DD-MON-RR' ),to_date( '29-JAN-18 ','DD-MON- RR')); | |
| 2293 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (349 ,406,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('29 -JAN-18',' DD-MON-RR' ),to_date( '29-JAN-18 ','DD-MON- RR')); | |
| 2294 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (350 ,407,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('29 -JAN-18',' DD-MON-RR' ),to_date( '29-JAN-18 ','DD-MON- RR')); | |
| 2295 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (351 ,408,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('30 -JAN-18',' DD-MON-RR' ),to_date( '30-JAN-18 ','DD-MON- RR')); | |
| 2296 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (352 ,409,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('30 -JAN-18',' DD-MON-RR' ),to_date( '30-JAN-18 ','DD-MON- RR')); | |
| 2297 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (353 ,410,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('30 -JAN-18',' DD-MON-RR' ),to_date( '30-JAN-18 ','DD-MON- RR')); | |
| 2298 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (354 ,411,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('30 -JAN-18',' DD-MON-RR' ),to_date( '30-JAN-18 ','DD-MON- RR')); | |
| 2299 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (355 ,412,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('30 -JAN-18',' DD-MON-RR' ),to_date( '30-JAN-18 ','DD-MON- RR')); | |
| 2300 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (356 ,413,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('30-JAN-1 8','DD-MON -RR'),to_d ate('30-JA N-18','DD- MON-RR')); | |
| 2301 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (357 ,413,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '30-JAN-18 ','DD-MON- RR'),to_da te('30-JAN -18','DD-M ON-RR')); | |
| 2302 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (359 ,419,'1',t o_date('11 -SEP-17',' DD-MON-RR' ),to_date( '12-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,EE,AA, AQ',16124. 57,to_date ('30-JAN-1 8','DD-MON -RR'),to_d ate('30-JA N-18','DD- MON-RR')); | |
| 2303 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (360 ,420,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('30 -JAN-18',' DD-MON-RR' ),to_date( '30-JAN-18 ','DD-MON- RR')); | |
| 2304 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (361 ,421,'1',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0551 ','G0154', 'G4,QS,LT, T5',9750.4 1,to_date( '30-JAN-18 ','DD-MON- RR'),to_da te('30-JAN -18','DD-M ON-RR')); | |
| 2305 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (362 ,422,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('30 -JAN-18',' DD-MON-RR' ),to_date( '30-JAN-18 ','DD-MON- RR')); | |
| 2306 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (363 ,423,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('30 -JAN-18',' DD-MON-RR' ),to_date( '30-JAN-18 ','DD-MON- RR')); | |
| 2307 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (364 ,424,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('30 -JAN-18',' DD-MON-RR' ),to_date( '30-JAN-18 ','DD-MON- RR')); | |
| 2308 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (365 ,425,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('30 -JAN-18',' DD-MON-RR' ),to_date( '30-JAN-18 ','DD-MON- RR')); | |
| 2309 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (366 ,426,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('30 -JAN-18',' DD-MON-RR' ),to_date( '30-JAN-18 ','DD-MON- RR')); | |
| 2310 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (367 ,427,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('30 -JAN-18',' DD-MON-RR' ),to_date( '30-JAN-18 ','DD-MON- RR')); | |
| 2311 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (368 ,428,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('30 -JAN-18',' DD-MON-RR' ),to_date( '30-JAN-18 ','DD-MON- RR')); | |
| 2312 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (369 ,430,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'GP,QS,QS, T5',11593. 46,to_date ('30-JAN-1 8','DD-MON -RR'),to_d ate('30-JA N-18','DD- MON-RR')); | |
| 2313 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (370 ,431,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '11-SEP-17 ','DD-MON- RR'),'0450 ','99283', 'G4,EE,LT, T5',1622.7 ,to_date(' 30-JAN-18' ,'DD-MON-R R'),to_dat e('30-JAN- 18','DD-MO N-RR')); | |
| 2314 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (371 ,432,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '31-JAN-18 ','DD-MON- RR'),to_da te('31-JAN -18','DD-M ON-RR')); | |
| 2315 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (372 ,432,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('31-JAN-1 8','DD-MON -RR'),to_d ate('31-JA N-18','DD- MON-RR')); | |
| 2316 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (373 ,433,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '31-JAN-18 ','DD-MON- RR'),to_da te('31-JAN -18','DD-M ON-RR')); | |
| 2317 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (374 ,434,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('01 -FEB-18',' DD-MON-RR' ),to_date( '01-FEB-18 ','DD-MON- RR')); | |
| 2318 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (375 ,435,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('01 -FEB-18',' DD-MON-RR' ),to_date( '01-FEB-18 ','DD-MON- RR')); | |
| 2319 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (376 ,439,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('01 -FEB-18',' DD-MON-RR' ),to_date( '01-FEB-18 ','DD-MON- RR')); | |
| 2320 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (377 ,440,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('02 -FEB-18',' DD-MON-RR' ),to_date( '02-FEB-18 ','DD-MON- RR')); | |
| 2321 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (378 ,441,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('02 -FEB-18',' DD-MON-RR' ),to_date( '02-FEB-18 ','DD-MON- RR')); | |
| 2322 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (379 ,442,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('05 -FEB-18',' DD-MON-RR' ),to_date( '05-FEB-18 ','DD-MON- RR')); | |
| 2323 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (380 ,443,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('05 -FEB-18',' DD-MON-RR' ),to_date( '05-FEB-18 ','DD-MON- RR')); | |
| 2324 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (381 ,444,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('05 -FEB-18',' DD-MON-RR' ),to_date( '05-FEB-18 ','DD-MON- RR')); | |
| 2325 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (382 ,445,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('05 -FEB-18',' DD-MON-RR' ),to_date( '05-FEB-18 ','DD-MON- RR')); | |
| 2326 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (383 ,446,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('06 -FEB-18',' DD-MON-RR' ),to_date( '06-FEB-18 ','DD-MON- RR')); | |
| 2327 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (384 ,447,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('06 -FEB-18',' DD-MON-RR' ),to_date( '06-FEB-18 ','DD-MON- RR')); | |
| 2328 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (385 ,448,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('06 -FEB-18',' DD-MON-RR' ),to_date( '06-FEB-18 ','DD-MON- RR')); | |
| 2329 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (386 ,449,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('06 -FEB-18',' DD-MON-RR' ),to_date( '06-FEB-18 ','DD-MON- RR')); | |
| 2330 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (387 ,450,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('06 -FEB-18',' DD-MON-RR' ),to_date( '06-FEB-18 ','DD-MON- RR')); | |
| 2331 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (388 ,451,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('06 -FEB-18',' DD-MON-RR' ),to_date( '06-FEB-18 ','DD-MON- RR')); | |
| 2332 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (389 ,454,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('06 -FEB-18',' DD-MON-RR' ),to_date( '06-FEB-18 ','DD-MON- RR')); | |
| 2333 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (390 ,455,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('06 -FEB-18',' DD-MON-RR' ),to_date( '06-FEB-18 ','DD-MON- RR')); | |
| 2334 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (391 ,457,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('06 -FEB-18',' DD-MON-RR' ),to_date( '06-FEB-18 ','DD-MON- RR')); | |
| 2335 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (392 ,459,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('06 -FEB-18',' DD-MON-RR' ),to_date( '06-FEB-18 ','DD-MON- RR')); | |
| 2336 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (393 ,460,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('06 -FEB-18',' DD-MON-RR' ),to_date( '06-FEB-18 ','DD-MON- RR')); | |
| 2337 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (394 ,461,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('06 -FEB-18',' DD-MON-RR' ),to_date( '06-FEB-18 ','DD-MON- RR')); | |
| 2338 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (395 ,463,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('06 -FEB-18',' DD-MON-RR' ),to_date( '06-FEB-18 ','DD-MON- RR')); | |
| 2339 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (396 ,464,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2340 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (397 ,465,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2341 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (398 ,466,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2342 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (399 ,467,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2343 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (400 ,468,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2344 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (401 ,469,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2345 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (402 ,471,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2346 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (403 ,472,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2347 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (404 ,473,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2348 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (405 ,474,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2349 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (406 ,475,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2350 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (407 ,476,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2351 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (408 ,477,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2352 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (409 ,478,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2353 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (410 ,479,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2354 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (411 ,480,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2355 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (412 ,481,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2356 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (413 ,482,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2357 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (414 ,483,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2358 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (415 ,484,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2359 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (416 ,485,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2360 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (417 ,486,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2361 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (418 ,487,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2362 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (419 ,488,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2363 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (420 ,489,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2364 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (421 ,490,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2365 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (422 ,491,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2366 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (423 ,492,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2367 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (424 ,493,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -FEB-18',' DD-MON-RR' ),to_date( '07-FEB-18 ','DD-MON- RR')); | |
| 2368 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (425 ,499,'1',t o_date('11 -SEP-17',' DD-MON-RR' ),to_date( '12-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,EE,AA, AQ',16124. 57,to_date ('08-FEB-1 8','DD-MON -RR'),to_d ate('08-FE B-18','DD- MON-RR')); | |
| 2369 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (426 ,504,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0450 ','99283', 'JA,EE,QS, EE',10365. 13,to_date ('08-FEB-1 8','DD-MON -RR'),to_d ate('08-FE B-18','DD- MON-RR')); | |
| 2370 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (427 ,507,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0450 ','99283', 'JA,EE,QS, EE',10365. 13,to_date ('08-FEB-1 8','DD-MON -RR'),to_d ate('08-FE B-18','DD- MON-RR')); | |
| 2371 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (428 ,508,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('08 -FEB-18',' DD-MON-RR' ),to_date( '08-FEB-18 ','DD-MON- RR')); | |
| 2372 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (429 ,509,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('08 -FEB-18',' DD-MON-RR' ),to_date( '08-FEB-18 ','DD-MON- RR')); | |
| 2373 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (430 ,510,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('08 -FEB-18',' DD-MON-RR' ),to_date( '08-FEB-18 ','DD-MON- RR')); | |
| 2374 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (431 ,511,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('08 -FEB-18',' DD-MON-RR' ),to_date( '08-FEB-18 ','DD-MON- RR')); | |
| 2375 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (432 ,517,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0551 ','G0154', 'JA,RT,LT, SG',16564. 32,to_date ('08-FEB-1 8','DD-MON -RR'),to_d ate('08-FE B-18','DD- MON-RR')); | |
| 2376 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (433 ,518,'1',t o_date('12 -APR-11',' DD-MON-RR' ),to_date( '12-APR-11 ','DD-MON- RR'),null, '99284',nu ll,646,to_ date('08-F EB-18','DD -MON-RR'), to_date('0 8-FEB-18', 'DD-MON-RR ')); | |
| 2377 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (434 ,519,'1',t o_date('11 -SEP-17',' DD-MON-RR' ),to_date( '12-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,EE,AA, AQ',16124. 57,to_date ('08-FEB-1 8','DD-MON -RR'),to_d ate('08-FE B-18','DD- MON-RR')); | |
| 2378 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (435 ,520,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('08 -FEB-18',' DD-MON-RR' ),to_date( '08-FEB-18 ','DD-MON- RR')); | |
| 2379 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (436 ,521,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('08 -FEB-18',' DD-MON-RR' ),to_date( '08-FEB-18 ','DD-MON- RR')); | |
| 2380 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (437 ,522,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('08 -FEB-18',' DD-MON-RR' ),to_date( '08-FEB-18 ','DD-MON- RR')); | |
| 2381 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (438 ,524,'123' ,to_date(' 01-SEP-16' ,'DD-MON-R R'),to_dat e('01-NOV- 17','DD-MO N-RR'),'11 1',null,'A , B, C',10 1.01,to_da te('09-FEB -18','DD-M ON-RR'),to _date('09- FEB-18','D D-MON-RR') ); | |
| 2382 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (439 ,525,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0551 ','G0154', 'JA,RT,LT, SG',16564. 32,to_date ('09-FEB-1 8','DD-MON -RR'),to_d ate('09-FE B-18','DD- MON-RR')); | |
| 2383 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (440 ,526,'101' ,to_date(' 01-JAN-17' ,'DD-MON-R R'),to_dat e('10-OCT- 17','DD-MO N-RR'),'11 1',null,'X YZ',10.5,t o_date('09 -FEB-18',' DD-MON-RR' ),to_date( '09-FEB-18 ','DD-MON- RR')); | |
| 2384 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (441 ,527,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'GP,RT,AS, T5',9985.7 7,to_date( '09-FEB-18 ','DD-MON- RR'),to_da te('09-FEB -18','DD-M ON-RR')); | |
| 2385 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (442 ,528,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('09 -FEB-18',' DD-MON-RR' ),to_date( '09-FEB-18 ','DD-MON- RR')); | |
| 2386 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (443 ,529,'123' ,to_date(' 01-JAN-17' ,'DD-MON-R R'),to_dat e('02-FEB- 17','DD-MO N-RR'),'11 1',null,'A BC',10.01, to_date('0 9-FEB-18', 'DD-MON-RR '),to_date ('09-FEB-1 8','DD-MON -RR')); | |
| 2387 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (444 ,530,'222' ,to_date(' 01-JAN-17' ,'DD-MON-R R'),to_dat e('02-FEB- 17','DD-MO N-RR'),'11 1',null,'A BC',10.01, to_date('0 9-FEB-18', 'DD-MON-RR '),to_date ('09-FEB-1 8','DD-MON -RR')); | |
| 2388 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (454 ,548,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('09 -FEB-18',' DD-MON-RR' ),to_date( '09-FEB-18 ','DD-MON- RR')); | |
| 2389 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (456 ,550,'1008 5',to_date ('11-SEP-1 7','DD-MON -RR'),to_d ate('21-SE P-17','DD- MON-RR'),' 11','A2054 ',null,999 9,to_date( '09-FEB-18 ','DD-MON- RR'),to_da te('09-FEB -18','DD-M ON-RR')); | |
| 2390 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (457 ,551,'1008 7',to_date ('11-SEP-1 7','DD-MON -RR'),to_d ate('21-SE P-17','DD- MON-RR'),' 16','test1 23',null,1 11,to_date ('09-FEB-1 8','DD-MON -RR'),to_d ate('09-FE B-18','DD- MON-RR')); | |
| 2391 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (458 ,552,'1008 7',to_date ('11-SEP-1 7','DD-MON -RR'),to_d ate('21-SE P-17','DD- MON-RR'),' 16','test9 86',null,1 11,to_date ('09-FEB-1 8','DD-MON -RR'),to_d ate('09-FE B-18','DD- MON-RR')); | |
| 2392 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (459 ,553,'1008 7',to_date ('11-SEP-1 7','DD-MON -RR'),to_d ate('21-SE P-17','DD- MON-RR'),' 16','test4 56',null,1 11,to_date ('09-FEB-1 8','DD-MON -RR'),to_d ate('09-FE B-18','DD- MON-RR')); | |
| 2393 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (460 ,554,'1008 7',to_date ('11-SEP-1 7','DD-MON -RR'),to_d ate('21-SE P-17','DD- MON-RR'),' 20','test4 56',null,1 11,to_date ('09-FEB-1 8','DD-MON -RR'),to_d ate('09-FE B-18','DD- MON-RR')); | |
| 2394 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (461 ,555,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('09 -FEB-18',' DD-MON-RR' ),to_date( '09-FEB-18 ','DD-MON- RR')); | |
| 2395 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (462 ,556,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('09 -FEB-18',' DD-MON-RR' ),to_date( '09-FEB-18 ','DD-MON- RR')); | |
| 2396 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (463 ,557,'222' ,to_date(' 01-SEP-17' ,'DD-MON-R R'),to_dat e('01-OCT- 17','DD-MO N-RR'),'1' ,null,'xyz ',10.01,to _date('09- FEB-18','D D-MON-RR') ,to_date(' 09-FEB-18' ,'DD-MON-R R')); | |
| 2397 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (464 ,558,'333' ,to_date(' 01-OCT-17' ,'DD-MON-R R'),to_dat e('01-DEC- 17','DD-MO N-RR'),'1' ,null,'XYZ ',10.01,to _date('09- FEB-18','D D-MON-RR') ,to_date(' 09-FEB-18' ,'DD-MON-R R')); | |
| 2398 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (465 ,560,'1008 7',to_date ('11-SEP-1 7','DD-MON -RR'),to_d ate('21-SE P-17','DD- MON-RR'),' 20','test4 56',null,1 11,to_date ('09-FEB-1 8','DD-MON -RR'),to_d ate('09-FE B-18','DD- MON-RR')); | |
| 2399 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (466 ,561,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('09 -FEB-18',' DD-MON-RR' ),to_date( '09-FEB-18 ','DD-MON- RR')); | |
| 2400 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (467 ,562,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('09 -FEB-18',' DD-MON-RR' ),to_date( '09-FEB-18 ','DD-MON- RR')); | |
| 2401 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (468 ,563,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0450 ','99283', 'JA,EE,QS, EE',10365. 13,to_date ('09-FEB-1 8','DD-MON -RR'),to_d ate('09-FE B-18','DD- MON-RR')); | |
| 2402 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (469 ,564,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('09 -FEB-18',' DD-MON-RR' ),to_date( '09-FEB-18 ','DD-MON- RR')); | |
| 2403 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (470 ,565,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('09 -FEB-18',' DD-MON-RR' ),to_date( '09-FEB-18 ','DD-MON- RR')); | |
| 2404 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (471 ,566,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('09 -FEB-18',' DD-MON-RR' ),to_date( '09-FEB-18 ','DD-MON- RR')); | |
| 2405 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (472 ,567,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('09 -FEB-18',' DD-MON-RR' ),to_date( '09-FEB-18 ','DD-MON- RR')); | |
| 2406 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (473 ,568,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('09 -FEB-18',' DD-MON-RR' ),to_date( '09-FEB-18 ','DD-MON- RR')); | |
| 2407 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (474 ,569,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('09 -FEB-18',' DD-MON-RR' ),to_date( '09-FEB-18 ','DD-MON- RR')); | |
| 2408 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (475 ,570,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('09 -FEB-18',' DD-MON-RR' ),to_date( '09-FEB-18 ','DD-MON- RR')); | |
| 2409 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (476 ,571,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('09 -FEB-18',' DD-MON-RR' ),to_date( '09-FEB-18 ','DD-MON- RR')); | |
| 2410 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (477 ,572,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('09 -FEB-18',' DD-MON-RR' ),to_date( '09-FEB-18 ','DD-MON- RR')); | |
| 2411 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (478 ,573,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('10 -FEB-18',' DD-MON-RR' ),to_date( '10-FEB-18 ','DD-MON- RR')); | |
| 2412 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (479 ,577,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('11-FEB-1 8','DD-MON -RR'),to_d ate('11-FE B-18','DD- MON-RR')); | |
| 2413 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (480 ,577,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '11-FEB-18 ','DD-MON- RR'),to_da te('11-FEB -18','DD-M ON-RR')); | |
| 2414 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (481 ,578,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '12-FEB-18 ','DD-MON- RR'),to_da te('12-FEB -18','DD-M ON-RR')); | |
| 2415 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (482 ,578,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('12-FEB-1 8','DD-MON -RR'),to_d ate('12-FE B-18','DD- MON-RR')); | |
| 2416 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (483 ,579,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('12-FEB-1 8','DD-MON -RR'),to_d ate('12-FE B-18','DD- MON-RR')); | |
| 2417 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (484 ,579,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '12-FEB-18 ','DD-MON- RR'),to_da te('12-FEB -18','DD-M ON-RR')); | |
| 2418 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (485 ,583,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -FEB-18',' DD-MON-RR' ),to_date( '12-FEB-18 ','DD-MON- RR')); | |
| 2419 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (486 ,584,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -FEB-18',' DD-MON-RR' ),to_date( '12-FEB-18 ','DD-MON- RR')); | |
| 2420 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (487 ,585,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -FEB-18',' DD-MON-RR' ),to_date( '12-FEB-18 ','DD-MON- RR')); | |
| 2421 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (488 ,586,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -FEB-18',' DD-MON-RR' ),to_date( '12-FEB-18 ','DD-MON- RR')); | |
| 2422 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (489 ,587,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -FEB-18',' DD-MON-RR' ),to_date( '12-FEB-18 ','DD-MON- RR')); | |
| 2423 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (490 ,588,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -FEB-18',' DD-MON-RR' ),to_date( '12-FEB-18 ','DD-MON- RR')); | |
| 2424 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (491 ,589,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -FEB-18',' DD-MON-RR' ),to_date( '12-FEB-18 ','DD-MON- RR')); | |
| 2425 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (492 ,590,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -FEB-18',' DD-MON-RR' ),to_date( '12-FEB-18 ','DD-MON- RR')); | |
| 2426 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (493 ,591,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -FEB-18',' DD-MON-RR' ),to_date( '12-FEB-18 ','DD-MON- RR')); | |
| 2427 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (494 ,594,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -FEB-18',' DD-MON-RR' ),to_date( '12-FEB-18 ','DD-MON- RR')); | |
| 2428 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (495 ,595,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -FEB-18',' DD-MON-RR' ),to_date( '12-FEB-18 ','DD-MON- RR')); | |
| 2429 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (496 ,596,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '10-SEP-17 ','DD-MON- RR'),'0582 ','99509', 'GP,QS,LT, EE',1859.0 2,to_date( '12-FEB-18 ','DD-MON- RR'),to_da te('12-FEB -18','DD-M ON-RR')); | |
| 2430 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (497 ,597,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0551 ','G0154', 'JA,RT,LT, SG',16564. 32,to_date ('12-FEB-1 8','DD-MON -RR'),to_d ate('12-FE B-18','DD- MON-RR')); | |
| 2431 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (498 ,598,'4',t o_date('30 -JAN-17',' DD-MON-RR' ),to_date( '01-FEB-17 ','DD-MON- RR'),'0123 ','ABC123' ,'A,B, C, D',101.011 ,to_date(' 12-FEB-18' ,'DD-MON-R R'),to_dat e('12-FEB- 18','DD-MO N-RR')); | |
| 2432 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (499 ,599,'101' ,to_date(' 11-NOV-15' ,'DD-MON-R R'),to_dat e('12-DEC- 16','DD-MO N-RR'),'11 1','XYZ123 ','XYZ',20 0,to_date( '12-FEB-18 ','DD-MON- RR'),to_da te('12-FEB -18','DD-M ON-RR')); | |
| 2433 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (500 ,599,'5',t o_date('11 -JAN-16',' DD-MON-RR' ),to_date( '02-FEB-19 ','DD-MON- RR'),'123' ,'ABC111', 'A, B, C', 1000.1,to_ date('12-F EB-18','DD -MON-RR'), to_date('1 2-FEB-18', 'DD-MON-RR ')); | |
| 2434 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (501 ,600,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('12 -FEB-18',' DD-MON-RR' ),to_date( '12-FEB-18 ','DD-MON- RR')); | |
| 2435 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (502 ,601,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('12 -FEB-18',' DD-MON-RR' ),to_date( '12-FEB-18 ','DD-MON- RR')); | |
| 2436 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (503 ,602,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('12 -FEB-18',' DD-MON-RR' ),to_date( '12-FEB-18 ','DD-MON- RR')); | |
| 2437 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (504 ,603,'1234 5',to_date ('01-JAN-1 7','DD-MON -RR'),to_d ate('01-JA N-18','DD- MON-RR'),' 12345','12 345','1234 5',12345,t o_date('12 -FEB-18',' DD-MON-RR' ),to_date( '12-FEB-18 ','DD-MON- RR')); | |
| 2438 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (505 ,604,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -FEB-18',' DD-MON-RR' ),to_date( '12-FEB-18 ','DD-MON- RR')); | |
| 2439 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (506 ,605,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -FEB-18',' DD-MON-RR' ),to_date( '12-FEB-18 ','DD-MON- RR')); | |
| 2440 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (507 ,606,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '12-FEB-18 ','DD-MON- RR'),to_da te('12-FEB -18','DD-M ON-RR')); | |
| 2441 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (508 ,606,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('12-FEB-1 8','DD-MON -RR'),to_d ate('12-FE B-18','DD- MON-RR')); | |
| 2442 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (509 ,607,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0450 ','99283', 'JA,EE,QS, EE',10365. 13,to_date ('12-FEB-1 8','DD-MON -RR'),to_d ate('12-FE B-18','DD- MON-RR')); | |
| 2443 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (511 ,609,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '10-SEP-17 ','DD-MON- RR'),'0582 ','99509', 'GP,QS,LT, EE',1859.0 2,to_date( '12-FEB-18 ','DD-MON- RR'),to_da te('12-FEB -18','DD-M ON-RR')); | |
| 2444 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (512 ,610,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('12 -FEB-18',' DD-MON-RR' ),to_date( '12-FEB-18 ','DD-MON- RR')); | |
| 2445 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (513 ,611,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0551 ','G0154', 'JA,RT,LT, SG',16564. 32,to_date ('12-FEB-1 8','DD-MON -RR'),to_d ate('12-FE B-18','DD- MON-RR')); | |
| 2446 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (514 ,612,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('12 -FEB-18',' DD-MON-RR' ),to_date( '12-FEB-18 ','DD-MON- RR')); | |
| 2447 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (515 ,613,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -FEB-18',' DD-MON-RR' ),to_date( '12-FEB-18 ','DD-MON- RR')); | |
| 2448 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (516 ,614,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('12-FEB-1 8','DD-MON -RR'),to_d ate('12-FE B-18','DD- MON-RR')); | |
| 2449 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (517 ,615,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -FEB-18',' DD-MON-RR' ),to_date( '12-FEB-18 ','DD-MON- RR')); | |
| 2450 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (518 ,616,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '12-FEB-18 ','DD-MON- RR'),to_da te('12-FEB -18','DD-M ON-RR')); | |
| 2451 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (519 ,616,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('12-FEB-1 8','DD-MON -RR'),to_d ate('12-FE B-18','DD- MON-RR')); | |
| 2452 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (520 ,618,'2',t o_date('11 -NOV-17',' DD-MON-RR' ),to_date( '12-NOV-17 ','DD-MON- RR'),'1',' 2','xyz',2 00.2,to_da te('12-FEB -18','DD-M ON-RR'),to _date('12- FEB-18','D D-MON-RR') ); | |
| 2453 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (521 ,618,'100' ,to_date(' 01-SEP-17' ,'DD-MON-R R'),to_dat e('03-SEP- 17','DD-MO N-RR'),'12 3','456',' abc',101.1 ,to_date(' 12-FEB-18' ,'DD-MON-R R'),to_dat e('12-FEB- 18','DD-MO N-RR')); | |
| 2454 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (522 ,619,'2',t o_date('11 -NOV-17',' DD-MON-RR' ),to_date( '12-NOV-17 ','DD-MON- RR'),'1',' 2','xyz',2 00.2,to_da te('12-FEB -18','DD-M ON-RR'),to _date('12- FEB-18','D D-MON-RR') ); | |
| 2455 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (523 ,619,'100' ,to_date(' 01-SEP-17' ,'DD-MON-R R'),to_dat e('03-SEP- 17','DD-MO N-RR'),'12 3','456',' abc',101.1 ,to_date(' 12-FEB-18' ,'DD-MON-R R'),to_dat e('12-FEB- 18','DD-MO N-RR')); | |
| 2456 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (524 ,620,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('13 -FEB-18',' DD-MON-RR' ),to_date( '13-FEB-18 ','DD-MON- RR')); | |
| 2457 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (525 ,621,'2',t o_date('02 -FEB-17',' DD-MON-RR' ),to_date( '02-FEB-17 ','DD-MON- RR'),'98', '76','54', 200,to_dat e('13-FEB- 18','DD-MO N-RR'),to_ date('13-F EB-18','DD -MON-RR')) ; | |
| 2458 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (526 ,621,'1',t o_date('01 -JAN-17',' DD-MON-RR' ),to_date( '01-JAN-17 ','DD-MON- RR'),'12', '34','56', 100,to_dat e('13-FEB- 18','DD-MO N-RR'),to_ date('13-F EB-18','DD -MON-RR')) ; | |
| 2459 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (527 ,622,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('13 -FEB-18',' DD-MON-RR' ),to_date( '13-FEB-18 ','DD-MON- RR')); | |
| 2460 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (528 ,623,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '13-FEB-18 ','DD-MON- RR'),to_da te('13-FEB -18','DD-M ON-RR')); | |
| 2461 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (529 ,623,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('13-FEB-1 8','DD-MON -RR'),to_d ate('13-FE B-18','DD- MON-RR')); | |
| 2462 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (530 ,624,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '13-FEB-18 ','DD-MON- RR'),to_da te('13-FEB -18','DD-M ON-RR')); | |
| 2463 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (531 ,624,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('13-FEB-1 8','DD-MON -RR'),to_d ate('13-FE B-18','DD- MON-RR')); | |
| 2464 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (532 ,625,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('13-FEB-1 8','DD-MON -RR'),to_d ate('13-FE B-18','DD- MON-RR')); | |
| 2465 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (533 ,625,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '13-FEB-18 ','DD-MON- RR'),to_da te('13-FEB -18','DD-M ON-RR')); | |
| 2466 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (534 ,626,'1',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '12-SEP-17 ','DD-MON- RR'),'0450 ','99283', 'G4,RT,AA, SG',8539.9 7,to_date( '13-FEB-18 ','DD-MON- RR'),to_da te('13-FEB -18','DD-M ON-RR')); | |
| 2467 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (535 ,627,'1',t o_date('01 -JAN-18',' DD-MON-RR' ),to_date( '02-JAN-18 ','DD-MON- RR'),'11', '22','33', 100,to_dat e('14-FEB- 18','DD-MO N-RR'),to_ date('14-F EB-18','DD -MON-RR')) ; | |
| 2468 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (536 ,627,'2',t o_date('02 -FEB-18',' DD-MON-RR' ),to_date( '03-FEB-18 ','DD-MON- RR'),'99', '88','77', 200,to_dat e('14-FEB- 18','DD-MO N-RR'),to_ date('14-F EB-18','DD -MON-RR')) ; | |
| 2469 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (537 ,628,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('14 -FEB-18',' DD-MON-RR' ),to_date( '14-FEB-18 ','DD-MON- RR')); | |
| 2470 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (538 ,629,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('14 -FEB-18',' DD-MON-RR' ),to_date( '14-FEB-18 ','DD-MON- RR')); | |
| 2471 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (539 ,630,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('14 -FEB-18',' DD-MON-RR' ),to_date( '14-FEB-18 ','DD-MON- RR')); | |
| 2472 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (540 ,631,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('14 -FEB-18',' DD-MON-RR' ),to_date( '14-FEB-18 ','DD-MON- RR')); | |
| 2473 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (541 ,632,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '14-FEB-18 ','DD-MON- RR'),to_da te('14-FEB -18','DD-M ON-RR')); | |
| 2474 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (542 ,632,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('14-FEB-1 8','DD-MON -RR'),to_d ate('14-FE B-18','DD- MON-RR')); | |
| 2475 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (543 ,633,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('14 -FEB-18',' DD-MON-RR' ),to_date( '14-FEB-18 ','DD-MON- RR')); | |
| 2476 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (544 ,634,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '14-FEB-18 ','DD-MON- RR'),to_da te('14-FEB -18','DD-M ON-RR')); | |
| 2477 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (545 ,634,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('14-FEB-1 8','DD-MON -RR'),to_d ate('14-FE B-18','DD- MON-RR')); | |
| 2478 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (546 ,635,'2',t o_date('01 -FEB-15',' DD-MON-RR' ),to_date( '01-FEB-20 ','DD-MON- RR'),'6541 020','5454 6354','523 12',121,to _date('14- FEB-18','D D-MON-RR') ,to_date(' 14-FEB-18' ,'DD-MON-R R')); | |
| 2479 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (547 ,635,'1',t o_date('01 -FEB-14',' DD-MON-RR' ),to_date( '01-FEB-18 ','DD-MON- RR'),'5463 54','54648 60','32423 4',23432,t o_date('14 -FEB-18',' DD-MON-RR' ),to_date( '14-FEB-18 ','DD-MON- RR')); | |
| 2480 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (548 ,636,'2',t o_date('01 -FEB-15',' DD-MON-RR' ),to_date( '01-FEB-20 ','DD-MON- RR'),'6541 020','5454 6354','523 12',121,to _date('14- FEB-18','D D-MON-RR') ,to_date(' 14-FEB-18' ,'DD-MON-R R')); | |
| 2481 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (549 ,636,'1',t o_date('01 -FEB-14',' DD-MON-RR' ),to_date( '01-FEB-18 ','DD-MON- RR'),'5463 54','54648 60','32423 4',23432,t o_date('14 -FEB-18',' DD-MON-RR' ),to_date( '14-FEB-18 ','DD-MON- RR')); | |
| 2482 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (550 ,637,'1',t o_date('01 -FEB-14',' DD-MON-RR' ),to_date( '01-FEB-18 ','DD-MON- RR'),'5463 54','54648 60','32423 4',23432,t o_date('14 -FEB-18',' DD-MON-RR' ),to_date( '14-FEB-18 ','DD-MON- RR')); | |
| 2483 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (551 ,637,'3',t o_date('01 -FEB-15',' DD-MON-RR' ),to_date( '01-FEB-18 ','DD-MON- RR'),'6541 020','5464 860','5231 2',23432,t o_date('14 -FEB-18',' DD-MON-RR' ),to_date( '14-FEB-18 ','DD-MON- RR')); | |
| 2484 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (552 ,637,'2',t o_date('01 -FEB-15',' DD-MON-RR' ),to_date( '01-FEB-20 ','DD-MON- RR'),'6541 020','5454 6354','523 12',121,to _date('14- FEB-18','D D-MON-RR') ,to_date(' 14-FEB-18' ,'DD-MON-R R')); | |
| 2485 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (553 ,638,'1',t o_date('01 -FEB-14',' DD-MON-RR' ),to_date( '01-FEB-18 ','DD-MON- RR'),'5463 54','54648 60','32423 4',23432,t o_date('14 -FEB-18',' DD-MON-RR' ),to_date( '14-FEB-18 ','DD-MON- RR')); | |
| 2486 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (554 ,638,'3',t o_date('01 -FEB-15',' DD-MON-RR' ),to_date( '01-FEB-18 ','DD-MON- RR'),'6541 020','5464 860','5231 2',23432,t o_date('14 -FEB-18',' DD-MON-RR' ),to_date( '14-FEB-18 ','DD-MON- RR')); | |
| 2487 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (555 ,638,'2',t o_date('01 -FEB-15',' DD-MON-RR' ),to_date( '01-FEB-20 ','DD-MON- RR'),'6541 020','5454 6354','523 12',121,to _date('14- FEB-18','D D-MON-RR') ,to_date(' 14-FEB-18' ,'DD-MON-R R')); | |
| 2488 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (556 ,639,'3',t o_date('01 -FEB-15',' DD-MON-RR' ),to_date( '01-FEB-18 ','DD-MON- RR'),'6541 020','5464 860','5231 2',23432,t o_date('14 -FEB-18',' DD-MON-RR' ),to_date( '14-FEB-18 ','DD-MON- RR')); | |
| 2489 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (557 ,639,'2',t o_date('01 -FEB-15',' DD-MON-RR' ),to_date( '01-FEB-20 ','DD-MON- RR'),'6541 020','5454 6354','523 12',121,to _date('14- FEB-18','D D-MON-RR') ,to_date(' 14-FEB-18' ,'DD-MON-R R')); | |
| 2490 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (558 ,639,'1',t o_date('01 -FEB-14',' DD-MON-RR' ),to_date( '01-FEB-18 ','DD-MON- RR'),'5463 54','54648 60','32423 4',23432,t o_date('14 -FEB-18',' DD-MON-RR' ),to_date( '14-FEB-18 ','DD-MON- RR')); | |
| 2491 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (559 ,640,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('14 -FEB-18',' DD-MON-RR' ),to_date( '14-FEB-18 ','DD-MON- RR')); | |
| 2492 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (560 ,641,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('14 -FEB-18',' DD-MON-RR' ),to_date( '14-FEB-18 ','DD-MON- RR')); | |
| 2493 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (561 ,642,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('14 -FEB-18',' DD-MON-RR' ),to_date( '14-FEB-18 ','DD-MON- RR')); | |
| 2494 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (562 ,643,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('14 -FEB-18',' DD-MON-RR' ),to_date( '14-FEB-18 ','DD-MON- RR')); | |
| 2495 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (563 ,644,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('15-FEB-1 8','DD-MON -RR'),to_d ate('15-FE B-18','DD- MON-RR')); | |
| 2496 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (564 ,644,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '15-FEB-18 ','DD-MON- RR'),to_da te('15-FEB -18','DD-M ON-RR')); | |
| 2497 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (565 ,645,'1',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0280 ','G0498', null,597,t o_date('15 -FEB-18',' DD-MON-RR' ),to_date( '15-FEB-18 ','DD-MON- RR')); | |
| 2498 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (566 ,645,'5',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0636 ','J7050', null,8.6,t o_date('15 -FEB-18',' DD-MON-RR' ),to_date( '15-FEB-18 ','DD-MON- RR')); | |
| 2499 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (567 ,645,'6',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0636 ','J9190', null,64.33 ,to_date(' 15-FEB-18' ,'DD-MON-R R'),to_dat e('15-FEB- 18','DD-MO N-RR')); | |
| 2500 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (568 ,645,'8',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0636 ','J9280', null,802.9 5,to_date( '15-FEB-18 ','DD-MON- RR'),to_da te('15-FEB -18','DD-M ON-RR')); | |
| 2501 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (569 ,645,'2',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0333 ','77386', null,3357, to_date('1 5-FEB-18', 'DD-MON-RR '),to_date ('15-FEB-1 8','DD-MON -RR')); | |
| 2502 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (570 ,645,'4',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0352 ','77014', null,1372, to_date('1 5-FEB-18', 'DD-MON-RR '),to_date ('15-FEB-1 8','DD-MON -RR')); | |
| 2503 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (571 ,645,'7',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0636 ','J9280', null,1042. 92,to_date ('15-FEB-1 8','DD-MON -RR'),to_d ate('15-FE B-18','DD- MON-RR')); | |
| 2504 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (572 ,645,'9',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0637 ',null,nul l,2.4,to_d ate('15-FE B-18','DD- MON-RR'),t o_date('15 -FEB-18',' DD-MON-RR' )); | |
| 2505 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (573 ,645,'3',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0335 ','96409', null,507,t o_date('15 -FEB-18',' DD-MON-RR' ),to_date( '15-FEB-18 ','DD-MON- RR')); | |
| 2506 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (574 ,646,'1',t o_date('18 -APR-11',' DD-MON-RR' ),to_date( '20-APR-11 ','DD-MON- RR'),'212' ,'99212',' 21,ac,14,2 1',60,to_d ate('15-FE B-18','DD- MON-RR'),t o_date('15 -FEB-18',' DD-MON-RR' )); | |
| 2507 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (575 ,648,'1',t o_date('01 -FEB-15',' DD-MON-RR' ),to_date( '01-FEB-18 ','DD-MON- RR'),'78', '545454',' 121212',78 7878,to_da te('15-FEB -18','DD-M ON-RR'),to _date('15- FEB-18','D D-MON-RR') ); | |
| 2508 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (576 ,649,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('15-FEB-1 8','DD-MON -RR'),to_d ate('15-FE B-18','DD- MON-RR')); | |
| 2509 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (577 ,649,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '15-FEB-18 ','DD-MON- RR'),to_da te('15-FEB -18','DD-M ON-RR')); | |
| 2510 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (578 ,650,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('15-FEB-1 8','DD-MON -RR'),to_d ate('15-FE B-18','DD- MON-RR')); | |
| 2511 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (579 ,650,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '15-FEB-18 ','DD-MON- RR'),to_da te('15-FEB -18','DD-M ON-RR')); | |
| 2512 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (580 ,651,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('15-FEB-1 8','DD-MON -RR'),to_d ate('15-FE B-18','DD- MON-RR')); | |
| 2513 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (581 ,652,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('15-FEB-1 8','DD-MON -RR'),to_d ate('15-FE B-18','DD- MON-RR')); | |
| 2514 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (582 ,654,'2',t o_date('12 -FEB-18',' DD-MON-RR' ),to_date( '30-MAR-18 ','DD-MON- RR'),'6789 453','8094 032','MI, NA, BT',75 8.43,to_da te('16-FEB -18','DD-M ON-RR'),to _date('16- FEB-18','D D-MON-RR') ); | |
| 2515 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (583 ,654,'1',t o_date('12 -FEB-18',' DD-MON-RR' ),to_date( '23-MAR-18 ','DD-MON- RR'),'4321 567','9872 316','GA', 457.98,to_ date('16-F EB-18','DD -MON-RR'), to_date('1 6-FEB-18', 'DD-MON-RR ')); | |
| 2516 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (584 ,655,'2',t o_date('12 -FEB-18',' DD-MON-RR' ),to_date( '30-MAR-18 ','DD-MON- RR'),'6789 453','8094 032','MI, NA, BT',75 8.43,to_da te('16-FEB -18','DD-M ON-RR'),to _date('16- FEB-18','D D-MON-RR') ); | |
| 2517 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (585 ,655,'1',t o_date('12 -FEB-18',' DD-MON-RR' ),to_date( '23-MAR-18 ','DD-MON- RR'),'4321 567','9872 316','GA', 457.98,to_ date('16-F EB-18','DD -MON-RR'), to_date('1 6-FEB-18', 'DD-MON-RR ')); | |
| 2518 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (586 ,656,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('16-FEB-1 8','DD-MON -RR'),to_d ate('16-FE B-18','DD- MON-RR')); | |
| 2519 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (589 ,659,'1',t o_date('22 -APR-11',' DD-MON-RR' ),to_date( '22-APR-11 ','DD-MON- RR'),null, '73610',nu ll,60,to_d ate('16-FE B-18','DD- MON-RR'),t o_date('16 -FEB-18',' DD-MON-RR' )); | |
| 2520 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (590 ,660,'8',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0636 ','J9280', null,802.9 5,to_date( '16-FEB-18 ','DD-MON- RR'),to_da te('16-FEB -18','DD-M ON-RR')); | |
| 2521 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (591 ,660,'2',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0333 ','77386', null,3357, to_date('1 6-FEB-18', 'DD-MON-RR '),to_date ('16-FEB-1 8','DD-MON -RR')); | |
| 2522 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (592 ,661,'1',t o_date('11 -SEP-17',' DD-MON-RR' ),to_date( '12-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,EE,AA, AQ',16124. 57,to_date ('16-FEB-1 8','DD-MON -RR'),to_d ate('16-FE B-18','DD- MON-RR')); | |
| 2523 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (597 ,664,'6',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0636 ','J9190', null,64.33 ,to_date(' 16-FEB-18' ,'DD-MON-R R'),to_dat e('16-FEB- 18','DD-MO N-RR')); | |
| 2524 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (598 ,664,'5',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0636 ','J7050', null,8.6,t o_date('16 -FEB-18',' DD-MON-RR' ),to_date( '16-FEB-18 ','DD-MON- RR')); | |
| 2525 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (599 ,664,'2',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0333 ','77386', null,3357, to_date('1 6-FEB-18', 'DD-MON-RR '),to_date ('16-FEB-1 8','DD-MON -RR')); | |
| 2526 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (600 ,664,'9',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-16 ','DD-MON- RR'),'0637 ',null,nul l,2.4,to_d ate('16-FE B-18','DD- MON-RR'),t o_date('16 -FEB-18',' DD-MON-RR' )); | |
| 2527 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (601 ,665,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('16-FEB-1 8','DD-MON -RR'),to_d ate('16-FE B-18','DD- MON-RR')); | |
| 2528 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (602 ,666,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('16 -FEB-18',' DD-MON-RR' ),to_date( '16-FEB-18 ','DD-MON- RR')); | |
| 2529 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (612 ,671,'3',t o_date('19 -FEB-18',' DD-MON-RR' ),to_date( '13-FEB-18 ','DD-MON- RR'),'1023 6','10136' ,'DE',123. 79,to_date ('16-FEB-1 8','DD-MON -RR'),to_d ate('16-FE B-18','DD- MON-RR')); | |
| 2530 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (613 ,671,'1',t o_date('16 -FEB-18',' DD-MON-RR' ),to_date( '16-MAR-18 ','DD-MON- RR'),'1023 4','10134' ,'ET, GA, MI',123.76 ,to_date(' 16-FEB-18' ,'DD-MON-R R'),to_dat e('16-FEB- 18','DD-MO N-RR')); | |
| 2531 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (614 ,671,'2',t o_date('18 -FEB-18',' DD-MON-RR' ),to_date( '17-FEB-18 ','DD-MON- RR'),'1023 5','10135' ,'TR, MI', 123.7,to_d ate('16-FE B-18','DD- MON-RR'),t o_date('16 -FEB-18',' DD-MON-RR' )); | |
| 2532 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (615 ,672,'2',t o_date('18 -FEB-18',' DD-MON-RR' ),to_date( '17-FEB-18 ','DD-MON- RR'),'1023 5','10135' ,'TR, MI', 123.7,to_d ate('16-FE B-18','DD- MON-RR'),t o_date('16 -FEB-18',' DD-MON-RR' )); | |
| 2533 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (616 ,672,'1',t o_date('16 -FEB-18',' DD-MON-RR' ),to_date( '16-MAR-18 ','DD-MON- RR'),'1023 4','10134' ,'ET, GA, MI',123.76 ,to_date(' 16-FEB-18' ,'DD-MON-R R'),to_dat e('16-FEB- 18','DD-MO N-RR')); | |
| 2534 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (617 ,672,'3',t o_date('19 -FEB-18',' DD-MON-RR' ),to_date( '13-FEB-18 ','DD-MON- RR'),'1023 6','10136' ,'DE',123. 79,to_date ('16-FEB-1 8','DD-MON -RR'),to_d ate('16-FE B-18','DD- MON-RR')); | |
| 2535 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (618 ,675,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('16-FEB-1 8','DD-MON -RR'),to_d ate('16-FE B-18','DD- MON-RR')); | |
| 2536 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (619 ,675,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '16-FEB-18 ','DD-MON- RR'),to_da te('16-FEB -18','DD-M ON-RR')); | |
| 2537 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (620 ,677,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('16 -FEB-18',' DD-MON-RR' ),to_date( '16-FEB-18 ','DD-MON- RR')); | |
| 2538 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (621 ,679,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('16 -FEB-18',' DD-MON-RR' ),to_date( '16-FEB-18 ','DD-MON- RR')); | |
| 2539 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (622 ,681,'9',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '18-JUL-17 ','DD-MON- RR'),'0637 ','J3475', 'GP,QS,AA, AQ',2.4,to _date('16- FEB-18','D D-MON-RR') ,to_date(' 16-FEB-18' ,'DD-MON-R R')); | |
| 2540 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (623 ,681,'4',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '25-OCT-17 ','DD-MON- RR'),'0352 ','77014', 'JA,EE,QS, AQ',1372,t o_date('16 -FEB-18',' DD-MON-RR' ),to_date( '16-FEB-18 ','DD-MON- RR')); | |
| 2541 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (624 ,681,'2',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '29-APR-17 ','DD-MON- RR'),'0333 ','77386', 'G4,QS,AA, EE',3357,t o_date('16 -FEB-18',' DD-MON-RR' ),to_date( '16-FEB-18 ','DD-MON- RR')); | |
| 2542 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (625 ,683,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('16 -FEB-18',' DD-MON-RR' ),to_date( '16-FEB-18 ','DD-MON- RR')); | |
| 2543 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (626 ,684,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('16-FEB-1 8','DD-MON -RR'),to_d ate('16-FE B-18','DD- MON-RR')); | |
| 2544 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (627 ,685,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('16 -FEB-18',' DD-MON-RR' ),to_date( '16-FEB-18 ','DD-MON- RR')); | |
| 2545 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (628 ,687,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('16 -FEB-18',' DD-MON-RR' ),to_date( '16-FEB-18 ','DD-MON- RR')); | |
| 2546 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (629 ,689,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('20-FEB-1 8','DD-MON -RR'),to_d ate('20-FE B-18','DD- MON-RR')); | |
| 2547 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (630 ,690,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('20-FEB-1 8','DD-MON -RR'),to_d ate('20-FE B-18','DD- MON-RR')); | |
| 2548 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (631 ,691,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('20 -FEB-18',' DD-MON-RR' ),to_date( '20-FEB-18 ','DD-MON- RR')); | |
| 2549 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (632 ,692,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('20-FEB-1 8','DD-MON -RR'),to_d ate('20-FE B-18','DD- MON-RR')); | |
| 2550 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (633 ,694,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('20 -FEB-18',' DD-MON-RR' ),to_date( '20-FEB-18 ','DD-MON- RR')); | |
| 2551 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (634 ,695,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('20 -FEB-18',' DD-MON-RR' ),to_date( '20-FEB-18 ','DD-MON- RR')); | |
| 2552 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (635 ,696,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('20 -FEB-18',' DD-MON-RR' ),to_date( '20-FEB-18 ','DD-MON- RR')); | |
| 2553 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (636 ,697,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('20 -FEB-18',' DD-MON-RR' ),to_date( '20-FEB-18 ','DD-MON- RR')); | |
| 2554 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (637 ,700,'1',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0551 ','G0154', 'G4,QS,LT, T5',9750.4 1,to_date( '20-FEB-18 ','DD-MON- RR'),to_da te('20-FEB -18','DD-M ON-RR')); | |
| 2555 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (638 ,702,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('20 -FEB-18',' DD-MON-RR' ),to_date( '20-FEB-18 ','DD-MON- RR')); | |
| 2556 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (639 ,703,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('20 -FEB-18',' DD-MON-RR' ),to_date( '20-FEB-18 ','DD-MON- RR')); | |
| 2557 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (640 ,704,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('20 -FEB-18',' DD-MON-RR' ),to_date( '20-FEB-18 ','DD-MON- RR')); | |
| 2558 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (641 ,705,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('20 -FEB-18',' DD-MON-RR' ),to_date( '20-FEB-18 ','DD-MON- RR')); | |
| 2559 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (642 ,706,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('20 -FEB-18',' DD-MON-RR' ),to_date( '20-FEB-18 ','DD-MON- RR')); | |
| 2560 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (643 ,707,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('20 -FEB-18',' DD-MON-RR' ),to_date( '20-FEB-18 ','DD-MON- RR')); | |
| 2561 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (644 ,708,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0551 ','G0154', 'JA,RT,LT, SG',16564. 32,to_date ('20-FEB-1 8','DD-MON -RR'),to_d ate('20-FE B-18','DD- MON-RR')); | |
| 2562 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (645 ,709,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('21 -FEB-18',' DD-MON-RR' ),to_date( '21-FEB-18 ','DD-MON- RR')); | |
| 2563 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (646 ,710,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('21 -FEB-18',' DD-MON-RR' ),to_date( '21-FEB-18 ','DD-MON- RR')); | |
| 2564 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (647 ,711,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('21 -FEB-18',' DD-MON-RR' ),to_date( '21-FEB-18 ','DD-MON- RR')); | |
| 2565 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (648 ,713,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('21-FEB-1 8','DD-MON -RR'),to_d ate('21-FE B-18','DD- MON-RR')); | |
| 2566 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (649 ,714,'1',t o_date('01 -JAN-15',' DD-MON-RR' ),to_date( '01-JAN-18 ','DD-MON- RR'),'1234 5','23545' ,'1212',34 34,to_date ('21-FEB-1 8','DD-MON -RR'),to_d ate('21-FE B-18','DD- MON-RR')); | |
| 2567 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (650 ,716,'1',t o_date('01 -FEB-13',' DD-MON-RR' ),to_date( '01-FEB-18 ','DD-MON- RR'),'1234 5','12345' ,'terg',12 345,to_dat e('21-FEB- 18','DD-MO N-RR'),to_ date('21-F EB-18','DD -MON-RR')) ; | |
| 2568 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (651 ,717,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('21 -FEB-18',' DD-MON-RR' ),to_date( '21-FEB-18 ','DD-MON- RR')); | |
| 2569 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (652 ,718,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('21 -FEB-18',' DD-MON-RR' ),to_date( '21-FEB-18 ','DD-MON- RR')); | |
| 2570 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (653 ,719,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('21 -FEB-18',' DD-MON-RR' ),to_date( '21-FEB-18 ','DD-MON- RR')); | |
| 2571 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (654 ,720,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('21 -FEB-18',' DD-MON-RR' ),to_date( '21-FEB-18 ','DD-MON- RR')); | |
| 2572 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (655 ,721,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('21 -FEB-18',' DD-MON-RR' ),to_date( '21-FEB-18 ','DD-MON- RR')); | |
| 2573 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (656 ,722,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('21 -FEB-18',' DD-MON-RR' ),to_date( '21-FEB-18 ','DD-MON- RR')); | |
| 2574 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (657 ,723,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('22 -FEB-18',' DD-MON-RR' ),to_date( '22-FEB-18 ','DD-MON- RR')); | |
| 2575 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (658 ,724,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '22-FEB-18 ','DD-MON- RR'),to_da te('22-FEB -18','DD-M ON-RR')); | |
| 2576 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (659 ,724,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('22-FEB-1 8','DD-MON -RR'),to_d ate('22-FE B-18','DD- MON-RR')); | |
| 2577 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (660 ,726,'1',t o_date('01 -FEB-17',' DD-MON-RR' ),to_date( '01-FEB-18 ','DD-MON- RR'),'1234 5','34566' ,'13243',4 56456,to_d ate('22-FE B-18','DD- MON-RR'),t o_date('22 -FEB-18',' DD-MON-RR' )); | |
| 2578 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (661 ,727,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('22 -FEB-18',' DD-MON-RR' ),to_date( '22-FEB-18 ','DD-MON- RR')); | |
| 2579 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (662 ,728,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('22 -FEB-18',' DD-MON-RR' ),to_date( '22-FEB-18 ','DD-MON- RR')); | |
| 2580 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (663 ,729,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('22 -FEB-18',' DD-MON-RR' ),to_date( '22-FEB-18 ','DD-MON- RR')); | |
| 2581 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (664 ,730,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('22 -FEB-18',' DD-MON-RR' ),to_date( '22-FEB-18 ','DD-MON- RR')); | |
| 2582 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (665 ,731,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('22 -FEB-18',' DD-MON-RR' ),to_date( '22-FEB-18 ','DD-MON- RR')); | |
| 2583 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (666 ,732,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('22 -FEB-18',' DD-MON-RR' ),to_date( '22-FEB-18 ','DD-MON- RR')); | |
| 2584 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (667 ,733,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('22 -FEB-18',' DD-MON-RR' ),to_date( '22-FEB-18 ','DD-MON- RR')); | |
| 2585 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (668 ,734,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '10-SEP-17 ','DD-MON- RR'),'0582 ','99509', 'GP,QS,LT, EE',1859.0 2,to_date( '22-FEB-18 ','DD-MON- RR'),to_da te('22-FEB -18','DD-M ON-RR')); | |
| 2586 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (669 ,737,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('22 -FEB-18',' DD-MON-RR' ),to_date( '22-FEB-18 ','DD-MON- RR')); | |
| 2587 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (670 ,738,'2',t o_date('15 -FEB-18',' DD-MON-RR' ),to_date( '11-MAR-18 ','DD-MON- RR'),'2345 672','2345 673','DE, ET, HG',12 1.43,to_da te('22-FEB -18','DD-M ON-RR'),to _date('22- FEB-18','D D-MON-RR') ); | |
| 2588 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (671 ,738,'1',t o_date('15 -JAN-18',' DD-MON-RR' ),to_date( '15-MAR-18 ','DD-MON- RR'),'2345 678','2345 671','GA, MR. EI',13 45.87,to_d ate('22-FE B-18','DD- MON-RR'),t o_date('22 -FEB-18',' DD-MON-RR' )); | |
| 2589 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (672 ,740,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('22 -FEB-18',' DD-MON-RR' ),to_date( '22-FEB-18 ','DD-MON- RR')); | |
| 2590 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (673 ,741,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('22 -FEB-18',' DD-MON-RR' ),to_date( '22-FEB-18 ','DD-MON- RR')); | |
| 2591 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (674 ,742,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('22 -FEB-18',' DD-MON-RR' ),to_date( '22-FEB-18 ','DD-MON- RR')); | |
| 2592 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (675 ,746,'123' ,to_date(' 01-JAN-17' ,'DD-MON-R R'),to_dat e('02-FEB- 17','DD-MO N-RR'),'12 3','456',' ABC',100.0 1,to_date( '23-FEB-18 ','DD-MON- RR'),to_da te('23-FEB -18','DD-M ON-RR')); | |
| 2593 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (676 ,747,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('23 -FEB-18',' DD-MON-RR' ),to_date( '23-FEB-18 ','DD-MON- RR')); | |
| 2594 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (677 ,748,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('23 -FEB-18',' DD-MON-RR' ),to_date( '23-FEB-18 ','DD-MON- RR')); | |
| 2595 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (678 ,749,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('23 -FEB-18',' DD-MON-RR' ),to_date( '23-FEB-18 ','DD-MON- RR')); | |
| 2596 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (679 ,750,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('23 -FEB-18',' DD-MON-RR' ),to_date( '23-FEB-18 ','DD-MON- RR')); | |
| 2597 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (680 ,751,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('23 -FEB-18',' DD-MON-RR' ),to_date( '23-FEB-18 ','DD-MON- RR')); | |
| 2598 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (681 ,752,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('23 -FEB-18',' DD-MON-RR' ),to_date( '23-FEB-18 ','DD-MON- RR')); | |
| 2599 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (682 ,753,'2',t o_date('01 -FEB-18',' DD-MON-RR' ),to_date( '01-MAR-18 ','DD-MON- RR'),'3264 82937','32 6483937',' TR, ET',12 1.33,to_da te('23-FEB -18','DD-M ON-RR'),to _date('23- FEB-18','D D-MON-RR') ); | |
| 2600 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (683 ,753,'1',t o_date('01 -JAN-18',' DD-MON-RR' ),to_date( '28-FEB-18 ','DD-MON- RR'),'3264 81937','32 6481938',' GA, MA',17 62.43,to_d ate('23-FE B-18','DD- MON-RR'),t o_date('23 -FEB-18',' DD-MON-RR' )); | |
| 2601 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (684 ,754,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('23 -FEB-18',' DD-MON-RR' ),to_date( '23-FEB-18 ','DD-MON- RR')); | |
| 2602 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (685 ,755,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('23 -FEB-18',' DD-MON-RR' ),to_date( '23-FEB-18 ','DD-MON- RR')); | |
| 2603 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (686 ,756,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('23 -FEB-18',' DD-MON-RR' ),to_date( '23-FEB-18 ','DD-MON- RR')); | |
| 2604 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (687 ,757,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('23 -FEB-18',' DD-MON-RR' ),to_date( '23-FEB-18 ','DD-MON- RR')); | |
| 2605 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (688 ,758,'1',t o_date('11 -SEP-17',' DD-MON-RR' ),to_date( '12-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,EE,AA, AQ',16124. 57,to_date ('25-FEB-1 8','DD-MON -RR'),to_d ate('25-FE B-18','DD- MON-RR')); | |
| 2606 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (689 ,759,'123' ,to_date(' 01-JAN-17' ,'DD-MON-R R'),to_dat e('02-FEB- 17','DD-MO N-RR'),'12 3','456',' ABC',100.0 1,to_date( '26-FEB-18 ','DD-MON- RR'),to_da te('26-FEB -18','DD-M ON-RR')); | |
| 2607 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (690 ,760,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0551 ','G0154', 'JA,RT,LT, SG',16564. 32,to_date ('26-FEB-1 8','DD-MON -RR'),to_d ate('26-FE B-18','DD- MON-RR')); | |
| 2608 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (691 ,762,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('26 -FEB-18',' DD-MON-RR' ),to_date( '26-FEB-18 ','DD-MON- RR')); | |
| 2609 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (692 ,763,'1',t o_date('12 -APR-11',' DD-MON-RR' ),to_date( '12-APR-11 ','DD-MON- RR'),null, '99284',nu ll,646,to_ date('26-F EB-18','DD -MON-RR'), to_date('2 6-FEB-18', 'DD-MON-RR ')); | |
| 2610 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (693 ,765,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '10-SEP-17 ','DD-MON- RR'),'0582 ','99509', 'GP,QS,LT, EE',1859.0 2,to_date( '26-FEB-18 ','DD-MON- RR'),to_da te('26-FEB -18','DD-M ON-RR')); | |
| 2611 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (694 ,766,'1',t o_date('12 -APR-11',' DD-MON-RR' ),to_date( '12-APR-11 ','DD-MON- RR'),null, '99284',nu ll,646,to_ date('26-F EB-18','DD -MON-RR'), to_date('2 6-FEB-18', 'DD-MON-RR ')); | |
| 2612 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (695 ,769,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0450 ','99283', 'JA,EE,QS, EE',10365. 13,to_date ('26-FEB-1 8','DD-MON -RR'),to_d ate('26-FE B-18','DD- MON-RR')); | |
| 2613 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (696 ,772,'1',t o_date('12 -APR-11',' DD-MON-RR' ),to_date( '12-APR-11 ','DD-MON- RR'),null, '99284',nu ll,646,to_ date('26-F EB-18','DD -MON-RR'), to_date('2 6-FEB-18', 'DD-MON-RR ')); | |
| 2614 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (697 ,773,'1',t o_date('12 -APR-11',' DD-MON-RR' ),to_date( '12-APR-11 ','DD-MON- RR'),null, '99284',nu ll,646,to_ date('26-F EB-18','DD -MON-RR'), to_date('2 6-FEB-18', 'DD-MON-RR ')); | |
| 2615 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (698 ,775,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '10-SEP-17 ','DD-MON- RR'),'0582 ','99509', 'GP,QS,LT, EE',1859.0 2,to_date( '26-FEB-18 ','DD-MON- RR'),to_da te('26-FEB -18','DD-M ON-RR')); | |
| 2616 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (699 ,778,'123' ,to_date(' 02-JAN-18' ,'DD-MON-R R'),to_dat e('05-FEB- 18','DD-MO N-RR'),'re v123','pro c456','A, B, C',100. 01,to_date ('27-FEB-1 8','DD-MON -RR'),to_d ate('27-FE B-18','DD- MON-RR')); | |
| 2617 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (700 ,779,'1',t o_date('11 -SEP-17',' DD-MON-RR' ),to_date( '11-SEP-17 ','DD-MON- RR'),'0450 ','99285', 'JA,SG,AS, EE',11348. 29,to_date ('27-FEB-1 8','DD-MON -RR'),to_d ate('27-FE B-18','DD- MON-RR')); | |
| 2618 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (701 ,783,'1',t o_date('12 -APR-11',' DD-MON-RR' ),to_date( '12-APR-11 ','DD-MON- RR'),null, '99284',nu ll,646,to_ date('27-F EB-18','DD -MON-RR'), to_date('2 7-FEB-18', 'DD-MON-RR ')); | |
| 2619 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (702 ,784,'123' ,to_date(' 10-SEP-17' ,'DD-MON-R R'),to_dat e('15-SEP- 17','DD-MO N-RR'),'re v1','proc2 ','ABC',10 0.01,to_da te('27-FEB -18','DD-M ON-RR'),to _date('27- FEB-18','D D-MON-RR') ); | |
| 2620 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (703 ,784,'456' ,to_date(' 20-JAN-17' ,'DD-MON-R R'),to_dat e('24-FEB- 17','DD-MO N-RR'),'re v2','proc3 ','A, B, C ',200.2,to _date('27- FEB-18','D D-MON-RR') ,to_date(' 27-FEB-18' ,'DD-MON-R R')); | |
| 2621 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (704 ,786,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('28-FEB-1 8','DD-MON -RR'),to_d ate('28-FE B-18','DD- MON-RR')); | |
| 2622 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (705 ,787,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('28-FEB-1 8','DD-MON -RR'),to_d ate('28-FE B-18','DD- MON-RR')); | |
| 2623 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (706 ,788,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '28-FEB-18 ','DD-MON- RR'),to_da te('28-FEB -18','DD-M ON-RR')); | |
| 2624 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (707 ,788,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('28-FEB-1 8','DD-MON -RR'),to_d ate('28-FE B-18','DD- MON-RR')); | |
| 2625 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (708 ,789,'1',t o_date('13 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ','Q5001', 'G4,RT,LT, P3',17888. 41,to_date ('28-FEB-1 8','DD-MON -RR'),to_d ate('28-FE B-18','DD- MON-RR')); | |
| 2626 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (709 ,789,'2',t o_date('14 -SEP-17',' DD-MON-RR' ),to_date( '14-SEP-17 ','DD-MON- RR'),'0430 ','97140', 'JA,EE,QS, SG',4829.5 2,to_date( '28-FEB-18 ','DD-MON- RR'),to_da te('28-FEB -18','DD-M ON-RR')); | |
| 2627 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (710 ,790,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '10-NOV-17 ','DD-MON- RR'),null, null,null, null,to_da te('28-FEB -18','DD-M ON-RR'),to _date('28- FEB-18','D D-MON-RR') ); | |
| 2628 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (711 ,791,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('01 -MAR-18',' DD-MON-RR' ),to_date( '01-MAR-18 ','DD-MON- RR')); | |
| 2629 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (712 ,792,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('02 -MAR-18',' DD-MON-RR' ),to_date( '02-MAR-18 ','DD-MON- RR')); | |
| 2630 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (713 ,793,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('02 -MAR-18',' DD-MON-RR' ),to_date( '02-MAR-18 ','DD-MON- RR')); | |
| 2631 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (714 ,794,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('02 -MAR-18',' DD-MON-RR' ),to_date( '02-MAR-18 ','DD-MON- RR')); | |
| 2632 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (715 ,795,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('02 -MAR-18',' DD-MON-RR' ),to_date( '02-MAR-18 ','DD-MON- RR')); | |
| 2633 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (716 ,796,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('02 -MAR-18',' DD-MON-RR' ),to_date( '02-MAR-18 ','DD-MON- RR')); | |
| 2634 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (717 ,797,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('02 -MAR-18',' DD-MON-RR' ),to_date( '02-MAR-18 ','DD-MON- RR')); | |
| 2635 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (718 ,798,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('02 -MAR-18',' DD-MON-RR' ),to_date( '02-MAR-18 ','DD-MON- RR')); | |
| 2636 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (719 ,799,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('05 -MAR-18',' DD-MON-RR' ),to_date( '05-MAR-18 ','DD-MON- RR')); | |
| 2637 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (720 ,800,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('05 -MAR-18',' DD-MON-RR' ),to_date( '05-MAR-18 ','DD-MON- RR')); | |
| 2638 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (721 ,801,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('05 -MAR-18',' DD-MON-RR' ),to_date( '05-MAR-18 ','DD-MON- RR')); | |
| 2639 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (722 ,802,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('05 -MAR-18',' DD-MON-RR' ),to_date( '05-MAR-18 ','DD-MON- RR')); | |
| 2640 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (723 ,803,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('05 -MAR-18',' DD-MON-RR' ),to_date( '05-MAR-18 ','DD-MON- RR')); | |
| 2641 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (724 ,804,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('05 -MAR-18',' DD-MON-RR' ),to_date( '05-MAR-18 ','DD-MON- RR')); | |
| 2642 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (725 ,805,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('05 -MAR-18',' DD-MON-RR' ),to_date( '05-MAR-18 ','DD-MON- RR')); | |
| 2643 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (726 ,806,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('05 -MAR-18',' DD-MON-RR' ),to_date( '05-MAR-18 ','DD-MON- RR')); | |
| 2644 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (727 ,807,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('05 -MAR-18',' DD-MON-RR' ),to_date( '05-MAR-18 ','DD-MON- RR')); | |
| 2645 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (728 ,808,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('05 -MAR-18',' DD-MON-RR' ),to_date( '05-MAR-18 ','DD-MON- RR')); | |
| 2646 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (729 ,809,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('05 -MAR-18',' DD-MON-RR' ),to_date( '05-MAR-18 ','DD-MON- RR')); | |
| 2647 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (730 ,810,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('06 -MAR-18',' DD-MON-RR' ),to_date( '06-MAR-18 ','DD-MON- RR')); | |
| 2648 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (731 ,811,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('06 -MAR-18',' DD-MON-RR' ),to_date( '06-MAR-18 ','DD-MON- RR')); | |
| 2649 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (732 ,812,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('06 -MAR-18',' DD-MON-RR' ),to_date( '06-MAR-18 ','DD-MON- RR')); | |
| 2650 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (733 ,813,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('06 -MAR-18',' DD-MON-RR' ),to_date( '06-MAR-18 ','DD-MON- RR')); | |
| 2651 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (734 ,814,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('06 -MAR-18',' DD-MON-RR' ),to_date( '06-MAR-18 ','DD-MON- RR')); | |
| 2652 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (735 ,815,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('06 -MAR-18',' DD-MON-RR' ),to_date( '06-MAR-18 ','DD-MON- RR')); | |
| 2653 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (736 ,816,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('06 -MAR-18',' DD-MON-RR' ),to_date( '06-MAR-18 ','DD-MON- RR')); | |
| 2654 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (737 ,817,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('06 -MAR-18',' DD-MON-RR' ),to_date( '06-MAR-18 ','DD-MON- RR')); | |
| 2655 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (738 ,818,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('06 -MAR-18',' DD-MON-RR' ),to_date( '06-MAR-18 ','DD-MON- RR')); | |
| 2656 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (739 ,819,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('06 -MAR-18',' DD-MON-RR' ),to_date( '06-MAR-18 ','DD-MON- RR')); | |
| 2657 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (740 ,820,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('06 -MAR-18',' DD-MON-RR' ),to_date( '06-MAR-18 ','DD-MON- RR')); | |
| 2658 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (741 ,821,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('06 -MAR-18',' DD-MON-RR' ),to_date( '06-MAR-18 ','DD-MON- RR')); | |
| 2659 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (742 ,822,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('06 -MAR-18',' DD-MON-RR' ),to_date( '06-MAR-18 ','DD-MON- RR')); | |
| 2660 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (743 ,823,'1',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '17-JUL-17 ','DD-MON- RR'),'0280 ','G0498', 'JA,QS,QS, P3',597,to _date('06- MAR-18','D D-MON-RR') ,to_date(' 06-MAR-18' ,'DD-MON-R R')); | |
| 2661 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (744 ,823,'2',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '29-APR-17 ','DD-MON- RR'),'0333 ','77386', 'G4,QS,AA, EE',3357,t o_date('06 -MAR-18',' DD-MON-RR' ),to_date( '06-MAR-18 ','DD-MON- RR')); | |
| 2662 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (745 ,824,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('06 -MAR-18',' DD-MON-RR' ),to_date( '06-MAR-18 ','DD-MON- RR')); | |
| 2663 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (746 ,826,'2',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '29-APR-17 ','DD-MON- RR'),'0333 ','77386', 'G4,QS,AA, EE',3357,t o_date('06 -MAR-18',' DD-MON-RR' ),to_date( '06-MAR-18 ','DD-MON- RR')); | |
| 2664 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (747 ,826,'1',t o_date('25 -OCT-16',' DD-MON-RR' ),to_date( '17-JUL-17 ','DD-MON- RR'),'0280 ','G0498', 'JA,QS,QS, P3',597,to _date('06- MAR-18','D D-MON-RR') ,to_date(' 06-MAR-18' ,'DD-MON-R R')); | |
| 2665 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (748 ,827,'1',t o_date('18 -APR-11',' DD-MON-RR' ),to_date( '20-APR-11 ','DD-MON- RR'),'212' ,'99212',' 21,ac,14,2 1',60,to_d ate('06-MA R-18','DD- MON-RR'),t o_date('06 -MAR-18',' DD-MON-RR' )); | |
| 2666 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (749 ,828,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('06 -MAR-18',' DD-MON-RR' ),to_date( '06-MAR-18 ','DD-MON- RR')); | |
| 2667 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (750 ,829,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('06 -MAR-18',' DD-MON-RR' ),to_date( '06-MAR-18 ','DD-MON- RR')); | |
| 2668 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (751 ,830,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('06 -MAR-18',' DD-MON-RR' ),to_date( '06-MAR-18 ','DD-MON- RR')); | |
| 2669 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (752 ,831,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('06 -MAR-18',' DD-MON-RR' ),to_date( '06-MAR-18 ','DD-MON- RR')); | |
| 2670 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (753 ,832,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('06 -MAR-18',' DD-MON-RR' ),to_date( '06-MAR-18 ','DD-MON- RR')); | |
| 2671 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (754 ,833,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('06 -MAR-18',' DD-MON-RR' ),to_date( '06-MAR-18 ','DD-MON- RR')); | |
| 2672 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (755 ,834,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -MAR-18',' DD-MON-RR' ),to_date( '07-MAR-18 ','DD-MON- RR')); | |
| 2673 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (756 ,835,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('07 -MAR-18',' DD-MON-RR' ),to_date( '07-MAR-18 ','DD-MON- RR')); | |
| 2674 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (757 ,836,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('07 -MAR-18',' DD-MON-RR' ),to_date( '07-MAR-18 ','DD-MON- RR')); | |
| 2675 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (758 ,837,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('07 -MAR-18',' DD-MON-RR' ),to_date( '07-MAR-18 ','DD-MON- RR')); | |
| 2676 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (759 ,838,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('07 -MAR-18',' DD-MON-RR' ),to_date( '07-MAR-18 ','DD-MON- RR')); | |
| 2677 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (760 ,839,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('07 -MAR-18',' DD-MON-RR' ),to_date( '07-MAR-18 ','DD-MON- RR')); | |
| 2678 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (761 ,840,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('07 -MAR-18',' DD-MON-RR' ),to_date( '07-MAR-18 ','DD-MON- RR')); | |
| 2679 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (762 ,841,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('07 -MAR-18',' DD-MON-RR' ),to_date( '07-MAR-18 ','DD-MON- RR')); | |
| 2680 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (764 ,845,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('07 -MAR-18',' DD-MON-RR' ),to_date( '07-MAR-18 ','DD-MON- RR')); | |
| 2681 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (763 ,842,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('07 -MAR-18',' DD-MON-RR' ),to_date( '07-MAR-18 ','DD-MON- RR')); | |
| 2682 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (765 ,844,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('07 -MAR-18',' DD-MON-RR' ),to_date( '07-MAR-18 ','DD-MON- RR')); | |
| 2683 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (766 ,843,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('07 -MAR-18',' DD-MON-RR' ),to_date( '07-MAR-18 ','DD-MON- RR')); | |
| 2684 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (767 ,846,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('07 -MAR-18',' DD-MON-RR' ),to_date( '07-MAR-18 ','DD-MON- RR')); | |
| 2685 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (768 ,847,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('07 -MAR-18',' DD-MON-RR' ),to_date( '07-MAR-18 ','DD-MON- RR')); | |
| 2686 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (769 ,848,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('07 -MAR-18',' DD-MON-RR' ),to_date( '07-MAR-18 ','DD-MON- RR')); | |
| 2687 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (770 ,849,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('07 -MAR-18',' DD-MON-RR' ),to_date( '07-MAR-18 ','DD-MON- RR')); | |
| 2688 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (772 ,851,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('07 -MAR-18',' DD-MON-RR' ),to_date( '07-MAR-18 ','DD-MON- RR')); | |
| 2689 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (771 ,850,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('07 -MAR-18',' DD-MON-RR' ),to_date( '07-MAR-18 ','DD-MON- RR')); | |
| 2690 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (773 ,852,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('07 -MAR-18',' DD-MON-RR' ),to_date( '07-MAR-18 ','DD-MON- RR')); | |
| 2691 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (774 ,853,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('07 -MAR-18',' DD-MON-RR' ),to_date( '07-MAR-18 ','DD-MON- RR')); | |
| 2692 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (775 ,854,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -MAR-18',' DD-MON-RR' ),to_date( '07-MAR-18 ','DD-MON- RR')); | |
| 2693 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (776 ,855,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -MAR-18',' DD-MON-RR' ),to_date( '07-MAR-18 ','DD-MON- RR')); | |
| 2694 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (777 ,856,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('07 -MAR-18',' DD-MON-RR' ),to_date( '07-MAR-18 ','DD-MON- RR')); | |
| 2695 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (778 ,857,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2696 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (779 ,858,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2697 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (780 ,859,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2698 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (781 ,860,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2699 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (782 ,861,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2700 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (783 ,862,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2701 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (784 ,863,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2702 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (785 ,864,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2703 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (786 ,865,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2704 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (787 ,866,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2705 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (788 ,867,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2706 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (789 ,868,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2707 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (790 ,869,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2708 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (791 ,870,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2709 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (792 ,871,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2710 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (793 ,872,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2711 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (794 ,873,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2712 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (795 ,874,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2713 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (796 ,875,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2714 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (797 ,876,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2715 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (798 ,877,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2716 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (799 ,878,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2717 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (800 ,879,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2718 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (801 ,880,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2719 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (802 ,881,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2720 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (803 ,882,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2721 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (804 ,883,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2722 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (805 ,884,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2723 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (806 ,885,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2724 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (807 ,886,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2725 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (808 ,887,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2726 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (809 ,888,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2727 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (810 ,889,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2728 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (811 ,890,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2729 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (812 ,891,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2730 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (813 ,892,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2731 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (814 ,893,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2732 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (815 ,894,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2733 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (816 ,895,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2734 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (817 ,896,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2735 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (818 ,897,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2736 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (819 ,898,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2737 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (820 ,899,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2738 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (821 ,900,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2739 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (822 ,901,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2740 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (823 ,902,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2741 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (824 ,903,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2742 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (825 ,904,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2743 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (826 ,905,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2744 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (827 ,906,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2745 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (828 ,907,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2746 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (829 ,908,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2747 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (830 ,909,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2748 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (831 ,910,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2749 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (832 ,911,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2750 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (833 ,912,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2751 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (834 ,913,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2752 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (835 ,914,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2753 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (836 ,915,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2754 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (837 ,916,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2755 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (838 ,917,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2756 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (839 ,918,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2757 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (840 ,919,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2758 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (841 ,920,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2759 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (842 ,921,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2760 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (843 ,922,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2761 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (844 ,923,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2762 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (845 ,924,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2763 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (846 ,925,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2764 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (847 ,926,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2765 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (848 ,927,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2766 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (849 ,928,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2767 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (850 ,929,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2768 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (851 ,930,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2769 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (852 ,931,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2770 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (853 ,932,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2771 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (854 ,933,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('08 -MAR-18',' DD-MON-RR' ),to_date( '08-MAR-18 ','DD-MON- RR')); | |
| 2772 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (855 ,934,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('09 -MAR-18',' DD-MON-RR' ),to_date( '09-MAR-18 ','DD-MON- RR')); | |
| 2773 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (856 ,935,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('09 -MAR-18',' DD-MON-RR' ),to_date( '09-MAR-18 ','DD-MON- RR')); | |
| 2774 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (857 ,936,'1',t o_date('10 -SEP-17',' DD-MON-RR' ),to_date( '13-SEP-17 ','DD-MON- RR'),'0651 ',null,'GP ,RT,AS,T5' ,9985.77,t o_date('10 -MAR-18',' DD-MON-RR' ),to_date( '10-MAR-18 ','DD-MON- RR')); | |
| 2775 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (858 ,937,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('11 -MAR-18',' DD-MON-RR' ),to_date( '11-MAR-18 ','DD-MON- RR')); | |
| 2776 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (859 ,938,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -MAR-18',' DD-MON-RR' ),to_date( '12-MAR-18 ','DD-MON- RR')); | |
| 2777 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (860 ,939,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -MAR-18',' DD-MON-RR' ),to_date( '12-MAR-18 ','DD-MON- RR')); | |
| 2778 | Insert int o ARS277_R EQUEST_TRA CKING.CLAI M_SVC_LINE S (SUBMISS IONSVCLINE ID,SUBMISS IONID,REF0 2SVCLNNMBR ,DTP03SVCF RMDT,DTP03 SVCTODT,SV C01REVCD,S VC01PROCCD ,SVC01MOD, SVC02CHRGA MT,DATECRE ATED,DATEM ODIFIED) v alues (861 ,940,'1000 089',to_da te('12-DEC -17','DD-M ON-RR'),to _date('12- DEC-17','D D-MON-RR') ,'456','25 6','modifi er',2.01,t o_date('12 -MAR-18',' DD-MON-RR' ),to_date( '12-MAR-18 ','DD-MON- RR')); | |
| 2779 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.CONTACT | |
| 2780 | SET DEFINE OFF; | |
| 2781 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.DOCUMEN T_CATEGORY | |
| 2782 | SET DEFINE OFF; | |
| 2783 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 52,'2100B' ,null,'275 _TEST_572_ TSET.txt', 'AE','IA', null,'05', 552); | |
| 2784 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 53,'2100B' ,null,'275 _TEST_572_ TSET.txt', 'AE','TX', null,'05', 553); | |
| 2785 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 54,'2100B' ,null,'275 _TEST_572_ TSET.txt', 'AE','MB', null,'05', 554); | |
| 2786 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 55,'2100B' ,null,'275 _TEST_572_ TSET.txt', 'AE','IA', null,'05', 555); | |
| 2787 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 56,'2100B' ,null,'275 _TEST_572_ TSET.txt', 'AE','IA', null,'05', 556); | |
| 2788 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 57,'2100B' ,null,'275 _TEST_572_ TSET.txt', 'AE','IA', null,'05', 557); | |
| 2789 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 58,'2100B' ,null,'275 _TEST_572_ TSET.txt', 'AE','IA', null,'05', 558); | |
| 2790 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 59,'2100B' ,null,'275 _TEST_572_ TSET.txt', 'AE','IA', null,'05', 559); | |
| 2791 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 60,'2100B' ,null,'275 _TEST_572_ TSET.txt', 'AE','IA', null,'05', 560); | |
| 2792 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 61,'2100B' ,null,'275 _TEST_572_ TSET.txt', 'AE','HL', null,'05', 561); | |
| 2793 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 62,'2100B' ,null,'275 _TEST_572_ TSET.txt', 'AE','IA', null,'05', 562); | |
| 2794 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 63,'2100B' ,null,'275 _TEST_572_ TSET.txt', 'AE','IA', null,'05', 563); | |
| 2795 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 64,'2100B' ,null,'275 _TEST_572_ TSET.txt', 'AE','IA', null,'05', 564); | |
| 2796 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 50,'2100B' ,null,'275 _TEST_572_ TSET.txt', 'AE','IA', null,'05', 550); | |
| 2797 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 51,'2100B' ,null,'275 _TEST_572_ TSET.txt', 'AE','IA', null,'05', 551); | |
| 2798 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 65,'2100B' ,null,'Dra gon1.txt', 'AE','IA', null,'05', 565); | |
| 2799 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 66,'2100B' ,null,'Dra gon1.txt', 'AE','IA', null,'05', 566); | |
| 2800 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 67,'2100B' ,null,'Dra gon1.txt', 'AE','IA', null,'05', 567); | |
| 2801 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 68,'2100B' ,null,'Dra gon1.txt', 'AE','TX', null,'05', 568); | |
| 2802 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 69,'2100B' ,null,'Dra gon1.txt', 'AE','MB', null,'05', 569); | |
| 2803 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 70,'2100B' ,null,'Dra gon1.txt', 'AE','IA', null,'05', 570); | |
| 2804 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 71,'2100B' ,null,'Dra gon1.txt', 'AE','IA', null,'05', 571); | |
| 2805 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 72,'2100B' ,null,'Dra gon1.txt', 'AE','IA', null,'05', 572); | |
| 2806 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 73,'2100B' ,null,'Dra gon1.txt', 'AE','IA', null,'05', 573); | |
| 2807 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 74,'2100B' ,null,'Dra gon1.txt', 'AE','IA', null,'05', 574); | |
| 2808 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 75,'2100B' ,null,'Dra gon1.txt', 'AE','IA', null,'05', 575); | |
| 2809 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 76,'2100B' ,null,'Dra gon1.txt', 'AE','HL', null,'05', 576); | |
| 2810 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 77,'2100B' ,null,'Dra gon1.txt', 'AE','IA', null,'05', 577); | |
| 2811 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 78,'2100B' ,null,'Dra gon1.txt', 'AE','IA', null,'05', 578); | |
| 2812 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 79,'2100B' ,null,'Dra gon1.txt', 'AE','IA', null,'05', 579); | |
| 2813 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 80,'2100B' ,null,'Dra gon2.txt', 'AE','IA', null,'05', 580); | |
| 2814 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 81,'2100B' ,null,'Dra gon2.txt', 'AE','IA', null,'05', 581); | |
| 2815 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 82,'2100B' ,null,'Dra gon3.txt', 'AE','IA', null,'05', 582); | |
| 2816 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 83,'2100B' ,null,'Dra gon3.txt', 'AE','IA', null,'05', 583); | |
| 2817 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 84,'2100B' ,null,'Dra gon3.txt', 'AE','IA', null,'05', 584); | |
| 2818 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 85,'2100B' ,null,'Dra gon3.txt', 'AE','TX', null,'05', 585); | |
| 2819 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 86,'2100B' ,null,'Dra gon3.txt', 'AE','MB', null,'05', 586); | |
| 2820 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 87,'2100B' ,null,'Dra gon3.txt', 'AE','IA', null,'05', 587); | |
| 2821 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 88,'2100B' ,null,'Dra gon3.txt', 'AE','IA', null,'05', 588); | |
| 2822 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 89,'2100B' ,null,'Dra gon3.txt', 'AE','IA', null,'05', 589); | |
| 2823 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 90,'2100B' ,null,'Dra gon3.txt', 'AE','IA', null,'05', 590); | |
| 2824 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 91,'2100B' ,null,'Dra gon3.txt', 'AE','IA', null,'05', 591); | |
| 2825 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 92,'2100B' ,null,'Dra gon3.txt', 'AE','IA', null,'05', 592); | |
| 2826 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 93,'2100B' ,null,'Dra gon3.txt', 'AE','HL', null,'05', 593); | |
| 2827 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 94,'2100B' ,null,'Dra gon3.txt', 'AE','IA', null,'05', 594); | |
| 2828 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 95,'2100B' ,null,'Dra gon3.txt', 'AE','IA', null,'05', 595); | |
| 2829 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 96,'2100B' ,null,'Dra gon3.txt', 'AE','IA', null,'05', 596); | |
| 2830 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 97,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt','A E','IA',nu ll,'05',59 7); | |
| 2831 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 98,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt','A E','IA',nu ll,'05',59 8); | |
| 2832 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (5 99,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt','A E','IA',nu ll,'05',59 9); | |
| 2833 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (6 00,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt','A E','TX',nu ll,'05',60 0); | |
| 2834 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (6 01,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt','A E','MB',nu ll,'05',60 1); | |
| 2835 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (6 02,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt','A E','IA',nu ll,'05',60 2); | |
| 2836 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (6 03,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt','A E','IA',nu ll,'05',60 3); | |
| 2837 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (6 04,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt','A E','IA',nu ll,'05',60 4); | |
| 2838 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (6 05,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt','A E','IA',nu ll,'05',60 5); | |
| 2839 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (6 06,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt','A E','IA',nu ll,'05',60 6); | |
| 2840 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (6 07,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt','A E','IA',nu ll,'05',60 7); | |
| 2841 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (6 08,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt','A E','HL',nu ll,'05',60 8); | |
| 2842 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (6 09,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt','A E','IA',nu ll,'05',60 9); | |
| 2843 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (6 10,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt','A E','IA',nu ll,'05',61 0); | |
| 2844 | Insert int o ARS277_R EQUEST_TRA CKING.DOCU MENT_CATEG ORY (ATTAC HMENT_ID,L OOP_ID,CLA IM_KEY,BAT CH_ID,CAT0 1,CAT02,CA T03,EF101, DOCUMENT_C ATEGORYID) values (6 11,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt','A E','IA',nu ll,'05',61 1); | |
| 2845 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.EMAIL_T EMPLATES | |
| 2846 | SET DEFINE OFF; | |
| 2847 | Insert int o ARS277_R EQUEST_TRA CKING.EMAI L_TEMPLATE S (EMAIL_T EMPLATE_ID ,EMAIL_TEM PLATE_HEAD ER,EMAIL_T EMPLATE_BO DY,EMAIL_T EMPLATE_TY PE,DATEMOD IFIED,MODI FIEDBY) va lues (2,'S ubmission of 277 Req uest','You r 275 was submitted successful ly.','pend ingTemplat e',to_date ('28-FEB-1 8','DD-MON -RR'),'VHA ISARSADMIN '); | |
| 2848 | Insert int o ARS277_R EQUEST_TRA CKING.EMAI L_TEMPLATE S (EMAIL_T EMPLATE_ID ,EMAIL_TEM PLATE_HEAD ER,EMAIL_T EMPLATE_BO DY,EMAIL_T EMPLATE_TY PE,DATEMOD IFIED,MODI FIEDBY) va lues (3,'O n Submissi on Error', 'Your subm ission has encounter ed an erro r.','error Template', to_date('2 8-FEB-18', 'DD-MON-RR '),'VHAISA RSADMIN'); | |
| 2849 | Insert int o ARS277_R EQUEST_TRA CKING.EMAI L_TEMPLATE S (EMAIL_T EMPLATE_ID ,EMAIL_TEM PLATE_HEAD ER,EMAIL_T EMPLATE_BO DY,EMAIL_T EMPLATE_TY PE,DATEMOD IFIED,MODI FIEDBY) va lues (4,'Y our Submis sion Was A bandoned', 'test aban doned','ab andonedTem plate',to_ date('28-F EB-18','DD -MON-RR'), 'VHAISARSA DMIN'); | |
| 2850 | Insert int o ARS277_R EQUEST_TRA CKING.EMAI L_TEMPLATE S (EMAIL_T EMPLATE_ID ,EMAIL_TEM PLATE_HEAD ER,EMAIL_T EMPLATE_BO DY,EMAIL_T EMPLATE_TY PE,DATEMOD IFIED,MODI FIEDBY) va lues (5,'! 123 COMPLE TE templat e header 1 23@TESTclo sed','!123 complete email temp late 123@T EST | |
| 2851 | ||
| 2852 | TEST COMPL ETE email closed','c ompleteOrC losedTempl ate',to_da te('26-FEB -18','DD-M ON-RR'),'V HAISARSADM IN'); | |
| 2853 | Insert int o ARS277_R EQUEST_TRA CKING.EMAI L_TEMPLATE S (EMAIL_T EMPLATE_ID ,EMAIL_TEM PLATE_HEAD ER,EMAIL_T EMPLATE_BO DY,EMAIL_T EMPLATE_TY PE,DATEMOD IFIED,MODI FIEDBY) va lues (6,'Y our Submis sion {SubI D} Was Clo sed By {Cl oserName}' ,'!123 man ually clos ed email t emplate 12 3@TEST | |
| 2854 | ||
| 2855 | TEST MANUA LLY Closed . manual', 'manuallyC losedTempl ate',to_da te('28-FEB -18','DD-M ON-RR'),'V HAISARSADM IN'); | |
| 2856 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.ENTITYA DDRESS | |
| 2857 | SET DEFINE OFF; | |
| 2858 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (552,'100 0C',null,' 275_TEST_5 72_TSET.tx t','615 FA IRHURST ST ',null,'ST ERLING','C O','807514 565',null, null,552); | |
| 2859 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (553,'100 0C',null,' 275_TEST_5 72_TSET.tx t','123 MA IN ST',nul l,'ANYTOWN ','AL','36 609',null, null,553); | |
| 2860 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (554,'100 0C',null,' 275_TEST_5 72_TSET.tx t','2000 B OISE AVE', null,'LOVE LAND','CO' ,'80538500 6',null,nu ll,554); | |
| 2861 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (555,'100 0C',null,' 275_TEST_5 72_TSET.tx t','1406 6 TH AVENUE N',null,'S AINT CLOUD ','MN','56 3031900',n ull,null,5 55); | |
| 2862 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (556,'100 0C',null,' 275_TEST_5 72_TSET.tx t','123 MA IN ST',nul l,'FORT CO LLINS','CO ','80525', null,null, 556); | |
| 2863 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (557,'100 0C',null,' 275_TEST_5 72_TSET.tx t','2000 B OISE AVE', null,'LOVE LAND','CO' ,'80538500 6',null,nu ll,557); | |
| 2864 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (558,'100 0C',null,' 275_TEST_5 72_TSET.tx t','3855 P RECISION D RIVE',null ,'LOVELAND ','CO','80 5389068',n ull,null,5 58); | |
| 2865 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (559,'100 0C',null,' 275_TEST_5 72_TSET.tx t','1801 1 6TH STREET ',null,'GR EELEY','CO ','8063151 54',null,n ull,559); | |
| 2866 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (560,'100 0C',null,' 275_TEST_5 72_TSET.tx t','2000 B OISE AVE', null,'LOVE LAND','CO' ,'80538500 6',null,nu ll,560); | |
| 2867 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (561,'100 0C',null,' 275_TEST_5 72_TSET.tx t','2095 W 6TH AVE', 'STE 209', 'BROOMFIEL D','CO','8 00200999', null,null, 561); | |
| 2868 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (562,'100 0C',null,' 275_TEST_5 72_TSET.tx t','1024 S LEMAY AVE NUE',null, 'FT COLLIN S','CO','8 05243929', null,null, 562); | |
| 2869 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (563,'100 0C',null,' 275_TEST_5 72_TSET.tx t','1024 S LEMAY AVE NUE',null, 'FT COLLIN S','CO','8 05243929', null,null, 563); | |
| 2870 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (564,'100 0C',null,' 275_TEST_5 72_TSET.tx t','615 FA IRHURST ST ',null,'ST ERLING','C O','807514 565',null, null,564); | |
| 2871 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (550,'100 0C',null,' 275_TEST_5 72_TSET.tx t','2000 B OISE AVE', null,'LOVE LAND','CO' ,'80538500 6',null,nu ll,550); | |
| 2872 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (551,'100 0C',null,' 275_TEST_5 72_TSET.tx t','2000 B OISE AVE', null,'LOVE LAND','CO' ,'80538500 6',null,nu ll,551); | |
| 2873 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (565,'100 0C',null,' Dragon1.tx t','2000 B OISE AVE', null,'LOVE LAND','CO' ,'80538500 6',null,nu ll,565); | |
| 2874 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (566,'100 0C',null,' Dragon1.tx t','2000 B OISE AVE', null,'LOVE LAND','CO' ,'80538500 6',null,nu ll,566); | |
| 2875 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (567,'100 0C',null,' Dragon1.tx t','615 FA IRHURST ST ',null,'ST ERLING','C O','807514 565',null, null,567); | |
| 2876 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (568,'100 0C',null,' Dragon1.tx t','123 MA IN ST',nul l,'ANYTOWN ','AL','36 609',null, null,568); | |
| 2877 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (569,'100 0C',null,' Dragon1.tx t','2000 B OISE AVE', null,'LOVE LAND','CO' ,'80538500 6',null,nu ll,569); | |
| 2878 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (570,'100 0C',null,' Dragon1.tx t','1406 6 TH AVENUE N',null,'S AINT CLOUD ','MN','56 3031900',n ull,null,5 70); | |
| 2879 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (571,'100 0C',null,' Dragon1.tx t','123 MA IN ST',nul l,'FORT CO LLINS','CO ','80525', null,null, 571); | |
| 2880 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (572,'100 0C',null,' Dragon1.tx t','2000 B OISE AVE', null,'LOVE LAND','CO' ,'80538500 6',null,nu ll,572); | |
| 2881 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (573,'100 0C',null,' Dragon1.tx t','3855 P RECISION D RIVE',null ,'LOVELAND ','CO','80 5389068',n ull,null,5 73); | |
| 2882 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (574,'100 0C',null,' Dragon1.tx t','1801 1 6TH STREET ',null,'GR EELEY','CO ','8063151 54',null,n ull,574); | |
| 2883 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (575,'100 0C',null,' Dragon1.tx t','2000 B OISE AVE', null,'LOVE LAND','CO' ,'80538500 6',null,nu ll,575); | |
| 2884 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (576,'100 0C',null,' Dragon1.tx t','2095 W 6TH AVE', 'STE 209', 'BROOMFIEL D','CO','8 00200999', null,null, 576); | |
| 2885 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (577,'100 0C',null,' Dragon1.tx t','1024 S LEMAY AVE NUE',null, 'FT COLLIN S','CO','8 05243929', null,null, 577); | |
| 2886 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (578,'100 0C',null,' Dragon1.tx t','1024 S LEMAY AVE NUE',null, 'FT COLLIN S','CO','8 05243929', null,null, 578); | |
| 2887 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (579,'100 0C',null,' Dragon1.tx t','615 FA IRHURST ST ',null,'ST ERLING','C O','807514 565',null, null,579); | |
| 2888 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (580,'100 0C',null,' Dragon2.tx t','834 N SEMINARY S T',null,'G ALESBURG', 'IL','6140 12852',nul l,null,580 ); | |
| 2889 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (581,'100 0C',null,' Dragon2.tx t','834 N SEMINARY S T',null,'G ALESBURG', 'IL','6140 12852',nul l,null,581 ); | |
| 2890 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (582,'100 0C',null,' Dragon3.tx t','2000 B OISE AVE', null,'LOVE LAND','CO' ,'80538500 6',null,nu ll,582); | |
| 2891 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (583,'100 0C',null,' Dragon3.tx t','2000 B OISE AVE', null,'LOVE LAND','CO' ,'80538500 6',null,nu ll,583); | |
| 2892 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (584,'100 0C',null,' Dragon3.tx t','615 FA IRHURST ST ',null,'ST ERLING','C O','807514 565',null, null,584); | |
| 2893 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (585,'100 0C',null,' Dragon3.tx t','123 MA IN ST',nul l,'ANYTOWN ','AL','36 609',null, null,585); | |
| 2894 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (586,'100 0C',null,' Dragon3.tx t','2000 B OISE AVE', null,'LOVE LAND','CO' ,'80538500 6',null,nu ll,586); | |
| 2895 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (587,'100 0C',null,' Dragon3.tx t','1406 6 TH AVENUE N',null,'S AINT CLOUD ','MN','56 3031900',n ull,null,5 87); | |
| 2896 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (588,'100 0C',null,' Dragon3.tx t','123 MA IN ST',nul l,'FORT CO LLINS','CO ','80525', null,null, 588); | |
| 2897 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (589,'100 0C',null,' Dragon3.tx t','2000 B OISE AVE', null,'LOVE LAND','CO' ,'80538500 6',null,nu ll,589); | |
| 2898 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (590,'100 0C',null,' Dragon3.tx t','3855 P RECISION D RIVE',null ,'LOVELAND ','CO','80 5389068',n ull,null,5 90); | |
| 2899 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (591,'100 0C',null,' Dragon3.tx t','1801 1 6TH STREET ',null,'GR EELEY','CO ','8063151 54',null,n ull,591); | |
| 2900 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (592,'100 0C',null,' Dragon3.tx t','2000 B OISE AVE', null,'LOVE LAND','CO' ,'80538500 6',null,nu ll,592); | |
| 2901 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (593,'100 0C',null,' Dragon3.tx t','2095 W 6TH AVE', 'STE 209', 'BROOMFIEL D','CO','8 00200999', null,null, 593); | |
| 2902 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (594,'100 0C',null,' Dragon3.tx t','1024 S LEMAY AVE NUE',null, 'FT COLLIN S','CO','8 05243929', null,null, 594); | |
| 2903 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (595,'100 0C',null,' Dragon3.tx t','1024 S LEMAY AVE NUE',null, 'FT COLLIN S','CO','8 05243929', null,null, 595); | |
| 2904 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (596,'100 0C',null,' Dragon3.tx t','615 FA IRHURST ST ',null,'ST ERLING','C O','807514 565',null, null,596); | |
| 2905 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (597,'100 0C',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,'2000 BOI SE AVE',nu ll,'LOVELA ND','CO',' 805385006' ,null,null ,597); | |
| 2906 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (598,'100 0C',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,'2000 BOI SE AVE',nu ll,'LOVELA ND','CO',' 805385006' ,null,null ,598); | |
| 2907 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (599,'100 0C',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,'615 FAIR HURST ST', null,'STER LING','CO' ,'80751456 5',null,nu ll,599); | |
| 2908 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (600,'100 0C',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,'123 MAIN ST',null, 'ANYTOWN', 'AL','3660 9',null,nu ll,600); | |
| 2909 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (601,'100 0C',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,'2000 BOI SE AVE',nu ll,'LOVELA ND','CO',' 805385006' ,null,null ,601); | |
| 2910 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (602,'100 0C',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,'1406 6TH AVENUE N' ,null,'SAI NT CLOUD', 'MN','5630 31900',nul l,null,602 ); | |
| 2911 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (603,'100 0C',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,'123 MAIN ST',null, 'FORT COLL INS','CO', '80525',nu ll,null,60 3); | |
| 2912 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (604,'100 0C',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,'2000 BOI SE AVE',nu ll,'LOVELA ND','CO',' 805385006' ,null,null ,604); | |
| 2913 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (605,'100 0C',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,'3855 PRE CISION DRI VE',null,' LOVELAND', 'CO','8053 89068',nul l,null,605 ); | |
| 2914 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (606,'100 0C',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,'1801 16T H STREET', null,'GREE LEY','CO', '806315154 ',null,nul l,606); | |
| 2915 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (607,'100 0C',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,'2000 BOI SE AVE',nu ll,'LOVELA ND','CO',' 805385006' ,null,null ,607); | |
| 2916 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (608,'100 0C',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,'2095 W 6 TH AVE','S TE 209','B ROOMFIELD' ,'CO','800 200999',nu ll,null,60 8); | |
| 2917 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (609,'100 0C',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,'1024 S L EMAY AVENU E',null,'F T COLLINS' ,'CO','805 243929',nu ll,null,60 9); | |
| 2918 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (610,'100 0C',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,'1024 S L EMAY AVENU E',null,'F T COLLINS' ,'CO','805 243929',nu ll,null,61 0); | |
| 2919 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYADDRESS (ATTACHMEN T_ID,LOOP_ ID,CLAIM_K EY,BATCH_I D,N301,N30 2,N401,N40 2,N403,N40 4,N407,ENT ITYADDRESS ID) values (611,'100 0C',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,'615 FAIR HURST ST', null,'STER LING','CO' ,'80751456 5',null,nu ll,611); | |
| 2920 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.ENTITYN AME | |
| 2921 | SET DEFINE OFF; | |
| 2922 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (550,'10 00B',null, '275_TEST_ 572_TSET.t xt','41',' 2','TEST S UBMITTER', null,null, null,null, '46','HT00 1755-009', null,null, null,1004) ; | |
| 2923 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (550,'10 00A',null, '275_TEST_ 572_TSET.t xt','PR',' 2','VA ADM INISTRATIO N',null,nu ll,null,nu ll,'PI','1 21150001', null,null, null,1005) ; | |
| 2924 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (551,'10 00C',null, '275_TEST_ 572_TSET.t xt','1P',' 2','MCKEE MEDICAL CE NTER',null ,null,null ,null,'XX' ,'14179805 66',null,n ull,null,1 006); | |
| 2925 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (551,'10 00B',null, '275_TEST_ 572_TSET.t xt','41',' 2','TEST S UBMITTER', null,null, null,null, '46','HT00 1755-009', null,null, null,1007) ; | |
| 2926 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (551,'10 00A',null, '275_TEST_ 572_TSET.t xt','PR',' 2','VETERA NS ADMINIS TRATION',n ull,null,n ull,null,' PI','12115 0001',null ,null,null ,1008); | |
| 2927 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (551,'10 00D',null, '275_TEST_ 572_TSET.t xt','QC',' 1','FBCSAA Q','KYYSSK ','ERIC',n ull,null,' MI','66633 3151',null ,null,null ,1009); | |
| 2928 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (552,'10 00C',null, '275_TEST_ 572_TSET.t xt','1P',' 2','STERLI NG REGIONA L MEDCENTE R',null,nu ll,null,nu ll,'XX','1 942238555' ,null,null ,null,1010 ); | |
| 2929 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (552,'10 00D',null, '275_TEST_ 572_TSET.t xt','QC',' 1','FBCSAA F','CKSWY' ,null,null ,null,'MI' ,'66677888 8',null,nu ll,null,10 11); | |
| 2930 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (552,'10 00A',null, '275_TEST_ 572_TSET.t xt','PR',' 2','VA MED ICAL CENTE R',null,nu ll,null,nu ll,'PI','1 21150001', null,null, null,1012) ; | |
| 2931 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (552,'10 00B',null, '275_TEST_ 572_TSET.t xt','41',' 2','TEST S UBMITTER', null,null, null,null, '46','HT00 1755-009', null,null, null,1013) ; | |
| 2932 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (553,'10 00C',null, '275_TEST_ 572_TSET.t xt','1P',' 2','STERLI NG REGIONA L MEDCENTE R',null,nu ll,null,nu ll,'XX','1 942238555' ,null,null ,null,1014 ); | |
| 2933 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (553,'10 00D',null, '275_TEST_ 572_TSET.t xt','QC',' 1','FBCSAA A','SKMKNT HK','E',nu ll,null,'M I','666554 444',null, null,null, 1015); | |
| 2934 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (553,'10 00A',null, '275_TEST_ 572_TSET.t xt','PR',' 2','VA MED ICAL CENTE R',null,nu ll,null,nu ll,'PI','1 21150001', null,null, null,1016) ; | |
| 2935 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (553,'10 00B',null, '275_TEST_ 572_TSET.t xt','41',' 2','SSI',n ull,null,n ull,null,' 46','SSIES MDX12',nul l,null,nul l,1017); | |
| 2936 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (554,'10 00B',null, '275_TEST_ 572_TSET.t xt','41',' 2','SSI',n ull,null,n ull,null,' 46','SSIES MDX12',nul l,null,nul l,1018); | |
| 2937 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (554,'10 00A',null, '275_TEST_ 572_TSET.t xt','PR',' 2','VETERA NS ADMINIS TRATION',n ull,null,n ull,null,' 46','12115 0001',null ,null,null ,1019); | |
| 2938 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (554,'10 00C',null, '275_TEST_ 572_TSET.t xt','1P',' 2','MCKEE MEDICAL CE NTER',null ,null,null ,null,'XX' ,'14179805 66',null,n ull,null,1 020); | |
| 2939 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (554,'10 00D',null, '275_TEST_ 572_TSET.t xt','QC',' 1','FBCSAA E','KWLLRW ','E',null ,null,'MI' ,'66677898 9',null,nu ll,null,10 21); | |
| 2940 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (555,'10 00C',null, '275_TEST_ 572_TSET.t xt','1P',' 2','STERLI NG REGIONA L MEDCENTE R',null,nu ll,null,nu ll,'XX','1 942238555' ,'BI','PXC ','282N000 00X',1022) ; | |
| 2941 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (555,'10 00D',null, '275_TEST_ 572_TSET.t xt','QC',' 1','FBCSAA J','TKNYK' ,null,null ,null,'MI' ,'66612880 1',null,nu ll,null,10 23); | |
| 2942 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (555,'10 00B',null, '275_TEST_ 572_TSET.t xt','41',' 2','RYCAN' ,null,null ,null,null ,'46','411 829363',nu ll,null,nu ll,1024); | |
| 2943 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (555,'10 00A',null, '275_TEST_ 572_TSET.t xt','PR',' 2','VA MED ICAL CENTE R',null,nu ll,null,nu ll,'PI','1 21150001', null,null, null,1025) ; | |
| 2944 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (556,'10 00D',null, '275_TEST_ 572_TSET.t xt','QC',' 1','FBCSAA J','TKNYK' ,null,null ,null,'MI' ,'66612880 1',null,nu ll,null,10 26); | |
| 2945 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (556,'10 00C',null, '275_TEST_ 572_TSET.t xt','1P',' 2','POUDRE VALLEY/CO LORADO HEA LTH MED GR P',null,nu ll,null,nu ll,'XX','1 225356868' ,'BI','PXC ','282N000 00X',1027) ; | |
| 2946 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (556,'10 00A',null, '275_TEST_ 572_TSET.t xt','PR',' 2','VETERA NS ADMINIS TRATION',n ull,null,n ull,null,' PI','12115 0001',null ,null,null ,1028); | |
| 2947 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (556,'10 00B',null, '275_TEST_ 572_TSET.t xt','41',' 2','RYCAN' ,null,null ,null,null ,'46','411 829363',nu ll,null,nu ll,1029); | |
| 2948 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (557,'10 00D',null, '275_TEST_ 572_TSET.t xt','QC',' 1','FBCSAA Q','KYYSSK ','ERIC',n ull,null,' MI','66633 3151',null ,null,null ,1030); | |
| 2949 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (557,'10 00A',null, '275_TEST_ 572_TSET.t xt','PR',' 2','VETERA NS ADMINIS TRATION',n ull,null,n ull,null,' PI','12115 0001',null ,null,null ,1031); | |
| 2950 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (557,'10 00B',null, '275_TEST_ 572_TSET.t xt','41',' 2','RYCAN' ,null,null ,null,null ,'46','411 829363',nu ll,null,nu ll,1032); | |
| 2951 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (557,'10 00C',null, '275_TEST_ 572_TSET.t xt','1P',' 2','MCKEE MEDICAL CE NTER',null ,null,null ,null,'XX' ,'14179805 66','BI',' PXC','282N 00000X',10 33); | |
| 2952 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (558,'10 00D',null, '275_TEST_ 572_TSET.t xt','QC',' 1','FBCSAA R','CKLRST K',null,nu ll,null,'M I','101992 906',null, null,null, 1034); | |
| 2953 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (558,'10 00C',null, '275_TEST_ 572_TSET.t xt','1P',' 2','POUDRE VALLEY/CO LORADO HEA LTH MED GR P',null,nu ll,null,nu ll,'XX','1 225356868' ,'BI','PXC ','282N000 00X',1035) ; | |
| 2954 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (558,'10 00B',null, '275_TEST_ 572_TSET.t xt','41',' 2','RYCAN' ,null,null ,null,null ,'46','411 829363',nu ll,null,nu ll,1036); | |
| 2955 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (558,'10 00A',null, '275_TEST_ 572_TSET.t xt','PR',' 2','VETERA NS ADMINIS TRATION',n ull,null,n ull,null,' PI','12115 0001',null ,null,null ,1037); | |
| 2956 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (559,'10 00D',null, '275_TEST_ 572_TSET.t xt','QC',' 1','FBCSAA A','SKMKNT HK','E',nu ll,null,'M I','666554 444',null, null,null, 1038); | |
| 2957 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (559,'10 00A',null, '275_TEST_ 572_TSET.t xt','PR',' 2','VETERA NS ADMINIS TRATION P BOX 292489 ',null,nul l,null,nul l,'PI','12 1150001',n ull,null,n ull,1039); | |
| 2958 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (559,'10 00C',null, '275_TEST_ 572_TSET.t xt','1P',' 2','NORTH COLORADO M EDICAL CEN TER',null, null,null, null,'XX', '172000445 0','BI','P XC','282N0 0000X',104 0); | |
| 2959 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (559,'10 00B',null, '275_TEST_ 572_TSET.t xt','41',' 2','RYCAN' ,null,null ,null,null ,'46','411 829363',nu ll,null,nu ll,1041); | |
| 2960 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (560,'10 00D',null, '275_TEST_ 572_TSET.t xt','QC',' 1','FBCSAA E','KWLLRW ','E',null ,null,'MI' ,'66677898 9',null,nu ll,null,10 42); | |
| 2961 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (560,'10 00B',null, '275_TEST_ 572_TSET.t xt','41',' 2','RYCAN' ,null,null ,null,null ,'46','411 829363',nu ll,null,nu ll,1043); | |
| 2962 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (560,'10 00A',null, '275_TEST_ 572_TSET.t xt','PR',' 2','VETERA NS ADMINIS TRATION',n ull,null,n ull,null,' PI','12115 0001',null ,null,null ,1044); | |
| 2963 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (560,'10 00C',null, '275_TEST_ 572_TSET.t xt','1P',' 2','MCKEE MEDICAL CE NTER',null ,null,null ,null,'XX' ,'14179805 66','BI',' PXC','282N 00000X',10 45); | |
| 2964 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (561,'10 00C',null, '275_TEST_ 572_TSET.t xt','1P',' 2','COMPLE TE HOME HL TH CARE',n ull,null,n ull,null,' XX','19927 89184',nul l,null,nul l,1046); | |
| 2965 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (561,'10 00B',null, '275_TEST_ 572_TSET.t xt','41',' 2','SSI',n ull,null,n ull,null,' 46','SSIES MDX12',nul l,null,nul l,1047); | |
| 2966 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (561,'10 00A',null, '275_TEST_ 572_TSET.t xt','PR',' 2','VETERA NS ADMIN C ENTER',nul l,null,nul l,null,'PI ','1211500 01',null,n ull,null,1 048); | |
| 2967 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (561,'10 00D',null, '275_TEST_ 572_TSET.t xt','QC',' 1','FBCSAA J','TKNYK' ,null,null ,null,'MI' ,'66666880 1',null,nu ll,null,10 49); | |
| 2968 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (562,'10 00C',null, '275_TEST_ 572_TSET.t xt','1P',' 2','POUDRE VALLEY/HE ALTH CARE INC',null, null,null, null,'XX', '176049271 4',null,nu ll,null,10 50); | |
| 2969 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (562,'10 00B',null, '275_TEST_ 572_TSET.t xt','41',' 2','ATHENA HEALTHCAR E',null,nu ll,null,nu ll,'46','0 43387530', null,null, null,1051) ; | |
| 2970 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (562,'10 00D',null, '275_TEST_ 572_TSET.t xt','QC',' 1','FBCSAA Q','KYYSSK ','ERIC',n ull,null,' MI','66633 3151',null ,null,null ,1052); | |
| 2971 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (562,'10 00A',null, '275_TEST_ 572_TSET.t xt','PR',' 2','VA FEE BASIS PRO GRAM',null ,null,null ,null,'PI' ,'12115000 1',null,nu ll,null,10 53); | |
| 2972 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (563,'10 00C',null, '275_TEST_ 572_TSET.t xt','1P',' 2','POUDRE VALLEY/HE ALTH CARE INC',null, null,null, null,'XX', '176049271 4',null,nu ll,null,10 54); | |
| 2973 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (563,'10 00B',null, '275_TEST_ 572_TSET.t xt','41',' 2','ATHENA HEALTHCAR E',null,nu ll,null,nu ll,'46','0 43387530', null,null, null,1055) ; | |
| 2974 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (563,'10 00D',null, '275_TEST_ 572_TSET.t xt','QC',' 1','FBCSAA Q','KYYSSK ','ERIC',n ull,null,' MI','66633 3151',null ,null,null ,1056); | |
| 2975 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (563,'10 00A',null, '275_TEST_ 572_TSET.t xt','PR',' 2','VA FEE BASIS PRO GRAM',null ,null,null ,null,'PI' ,'12115000 1',null,nu ll,null,10 57); | |
| 2976 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (564,'10 00A',null, '275_TEST_ 572_TSET.t xt','PR',' 2','VA FEE ',null,nul l,null,nul l,'PI','12 1150001',n ull,null,n ull,1058); | |
| 2977 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (564,'10 00C',null, '275_TEST_ 572_TSET.t xt','1P',' 2','STERLI NG REGIONA L MEDCENTE R',null,nu ll,null,nu ll,'XX','1 942238555' ,'BI','PXC ','282N000 00X',1059) ; | |
| 2978 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (564,'10 00B',null, '275_TEST_ 572_TSET.t xt','41',' 2','RYCAN' ,null,null ,null,null ,'46','411 829363',nu ll,null,nu ll,1060); | |
| 2979 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (564,'10 00D',null, '275_TEST_ 572_TSET.t xt','QC',' 1','FBCSAA F','CKSWY' ,null,null ,null,'MI' ,'66677888 8',null,nu ll,null,10 61); | |
| 2980 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (550,'10 00D',null, '275_TEST_ 572_TSET.t xt','QC',' 1','FBCSAA J','TKNYK' ,null,null ,null,'MI' ,'66612880 1',null,nu ll,null,10 02); | |
| 2981 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (550,'10 00C',null, '275_TEST_ 572_TSET.t xt','1P',' 2','MCKEE MEDICAL CE NTER',null ,null,null ,null,'XX' ,'14179805 66',null,n ull,null,1 003); | |
| 2982 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (565,'10 00B',null, 'Dragon1.t xt','41',' 2','TEST S UBMITTER', null,null, null,null, '46','HT00 1755-009', null,null, null,1062) ; | |
| 2983 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (565,'10 00A',null, 'Dragon1.t xt','PR',' 2','VA ADM INISTRATIO N',null,nu ll,null,nu ll,'PI','1 21150001', null,null, null,1063) ; | |
| 2984 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (565,'10 00C',null, 'Dragon1.t xt','1P',' 2','MCKEE MEDICAL CE NTER',null ,null,null ,null,'XX' ,'14179805 66',null,n ull,null,1 064); | |
| 2985 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (565,'10 00D',null, 'Dragon1.t xt','QC',' 1','FBCSAA J','TKNYK' ,null,null ,null,'MI' ,'66612880 1',null,nu ll,null,10 65); | |
| 2986 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (566,'10 00A',null, 'Dragon1.t xt','PR',' 2','VETERA NS ADMINIS TRATION',n ull,null,n ull,null,' PI','12115 0001',null ,null,null ,1066); | |
| 2987 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (566,'10 00B',null, 'Dragon1.t xt','41',' 2','TEST S UBMITTER', null,null, null,null, '46','HT00 1755-009', null,null, null,1067) ; | |
| 2988 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (566,'10 00C',null, 'Dragon1.t xt','1P',' 2','MCKEE MEDICAL CE NTER',null ,null,null ,null,'XX' ,'14179805 66',null,n ull,null,1 068); | |
| 2989 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (566,'10 00D',null, 'Dragon1.t xt','QC',' 1','FBCSAA Q','KYYSSK ','ERIC',n ull,null,' MI','66633 3151',null ,null,null ,1069); | |
| 2990 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (567,'10 00C',null, 'Dragon1.t xt','1P',' 2','STERLI NG REGIONA L MEDCENTE R',null,nu ll,null,nu ll,'XX','1 942238555' ,null,null ,null,1070 ); | |
| 2991 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (567,'10 00A',null, 'Dragon1.t xt','PR',' 2','VA MED ICAL CENTE R',null,nu ll,null,nu ll,'PI','1 21150001', null,null, null,1071) ; | |
| 2992 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (567,'10 00B',null, 'Dragon1.t xt','41',' 2','TEST S UBMITTER', null,null, null,null, '46','HT00 1755-009', null,null, null,1072) ; | |
| 2993 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (567,'10 00D',null, 'Dragon1.t xt','QC',' 1','FBCSAA F','CKSWY' ,null,null ,null,'MI' ,'66677888 8',null,nu ll,null,10 73); | |
| 2994 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (568,'10 00A',null, 'Dragon1.t xt','PR',' 2','VA MED ICAL CENTE R',null,nu ll,null,nu ll,'PI','1 21150001', null,null, null,1074) ; | |
| 2995 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (568,'10 00D',null, 'Dragon1.t xt','QC',' 1','FBCSAA A','SKMKNT HK','E',nu ll,null,'M I','666554 444',null, null,null, 1075); | |
| 2996 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (568,'10 00B',null, 'Dragon1.t xt','41',' 2','SSI',n ull,null,n ull,null,' 46','SSIES MDX12',nul l,null,nul l,1076); | |
| 2997 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (568,'10 00C',null, 'Dragon1.t xt','1P',' 2','STERLI NG REGIONA L MEDCENTE R',null,nu ll,null,nu ll,'XX','1 942238555' ,null,null ,null,1077 ); | |
| 2998 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (569,'10 00A',null, 'Dragon1.t xt','PR',' 2','VETERA NS ADMINIS TRATION',n ull,null,n ull,null,' 46','12115 0001',null ,null,null ,1078); | |
| 2999 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (569,'10 00C',null, 'Dragon1.t xt','1P',' 2','MCKEE MEDICAL CE NTER',null ,null,null ,null,'XX' ,'14179805 66',null,n ull,null,1 079); | |
| 3000 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (569,'10 00D',null, 'Dragon1.t xt','QC',' 1','FBCSAA E','KWLLRW ','E',null ,null,'MI' ,'66677898 9',null,nu ll,null,10 80); | |
| 3001 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (569,'10 00B',null, 'Dragon1.t xt','41',' 2','SSI',n ull,null,n ull,null,' 46','SSIES MDX12',nul l,null,nul l,1081); | |
| 3002 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (570,'10 00A',null, 'Dragon1.t xt','PR',' 2','VA MED ICAL CENTE R',null,nu ll,null,nu ll,'PI','1 21150001', null,null, null,1082) ; | |
| 3003 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (570,'10 00B',null, 'Dragon1.t xt','41',' 2','RYCAN' ,null,null ,null,null ,'46','411 829363',nu ll,null,nu ll,1083); | |
| 3004 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (570,'10 00D',null, 'Dragon1.t xt','QC',' 1','FBCSAA J','TKNYK' ,null,null ,null,'MI' ,'66612880 1',null,nu ll,null,10 84); | |
| 3005 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (570,'10 00C',null, 'Dragon1.t xt','1P',' 2','STERLI NG REGIONA L MEDCENTE R',null,nu ll,null,nu ll,'XX','1 942238555' ,'BI','PXC ','282N000 00X',1085) ; | |
| 3006 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (571,'10 00B',null, 'Dragon1.t xt','41',' 2','RYCAN' ,null,null ,null,null ,'46','411 829363',nu ll,null,nu ll,1086); | |
| 3007 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (571,'10 00A',null, 'Dragon1.t xt','PR',' 2','VETERA NS ADMINIS TRATION',n ull,null,n ull,null,' PI','12115 0001',null ,null,null ,1087); | |
| 3008 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (571,'10 00C',null, 'Dragon1.t xt','1P',' 2','POUDRE VALLEY/CO LORADO HEA LTH MED GR P',null,nu ll,null,nu ll,'XX','1 225356868' ,'BI','PXC ','282N000 00X',1088) ; | |
| 3009 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (571,'10 00D',null, 'Dragon1.t xt','QC',' 1','FBCSAA J','TKNYK' ,null,null ,null,'MI' ,'66612880 1',null,nu ll,null,10 89); | |
| 3010 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (572,'10 00D',null, 'Dragon1.t xt','QC',' 1','FBCSAA Q','KYYSSK ','ERIC',n ull,null,' MI','66633 3151',null ,null,null ,1090); | |
| 3011 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (572,'10 00B',null, 'Dragon1.t xt','41',' 2','RYCAN' ,null,null ,null,null ,'46','411 829363',nu ll,null,nu ll,1091); | |
| 3012 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (572,'10 00A',null, 'Dragon1.t xt','PR',' 2','VETERA NS ADMINIS TRATION',n ull,null,n ull,null,' PI','12115 0001',null ,null,null ,1092); | |
| 3013 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (572,'10 00C',null, 'Dragon1.t xt','1P',' 2','MCKEE MEDICAL CE NTER',null ,null,null ,null,'XX' ,'14179805 66','BI',' PXC','282N 00000X',10 93); | |
| 3014 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (573,'10 00D',null, 'Dragon1.t xt','QC',' 1','FBCSAA R','CKLRST K',null,nu ll,null,'M I','101992 906',null, null,null, 1094); | |
| 3015 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (573,'10 00B',null, 'Dragon1.t xt','41',' 2','RYCAN' ,null,null ,null,null ,'46','411 829363',nu ll,null,nu ll,1095); | |
| 3016 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (573,'10 00A',null, 'Dragon1.t xt','PR',' 2','VETERA NS ADMINIS TRATION',n ull,null,n ull,null,' PI','12115 0001',null ,null,null ,1096); | |
| 3017 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (573,'10 00C',null, 'Dragon1.t xt','1P',' 2','POUDRE VALLEY/CO LORADO HEA LTH MED GR P',null,nu ll,null,nu ll,'XX','1 225356868' ,'BI','PXC ','282N000 00X',1097) ; | |
| 3018 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (574,'10 00D',null, 'Dragon1.t xt','QC',' 1','FBCSAA A','SKMKNT HK','E',nu ll,null,'M I','666554 444',null, null,null, 1098); | |
| 3019 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (574,'10 00B',null, 'Dragon1.t xt','41',' 2','RYCAN' ,null,null ,null,null ,'46','411 829363',nu ll,null,nu ll,1099); | |
| 3020 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (574,'10 00A',null, 'Dragon1.t xt','PR',' 2','VETERA NS ADMINIS TRATION P BOX 292489 ',null,nul l,null,nul l,'PI','12 1150001',n ull,null,n ull,1100); | |
| 3021 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (574,'10 00C',null, 'Dragon1.t xt','1P',' 2','NORTH COLORADO M EDICAL CEN TER',null, null,null, null,'XX', '172000445 0','BI','P XC','282N0 0000X',110 1); | |
| 3022 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (575,'10 00B',null, 'Dragon1.t xt','41',' 2','RYCAN' ,null,null ,null,null ,'46','411 829363',nu ll,null,nu ll,1102); | |
| 3023 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (575,'10 00C',null, 'Dragon1.t xt','1P',' 2','MCKEE MEDICAL CE NTER',null ,null,null ,null,'XX' ,'14179805 66','BI',' PXC','282N 00000X',11 03); | |
| 3024 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (575,'10 00A',null, 'Dragon1.t xt','PR',' 2','VETERA NS ADMINIS TRATION',n ull,null,n ull,null,' PI','12115 0001',null ,null,null ,1104); | |
| 3025 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (575,'10 00D',null, 'Dragon1.t xt','QC',' 1','FBCSAA E','KWLLRW ','E',null ,null,'MI' ,'66677898 9',null,nu ll,null,11 05); | |
| 3026 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (576,'10 00A',null, 'Dragon1.t xt','PR',' 2','VETERA NS ADMIN C ENTER',nul l,null,nul l,null,'PI ','1211500 01',null,n ull,null,1 106); | |
| 3027 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (576,'10 00B',null, 'Dragon1.t xt','41',' 2','SSI',n ull,null,n ull,null,' 46','SSIES MDX12',nul l,null,nul l,1107); | |
| 3028 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (576,'10 00D',null, 'Dragon1.t xt','QC',' 1','FBCSAA J','TKNYK' ,null,null ,null,'MI' ,'66666880 1',null,nu ll,null,11 08); | |
| 3029 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (576,'10 00C',null, 'Dragon1.t xt','1P',' 2','COMPLE TE HOME HL TH CARE',n ull,null,n ull,null,' XX','19927 89184',nul l,null,nul l,1109); | |
| 3030 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (577,'10 00D',null, 'Dragon1.t xt','QC',' 1','FBCSAA Q','KYYSSK ','ERIC',n ull,null,' MI','66633 3151',null ,null,null ,1110); | |
| 3031 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (577,'10 00A',null, 'Dragon1.t xt','PR',' 2','VA FEE BASIS PRO GRAM',null ,null,null ,null,'PI' ,'12115000 1',null,nu ll,null,11 11); | |
| 3032 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (577,'10 00B',null, 'Dragon1.t xt','41',' 2','ATHENA HEALTHCAR E',null,nu ll,null,nu ll,'46','0 43387530', null,null, null,1112) ; | |
| 3033 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (577,'10 00C',null, 'Dragon1.t xt','1P',' 2','POUDRE VALLEY/HE ALTH CARE INC',null, null,null, null,'XX', '176049271 4',null,nu ll,null,11 13); | |
| 3034 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (578,'10 00D',null, 'Dragon1.t xt','QC',' 1','FBCSAA Q','KYYSSK ','ERIC',n ull,null,' MI','66633 3151',null ,null,null ,1114); | |
| 3035 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (578,'10 00A',null, 'Dragon1.t xt','PR',' 2','VA FEE BASIS PRO GRAM',null ,null,null ,null,'PI' ,'12115000 1',null,nu ll,null,11 15); | |
| 3036 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (578,'10 00B',null, 'Dragon1.t xt','41',' 2','ATHENA HEALTHCAR E',null,nu ll,null,nu ll,'46','0 43387530', null,null, null,1116) ; | |
| 3037 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (578,'10 00C',null, 'Dragon1.t xt','1P',' 2','POUDRE VALLEY/HE ALTH CARE INC',null, null,null, null,'XX', '176049271 4',null,nu ll,null,11 17); | |
| 3038 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (579,'10 00C',null, 'Dragon1.t xt','1P',' 2','STERLI NG REGIONA L MEDCENTE R',null,nu ll,null,nu ll,'XX','1 942238555' ,'BI','PXC ','282N000 00X',1118) ; | |
| 3039 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (579,'10 00A',null, 'Dragon1.t xt','PR',' 2','VA FEE ',null,nul l,null,nul l,'PI','12 1150001',n ull,null,n ull,1119); | |
| 3040 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (579,'10 00B',null, 'Dragon1.t xt','41',' 2','RYCAN' ,null,null ,null,null ,'46','411 829363',nu ll,null,nu ll,1120); | |
| 3041 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (579,'10 00D',null, 'Dragon1.t xt','QC',' 1','FBCSAA F','CKSWY' ,null,null ,null,'MI' ,'66677888 8',null,nu ll,null,11 21); | |
| 3042 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (580,'10 00D',null, 'Dragon2.t xt','QC',' 1','FBCSAA G','BKRRY' ,null,null ,null,'MI' ,'10136557 5',null,nu ll,null,11 22); | |
| 3043 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (580,'10 00C',null, 'Dragon2.t xt','1P',' 2','KNOX C LINIC CORP ',null,nul l,null,nul l,'XX','12 65481006', null,null, null,1123) ; | |
| 3044 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (580,'10 00B',null, 'Dragon2.t xt','41',' 2','ATHENA HEALTHCAR E',null,nu ll,null,nu ll,'46','0 43387530', null,null, null,1124) ; | |
| 3045 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (580,'10 00A',null, 'Dragon2.t xt','PR',' 2','VETERA NS ADMINIS TRATION ME DICAL CENT ER',null,n ull,null,n ull,'PI',' 12115',nul l,null,nul l,1125); | |
| 3046 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (581,'10 00C',null, 'Dragon2.t xt','1P',' 2','KNOX C LINIC CORP ',null,nul l,null,nul l,'XX','12 65481006', null,null, null,1126) ; | |
| 3047 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (581,'10 00B',null, 'Dragon2.t xt','41',' 2','ATHENA HEALTHCAR E',null,nu ll,null,nu ll,'46','0 43387530', null,null, null,1127) ; | |
| 3048 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (581,'10 00D',null, 'Dragon2.t xt','QC',' 1','FBCSAA F','CKSWY' ,null,null ,null,'MI' ,'66677888 8',null,nu ll,null,11 28); | |
| 3049 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (581,'10 00A',null, 'Dragon2.t xt','PR',' 2','VETERA NS ADMINIS TRATION ME DICAL CENT ER',null,n ull,null,n ull,'PI',' 12115',nul l,null,nul l,1129); | |
| 3050 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (582,'10 00D',null, 'Dragon3.t xt','QC',' 1','FBCSAA J','TKNYK' ,null,null ,null,'MI' ,'66612880 1',null,nu ll,null,11 30); | |
| 3051 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (582,'10 00C',null, 'Dragon3.t xt','1P',' 2','MCKEE MEDICAL CE NTER',null ,null,null ,null,'XX' ,'14179805 66',null,n ull,null,1 131); | |
| 3052 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (582,'10 00B',null, 'Dragon3.t xt','41',' 2','TEST S UBMITTER', null,null, null,null, '46','HT00 1755-009', null,null, null,1132) ; | |
| 3053 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (582,'10 00A',null, 'Dragon3.t xt','PR',' 2','VA ADM INISTRATIO N',null,nu ll,null,nu ll,'PI','1 21150001', null,null, null,1133) ; | |
| 3054 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (583,'10 00C',null, 'Dragon3.t xt','1P',' 2','MCKEE MEDICAL CE NTER',null ,null,null ,null,'XX' ,'14179805 66',null,n ull,null,1 134); | |
| 3055 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (583,'10 00B',null, 'Dragon3.t xt','41',' 2','TEST S UBMITTER', null,null, null,null, '46','HT00 1755-009', null,null, null,1135) ; | |
| 3056 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (583,'10 00A',null, 'Dragon3.t xt','PR',' 2','VETERA NS ADMINIS TRATION',n ull,null,n ull,null,' PI','12115 0001',null ,null,null ,1136); | |
| 3057 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (583,'10 00D',null, 'Dragon3.t xt','QC',' 1','FBCSAA Q','KYYSSK ','ERIC',n ull,null,' MI','66633 3151',null ,null,null ,1137); | |
| 3058 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (584,'10 00C',null, 'Dragon3.t xt','1P',' 2','STERLI NG REGIONA L MEDCENTE R',null,nu ll,null,nu ll,'XX','1 942238555' ,null,null ,null,1138 ); | |
| 3059 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (584,'10 00D',null, 'Dragon3.t xt','QC',' 1','FBCSAA F','CKSWY' ,null,null ,null,'MI' ,'66677888 8',null,nu ll,null,11 39); | |
| 3060 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (584,'10 00A',null, 'Dragon3.t xt','PR',' 2','VA MED ICAL CENTE R',null,nu ll,null,nu ll,'PI','1 21150001', null,null, null,1140) ; | |
| 3061 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (584,'10 00B',null, 'Dragon3.t xt','41',' 2','TEST S UBMITTER', null,null, null,null, '46','HT00 1755-009', null,null, null,1141) ; | |
| 3062 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (585,'10 00C',null, 'Dragon3.t xt','1P',' 2','STERLI NG REGIONA L MEDCENTE R',null,nu ll,null,nu ll,'XX','1 942238555' ,null,null ,null,1142 ); | |
| 3063 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (585,'10 00D',null, 'Dragon3.t xt','QC',' 1','FBCSAA A','SKMKNT HK','E',nu ll,null,'M I','666554 444',null, null,null, 1143); | |
| 3064 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (585,'10 00A',null, 'Dragon3.t xt','PR',' 2','VA MED ICAL CENTE R',null,nu ll,null,nu ll,'PI','1 21150001', null,null, null,1144) ; | |
| 3065 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (585,'10 00B',null, 'Dragon3.t xt','41',' 2','SSI',n ull,null,n ull,null,' 46','SSIES MDX12',nul l,null,nul l,1145); | |
| 3066 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (586,'10 00B',null, 'Dragon3.t xt','41',' 2','SSI',n ull,null,n ull,null,' 46','SSIES MDX12',nul l,null,nul l,1146); | |
| 3067 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (586,'10 00A',null, 'Dragon3.t xt','PR',' 2','VETERA NS ADMINIS TRATION',n ull,null,n ull,null,' 46','12115 0001',null ,null,null ,1147); | |
| 3068 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (586,'10 00C',null, 'Dragon3.t xt','1P',' 2','MCKEE MEDICAL CE NTER',null ,null,null ,null,'XX' ,'14179805 66',null,n ull,null,1 148); | |
| 3069 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (586,'10 00D',null, 'Dragon3.t xt','QC',' 1','FBCSAA E','KWLLRW ','E',null ,null,'MI' ,'66677898 9',null,nu ll,null,11 49); | |
| 3070 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (587,'10 00C',null, 'Dragon3.t xt','1P',' 2','STERLI NG REGIONA L MEDCENTE R',null,nu ll,null,nu ll,'XX','1 942238555' ,'BI','PXC ','282N000 00X',1150) ; | |
| 3071 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (587,'10 00D',null, 'Dragon3.t xt','QC',' 1','FBCSAA J','TKNYK' ,null,null ,null,'MI' ,'66612880 1',null,nu ll,null,11 51); | |
| 3072 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (587,'10 00B',null, 'Dragon3.t xt','41',' 2','RYCAN' ,null,null ,null,null ,'46','411 829363',nu ll,null,nu ll,1152); | |
| 3073 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (587,'10 00A',null, 'Dragon3.t xt','PR',' 2','VA MED ICAL CENTE R',null,nu ll,null,nu ll,'PI','1 21150001', null,null, null,1153) ; | |
| 3074 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (588,'10 00D',null, 'Dragon3.t xt','QC',' 1','FBCSAA J','TKNYK' ,null,null ,null,'MI' ,'66612880 1',null,nu ll,null,11 54); | |
| 3075 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (588,'10 00C',null, 'Dragon3.t xt','1P',' 2','POUDRE VALLEY/CO LORADO HEA LTH MED GR P',null,nu ll,null,nu ll,'XX','1 225356868' ,'BI','PXC ','282N000 00X',1155) ; | |
| 3076 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (588,'10 00A',null, 'Dragon3.t xt','PR',' 2','VETERA NS ADMINIS TRATION',n ull,null,n ull,null,' PI','12115 0001',null ,null,null ,1156); | |
| 3077 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (588,'10 00B',null, 'Dragon3.t xt','41',' 2','RYCAN' ,null,null ,null,null ,'46','411 829363',nu ll,null,nu ll,1157); | |
| 3078 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (589,'10 00D',null, 'Dragon3.t xt','QC',' 1','FBCSAA Q','KYYSSK ','ERIC',n ull,null,' MI','66633 3151',null ,null,null ,1158); | |
| 3079 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (589,'10 00A',null, 'Dragon3.t xt','PR',' 2','VETERA NS ADMINIS TRATION',n ull,null,n ull,null,' PI','12115 0001',null ,null,null ,1159); | |
| 3080 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (589,'10 00B',null, 'Dragon3.t xt','41',' 2','RYCAN' ,null,null ,null,null ,'46','411 829363',nu ll,null,nu ll,1160); | |
| 3081 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (589,'10 00C',null, 'Dragon3.t xt','1P',' 2','MCKEE MEDICAL CE NTER',null ,null,null ,null,'XX' ,'14179805 66','BI',' PXC','282N 00000X',11 61); | |
| 3082 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (590,'10 00D',null, 'Dragon3.t xt','QC',' 1','FBCSAA R','CKLRST K',null,nu ll,null,'M I','101992 906',null, null,null, 1162); | |
| 3083 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (590,'10 00C',null, 'Dragon3.t xt','1P',' 2','POUDRE VALLEY/CO LORADO HEA LTH MED GR P',null,nu ll,null,nu ll,'XX','1 225356868' ,'BI','PXC ','282N000 00X',1163) ; | |
| 3084 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (590,'10 00B',null, 'Dragon3.t xt','41',' 2','RYCAN' ,null,null ,null,null ,'46','411 829363',nu ll,null,nu ll,1164); | |
| 3085 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (590,'10 00A',null, 'Dragon3.t xt','PR',' 2','VETERA NS ADMINIS TRATION',n ull,null,n ull,null,' PI','12115 0001',null ,null,null ,1165); | |
| 3086 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (591,'10 00D',null, 'Dragon3.t xt','QC',' 1','FBCSAA A','SKMKNT HK','E',nu ll,null,'M I','666554 444',null, null,null, 1166); | |
| 3087 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (591,'10 00A',null, 'Dragon3.t xt','PR',' 2','VETERA NS ADMINIS TRATION P BOX 292489 ',null,nul l,null,nul l,'PI','12 1150001',n ull,null,n ull,1167); | |
| 3088 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (591,'10 00C',null, 'Dragon3.t xt','1P',' 2','NORTH COLORADO M EDICAL CEN TER',null, null,null, null,'XX', '172000445 0','BI','P XC','282N0 0000X',116 8); | |
| 3089 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (591,'10 00B',null, 'Dragon3.t xt','41',' 2','RYCAN' ,null,null ,null,null ,'46','411 829363',nu ll,null,nu ll,1169); | |
| 3090 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (592,'10 00D',null, 'Dragon3.t xt','QC',' 1','FBCSAA E','KWLLRW ','E',null ,null,'MI' ,'66677898 9',null,nu ll,null,11 70); | |
| 3091 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (592,'10 00B',null, 'Dragon3.t xt','41',' 2','RYCAN' ,null,null ,null,null ,'46','411 829363',nu ll,null,nu ll,1171); | |
| 3092 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (592,'10 00A',null, 'Dragon3.t xt','PR',' 2','VETERA NS ADMINIS TRATION',n ull,null,n ull,null,' PI','12115 0001',null ,null,null ,1172); | |
| 3093 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (592,'10 00C',null, 'Dragon3.t xt','1P',' 2','MCKEE MEDICAL CE NTER',null ,null,null ,null,'XX' ,'14179805 66','BI',' PXC','282N 00000X',11 73); | |
| 3094 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (593,'10 00C',null, 'Dragon3.t xt','1P',' 2','COMPLE TE HOME HL TH CARE',n ull,null,n ull,null,' XX','19927 89184',nul l,null,nul l,1174); | |
| 3095 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (593,'10 00B',null, 'Dragon3.t xt','41',' 2','SSI',n ull,null,n ull,null,' 46','SSIES MDX12',nul l,null,nul l,1175); | |
| 3096 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (593,'10 00A',null, 'Dragon3.t xt','PR',' 2','VETERA NS ADMIN C ENTER',nul l,null,nul l,null,'PI ','1211500 01',null,n ull,null,1 176); | |
| 3097 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (593,'10 00D',null, 'Dragon3.t xt','QC',' 1','FBCSAA J','TKNYK' ,null,null ,null,'MI' ,'66666880 1',null,nu ll,null,11 77); | |
| 3098 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (594,'10 00C',null, 'Dragon3.t xt','1P',' 2','POUDRE VALLEY/HE ALTH CARE INC',null, null,null, null,'XX', '176049271 4',null,nu ll,null,11 78); | |
| 3099 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (594,'10 00B',null, 'Dragon3.t xt','41',' 2','ATHENA HEALTHCAR E',null,nu ll,null,nu ll,'46','0 43387530', null,null, null,1179) ; | |
| 3100 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (594,'10 00D',null, 'Dragon3.t xt','QC',' 1','FBCSAA Q','KYYSSK ','ERIC',n ull,null,' MI','66633 3151',null ,null,null ,1180); | |
| 3101 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (594,'10 00A',null, 'Dragon3.t xt','PR',' 2','VA FEE BASIS PRO GRAM',null ,null,null ,null,'PI' ,'12115000 1',null,nu ll,null,11 81); | |
| 3102 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (595,'10 00C',null, 'Dragon3.t xt','1P',' 2','POUDRE VALLEY/HE ALTH CARE INC',null, null,null, null,'XX', '176049271 4',null,nu ll,null,11 82); | |
| 3103 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (595,'10 00B',null, 'Dragon3.t xt','41',' 2','ATHENA HEALTHCAR E',null,nu ll,null,nu ll,'46','0 43387530', null,null, null,1183) ; | |
| 3104 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (595,'10 00D',null, 'Dragon3.t xt','QC',' 1','FBCSAA Q','KYYSSK ','ERIC',n ull,null,' MI','66633 3151',null ,null,null ,1184); | |
| 3105 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (595,'10 00A',null, 'Dragon3.t xt','PR',' 2','VA FEE BASIS PRO GRAM',null ,null,null ,null,'PI' ,'12115000 1',null,nu ll,null,11 85); | |
| 3106 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (596,'10 00A',null, 'Dragon3.t xt','PR',' 2','VA FEE ',null,nul l,null,nul l,'PI','12 1150001',n ull,null,n ull,1186); | |
| 3107 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (596,'10 00C',null, 'Dragon3.t xt','1P',' 2','STERLI NG REGIONA L MEDCENTE R',null,nu ll,null,nu ll,'XX','1 942238555' ,'BI','PXC ','282N000 00X',1187) ; | |
| 3108 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (596,'10 00B',null, 'Dragon3.t xt','41',' 2','RYCAN' ,null,null ,null,null ,'46','411 829363',nu ll,null,nu ll,1188); | |
| 3109 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (596,'10 00D',null, 'Dragon3.t xt','QC',' 1','FBCSAA F','CKSWY' ,null,null ,null,'MI' ,'66677888 8',null,nu ll,null,11 89); | |
| 3110 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (597,'10 00B',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','41','2' ,'TEST SUB MITTER',nu ll,null,nu ll,null,'4 6','HT0017 55-009',nu ll,null,nu ll,1190); | |
| 3111 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (597,'10 00A',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','PR','2' ,'VA ADMIN ISTRATION' ,null,null ,null,null ,'PI','121 150001',nu ll,null,nu ll,1191); | |
| 3112 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (597,'10 00D',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','QC','1' ,'FBCSAAJ' ,'TKNYK',n ull,null,n ull,'MI',' 666128801' ,null,null ,null,1192 ); | |
| 3113 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (597,'10 00C',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','1P','2' ,'MCKEE ME DICAL CENT ER',null,n ull,null,n ull,'XX',' 1417980566 ',null,nul l,null,119 3); | |
| 3114 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (598,'10 00B',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','41','2' ,'TEST SUB MITTER',nu ll,null,nu ll,null,'4 6','HT0017 55-009',nu ll,null,nu ll,1194); | |
| 3115 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (598,'10 00C',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','1P','2' ,'MCKEE ME DICAL CENT ER',null,n ull,null,n ull,'XX',' 1417980566 ',null,nul l,null,119 5); | |
| 3116 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (598,'10 00A',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','PR','2' ,'VETERANS ADMINISTR ATION',nul l,null,nul l,null,'PI ','1211500 01',null,n ull,null,1 196); | |
| 3117 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (598,'10 00D',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','QC','1' ,'FBCSAAQ' ,'KYYSSK', 'ERIC',nul l,null,'MI ','6663331 51',null,n ull,null,1 197); | |
| 3118 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (599,'10 00A',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','PR','2' ,'VA MEDIC AL CENTER' ,null,null ,null,null ,'PI','121 150001',nu ll,null,nu ll,1198); | |
| 3119 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (599,'10 00B',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','41','2' ,'TEST SUB MITTER',nu ll,null,nu ll,null,'4 6','HT0017 55-009',nu ll,null,nu ll,1199); | |
| 3120 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (599,'10 00C',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','1P','2' ,'STERLING REGIONAL MEDCENTER' ,null,null ,null,null ,'XX','194 2238555',n ull,null,n ull,1200); | |
| 3121 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (599,'10 00D',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','QC','1' ,'FBCSAAF' ,'CKSWY',n ull,null,n ull,'MI',' 666778888' ,null,null ,null,1201 ); | |
| 3122 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (600,'10 00B',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','41','2' ,'SSI',nul l,null,nul l,null,'46 ','SSIESMD X12',null, null,null, 1202); | |
| 3123 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (600,'10 00A',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','PR','2' ,'VA MEDIC AL CENTER' ,null,null ,null,null ,'PI','121 150001',nu ll,null,nu ll,1203); | |
| 3124 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (600,'10 00C',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','1P','2' ,'STERLING REGIONAL MEDCENTER' ,null,null ,null,null ,'XX','194 2238555',n ull,null,n ull,1204); | |
| 3125 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (600,'10 00D',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','QC','1' ,'FBCSAAA' ,'SKMKNTHK ','E',null ,null,'MI' ,'66655444 4',null,nu ll,null,12 05); | |
| 3126 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (601,'10 00D',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','QC','1' ,'FBCSAAE' ,'KWLLRW', 'E',null,n ull,'MI',' 666778989' ,null,null ,null,1206 ); | |
| 3127 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (601,'10 00A',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','PR','2' ,'VETERANS ADMINISTR ATION',nul l,null,nul l,null,'46 ','1211500 01',null,n ull,null,1 207); | |
| 3128 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (601,'10 00C',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','1P','2' ,'MCKEE ME DICAL CENT ER',null,n ull,null,n ull,'XX',' 1417980566 ',null,nul l,null,120 8); | |
| 3129 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (601,'10 00B',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','41','2' ,'SSI',nul l,null,nul l,null,'46 ','SSIESMD X12',null, null,null, 1209); | |
| 3130 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (602,'10 00B',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','41','2' ,'RYCAN',n ull,null,n ull,null,' 46','41182 9363',null ,null,null ,1210); | |
| 3131 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (602,'10 00C',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','1P','2' ,'STERLING REGIONAL MEDCENTER' ,null,null ,null,null ,'XX','194 2238555',' BI','PXC', '282N00000 X',1211); | |
| 3132 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (602,'10 00A',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','PR','2' ,'VA MEDIC AL CENTER' ,null,null ,null,null ,'PI','121 150001',nu ll,null,nu ll,1212); | |
| 3133 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (602,'10 00D',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','QC','1' ,'FBCSAAJ' ,'TKNYK',n ull,null,n ull,'MI',' 666128801' ,null,null ,null,1213 ); | |
| 3134 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (603,'10 00B',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','41','2' ,'RYCAN',n ull,null,n ull,null,' 46','41182 9363',null ,null,null ,1214); | |
| 3135 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (603,'10 00C',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','1P','2' ,'POUDRE V ALLEY/COLO RADO HEALT H MED GRP' ,null,null ,null,null ,'XX','122 5356868',' BI','PXC', '282N00000 X',1215); | |
| 3136 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (603,'10 00A',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','PR','2' ,'VETERANS ADMINISTR ATION',nul l,null,nul l,null,'PI ','1211500 01',null,n ull,null,1 216); | |
| 3137 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (603,'10 00D',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','QC','1' ,'FBCSAAJ' ,'TKNYK',n ull,null,n ull,'MI',' 666128801' ,null,null ,null,1217 ); | |
| 3138 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (604,'10 00D',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','QC','1' ,'FBCSAAQ' ,'KYYSSK', 'ERIC',nul l,null,'MI ','6663331 51',null,n ull,null,1 218); | |
| 3139 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (604,'10 00B',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','41','2' ,'RYCAN',n ull,null,n ull,null,' 46','41182 9363',null ,null,null ,1219); | |
| 3140 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (604,'10 00A',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','PR','2' ,'VETERANS ADMINISTR ATION',nul l,null,nul l,null,'PI ','1211500 01',null,n ull,null,1 220); | |
| 3141 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (604,'10 00C',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','1P','2' ,'MCKEE ME DICAL CENT ER',null,n ull,null,n ull,'XX',' 1417980566 ','BI','PX C','282N00 000X',1221 ); | |
| 3142 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (605,'10 00A',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','PR','2' ,'VETERANS ADMINISTR ATION',nul l,null,nul l,null,'PI ','1211500 01',null,n ull,null,1 222); | |
| 3143 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (605,'10 00C',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','1P','2' ,'POUDRE V ALLEY/COLO RADO HEALT H MED GRP' ,null,null ,null,null ,'XX','122 5356868',' BI','PXC', '282N00000 X',1223); | |
| 3144 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (605,'10 00B',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','41','2' ,'RYCAN',n ull,null,n ull,null,' 46','41182 9363',null ,null,null ,1224); | |
| 3145 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (605,'10 00D',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','QC','1' ,'FBCSAAR' ,'CKLRSTK' ,null,null ,null,'MI' ,'10199290 6',null,nu ll,null,12 25); | |
| 3146 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (606,'10 00A',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','PR','2' ,'VETERANS ADMINISTR ATION P BO X 292489', null,null, null,null, 'PI','1211 50001',nul l,null,nul l,1226); | |
| 3147 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (606,'10 00B',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','41','2' ,'RYCAN',n ull,null,n ull,null,' 46','41182 9363',null ,null,null ,1227); | |
| 3148 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (606,'10 00D',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','QC','1' ,'FBCSAAA' ,'SKMKNTHK ','E',null ,null,'MI' ,'66655444 4',null,nu ll,null,12 28); | |
| 3149 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (606,'10 00C',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','1P','2' ,'NORTH CO LORADO MED ICAL CENTE R',null,nu ll,null,nu ll,'XX','1 720004450' ,'BI','PXC ','282N000 00X',1229) ; | |
| 3150 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (607,'10 00C',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','1P','2' ,'MCKEE ME DICAL CENT ER',null,n ull,null,n ull,'XX',' 1417980566 ','BI','PX C','282N00 000X',1230 ); | |
| 3151 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (607,'10 00D',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','QC','1' ,'FBCSAAE' ,'KWLLRW', 'E',null,n ull,'MI',' 666778989' ,null,null ,null,1231 ); | |
| 3152 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (607,'10 00A',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','PR','2' ,'VETERANS ADMINISTR ATION',nul l,null,nul l,null,'PI ','1211500 01',null,n ull,null,1 232); | |
| 3153 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (607,'10 00B',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','41','2' ,'RYCAN',n ull,null,n ull,null,' 46','41182 9363',null ,null,null ,1233); | |
| 3154 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (608,'10 00D',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','QC','1' ,'FBCSAAJ' ,'TKNYK',n ull,null,n ull,'MI',' 666668801' ,null,null ,null,1234 ); | |
| 3155 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (608,'10 00C',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','1P','2' ,'COMPLETE HOME HLTH CARE',nul l,null,nul l,null,'XX ','1992789 184',null, null,null, 1235); | |
| 3156 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (608,'10 00A',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','PR','2' ,'VETERANS ADMIN CEN TER',null, null,null, null,'PI', '121150001 ',null,nul l,null,123 6); | |
| 3157 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (608,'10 00B',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','41','2' ,'SSI',nul l,null,nul l,null,'46 ','SSIESMD X12',null, null,null, 1237); | |
| 3158 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (609,'10 00D',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','QC','1' ,'FBCSAAQ' ,'KYYSSK', 'ERIC',nul l,null,'MI ','6663331 51',null,n ull,null,1 238); | |
| 3159 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (609,'10 00C',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','1P','2' ,'POUDRE V ALLEY/HEAL TH CARE IN C',null,nu ll,null,nu ll,'XX','1 760492714' ,null,null ,null,1239 ); | |
| 3160 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (609,'10 00A',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','PR','2' ,'VA FEE B ASIS PROGR AM',null,n ull,null,n ull,'PI',' 121150001' ,null,null ,null,1240 ); | |
| 3161 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (609,'10 00B',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','41','2' ,'ATHENA H EALTHCARE' ,null,null ,null,null ,'46','043 387530',nu ll,null,nu ll,1241); | |
| 3162 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (610,'10 00D',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','QC','1' ,'FBCSAAQ' ,'KYYSSK', 'ERIC',nul l,null,'MI ','6663331 51',null,n ull,null,1 242); | |
| 3163 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (610,'10 00C',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','1P','2' ,'POUDRE V ALLEY/HEAL TH CARE IN C',null,nu ll,null,nu ll,'XX','1 760492714' ,null,null ,null,1243 ); | |
| 3164 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (610,'10 00A',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','PR','2' ,'VA FEE B ASIS PROGR AM',null,n ull,null,n ull,'PI',' 121150001' ,null,null ,null,1244 ); | |
| 3165 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (610,'10 00B',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','41','2' ,'ATHENA H EALTHCARE' ,null,null ,null,null ,'46','043 387530',nu ll,null,nu ll,1245); | |
| 3166 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (611,'10 00A',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','PR','2' ,'VA FEE', null,null, null,null, 'PI','1211 50001',nul l,null,nul l,1246); | |
| 3167 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (611,'10 00B',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','41','2' ,'RYCAN',n ull,null,n ull,null,' 46','41182 9363',null ,null,null ,1247); | |
| 3168 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (611,'10 00C',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','1P','2' ,'STERLING REGIONAL MEDCENTER' ,null,null ,null,null ,'XX','194 2238555',' BI','PXC', '282N00000 X',1248); | |
| 3169 | Insert int o ARS277_R EQUEST_TRA CKING.ENTI TYNAME (AT TACHMENT_I D,LOOP_ID, CLAIM_KEY, BATCH_ID,N M101,NM102 ,NM103,NM1 04,NM105,N M106,NM107 ,NM108,NM1 09,PRV01,P RV02,PRV03 ,ENTITYNAM EID) value s (611,'10 00D',null, '275sCorre spondingTo 837Pand837 _TEST5.txt ','QC','1' ,'FBCSAAF' ,'CKSWY',n ull,null,n ull,'MI',' 666778888' ,null,null ,null,1249 ); | |
| 3170 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.EREPOSD ATA | |
| 3171 | SET DEFINE OFF; | |
| 3172 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.HCCS_CD | |
| 3173 | SET DEFINE OFF; | |
| 3174 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (1 ,'R0','Req uests for additional Informati on/General Requests- Requests t hat don''t fall into other R-t ype catego ries.','Y' ,to_date(' 11-JAN-18' ,'DD-MON-R R'),to_dat e('02-MAR- 18','DD-MO N-RR')); | |
| 3175 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (2 ,'R1','Req uests for additional Informati on/Entity Requests-R equests fo r informat ion about specific e ntities (s ubscribers , patients , various providers) .','Y',to_ date('11-J AN-18','DD -MON-RR'), to_date('1 5-FEB-18', 'DD-MON-RR ')); | |
| 3176 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (3 ,'R3','Req uests for additional Informati on/Claim/L ine-Reques ts for inf ormation t hat could normally b e submitte d on a cla im.','Y',t o_date('11 -JAN-18',' DD-MON-RR' ),to_date( '02-MAR-18 ','DD-MON- RR')); | |
| 3177 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (4 ,'R4',' Re quests for additiona l Informat ion/Docume ntation-Re quests for additiona l supporti ng documen tation. Ex amples: ce rtificatio n, x-ray, notes.','Y ',to_date( '11-JAN-18 ','DD-MON- RR'),to_da te('02-MAR -18','DD-M ON-RR')); | |
| 3178 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (5 ,'R5',' RF AI/more sp ecific det ail-Additi onal infor mation as a follow u p to a pre vious requ est is nee ded. The o riginal in formation was receiv ed but is inadequate . More spe cific/deta iled infor mation is requested. ','Y',to_d ate('11-JA N-18','DD- MON-RR'),t o_date('15 -FEB-18',' DD-MON-RR' )); | |
| 3179 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (6 ,'R6',' Re quests for additiona l informat ion Regula tory requi rements',' Y',to_date ('11-JAN-1 8','DD-MON -RR'),to_d ate('15-FE B-18','DD- MON-RR')); | |
| 3180 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (7 ,'R7',' Re quests for additiona l informat ion Confir m care is consistent with Heal th Plan po licy cover age','Y',t o_date('11 -JAN-18',' DD-MON-RR' ),to_date( '15-FEB-18 ','DD-MON- RR')); | |
| 3181 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (8 ,'R8',' Re quests for additiona l informat ion Confir m care is consistent with heal th plan co verage exc eptions',' Y',to_date ('11-JAN-1 8','DD-MON -RR'),to_d ate('15-FE B-18','DD- MON-RR')); | |
| 3182 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (9 ,'R9',' Re quests for additiona l informat ion Determ ination of medical n ecessity', 'Y',to_dat e('11-JAN- 18','DD-MO N-RR'),to_ date('15-F EB-18','DD -MON-RR')) ; | |
| 3183 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (1 0,'R10',' Requests f or additio nal inform ation Supp ort a file d grievanc e or appea l','Y',to_ date('11-J AN-18','DD -MON-RR'), to_date('1 5-FEB-18', 'DD-MON-RR ')); | |
| 3184 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (1 1,'R11',' Requests f or additio nal inform ation Pre- payment re view of cl aims','Y', to_date('1 1-JAN-18', 'DD-MON-RR '),to_date ('22-FEB-1 8','DD-MON -RR')); | |
| 3185 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (1 2,'R12',' Requests f or additio nal inform ation Clar ification or justifi cation of use for sp ecified pr ocedure co de','Y',to _date('11- JAN-18','D D-MON-RR') ,to_date(' 15-FEB-18' ,'DD-MON-R R')); | |
| 3186 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (1 3,'R13',' Requests f or additio nal inform ation Orig inal docum ents submi tted are n ot readabl e. Used on ly for sub sequent re quest(s).' ,'Y',to_da te('11-JAN -18','DD-M ON-RR'),to _date('15- FEB-18','D D-MON-RR') ); | |
| 3187 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (1 4,'R14',' Requests f or additio nal inform ation Orig inal docum ents recei ved are no t what was requested . Used onl y for subs equent req uest(s).', 'Y',to_dat e('11-JAN- 18','DD-MO N-RR'),to_ date('26-F EB-18','DD -MON-RR')) ; | |
| 3188 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (1 5,'R15',' Requests f or additio nal inform ation Work ers Compen sation cov erage dete rmination. ','Y',to_d ate('11-JA N-18','DD- MON-RR'),t o_date('26 -FEB-18',' DD-MON-RR' )); | |
| 3189 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (1 6,'R16',' Requests f or additio nal inform ation Elig ibility de terminatio n','Y',to_ date('11-J AN-18','DD -MON-RR'), to_date('1 5-FEB-18', 'DD-MON-RR ')); | |
| 3190 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (1 7,'R17',' Replacemen t of a Pri or Request . Used to indicate t hat the cu rrent atta chment req uest repla ces a prio r attachme nt request .','Y',to_ date('11-J AN-18','DD -MON-RR'), to_date('0 2-MAR-18', 'DD-MON-RR ')); | |
| 3191 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (1 32,'123T', 'TEST','N' ,to_date(' 22-FEB-18' ,'DD-MON-R R'),to_dat e('26-FEB- 18','DD-MO N-RR')); | |
| 3192 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (1 33,'R2','N ew Code',' N',to_date ('28-FEB-1 8','DD-MON -RR'),to_d ate('28-FE B-18','DD- MON-RR')); | |
| 3193 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (1 34,'R36',' TEST R36', 'N',to_dat e('02-MAR- 18','DD-MO N-RR'),to_ date('02-M AR-18','DD -MON-RR')) ; | |
| 3194 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (1 35,'TESTxy z','TEST x yz','N',to _date('02- MAR-18','D D-MON-RR') ,to_date(' 02-MAR-18' ,'DD-MON-R R')); | |
| 3195 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (1 36,'R36',' TEST R36', 'N',to_dat e('05-MAR- 18','DD-MO N-RR'),to_ date('05-M AR-18','DD -MON-RR')) ; | |
| 3196 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (1 37,'R36',' TEST R36', 'N',to_dat e('05-MAR- 18','DD-MO N-RR'),to_ date('05-M AR-18','DD -MON-RR')) ; | |
| 3197 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (1 38,'R36',' TEST R36', 'N',to_dat e('06-MAR- 18','DD-MO N-RR'),to_ date('06-M AR-18','DD -MON-RR')) ; | |
| 3198 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (1 39,'R36',' TEST R36', 'N',to_dat e('06-MAR- 18','DD-MO N-RR'),to_ date('06-M AR-18','DD -MON-RR')) ; | |
| 3199 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (1 40,'R36',' TEST R36', 'N',to_dat e('08-MAR- 18','DD-MO N-RR'),to_ date('08-M AR-18','DD -MON-RR')) ; | |
| 3200 | Insert int o ARS277_R EQUEST_TRA CKING.HCCS _CD (HCCS_ ID,STCHCCS TATUSCAT_C D,STCHCCST ATUSCAT_CD _DESC,ISAC TIVE,DATEC REATED,DAT EMODIFIED) values (1 31,'R18',' Request fo r Surgical Note deta iling medi cal proced ure. TEST CODE TEST CODE TEST CODE ','N' ,to_date(' 16-FEB-18' ,'DD-MON-R R'),to_dat e('02-MAR- 18','DD-MO N-RR')); | |
| 3201 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.LOINC_C D | |
| 3202 | SET DEFINE OFF; | |
| 3203 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_CD (LOIN C_ID,STCLO INC_CD,STC LOINC_CD_D ESC,ISACTI VE,DATECRE ATED,DATEM ODIFIED) v alues (1,' 34133-9',' Continuity of Care D ocument',' Y',to_date ('11-JAN-1 8','DD-MON -RR'),to_d ate('22-FE B-18','DD- MON-RR')); | |
| 3204 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_CD (LOIN C_ID,STCLO INC_CD,STC LOINC_CD_D ESC,ISACTI VE,DATECRE ATED,DATEM ODIFIED) v alues (2,' 11488-4',' Consultati on Note',' Y',to_date ('11-JAN-1 8','DD-MON -RR'),to_d ate('15-FE B-18','DD- MON-RR')); | |
| 3205 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_CD (LOIN C_ID,STCLO INC_CD,STC LOINC_CD_D ESC,ISACTI VE,DATECRE ATED,DATEM ODIFIED) v alues (3,' 18748-4',' Diagnostic Imaging S tudy','Y', to_date('1 1-JAN-18', 'DD-MON-RR '),to_date ('22-FEB-1 8','DD-MON -RR')); | |
| 3206 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_CD (LOIN C_ID,STCLO INC_CD,STC LOINC_CD_D ESC,ISACTI VE,DATECRE ATED,DATEM ODIFIED) v alues (4,' 18842-5',' Discharge Summary',' Y',to_date ('11-JAN-1 8','DD-MON -RR'),to_d ate('15-FE B-18','DD- MON-RR')); | |
| 3207 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_CD (LOIN C_ID,STCLO INC_CD,STC LOINC_CD_D ESC,ISACTI VE,DATECRE ATED,DATEM ODIFIED) v alues (5,' 34117-2',' History an d Physical Note','Y' ,to_date(' 11-JAN-18' ,'DD-MON-R R'),to_dat e('15-FEB- 18','DD-MO N-RR')); | |
| 3208 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_CD (LOIN C_ID,STCLO INC_CD,STC LOINC_CD_D ESC,ISACTI VE,DATECRE ATED,DATEM ODIFIED) v alues (6,' 11504-8',' Provider-u nspecified Operative Note','Y' ,to_date(' 11-JAN-18' ,'DD-MON-R R'),to_dat e('15-FEB- 18','DD-MO N-RR')); | |
| 3209 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_CD (LOIN C_ID,STCLO INC_CD,STC LOINC_CD_D ESC,ISACTI VE,DATECRE ATED,DATEM ODIFIED) v alues (7,' 28570-0',' Provider-u nspecified Procedure Note','Y' ,to_date(' 11-JAN-18' ,'DD-MON-R R'),to_dat e('15-FEB- 18','DD-MO N-RR')); | |
| 3210 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_CD (LOIN C_ID,STCLO INC_CD,STC LOINC_CD_D ESC,ISACTI VE,DATECRE ATED,DATEM ODIFIED) v alues (8,' 11506-3',' Provider-u nspecified Progress Note','Y', to_date('1 1-JAN-18', 'DD-MON-RR '),to_date ('28-FEB-1 8','DD-MON -RR')); | |
| 3211 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_CD (LOIN C_ID,STCLO INC_CD,STC LOINC_CD_D ESC,ISACTI VE,DATECRE ATED,DATEM ODIFIED) v alues (0,' 18789-8',' Include al l data of the select ed type wi thin the d ate window associate d with the service', 'Y',to_dat e('07-FEB- 18','DD-MO N-RR'),to_ date('07-F EB-18','DD -MON-RR')) ; | |
| 3212 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_CD (LOIN C_ID,STCLO INC_CD,STC LOINC_CD_D ESC,ISACTI VE,DATECRE ATED,DATEM ODIFIED) v alues (128 ,'TEST123' ,'TEST LOI NC codes', 'N',to_dat e('22-FEB- 18','DD-MO N-RR'),to_ date('26-F EB-18','DD -MON-RR')) ; | |
| 3213 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_CD (LOIN C_ID,STCLO INC_CD,STC LOINC_CD_D ESC,ISACTI VE,DATECRE ATED,DATEM ODIFIED) v alues (129 ,'18789-8' ,'Include all data o f the sele cted type within the date wind ow associa ted with t he service ','Y',to_d ate('07-FE B-18','DD- MON-RR'),t o_date('28 -FEB-18',' DD-MON-RR' )); | |
| 3214 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_CD (LOIN C_ID,STCLO INC_CD,STC LOINC_CD_D ESC,ISACTI VE,DATECRE ATED,DATEM ODIFIED) v alues (130 ,'1000-89A ','New Cod e Updated' ,'N',to_da te('28-FEB -18','DD-M ON-RR'),to _date('28- FEB-18','D D-MON-RR') ); | |
| 3215 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_CD (LOIN C_ID,STCLO INC_CD,STC LOINC_CD_D ESC,ISACTI VE,DATECRE ATED,DATEM ODIFIED) v alues (131 ,'2018','I t is this year','N', to_date('0 2-MAR-18', 'DD-MON-RR '),to_date ('02-MAR-1 8','DD-MON -RR')); | |
| 3216 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_CD (LOIN C_ID,STCLO INC_CD,STC LOINC_CD_D ESC,ISACTI VE,DATECRE ATED,DATEM ODIFIED) v alues (132 ,'2018','I ts this ye ar','N',to _date('02- MAR-18','D D-MON-RR') ,to_date(' 02-MAR-18' ,'DD-MON-R R')); | |
| 3217 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_CD (LOIN C_ID,STCLO INC_CD,STC LOINC_CD_D ESC,ISACTI VE,DATECRE ATED,DATEM ODIFIED) v alues (133 ,'2018','I t is this year','N', to_date('0 5-MAR-18', 'DD-MON-RR '),to_date ('05-MAR-1 8','DD-MON -RR')); | |
| 3218 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_CD (LOIN C_ID,STCLO INC_CD,STC LOINC_CD_D ESC,ISACTI VE,DATECRE ATED,DATEM ODIFIED) v alues (134 ,'2018','I t is this year','N', to_date('0 5-MAR-18', 'DD-MON-RR '),to_date ('05-MAR-1 8','DD-MON -RR')); | |
| 3219 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_CD (LOIN C_ID,STCLO INC_CD,STC LOINC_CD_D ESC,ISACTI VE,DATECRE ATED,DATEM ODIFIED) v alues (135 ,'2018','I t is this year','N', to_date('0 6-MAR-18', 'DD-MON-RR '),to_date ('06-MAR-1 8','DD-MON -RR')); | |
| 3220 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_CD (LOIN C_ID,STCLO INC_CD,STC LOINC_CD_D ESC,ISACTI VE,DATECRE ATED,DATEM ODIFIED) v alues (136 ,'2018','I t is this year','N', to_date('0 6-MAR-18', 'DD-MON-RR '),to_date ('06-MAR-1 8','DD-MON -RR')); | |
| 3221 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_CD (LOIN C_ID,STCLO INC_CD,STC LOINC_CD_D ESC,ISACTI VE,DATECRE ATED,DATEM ODIFIED) v alues (137 ,'2018','I t is this year','N', to_date('0 8-MAR-18', 'DD-MON-RR '),to_date ('08-MAR-1 8','DD-MON -RR')); | |
| 3222 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.LOINC_M OD_CD | |
| 3223 | SET DEFINE OFF; | |
| 3224 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (1,'1878 9-8','Incl ude all da ta of the selected t ype within the date window ass ociated wi th the ser vice','Y', to_date('1 1-JAN-18', 'DD-MON-RR '),to_date ('15-FEB-1 8','DD-MON -RR')); | |
| 3225 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (2,'1879 0-6','Incl ude all da ta of the selected t ype on or before the date of s ervice','Y ',to_date( '11-JAN-18 ','DD-MON- RR'),to_da te('15-FEB -18','DD-M ON-RR')); | |
| 3226 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (3,'1879 1-4','Incl ude all da ta of the selected t ype within or aligne d to a ser vice','Y', to_date('1 1-JAN-18', 'DD-MON-RR '),to_date ('15-FEB-1 8','DD-MON -RR')); | |
| 3227 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (4,'1879 2-2','Incl ude all da ta of the selected t ype on or after the date of se rvice','Y' ,to_date(' 11-JAN-18' ,'DD-MON-R R'),to_dat e('15-FEB- 18','DD-MO N-RR')); | |
| 3228 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (5,'1880 3-7','Incl ude all da ta of the selected t ype that r epresents observatio ns made 30 days or f ewer befor e the star ting date of service ','Y',to_d ate('11-JA N-18','DD- MON-RR'),t o_date('15 -FEB-18',' DD-MON-RR' )); | |
| 3229 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (6,'1880 4-5','Incl ude all da ta of the selected t ype that r epresents observatio ns made th ree months or fewer before the starting date of se rvice','Y' ,to_date(' 11-JAN-18' ,'DD-MON-R R'),to_dat e('22-FEB- 18','DD-MO N-RR')); | |
| 3230 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (7,'1880 5-2','Incl ude all da ta of the selected t ype that r epresents observatio ns made si x months o r fewer be fore the s tarting da te of serv ice','Y',t o_date('11 -JAN-18',' DD-MON-RR' ),to_date( '15-FEB-18 ','DD-MON- RR')); | |
| 3231 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (8,'1880 6-0','Incl ude all da ta of the selected t ype that r epresents observatio ns made ni ne months or fewer b efore the starting d ate of ser vice','Y', to_date('1 1-JAN-18', 'DD-MON-RR '),to_date ('26-FEB-1 8','DD-MON -RR')); | |
| 3232 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (9,'1880 7-8','Incl ude all da ta of the selected t ype that r epresents observatio ns made on e year or less befor e the star ting date of service ','Y',to_d ate('11-JA N-18','DD- MON-RR'),t o_date('15 -FEB-18',' DD-MON-RR' )); | |
| 3233 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (10,'530 33-7','Inc lude all d ata of the selected type that represents observati ons made t wo years o r less bef ore the st arting dat e of servi ce','Y',to _date('11- JAN-18','D D-MON-RR') ,to_date(' 15-FEB-18' ,'DD-MON-R R')); | |
| 3234 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (11,'187 93-0','Use no fixed time limit on data a ny of the selected t ype are re levant no matter whe n obtained ','Y',to_d ate('11-JA N-18','DD- MON-RR'),t o_date('15 -FEB-18',' DD-MON-RR' )); | |
| 3235 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (12,'187 94-8','Sen d all item s of the s pecified t ype within the time window','Y ',to_date( '11-JAN-18 ','DD-MON- RR'),to_da te('15-FEB -18','DD-M ON-RR')); | |
| 3236 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (13,'187 95-5','Sen d all item s of the s pecified t ype within the time window rel evant to t he service ','Y',to_d ate('11-JA N-18','DD- MON-RR'),t o_date('15 -FEB-18',' DD-MON-RR' )); | |
| 3237 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (14,'187 96-3','Sen d all abno rmals with in the tim e window', 'Y',to_dat e('11-JAN- 18','DD-MO N-RR'),to_ date('15-F EB-18','DD -MON-RR')) ; | |
| 3238 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (15,'187 97-1','Sen d the firs t abnormal s within t he time wi ndow','Y', to_date('1 1-JAN-18', 'DD-MON-RR '),to_date ('15-FEB-1 8','DD-MON -RR')); | |
| 3239 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (16,'187 98-9','Sen d the last abnormals within th e time win dow','Y',t o_date('11 -JAN-18',' DD-MON-RR' ),to_date( '15-FEB-18 ','DD-MON- RR')); | |
| 3240 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (17,'188 00-3','Sen d the wors t abnormal result fo r each kin d of obser vation in the time w indow','Y' ,to_date(' 11-JAN-18' ,'DD-MON-R R'),to_dat e('15-FEB- 18','DD-MO N-RR')); | |
| 3241 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (18,'187 99-7','Sen d the firs t (i.e., o ldest) res ult for ea ch kind of observati on in the time windo w','Y',to_ date('11-J AN-18','DD -MON-RR'), to_date('2 2-FEB-18', 'DD-MON-RR ')); | |
| 3242 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (19,'188 02-9','Sen d the last (most rec ent) withi n the time window',' Y',to_date ('11-JAN-1 8','DD-MON -RR'),to_d ate('15-FE B-18','DD- MON-RR')); | |
| 3243 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (113,'TE ST123','TE ST12345',' N',to_date ('22-FEB-1 8','DD-MON -RR'),to_d ate('26-FE B-18','DD- MON-RR')); | |
| 3244 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (114,'12 3-456-789' ,'LOINC Co de Updated ','N',to_d ate('28-FE B-18','DD- MON-RR'),t o_date('28 -FEB-18',' DD-MON-RR' )); | |
| 3245 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (115,'20 18','It is this year ','Y',to_d ate('02-MA R-18','DD- MON-RR'),t o_date('02 -MAR-18',' DD-MON-RR' )); | |
| 3246 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (116,'20 18','Its t his year', 'Y',to_dat e('02-MAR- 18','DD-MO N-RR'),to_ date('02-M AR-18','DD -MON-RR')) ; | |
| 3247 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (117,'20 18','It is this year ','Y',to_d ate('05-MA R-18','DD- MON-RR'),t o_date('05 -MAR-18',' DD-MON-RR' )); | |
| 3248 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (118,'20 18','It is this year ','Y',to_d ate('05-MA R-18','DD- MON-RR'),t o_date('05 -MAR-18',' DD-MON-RR' )); | |
| 3249 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (119,'20 18','It is this year ','Y',to_d ate('06-MA R-18','DD- MON-RR'),t o_date('06 -MAR-18',' DD-MON-RR' )); | |
| 3250 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (120,'20 18','It is this year ','Y',to_d ate('06-MA R-18','DD- MON-RR'),t o_date('06 -MAR-18',' DD-MON-RR' )); | |
| 3251 | Insert int o ARS277_R EQUEST_TRA CKING.LOIN C_MOD_CD ( LOINC_MOD_ ID,STCLOIN C_CD_MOD,S TCLOINC_CD _MOD_DESC, ISACTIVE,D ATECREATED ,DATEMODIF IED) value s (121,'20 18','It is this year ','Y',to_d ate('08-MA R-18','DD- MON-RR'),t o_date('08 -MAR-18',' DD-MON-RR' )); | |
| 3252 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.OAUTH_C LIENT_AUTH ORITIES | |
| 3253 | SET DEFINE OFF; | |
| 3254 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.OAUTH_C LIENT_INFO | |
| 3255 | SET DEFINE OFF; | |
| 3256 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.PATHS | |
| 3257 | SET DEFINE OFF; | |
| 3258 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (172, 552,'C:\da ta\output\ 552\GIF.gi f'); | |
| 3259 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (173, 553,'C:\da ta\output\ 553\XML.XM L'); | |
| 3260 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (174, 554,'C:\da ta\output\ 554\XML.XM L'); | |
| 3261 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (175, 554,'C:\da ta\output\ 554\SSI TE STING.pdf' ); | |
| 3262 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (176, 555,'C:\da ta\output\ 555\201504 1517174797 .pdf'); | |
| 3263 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (177, 556,'C:\da ta\output\ 556\701330 56900.pdf' ); | |
| 3264 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (178, 557,'C:\da ta\output\ 557\201504 1517174797 .pdf'); | |
| 3265 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (179, 558,'C:\da ta\output\ 558\201512 2214120125 .pdf'); | |
| 3266 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (180, 559,'C:\da ta\output\ 559\201511 1116245338 .pdf'); | |
| 3267 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (181, 560,'C:\da ta\output\ 560\201510 1316053426 .pdf'); | |
| 3268 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (182, 561,'C:\da ta\output\ 561\XML.XM L'); | |
| 3269 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (183, 561,'C:\da ta\output\ 561\SSI TE STING.pdf' ); | |
| 3270 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (184, 562,'C:\da ta\output\ 562\280580 .pdf'); | |
| 3271 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (185, 563,'C:\da ta\output\ 563\280582 .pdf'); | |
| 3272 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (186, 564,'C:\da ta\output\ 564\201510 3021083278 .pdf'); | |
| 3273 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (187, 565,'C:\da ta\output\ 565\TIF.ti f'); | |
| 3274 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (188, 566,'C:\da ta\output\ 566\JPG.jp g'); | |
| 3275 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (170, 550,'C:\da ta\output\ 550\TIF.ti f'); | |
| 3276 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (171, 551,'C:\da ta\output\ 551\JPG.jp g'); | |
| 3277 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (189, 567,'C:\da ta\output\ 567\GIF.gi f'); | |
| 3278 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (190, 568,'C:\da ta\output\ 568\XML.XM L'); | |
| 3279 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (191, 569,'C:\da ta\output\ 569\XML.XM L'); | |
| 3280 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (192, 569,'C:\da ta\output\ 569\SSI TE STING.pdf' ); | |
| 3281 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (193, 570,'C:\da ta\output\ 570\201504 1517174797 .pdf'); | |
| 3282 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (194, 571,'C:\da ta\output\ 571\701330 56900.pdf' ); | |
| 3283 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (195, 572,'C:\da ta\output\ 572\201504 1517174797 .pdf'); | |
| 3284 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (196, 573,'C:\da ta\output\ 573\201512 2214120125 .pdf'); | |
| 3285 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (197, 574,'C:\da ta\output\ 574\201511 1116245338 .pdf'); | |
| 3286 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (198, 575,'C:\da ta\output\ 575\201510 1316053426 .pdf'); | |
| 3287 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (199, 576,'C:\da ta\output\ 576\XML.XM L'); | |
| 3288 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (200, 576,'C:\da ta\output\ 576\SSI TE STING.pdf' ); | |
| 3289 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (201, 577,'C:\da ta\output\ 577\280580 .pdf'); | |
| 3290 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (202, 578,'C:\da ta\output\ 578\280582 .pdf'); | |
| 3291 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (203, 579,'C:\da ta\output\ 579\201510 3021083278 .pdf'); | |
| 3292 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (204, 580,'C:\da ta\output\ 580\GS.TSO F36E.275AT 2018022653 8_001_1519 654505172_ 925039.pdf '); | |
| 3293 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (205, 581,'C:\da ta\output\ 581\GS.TSO F36E.275AT 2018022653 8_001_1519 654505188_ 765974.pdf '); | |
| 3294 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (206, 582,'C:\da ta\output\ 582\TIF.ti f'); | |
| 3295 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (207, 583,'C:\da ta\output\ 583\JPG.jp g'); | |
| 3296 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (208, 584,'C:\da ta\output\ 584\GIF.gi f'); | |
| 3297 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (209, 585,'C:\da ta\output\ 585\XML.XM L'); | |
| 3298 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (210, 586,'C:\da ta\output\ 586\XML.XM L'); | |
| 3299 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (211, 586,'C:\da ta\output\ 586\SSI TE STING.pdf' ); | |
| 3300 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (212, 587,'C:\da ta\output\ 587\201504 1517174797 .pdf'); | |
| 3301 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (213, 588,'C:\da ta\output\ 588\701330 56900.pdf' ); | |
| 3302 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (214, 589,'C:\da ta\output\ 589\201504 1517174797 .pdf'); | |
| 3303 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (215, 590,'C:\da ta\output\ 590\201512 2214120125 .pdf'); | |
| 3304 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (216, 591,'C:\da ta\output\ 591\201511 1116245338 .pdf'); | |
| 3305 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (217, 592,'C:\da ta\output\ 592\201510 1316053426 .pdf'); | |
| 3306 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (218, 593,'C:\da ta\output\ 593\XML.XM L'); | |
| 3307 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (219, 593,'C:\da ta\output\ 593\SSI TE STING.pdf' ); | |
| 3308 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (220, 594,'C:\da ta\output\ 594\280580 .pdf'); | |
| 3309 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (221, 595,'C:\da ta\output\ 595\280582 .pdf'); | |
| 3310 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (222, 596,'C:\da ta\output\ 596\201510 3021083278 .pdf'); | |
| 3311 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (223, 597,'C:\da ta\output\ 597\TIF.ti f'); | |
| 3312 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (224, 598,'C:\da ta\output\ 598\JPG.jp g'); | |
| 3313 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (225, 599,'C:\da ta\output\ 599\GIF.gi f'); | |
| 3314 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (226, 600,'C:\da ta\output\ 600\XML.XM L'); | |
| 3315 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (227, 601,'C:\da ta\output\ 601\XML.XM L'); | |
| 3316 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (228, 601,'C:\da ta\output\ 601\SSI TE STING.pdf' ); | |
| 3317 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (229, 602,'C:\da ta\output\ 602\201504 1517174797 .pdf'); | |
| 3318 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (230, 603,'C:\da ta\output\ 603\701330 56900.pdf' ); | |
| 3319 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (231, 604,'C:\da ta\output\ 604\201504 1517174797 .pdf'); | |
| 3320 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (232, 605,'C:\da ta\output\ 605\201512 2214120125 .pdf'); | |
| 3321 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (233, 606,'C:\da ta\output\ 606\201511 1116245338 .pdf'); | |
| 3322 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (234, 607,'C:\da ta\output\ 607\201510 1316053426 .pdf'); | |
| 3323 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (235, 608,'C:\da ta\output\ 608\XML.XM L'); | |
| 3324 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (236, 608,'C:\da ta\output\ 608\SSI TE STING.pdf' ); | |
| 3325 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (237, 609,'C:\da ta\output\ 609\280580 .pdf'); | |
| 3326 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (238, 610,'C:\da ta\output\ 610\280582 .pdf'); | |
| 3327 | Insert int o ARS277_R EQUEST_TRA CKING.PATH S (PATH_ID ,ATTACHMEN T_ID,PATH_ STRING) va lues (239, 611,'C:\da ta\output\ 611\201510 3021083278 .pdf'); | |
| 3328 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.REFEREN CE_IDENTIF ICATION | |
| 3329 | SET DEFINE OFF; | |
| 3330 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (550,'100 0D',null,' 275_TEST_5 72_TSET.tx t',1,'EJ', 'END 2 END 1I CLM000 8',null,nu ll,884); | |
| 3331 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (551,'100 0D',null,' 275_TEST_5 72_TSET.tx t',1,'EJ', 'END 2 END 1J CLM000 8',null,nu ll,885); | |
| 3332 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (551,'100 0D',null,' 275_TEST_5 72_TSET.tx t',2,'BLT' ,'111',nul l,null,886 ); | |
| 3333 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (551,'100 0D',null,' 275_TEST_5 72_TSET.tx t',3,'D9', 'SCN201712 27165655-0 2',null,nu ll,887); | |
| 3334 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (552,'100 0D',null,' 275_TEST_5 72_TSET.tx t',3,'D9', 'SCN201712 27165655-0 3',null,nu ll,888); | |
| 3335 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (552,'100 0D',null,' 275_TEST_5 72_TSET.tx t',1,'EJ', 'END 2 END 1K CLM000 8',null,nu ll,889); | |
| 3336 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (552,'100 0D',null,' 275_TEST_5 72_TSET.tx t',2,'BLT' ,'111',nul l,null,890 ); | |
| 3337 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (553,'100 0D',null,' 275_TEST_5 72_TSET.tx t',1,'EJ', 'END 2 END 1L CLM000 8',null,nu ll,891); | |
| 3338 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (553,'100 0D',null,' 275_TEST_5 72_TSET.tx t',2,'BLT' ,'131',nul l,null,892 ); | |
| 3339 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (553,'100 0D',null,' 275_TEST_5 72_TSET.tx t',3,'EA', '123456',n ull,null,8 93); | |
| 3340 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (553,'100 0D',null,' 275_TEST_5 72_TSET.tx t',4,'D9', 'SCN201712 27165655-0 4',null,nu ll,894); | |
| 3341 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (554,'100 0D',null,' 275_TEST_5 72_TSET.tx t',4,'D9', 'SCN201712 27165655-0 5',null,nu ll,895); | |
| 3342 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (554,'100 0D',null,' 275_TEST_5 72_TSET.tx t',3,'EA', '123456',n ull,null,8 96); | |
| 3343 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (554,'100 0D',null,' 275_TEST_5 72_TSET.tx t',2,'BLT' ,'131',nul l,null,897 ); | |
| 3344 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (554,'100 0D',null,' 275_TEST_5 72_TSET.tx t',1,'EJ', 'END 2 END 1M CLM000 8',null,nu ll,898); | |
| 3345 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (555,'100 0D',null,' 275_TEST_5 72_TSET.tx t',2,'BLT' ,'131',nul l,null,899 ); | |
| 3346 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (555,'100 0D',null,' 275_TEST_5 72_TSET.tx t',3,'EA', '10217566' ,null,null ,900); | |
| 3347 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (555,'100 0D',null,' 275_TEST_5 72_TSET.tx t',4,'D9', 'SCN201712 27165655-0 6',null,nu ll,901); | |
| 3348 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (555,'100 0D',null,' 275_TEST_5 72_TSET.tx t',1,'EJ', 'END 2 END 1N CLM000 8',null,nu ll,902); | |
| 3349 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (556,'100 0D',null,' 275_TEST_5 72_TSET.tx t',2,'EA', '10005257' ,null,null ,903); | |
| 3350 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (556,'100 0D',null,' 275_TEST_5 72_TSET.tx t',3,'D9', 'SCN201712 27165655-0 7',null,nu ll,904); | |
| 3351 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (556,'100 0D',null,' 275_TEST_5 72_TSET.tx t',1,'EJ', 'END 2 END 1A CLM000 8',null,nu ll,905); | |
| 3352 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (557,'100 0D',null,' 275_TEST_5 72_TSET.tx t',4,'D9', 'SCN201712 27165655-0 8',null,nu ll,906); | |
| 3353 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (557,'100 0D',null,' 275_TEST_5 72_TSET.tx t',1,'EJ', 'END 2 END 1B CLM000 8',null,nu ll,907); | |
| 3354 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (557,'100 0D',null,' 275_TEST_5 72_TSET.tx t',2,'BLT' ,'231',nul l,null,908 ); | |
| 3355 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (557,'100 0D',null,' 275_TEST_5 72_TSET.tx t',3,'EA', '10217566' ,null,null ,909); | |
| 3356 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (558,'100 0D',null,' 275_TEST_5 72_TSET.tx t',1,'EJ', 'END 2 END 1C CLM000 8',null,nu ll,910); | |
| 3357 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (558,'100 0D',null,' 275_TEST_5 72_TSET.tx t',4,'D9', 'SCN201712 27165655-0 9',null,nu ll,911); | |
| 3358 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (558,'100 0D',null,' 275_TEST_5 72_TSET.tx t',3,'EA', '10251908' ,null,null ,912); | |
| 3359 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (558,'100 0D',null,' 275_TEST_5 72_TSET.tx t',2,'BLT' ,'111',nul l,null,913 ); | |
| 3360 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (559,'100 0D',null,' 275_TEST_5 72_TSET.tx t',3,'D9', 'SCN201712 27165655-1 0',null,nu ll,914); | |
| 3361 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (559,'100 0D',null,' 275_TEST_5 72_TSET.tx t',2,'EA', '10219591' ,null,null ,915); | |
| 3362 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (559,'100 0D',null,' 275_TEST_5 72_TSET.tx t',1,'EJ', 'END 2 END 1D CLM000 8',null,nu ll,916); | |
| 3363 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (560,'100 0D',null,' 275_TEST_5 72_TSET.tx t',3,'D9', 'SCN201712 27165655-1 1',null,nu ll,917); | |
| 3364 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (560,'100 0D',null,' 275_TEST_5 72_TSET.tx t',1,'EJ', 'END 2 END 1E CLM000 8',null,nu ll,918); | |
| 3365 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (560,'100 0D',null,' 275_TEST_5 72_TSET.tx t',2,'EA', '10213275' ,null,null ,919); | |
| 3366 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (561,'100 0D',null,' 275_TEST_5 72_TSET.tx t',1,'EJ', 'END 2 END 1F CLM000 8',null,nu ll,920); | |
| 3367 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (561,'100 0D',null,' 275_TEST_5 72_TSET.tx t',2,'EA', '123456',n ull,null,9 21); | |
| 3368 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (561,'100 0D',null,' 275_TEST_5 72_TSET.tx t',3,'D9', 'SCN201712 27165655-1 2',null,nu ll,922); | |
| 3369 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (562,'100 0D',null,' 275_TEST_5 72_TSET.tx t',2,'D9', 'SCN201712 27165655-1 3',null,nu ll,923); | |
| 3370 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (562,'100 0D',null,' 275_TEST_5 72_TSET.tx t',1,'EJ', 'END 2 END 1G CLM000 8',null,nu ll,924); | |
| 3371 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (563,'100 0D',null,' 275_TEST_5 72_TSET.tx t',2,'D9', 'SCN201712 27165655-1 3',null,nu ll,925); | |
| 3372 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (563,'100 0D',null,' 275_TEST_5 72_TSET.tx t',1,'EJ', 'END 2 END 1G CLM000 8',null,nu ll,926); | |
| 3373 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (564,'100 0D',null,' 275_TEST_5 72_TSET.tx t',1,'EJ', 'END 2 END 1H CLM000 8',null,nu ll,927); | |
| 3374 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (564,'100 0D',null,' 275_TEST_5 72_TSET.tx t',2,'EA', '00794003' ,null,null ,928); | |
| 3375 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (564,'100 0D',null,' 275_TEST_5 72_TSET.tx t',3,'D9', 'SCN201712 27165655-1 4',null,nu ll,929); | |
| 3376 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (550,'100 0D',null,' 275_TEST_5 72_TSET.tx t',3,'D9', 'SCN201712 27165655-0 1',null,nu ll,882); | |
| 3377 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (550,'100 0D',null,' 275_TEST_5 72_TSET.tx t',2,'BLT' ,'111',nul l,null,883 ); | |
| 3378 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (565,'100 0D',null,' Dragon1.tx t',1,'EJ', 'END 2 END 1I CLM000 8',null,nu ll,930); | |
| 3379 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (565,'100 0D',null,' Dragon1.tx t',2,'BLT' ,'111',nul l,null,931 ); | |
| 3380 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (565,'100 0D',null,' Dragon1.tx t',3,'D9', 'SCN201712 27165655-0 1',null,nu ll,932); | |
| 3381 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (566,'100 0D',null,' Dragon1.tx t',3,'D9', 'SCN201712 27165655-0 2',null,nu ll,933); | |
| 3382 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (566,'100 0D',null,' Dragon1.tx t',2,'BLT' ,'111',nul l,null,934 ); | |
| 3383 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (566,'100 0D',null,' Dragon1.tx t',1,'EJ', 'END 2 END 1J CLM000 8',null,nu ll,935); | |
| 3384 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (567,'100 0D',null,' Dragon1.tx t',1,'EJ', 'END 2 END 1K CLM000 8',null,nu ll,936); | |
| 3385 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (567,'100 0D',null,' Dragon1.tx t',2,'BLT' ,'111',nul l,null,937 ); | |
| 3386 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (567,'100 0D',null,' Dragon1.tx t',3,'D9', 'SCN201712 27165655-0 3',null,nu ll,938); | |
| 3387 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (568,'100 0D',null,' Dragon1.tx t',1,'EJ', 'END 2 END 1L CLM000 8',null,nu ll,939); | |
| 3388 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (568,'100 0D',null,' Dragon1.tx t',4,'D9', 'SCN201712 27165655-0 4',null,nu ll,940); | |
| 3389 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (568,'100 0D',null,' Dragon1.tx t',3,'EA', '123456',n ull,null,9 41); | |
| 3390 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (568,'100 0D',null,' Dragon1.tx t',2,'BLT' ,'131',nul l,null,942 ); | |
| 3391 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (569,'100 0D',null,' Dragon1.tx t',2,'BLT' ,'131',nul l,null,943 ); | |
| 3392 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (569,'100 0D',null,' Dragon1.tx t',1,'EJ', 'END 2 END 1M CLM000 8',null,nu ll,944); | |
| 3393 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (569,'100 0D',null,' Dragon1.tx t',3,'EA', '123456',n ull,null,9 45); | |
| 3394 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (569,'100 0D',null,' Dragon1.tx t',4,'D9', 'SCN201712 27165655-0 5',null,nu ll,946); | |
| 3395 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (570,'100 0D',null,' Dragon1.tx t',4,'D9', 'SCN201712 27165655-0 6',null,nu ll,947); | |
| 3396 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (570,'100 0D',null,' Dragon1.tx t',1,'EJ', 'END 2 END 1N CLM000 8',null,nu ll,948); | |
| 3397 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (570,'100 0D',null,' Dragon1.tx t',3,'EA', '10217566' ,null,null ,949); | |
| 3398 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (570,'100 0D',null,' Dragon1.tx t',2,'BLT' ,'131',nul l,null,950 ); | |
| 3399 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (571,'100 0D',null,' Dragon1.tx t',2,'EA', '10005257' ,null,null ,951); | |
| 3400 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (571,'100 0D',null,' Dragon1.tx t',3,'D9', 'SCN201712 27165655-0 7',null,nu ll,952); | |
| 3401 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (571,'100 0D',null,' Dragon1.tx t',1,'EJ', 'END 2 END 1A CLM000 8',null,nu ll,953); | |
| 3402 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (572,'100 0D',null,' Dragon1.tx t',2,'BLT' ,'231',nul l,null,954 ); | |
| 3403 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (572,'100 0D',null,' Dragon1.tx t',3,'EA', '10217566' ,null,null ,955); | |
| 3404 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (572,'100 0D',null,' Dragon1.tx t',1,'EJ', 'END 2 END 1B CLM000 8',null,nu ll,956); | |
| 3405 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (572,'100 0D',null,' Dragon1.tx t',4,'D9', 'SCN201712 27165655-0 8',null,nu ll,957); | |
| 3406 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (573,'100 0D',null,' Dragon1.tx t',4,'D9', 'SCN201712 27165655-0 9',null,nu ll,958); | |
| 3407 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (573,'100 0D',null,' Dragon1.tx t',2,'BLT' ,'111',nul l,null,959 ); | |
| 3408 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (573,'100 0D',null,' Dragon1.tx t',1,'EJ', 'END 2 END 1C CLM000 8',null,nu ll,960); | |
| 3409 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (573,'100 0D',null,' Dragon1.tx t',3,'EA', '10251908' ,null,null ,961); | |
| 3410 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (574,'100 0D',null,' Dragon1.tx t',1,'EJ', 'END 2 END 1D CLM000 8',null,nu ll,962); | |
| 3411 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (574,'100 0D',null,' Dragon1.tx t',3,'D9', 'SCN201712 27165655-1 0',null,nu ll,963); | |
| 3412 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (574,'100 0D',null,' Dragon1.tx t',2,'EA', '10219591' ,null,null ,964); | |
| 3413 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (575,'100 0D',null,' Dragon1.tx t',1,'EJ', 'END 2 END 1E CLM000 8',null,nu ll,965); | |
| 3414 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (575,'100 0D',null,' Dragon1.tx t',2,'EA', '10213275' ,null,null ,966); | |
| 3415 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (575,'100 0D',null,' Dragon1.tx t',3,'D9', 'SCN201712 27165655-1 1',null,nu ll,967); | |
| 3416 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (576,'100 0D',null,' Dragon1.tx t',3,'D9', 'SCN201712 27165655-1 2',null,nu ll,968); | |
| 3417 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (576,'100 0D',null,' Dragon1.tx t',1,'EJ', 'END 2 END 1F CLM000 8',null,nu ll,969); | |
| 3418 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (576,'100 0D',null,' Dragon1.tx t',2,'EA', '123456',n ull,null,9 70); | |
| 3419 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (577,'100 0D',null,' Dragon1.tx t',1,'EJ', 'END 2 END 1G CLM000 8',null,nu ll,971); | |
| 3420 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (577,'100 0D',null,' Dragon1.tx t',2,'D9', 'SCN201712 27165655-1 3',null,nu ll,972); | |
| 3421 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (578,'100 0D',null,' Dragon1.tx t',1,'EJ', 'END 2 END 1G CLM000 8',null,nu ll,973); | |
| 3422 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (578,'100 0D',null,' Dragon1.tx t',2,'D9', 'SCN201712 27165655-1 3',null,nu ll,974); | |
| 3423 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (579,'100 0D',null,' Dragon1.tx t',2,'EA', '00794003' ,null,null ,975); | |
| 3424 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (579,'100 0D',null,' Dragon1.tx t',1,'EJ', 'END 2 END 1H CLM000 8',null,nu ll,976); | |
| 3425 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (579,'100 0D',null,' Dragon1.tx t',3,'D9', 'SCN201712 27165655-1 4',null,nu ll,977); | |
| 3426 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (580,'100 0D',null,' Dragon2.tx t',2,'D9', 'EP0223186 18611207', null,null, 978); | |
| 3427 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (580,'100 0D',null,' Dragon2.tx t',1,'EJ', '949588V26 23',null,n ull,979); | |
| 3428 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (581,'100 0D',null,' Dragon2.tx t',2,'D9', 'EP0223186 18611206', null,null, 980); | |
| 3429 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (581,'100 0D',null,' Dragon2.tx t',1,'EJ', '948665V26 23',null,n ull,981); | |
| 3430 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (582,'100 0D',null,' Dragon3.tx t',3,'D9', 'SCN201712 27165655-0 1',null,nu ll,982); | |
| 3431 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (582,'100 0D',null,' Dragon3.tx t',2,'BLT' ,'111',nul l,null,983 ); | |
| 3432 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (582,'100 0D',null,' Dragon3.tx t',1,'EJ', 'END 2 END 1I CLM000 8',null,nu ll,984); | |
| 3433 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (583,'100 0D',null,' Dragon3.tx t',1,'EJ', 'END 2 END 1J CLM000 8',null,nu ll,985); | |
| 3434 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (583,'100 0D',null,' Dragon3.tx t',2,'BLT' ,'111',nul l,null,986 ); | |
| 3435 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (583,'100 0D',null,' Dragon3.tx t',3,'D9', 'SCN201712 27165655-0 2',null,nu ll,987); | |
| 3436 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (584,'100 0D',null,' Dragon3.tx t',3,'D9', 'SCN201712 27165655-0 3',null,nu ll,988); | |
| 3437 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (584,'100 0D',null,' Dragon3.tx t',1,'EJ', 'END 2 END 1K CLM000 8',null,nu ll,989); | |
| 3438 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (584,'100 0D',null,' Dragon3.tx t',2,'BLT' ,'111',nul l,null,990 ); | |
| 3439 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (585,'100 0D',null,' Dragon3.tx t',1,'EJ', 'END 2 END 1L CLM000 8',null,nu ll,991); | |
| 3440 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (585,'100 0D',null,' Dragon3.tx t',2,'BLT' ,'131',nul l,null,992 ); | |
| 3441 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (585,'100 0D',null,' Dragon3.tx t',3,'EA', '123456',n ull,null,9 93); | |
| 3442 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (585,'100 0D',null,' Dragon3.tx t',4,'D9', 'SCN201712 27165655-0 4',null,nu ll,994); | |
| 3443 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (586,'100 0D',null,' Dragon3.tx t',4,'D9', 'SCN201712 27165655-0 5',null,nu ll,995); | |
| 3444 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (586,'100 0D',null,' Dragon3.tx t',3,'EA', '123456',n ull,null,9 96); | |
| 3445 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (586,'100 0D',null,' Dragon3.tx t',2,'BLT' ,'131',nul l,null,997 ); | |
| 3446 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (586,'100 0D',null,' Dragon3.tx t',1,'EJ', 'END 2 END 1M CLM000 8',null,nu ll,998); | |
| 3447 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (587,'100 0D',null,' Dragon3.tx t',2,'BLT' ,'131',nul l,null,999 ); | |
| 3448 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (587,'100 0D',null,' Dragon3.tx t',3,'EA', '10217566' ,null,null ,1000); | |
| 3449 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (587,'100 0D',null,' Dragon3.tx t',4,'D9', 'SCN201712 27165655-0 6',null,nu ll,1001); | |
| 3450 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (587,'100 0D',null,' Dragon3.tx t',1,'EJ', 'END 2 END 1N CLM000 8',null,nu ll,1002); | |
| 3451 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (588,'100 0D',null,' Dragon3.tx t',2,'EA', '10005257' ,null,null ,1003); | |
| 3452 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (588,'100 0D',null,' Dragon3.tx t',3,'D9', 'SCN201712 27165655-0 7',null,nu ll,1004); | |
| 3453 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (588,'100 0D',null,' Dragon3.tx t',1,'EJ', 'END 2 END 1A CLM000 8',null,nu ll,1005); | |
| 3454 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (589,'100 0D',null,' Dragon3.tx t',4,'D9', 'SCN201712 27165655-0 8',null,nu ll,1006); | |
| 3455 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (589,'100 0D',null,' Dragon3.tx t',1,'EJ', 'END 2 END 1B CLM000 8',null,nu ll,1007); | |
| 3456 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (589,'100 0D',null,' Dragon3.tx t',2,'BLT' ,'231',nul l,null,100 8); | |
| 3457 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (589,'100 0D',null,' Dragon3.tx t',3,'EA', '10217566' ,null,null ,1009); | |
| 3458 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (590,'100 0D',null,' Dragon3.tx t',1,'EJ', 'END 2 END 1C CLM000 8',null,nu ll,1010); | |
| 3459 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (590,'100 0D',null,' Dragon3.tx t',4,'D9', 'SCN201712 27165655-0 9',null,nu ll,1011); | |
| 3460 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (590,'100 0D',null,' Dragon3.tx t',3,'EA', '10251908' ,null,null ,1012); | |
| 3461 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (590,'100 0D',null,' Dragon3.tx t',2,'BLT' ,'111',nul l,null,101 3); | |
| 3462 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (591,'100 0D',null,' Dragon3.tx t',3,'D9', 'SCN201712 27165655-1 0',null,nu ll,1014); | |
| 3463 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (591,'100 0D',null,' Dragon3.tx t',2,'EA', '10219591' ,null,null ,1015); | |
| 3464 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (591,'100 0D',null,' Dragon3.tx t',1,'EJ', 'END 2 END 1D CLM000 8',null,nu ll,1016); | |
| 3465 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (592,'100 0D',null,' Dragon3.tx t',3,'D9', 'SCN201712 27165655-1 1',null,nu ll,1017); | |
| 3466 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (592,'100 0D',null,' Dragon3.tx t',1,'EJ', 'END 2 END 1E CLM000 8',null,nu ll,1018); | |
| 3467 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (592,'100 0D',null,' Dragon3.tx t',2,'EA', '10213275' ,null,null ,1019); | |
| 3468 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (593,'100 0D',null,' Dragon3.tx t',1,'EJ', 'END 2 END 1F CLM000 8',null,nu ll,1020); | |
| 3469 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (593,'100 0D',null,' Dragon3.tx t',2,'EA', '123456',n ull,null,1 021); | |
| 3470 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (593,'100 0D',null,' Dragon3.tx t',3,'D9', 'SCN201712 27165655-1 2',null,nu ll,1022); | |
| 3471 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (594,'100 0D',null,' Dragon3.tx t',2,'D9', 'SCN201712 27165655-1 3',null,nu ll,1023); | |
| 3472 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (594,'100 0D',null,' Dragon3.tx t',1,'EJ', 'END 2 END 1G CLM000 8',null,nu ll,1024); | |
| 3473 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (595,'100 0D',null,' Dragon3.tx t',2,'D9', 'SCN201712 27165655-1 3',null,nu ll,1025); | |
| 3474 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (595,'100 0D',null,' Dragon3.tx t',1,'EJ', 'END 2 END 1G CLM000 8',null,nu ll,1026); | |
| 3475 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (596,'100 0D',null,' Dragon3.tx t',1,'EJ', 'END 2 END 1H CLM000 8',null,nu ll,1027); | |
| 3476 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (596,'100 0D',null,' Dragon3.tx t',2,'EA', '00794003' ,null,null ,1028); | |
| 3477 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (596,'100 0D',null,' Dragon3.tx t',3,'D9', 'SCN201712 27165655-1 4',null,nu ll,1029); | |
| 3478 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (597,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,1,'EJ','E ND 2 END 1 I CLM0008' ,null,null ,1030); | |
| 3479 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (597,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,3,'D9','S CN20171227 165655-01' ,null,null ,1031); | |
| 3480 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (597,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,2,'BLT',' 111',null, null,1032) ; | |
| 3481 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (598,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,1,'EJ','E ND 2 END 1 J CLM0008' ,null,null ,1033); | |
| 3482 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (598,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,2,'BLT',' 111',null, null,1034) ; | |
| 3483 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (598,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,3,'D9','S CN20171227 165655-02' ,null,null ,1035); | |
| 3484 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (599,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,2,'BLT',' 111',null, null,1036) ; | |
| 3485 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (599,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,1,'EJ','E ND 2 END 1 K CLM0008' ,null,null ,1037); | |
| 3486 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (599,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,3,'D9','S CN20171227 165655-03' ,null,null ,1038); | |
| 3487 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (600,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,1,'EJ','E ND 2 END 1 L CLM0008' ,null,null ,1039); | |
| 3488 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (600,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,4,'D9','S CN20171227 165655-04' ,null,null ,1040); | |
| 3489 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (600,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,2,'BLT',' 131',null, null,1041) ; | |
| 3490 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (600,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,3,'EA','1 23456',nul l,null,104 2); | |
| 3491 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (601,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,1,'EJ','E ND 2 END 1 M CLM0008' ,null,null ,1043); | |
| 3492 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (601,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,3,'EA','1 23456',nul l,null,104 4); | |
| 3493 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (601,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,4,'D9','S CN20171227 165655-05' ,null,null ,1045); | |
| 3494 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (601,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,2,'BLT',' 131',null, null,1046) ; | |
| 3495 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (602,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,1,'EJ','E ND 2 END 1 N CLM0008' ,null,null ,1047); | |
| 3496 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (602,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,2,'BLT',' 131',null, null,1048) ; | |
| 3497 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (602,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,4,'D9','S CN20171227 165655-06' ,null,null ,1049); | |
| 3498 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (602,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,3,'EA','1 0217566',n ull,null,1 050); | |
| 3499 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (603,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,1,'EJ','E ND 2 END 1 A CLM0008' ,null,null ,1051); | |
| 3500 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (603,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,2,'EA','1 0005257',n ull,null,1 052); | |
| 3501 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (603,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,3,'D9','S CN20171227 165655-07' ,null,null ,1053); | |
| 3502 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (604,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,4,'D9','S CN20171227 165655-08' ,null,null ,1054); | |
| 3503 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (604,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,2,'BLT',' 231',null, null,1055) ; | |
| 3504 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (604,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,1,'EJ','E ND 2 END 1 B CLM0008' ,null,null ,1056); | |
| 3505 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (604,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,3,'EA','1 0217566',n ull,null,1 057); | |
| 3506 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (605,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,4,'D9','S CN20171227 165655-09' ,null,null ,1058); | |
| 3507 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (605,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,2,'BLT',' 111',null, null,1059) ; | |
| 3508 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (605,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,1,'EJ','E ND 2 END 1 C CLM0008' ,null,null ,1060); | |
| 3509 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (605,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,3,'EA','1 0251908',n ull,null,1 061); | |
| 3510 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (606,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,3,'D9','S CN20171227 165655-10' ,null,null ,1062); | |
| 3511 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (606,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,1,'EJ','E ND 2 END 1 D CLM0008' ,null,null ,1063); | |
| 3512 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (606,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,2,'EA','1 0219591',n ull,null,1 064); | |
| 3513 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (607,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,1,'EJ','E ND 2 END 1 E CLM0008' ,null,null ,1065); | |
| 3514 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (607,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,2,'EA','1 0213275',n ull,null,1 066); | |
| 3515 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (607,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,3,'D9','S CN20171227 165655-11' ,null,null ,1067); | |
| 3516 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (608,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,1,'EJ','E ND 2 END 1 F CLM0008' ,null,null ,1068); | |
| 3517 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (608,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,3,'D9','S CN20171227 165655-12' ,null,null ,1069); | |
| 3518 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (608,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,2,'EA','1 23456',nul l,null,107 0); | |
| 3519 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (609,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,2,'D9','S CN20171227 165655-13' ,null,null ,1071); | |
| 3520 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (609,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,1,'EJ','E ND 2 END 1 G CLM0008' ,null,null ,1072); | |
| 3521 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (610,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,2,'D9','S CN20171227 165655-13' ,null,null ,1073); | |
| 3522 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (610,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,1,'EJ','E ND 2 END 1 G CLM0008' ,null,null ,1074); | |
| 3523 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (611,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,2,'EA','0 0794003',n ull,null,1 075); | |
| 3524 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (611,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,1,'EJ','E ND 2 END 1 H CLM0008' ,null,null ,1076); | |
| 3525 | Insert int o ARS277_R EQUEST_TRA CKING.REFE RENCE_IDEN TIFICATION (ATTACHME NT_ID,LOOP _ID,CLAIM_ KEY,BATCH_ ID,REC_NUM ,REF01,REF 02,REF03,R EF04,REFER ENCE_IDENT IFICATION_ ID) values (611,'100 0D',null,' 275sCorres pondingTo8 37Pand837_ TEST5.txt' ,3,'D9','S CN20171227 165655-14' ,null,null ,1077); | |
| 3526 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.SSO_AUT HENTICATIO N | |
| 3527 | SET DEFINE OFF; | |
| 3528 | Insert int o ARS277_R EQUEST_TRA CKING.SSO_ AUTHENTICA TION (GUID ,SESSIONID ,NTNAME) v alues ('10 0','100010 1','VHAISB ASEUSER'); | |
| 3529 | Insert int o ARS277_R EQUEST_TRA CKING.SSO_ AUTHENTICA TION (GUID ,SESSIONID ,NTNAME) v alues ('10 1','100020 1','VHAISA RSADMIN'); | |
| 3530 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.STATUS_ INFORMATIO N | |
| 3531 | SET DEFINE OFF; | |
| 3532 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.TRACE_N UMBER | |
| 3533 | SET DEFINE OFF; | |
| 3534 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 52,'1','EN D 2 END 1K 2750008', 563); | |
| 3535 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 53,'1','EN D 2 END 1L 2750008', 564); | |
| 3536 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 54,'1','EN D 2 END 1M 2750008', 565); | |
| 3537 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 55,'1','EN D 2 END 1N 2750008', 566); | |
| 3538 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 56,'1','EN D 2 END 1A 2750008', 567); | |
| 3539 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 57,'1','EN D 2 END 1B 2750008', 568); | |
| 3540 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 58,'1','EN D 2 END 1C 2750008', 569); | |
| 3541 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 59,'1','EN D 2 END 1D 2750008', 570); | |
| 3542 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 60,'1','EN D 2 END 1E 2750008', 571); | |
| 3543 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 61,'1','EN D 2 END 1F 2750008', 572); | |
| 3544 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 62,'1','EN D 2 END 1G 1 2750008' ,573); | |
| 3545 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 62,'1','EN D 2 END 1G 2 2750008' ,574); | |
| 3546 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 63,'1','EN D 2 END 1G 2 2750008' ,575); | |
| 3547 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 64,'1','EN D 2 END TI MING P0008 ',576); | |
| 3548 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 50,'1','EN D 2 END 1I 2750008', 561); | |
| 3549 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 51,'1','EN D 2 END 1J 2750008', 562); | |
| 3550 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 65,'1','EN D 2 END 1I 2750008', 577); | |
| 3551 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 66,'1','EN D 2 END 1J 2750008', 578); | |
| 3552 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 67,'1','EN D 2 END 1K 2750008', 579); | |
| 3553 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 68,'1','EN D 2 END 1L 2750008', 580); | |
| 3554 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 69,'1','EN D 2 END 1M 2750008', 581); | |
| 3555 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 70,'1','EN D 2 END 1N 2750008', 582); | |
| 3556 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 71,'1','EN D 2 END 1A 2750008', 583); | |
| 3557 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 72,'1','EN D 2 END 1B 2750008', 584); | |
| 3558 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 73,'1','EN D 2 END 1C 2750008', 585); | |
| 3559 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 74,'1','EN D 2 END 1D 2750008', 586); | |
| 3560 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 75,'1','EN D 2 END 1E 2750008', 587); | |
| 3561 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 76,'1','EN D 2 END 1F 2750008', 588); | |
| 3562 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 77,'1','EN D 2 END 1G 1 2750008' ,589); | |
| 3563 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 77,'1','EN D 2 END 1G 2 2750008' ,590); | |
| 3564 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 78,'1','EN D 2 END 1G 2 2750008' ,591); | |
| 3565 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 79,'1','EN D 2 END TI MING P0008 ',592); | |
| 3566 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 80,'1','94 9588V2623_ 96540_01', 593); | |
| 3567 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 81,'1','94 8665V2623_ 96540_01', 594); | |
| 3568 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 82,'1','EN D 2 END 1I 2750008', 595); | |
| 3569 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 83,'1','EN D 2 END 1J 2750008', 596); | |
| 3570 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 84,'1','EN D 2 END 1K 2750008', 597); | |
| 3571 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 85,'1','EN D 2 END 1L 2750008', 598); | |
| 3572 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 86,'1','EN D 2 END 1M 2750008', 599); | |
| 3573 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 87,'1','EN D 2 END 1N 2750008', 600); | |
| 3574 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 88,'1','EN D 2 END 1A 2750008', 601); | |
| 3575 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 89,'1','EN D 2 END 1B 2750008', 602); | |
| 3576 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 90,'1','EN D 2 END 1C 2750008', 603); | |
| 3577 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 91,'1','EN D 2 END 1D 2750008', 604); | |
| 3578 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 92,'1','EN D 2 END 1E 2750008', 605); | |
| 3579 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 93,'1','EN D 2 END 1F 2750008', 606); | |
| 3580 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 94,'1','EN D 2 END 1G 1 2750008' ,607); | |
| 3581 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 94,'1','EN D 2 END 1G 2 2750008' ,608); | |
| 3582 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 95,'1','EN D 2 END 1G 2 2750008' ,609); | |
| 3583 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 96,'1','EN D 2 END TI MING P0008 ',610); | |
| 3584 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 97,'1','EN D 2 END 1I 2750008', 611); | |
| 3585 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 98,'1','EN D 2 END 1J 2750008', 612); | |
| 3586 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (5 99,'1','EN D 2 END 1K 2750008', 613); | |
| 3587 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (6 00,'1','EN D 2 END 1L 2750008', 614); | |
| 3588 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (6 01,'1','EN D 2 END 1M 2750008', 615); | |
| 3589 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (6 02,'1','EN D 2 END 1N 2750008', 616); | |
| 3590 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (6 03,'1','EN D 2 END 1A 2750008', 617); | |
| 3591 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (6 04,'1','EN D 2 END 1B 2750008', 618); | |
| 3592 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (6 05,'1','EN D 2 END 1C 2750008', 619); | |
| 3593 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (6 06,'1','EN D 2 END 1D 2750008', 620); | |
| 3594 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (6 07,'1','EN D 2 END 1E 2750008', 621); | |
| 3595 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (6 08,'1','EN D 2 END 1F 2750008', 622); | |
| 3596 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (6 09,'1','EN D 2 END 1G 1 2750008' ,623); | |
| 3597 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (6 09,'1','EN D 2 END 1G 2 2750008' ,624); | |
| 3598 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (6 10,'1','EN D 2 END 1G 2 2750008' ,625); | |
| 3599 | Insert int o ARS277_R EQUEST_TRA CKING.TRAC E_NUMBER ( ATTACHMENT _ID,TRN01, TRN02,TRAC ENUMBERID) values (6 11,'1','EN D 2 END TI MING P0008 ',626); | |
| 3600 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.TRANSAC TIONS | |
| 3601 | SET DEFINE OFF; | |
| 3602 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 52,'2100B' ,null,'275 _TEST_572_ TSET.txt', 0,'AZ','GI F.gif','GI F',null,'1 510139797' ,'A','275' ,'0011','0 05010X210E 1','21','0 011','02', 'SCN201712 27165655-0 3','201406 04',to_tim estamp('12 -MAR-18 04 .29.40.327 000000 PM' ,'DD-MON-R R HH.MI.SS XFF AM'),' 1',null,nu ll,546); | |
| 3603 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 53,'2100B' ,null,'275 _TEST_572_ TSET.txt', 0,'AZ','XM L.XML','XM L',null,'1 510139797' ,'A','275' ,'0012','0 05010X210' ,'21','001 2','02','S CN20171227 165655-04' ,'20160807 ',to_times tamp('12-M AR-18 04.2 9.51.57600 0000 PM',' DD-MON-RR HH.MI.SSXF F AM'),'1' ,null,null ,547); | |
| 3604 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 54,'2100B' ,null,'275 _TEST_572_ TSET.txt', 0,'AZ','SS I TESTING. pdf','PDF' ,null,'151 0139797',' A','275',' 0013','005 010X210',' 21','0013' ,'02','SCN 2017122716 5655-05',' 20160405', to_timesta mp('12-MAR -18 04.30. 02.8500000 00 PM','DD -MON-RR HH .MI.SSXFF AM'),'1',n ull,null,5 48); | |
| 3605 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 55,'2100B' ,null,'275 _TEST_572_ TSET.txt', 0,'AZ','20 1504151717 4797.pdf', 'PDF',null ,'15101397 97','A','2 75','0014' ,'005010X2 10','22',' 0014','02' ,'SCN20171 227165655- 06','20150 415',to_ti mestamp('1 2-MAR-18 0 4.30.12.79 2000000 PM ','DD-MON- RR HH.MI.S SXFF AM'), '1',null,n ull,549); | |
| 3606 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 56,'2100B' ,null,'275 _TEST_572_ TSET.txt', 0,'AZ','70 133056900. pdf','PDF' ,null,'151 0139797',' A','275',' 0001','005 010X210',' 21','0001' ,'02','SCN 2017122716 5655-07',' 20131228', to_timesta mp('12-MAR -18 04.30. 21.2240000 00 PM','DD -MON-RR HH .MI.SSXFF AM'),'1',n ull,null,5 50); | |
| 3607 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 57,'2100B' ,null,'275 _TEST_572_ TSET.txt', 0,'AZ','20 1504151717 4797.pdf', 'PDF',null ,'15101397 97','A','2 75','0002' ,'005010X2 10','22',' 0002','02' ,'SCN20171 227165655- 08','20150 415',to_ti mestamp('1 2-MAR-18 0 4.30.31.18 7000000 PM ','DD-MON- RR HH.MI.S SXFF AM'), '1',null,n ull,551); | |
| 3608 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 58,'2100B' ,null,'275 _TEST_572_ TSET.txt', 0,'AZ','20 1512221412 0125.pdf', 'PDF',null ,'15101397 97','A','2 75','0003' ,'005010X2 10','22',' 0003','02' ,'SCN20171 227165655- 09','20151 222',to_ti mestamp('1 2-MAR-18 0 4.30.47.29 1000000 PM ','DD-MON- RR HH.MI.S SXFF AM'), '1',null,n ull,552); | |
| 3609 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 59,'2100B' ,null,'275 _TEST_572_ TSET.txt', 0,'AZ','20 1511111624 5338.pdf', 'PDF',null ,'15101397 97','A','2 75','0004' ,'005010X2 10','23',' 0004','02' ,'SCN20171 227165655- 10','20151 111',to_ti mestamp('1 2-MAR-18 0 4.30.54.37 1000000 PM ','DD-MON- RR HH.MI.S SXFF AM'), '1',null,n ull,553); | |
| 3610 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 60,'2100B' ,null,'275 _TEST_572_ TSET.txt', 0,'AZ','20 1510131605 3426.pdf', 'PDF',null ,'15101397 97','A','2 75','0005' ,'005010X2 10','21',' 0005','02' ,'SCN20171 227165655- 11','20151 013',to_ti mestamp('1 2-MAR-18 0 4.31.05.07 8000000 PM ','DD-MON- RR HH.MI.S SXFF AM'), '1',null,n ull,554); | |
| 3611 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 61,'2100B' ,null,'275 _TEST_572_ TSET.txt', 0,'AZ','SS I TESTING. pdf','PDF' ,null,'151 0139797',' A','275',' 0006','005 010X210',' 20','0006' ,'02','SCN 2017122716 5655-12',' 20160405', to_timesta mp('12-MAR -18 04.31. 15.2070000 00 PM','DD -MON-RR HH .MI.SSXFF AM'),'1',n ull,null,5 55); | |
| 3612 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 62,'2100B' ,null,'275 _TEST_572_ TSET.txt', 0,'AZ','28 0580.pdf', 'PDF',null ,'15101397 97','A','2 75','0007' ,'005010X2 10','25',' 0007','02' ,'SCN20171 227165655- 13','20160 715',to_ti mestamp('1 2-MAR-18 0 4.31.29.97 8000000 PM ','DD-MON- RR HH.MI.S SXFF AM'), '2',null,n ull,556); | |
| 3613 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 63,'2100B' ,null,'275 _TEST_572_ TSET.txt', 0,'AZ','28 0582.pdf', 'PDF',null ,'15101397 97','A','2 75','0007' ,'005010X2 10','25',' 0007','02' ,'SCN20171 227165655- 13','20160 715',to_ti mestamp('1 2-MAR-18 0 4.31.36.24 6000000 PM ','DD-MON- RR HH.MI.S SXFF AM'), '2',null,n ull,557); | |
| 3614 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 64,'2100B' ,null,'275 _TEST_572_ TSET.txt', 0,'AZ','20 1510302108 3278.pdf', 'PDF',null ,'15101397 97','A','2 75','0008' ,'005010X2 10','21',' 0008','02' ,'SCN20171 227165655- 14','20151 031',to_ti mestamp('1 2-MAR-18 0 4.31.46.87 5000000 PM ','DD-MON- RR HH.MI.S SXFF AM'), '1',null,n ull,558); | |
| 3615 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 65,'2100B' ,null,'Dra gon1.txt', 0,'AZ','TI F.tif','TI F',null,'1 510139797' ,'A','275' ,'0009','0 05010X210E 1','21','0 009','02', 'SCN201712 27165655-0 1','201406 04',to_tim estamp('12 -MAR-18 05 .14.08.000 000000 PM' ,'DD-MON-R R HH.MI.SS XFF AM'),' 1',null,nu ll,559); | |
| 3616 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 66,'2100B' ,null,'Dra gon1.txt', 0,'AZ','JP G.jpg','JP G',null,'1 510139797' ,'A','275' ,'0010','0 05010X210E 1','21','0 010','02', 'SCN201712 27165655-0 2','201406 04',to_tim estamp('12 -MAR-18 05 .14.33.811 000000 PM' ,'DD-MON-R R HH.MI.SS XFF AM'),' 1',null,nu ll,560); | |
| 3617 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 50,'2100B' ,null,'275 _TEST_572_ TSET.txt', 0,'AZ','TI F.tif','TI F',null,'1 510139797' ,'A','275' ,'0009','0 05010X210E 1','21','0 009','02', 'SCN201712 27165655-0 1','201406 04',to_tim estamp('12 -MAR-18 04 .29.21.531 000000 PM' ,'DD-MON-R R HH.MI.SS XFF AM'),' 1',null,nu ll,544); | |
| 3618 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 51,'2100B' ,null,'275 _TEST_572_ TSET.txt', 0,'AZ','JP G.jpg','JP G',null,'1 510139797' ,'A','275' ,'0010','0 05010X210E 1','21','0 010','02', 'SCN201712 27165655-0 2','201406 04',to_tim estamp('12 -MAR-18 04 .29.28.540 000000 PM' ,'DD-MON-R R HH.MI.SS XFF AM'),' 1',null,nu ll,545); | |
| 3619 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 67,'2100B' ,null,'Dra gon1.txt', 0,'AZ','GI F.gif','GI F',null,'1 510139797' ,'A','275' ,'0011','0 05010X210E 1','21','0 011','02', 'SCN201712 27165655-0 3','201406 04',to_tim estamp('12 -MAR-18 05 .14.42.466 000000 PM' ,'DD-MON-R R HH.MI.SS XFF AM'),' 1',null,nu ll,561); | |
| 3620 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 68,'2100B' ,null,'Dra gon1.txt', 0,'AZ','XM L.XML','XM L',null,'1 510139797' ,'A','275' ,'0012','0 05010X210' ,'21','001 2','02','S CN20171227 165655-04' ,'20160807 ',to_times tamp('12-M AR-18 05.1 4.50.77000 0000 PM',' DD-MON-RR HH.MI.SSXF F AM'),'1' ,null,null ,562); | |
| 3621 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 69,'2100B' ,null,'Dra gon1.txt', 0,'AZ','SS I TESTING. pdf','PDF' ,null,'151 0139797',' A','275',' 0013','005 010X210',' 21','0013' ,'02','SCN 2017122716 5655-05',' 20160405', to_timesta mp('12-MAR -18 05.14. 57.1840000 00 PM','DD -MON-RR HH .MI.SSXFF AM'),'1',n ull,null,5 63); | |
| 3622 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 70,'2100B' ,null,'Dra gon1.txt', 0,'AZ','20 1504151717 4797.pdf', 'PDF',null ,'15101397 97','A','2 75','0014' ,'005010X2 10','22',' 0014','02' ,'SCN20171 227165655- 06','20150 415',to_ti mestamp('1 2-MAR-18 0 5.15.03.27 3000000 PM ','DD-MON- RR HH.MI.S SXFF AM'), '1',null,n ull,564); | |
| 3623 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 71,'2100B' ,null,'Dra gon1.txt', 0,'AZ','70 133056900. pdf','PDF' ,null,'151 0139797',' A','275',' 0001','005 010X210',' 21','0001' ,'02','SCN 2017122716 5655-07',' 20131228', to_timesta mp('12-MAR -18 05.15. 18.5180000 00 PM','DD -MON-RR HH .MI.SSXFF AM'),'1',n ull,null,5 65); | |
| 3624 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 72,'2100B' ,null,'Dra gon1.txt', 0,'AZ','20 1504151717 4797.pdf', 'PDF',null ,'15101397 97','A','2 75','0002' ,'005010X2 10','22',' 0002','02' ,'SCN20171 227165655- 08','20150 415',to_ti mestamp('1 2-MAR-18 0 5.15.24.67 3000000 PM ','DD-MON- RR HH.MI.S SXFF AM'), '1',null,n ull,566); | |
| 3625 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 73,'2100B' ,null,'Dra gon1.txt', 0,'AZ','20 1512221412 0125.pdf', 'PDF',null ,'15101397 97','A','2 75','0003' ,'005010X2 10','22',' 0003','02' ,'SCN20171 227165655- 09','20151 222',to_ti mestamp('1 2-MAR-18 0 5.15.31.16 8000000 PM ','DD-MON- RR HH.MI.S SXFF AM'), '1',null,n ull,567); | |
| 3626 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 74,'2100B' ,null,'Dra gon1.txt', 0,'AZ','20 1511111624 5338.pdf', 'PDF',null ,'15101397 97','A','2 75','0004' ,'005010X2 10','23',' 0004','02' ,'SCN20171 227165655- 10','20151 111',to_ti mestamp('1 2-MAR-18 0 5.15.45.78 3000000 PM ','DD-MON- RR HH.MI.S SXFF AM'), '1',null,n ull,568); | |
| 3627 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 75,'2100B' ,null,'Dra gon1.txt', 0,'AZ','20 1510131605 3426.pdf', 'PDF',null ,'15101397 97','A','2 75','0005' ,'005010X2 10','21',' 0005','02' ,'SCN20171 227165655- 11','20151 013',to_ti mestamp('1 2-MAR-18 0 5.15.52.74 8000000 PM ','DD-MON- RR HH.MI.S SXFF AM'), '1',null,n ull,569); | |
| 3628 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 76,'2100B' ,null,'Dra gon1.txt', 0,'AZ','SS I TESTING. pdf','PDF' ,null,'151 0139797',' A','275',' 0006','005 010X210',' 20','0006' ,'02','SCN 2017122716 5655-12',' 20160405', to_timesta mp('12-MAR -18 05.16. 01.5900000 00 PM','DD -MON-RR HH .MI.SSXFF AM'),'1',n ull,null,5 70); | |
| 3629 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 77,'2100B' ,null,'Dra gon1.txt', 0,'AZ','28 0580.pdf', 'PDF',null ,'15101397 97','A','2 75','0007' ,'005010X2 10','25',' 0007','02' ,'SCN20171 227165655- 13','20160 715',to_ti mestamp('1 2-MAR-18 0 5.16.17.28 9000000 PM ','DD-MON- RR HH.MI.S SXFF AM'), '2',null,n ull,571); | |
| 3630 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 78,'2100B' ,null,'Dra gon1.txt', 0,'AZ','28 0582.pdf', 'PDF',null ,'15101397 97','A','2 75','0007' ,'005010X2 10','25',' 0007','02' ,'SCN20171 227165655- 13','20160 715',to_ti mestamp('1 2-MAR-18 0 5.16.24.54 3000000 PM ','DD-MON- RR HH.MI.S SXFF AM'), '2',null,n ull,572); | |
| 3631 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 79,'2100B' ,null,'Dra gon1.txt', 0,'AZ','20 1510302108 3278.pdf', 'PDF',null ,'15101397 97','A','2 75','0008' ,'005010X2 10','21',' 0008','02' ,'SCN20171 227165655- 14','20151 031',to_ti mestamp('1 2-MAR-18 0 5.16.32.34 3000000 PM ','DD-MON- RR HH.MI.S SXFF AM'), '1',null,n ull,573); | |
| 3632 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 80,'2100B' ,null,'Dra gon2.txt', 0,'AZ','GS .TSOF36E.2 75AT201802 26538_001_ 1519654505 172_925039 .pdf','PDF ',null,'15 10139797', 'A','275', '0001','00 5010X210E1 ','19','00 01','02',' 96539A2623 ','2018022 1',to_time stamp('12- MAR-18 05. 17.04.5470 00000 PM', 'DD-MON-RR HH.MI.SSX FF AM'),'1 ',null,nul l,574); | |
| 3633 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 81,'2100B' ,null,'Dra gon2.txt', 0,'AZ','GS .TSOF36E.2 75AT201802 26538_001_ 1519654505 188_765974 .pdf','PDF ',null,'15 10139797', 'A','275', '0002','00 5010X210E1 ','19','00 02','02',' 96539A2623 ','2018022 1',to_time stamp('12- MAR-18 05. 17.09.5350 00000 PM', 'DD-MON-RR HH.MI.SSX FF AM'),'1 ',null,nul l,575); | |
| 3634 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 82,'2100B' ,null,'Dra gon3.txt', 0,'AZ','TI F.tif','TI F',null,'1 510139797' ,'A','275' ,'0009','0 05010X210E 1','21','0 009','02', 'SCN201712 27165655-0 1','201406 04',to_tim estamp('12 -MAR-18 05 .17.35.251 000000 PM' ,'DD-MON-R R HH.MI.SS XFF AM'),' 1',null,nu ll,576); | |
| 3635 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 83,'2100B' ,null,'Dra gon3.txt', 0,'AZ','JP G.jpg','JP G',null,'1 510139797' ,'A','275' ,'0010','0 05010X210E 1','21','0 010','02', 'SCN201712 27165655-0 2','201406 04',to_tim estamp('12 -MAR-18 05 .17.47.349 000000 PM' ,'DD-MON-R R HH.MI.SS XFF AM'),' 1',null,nu ll,577); | |
| 3636 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 84,'2100B' ,null,'Dra gon3.txt', 0,'AZ','GI F.gif','GI F',null,'1 510139797' ,'A','275' ,'0011','0 05010X210E 1','21','0 011','02', 'SCN201712 27165655-0 3','201406 04',to_tim estamp('12 -MAR-18 05 .18.12.079 000000 PM' ,'DD-MON-R R HH.MI.SS XFF AM'),' 1',null,nu ll,578); | |
| 3637 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 85,'2100B' ,null,'Dra gon3.txt', 0,'AZ','XM L.XML','XM L',null,'1 510139797' ,'A','275' ,'0012','0 05010X210' ,'21','001 2','02','S CN20171227 165655-04' ,'20160807 ',to_times tamp('12-M AR-18 05.1 8.22.49200 0000 PM',' DD-MON-RR HH.MI.SSXF F AM'),'1' ,null,null ,579); | |
| 3638 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 86,'2100B' ,null,'Dra gon3.txt', 0,'AZ','SS I TESTING. pdf','PDF' ,null,'151 0139797',' A','275',' 0013','005 010X210',' 21','0013' ,'02','SCN 2017122716 5655-05',' 20160405', to_timesta mp('12-MAR -18 05.18. 33.1970000 00 PM','DD -MON-RR HH .MI.SSXFF AM'),'1',n ull,null,5 80); | |
| 3639 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 87,'2100B' ,null,'Dra gon3.txt', 0,'AZ','20 1504151717 4797.pdf', 'PDF',null ,'15101397 97','A','2 75','0014' ,'005010X2 10','22',' 0014','02' ,'SCN20171 227165655- 06','20150 415',to_ti mestamp('1 2-MAR-18 0 5.18.40.03 0000000 PM ','DD-MON- RR HH.MI.S SXFF AM'), '1',null,n ull,581); | |
| 3640 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 88,'2100B' ,null,'Dra gon3.txt', 0,'AZ','70 133056900. pdf','PDF' ,null,'151 0139797',' A','275',' 0001','005 010X210',' 21','0001' ,'02','SCN 2017122716 5655-07',' 20131228', to_timesta mp('12-MAR -18 05.18. 49.2310000 00 PM','DD -MON-RR HH .MI.SSXFF AM'),'1',n ull,null,5 82); | |
| 3641 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 89,'2100B' ,null,'Dra gon3.txt', 0,'AZ','20 1504151717 4797.pdf', 'PDF',null ,'15101397 97','A','2 75','0002' ,'005010X2 10','22',' 0002','02' ,'SCN20171 227165655- 08','20150 415',to_ti mestamp('1 2-MAR-18 0 5.19.04.03 7000000 PM ','DD-MON- RR HH.MI.S SXFF AM'), '1',null,n ull,583); | |
| 3642 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 90,'2100B' ,null,'Dra gon3.txt', 0,'AZ','20 1512221412 0125.pdf', 'PDF',null ,'15101397 97','A','2 75','0003' ,'005010X2 10','22',' 0003','02' ,'SCN20171 227165655- 09','20151 222',to_ti mestamp('1 2-MAR-18 0 5.19.10.36 2000000 PM ','DD-MON- RR HH.MI.S SXFF AM'), '1',null,n ull,584); | |
| 3643 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 91,'2100B' ,null,'Dra gon3.txt', 0,'AZ','20 1511111624 5338.pdf', 'PDF',null ,'15101397 97','A','2 75','0004' ,'005010X2 10','23',' 0004','02' ,'SCN20171 227165655- 10','20151 111',to_ti mestamp('1 2-MAR-18 0 5.19.15.65 0000000 PM ','DD-MON- RR HH.MI.S SXFF AM'), '1',null,n ull,585); | |
| 3644 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 92,'2100B' ,null,'Dra gon3.txt', 0,'AZ','20 1510131605 3426.pdf', 'PDF',null ,'15101397 97','A','2 75','0005' ,'005010X2 10','21',' 0005','02' ,'SCN20171 227165655- 11','20151 013',to_ti mestamp('1 2-MAR-18 0 5.19.29.65 6000000 PM ','DD-MON- RR HH.MI.S SXFF AM'), '1',null,n ull,586); | |
| 3645 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 93,'2100B' ,null,'Dra gon3.txt', 0,'AZ','SS I TESTING. pdf','PDF' ,null,'151 0139797',' A','275',' 0006','005 010X210',' 20','0006' ,'02','SCN 2017122716 5655-12',' 20160405', to_timesta mp('12-MAR -18 05.19. 35.9150000 00 PM','DD -MON-RR HH .MI.SSXFF AM'),'1',n ull,null,5 87); | |
| 3646 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 94,'2100B' ,null,'Dra gon3.txt', 0,'AZ','28 0580.pdf', 'PDF',null ,'15101397 97','A','2 75','0007' ,'005010X2 10','25',' 0007','02' ,'SCN20171 227165655- 13','20160 715',to_ti mestamp('1 2-MAR-18 0 5.19.49.62 6000000 PM ','DD-MON- RR HH.MI.S SXFF AM'), '2',null,n ull,588); | |
| 3647 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 95,'2100B' ,null,'Dra gon3.txt', 0,'AZ','28 0582.pdf', 'PDF',null ,'15101397 97','A','2 75','0007' ,'005010X2 10','25',' 0007','02' ,'SCN20171 227165655- 13','20160 715',to_ti mestamp('1 2-MAR-18 0 5.19.53.82 7000000 PM ','DD-MON- RR HH.MI.S SXFF AM'), '2',null,n ull,589); | |
| 3648 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 96,'2100B' ,null,'Dra gon3.txt', 0,'AZ','20 1510302108 3278.pdf', 'PDF',null ,'15101397 97','A','2 75','0008' ,'005010X2 10','21',' 0008','02' ,'SCN20171 227165655- 14','20151 031',to_ti mestamp('1 2-MAR-18 0 5.20.02.84 4000000 PM ','DD-MON- RR HH.MI.S SXFF AM'), '1',null,n ull,590); | |
| 3649 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 97,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt',0, 'AZ','TIF. tif','TIF' ,null,'151 0139797',' A','275',' 0009','005 010X210E1' ,'21','000 9','02','S CN20171227 165655-01' ,'20140604 ',to_times tamp('12-M AR-18 06.3 6.26.87200 0000 PM',' DD-MON-RR HH.MI.SSXF F AM'),'1' ,null,null ,591); | |
| 3650 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 98,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt',0, 'AZ','JPG. jpg','JPG' ,null,'151 0139797',' A','275',' 0010','005 010X210E1' ,'21','001 0','02','S CN20171227 165655-02' ,'20140604 ',to_times tamp('12-M AR-18 06.3 6.32.50400 0000 PM',' DD-MON-RR HH.MI.SSXF F AM'),'1' ,null,null ,592); | |
| 3651 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (5 99,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt',0, 'AZ','GIF. gif','GIF' ,null,'151 0139797',' A','275',' 0011','005 010X210E1' ,'21','001 1','02','S CN20171227 165655-03' ,'20140604 ',to_times tamp('12-M AR-18 06.3 6.47.85500 0000 PM',' DD-MON-RR HH.MI.SSXF F AM'),'1' ,null,null ,593); | |
| 3652 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (6 00,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt',0, 'AZ','XML. XML','XML' ,null,'151 0139797',' A','275',' 0012','005 010X210',' 21','0012' ,'02','SCN 2017122716 5655-04',' 20160807', to_timesta mp('12-MAR -18 06.36. 53.5020000 00 PM','DD -MON-RR HH .MI.SSXFF AM'),'1',n ull,null,5 94); | |
| 3653 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (6 01,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt',0, 'AZ','SSI TESTING.pd f','PDF',n ull,'15101 39797','A' ,'275','00 13','00501 0X210','21 ','0013',' 02','SCN20 1712271656 55-05','20 160405',to _timestamp ('12-MAR-1 8 06.37.01 .973000000 PM','DD-M ON-RR HH.M I.SSXFF AM '),'1',nul l,null,595 ); | |
| 3654 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (6 02,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt',0, 'AZ','2015 0415171747 97.pdf','P DF',null,' 1510139797 ','A','275 ','0014',' 005010X210 ','22','00 14','02',' SCN2017122 7165655-06 ','2015041 5',to_time stamp('12- MAR-18 06. 37.07.5730 00000 PM', 'DD-MON-RR HH.MI.SSX FF AM'),'1 ',null,nul l,596); | |
| 3655 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (6 03,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt',0, 'AZ','7013 3056900.pd f','PDF',n ull,'15101 39797','A' ,'275','00 01','00501 0X210','21 ','0001',' 02','SCN20 1712271656 55-07','20 131228',to _timestamp ('12-MAR-1 8 06.37.18 .681000000 PM','DD-M ON-RR HH.M I.SSXFF AM '),'1',nul l,null,597 ); | |
| 3656 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (6 04,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt',0, 'AZ','2015 0415171747 97.pdf','P DF',null,' 1510139797 ','A','275 ','0002',' 005010X210 ','22','00 02','02',' SCN2017122 7165655-08 ','2015041 5',to_time stamp('12- MAR-18 06. 37.27.1360 00000 PM', 'DD-MON-RR HH.MI.SSX FF AM'),'1 ',null,nul l,598); | |
| 3657 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (6 05,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt',0, 'AZ','2015 1222141201 25.pdf','P DF',null,' 1510139797 ','A','275 ','0003',' 005010X210 ','22','00 03','02',' SCN2017122 7165655-09 ','2015122 2',to_time stamp('12- MAR-18 06. 37.32.8610 00000 PM', 'DD-MON-RR HH.MI.SSX FF AM'),'1 ',null,nul l,599); | |
| 3658 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (6 06,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt',0, 'AZ','2015 1111162453 38.pdf','P DF',null,' 1510139797 ','A','275 ','0004',' 005010X210 ','23','00 04','02',' SCN2017122 7165655-10 ','2015111 1',to_time stamp('12- MAR-18 06. 37.37.8690 00000 PM', 'DD-MON-RR HH.MI.SSX FF AM'),'1 ',null,nul l,600); | |
| 3659 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (6 07,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt',0, 'AZ','2015 1013160534 26.pdf','P DF',null,' 1510139797 ','A','275 ','0005',' 005010X210 ','21','00 05','02',' SCN2017122 7165655-11 ','2015101 3',to_time stamp('12- MAR-18 06. 37.54.4210 00000 PM', 'DD-MON-RR HH.MI.SSX FF AM'),'1 ',null,nul l,601); | |
| 3660 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (6 08,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt',0, 'AZ','SSI TESTING.pd f','PDF',n ull,'15101 39797','A' ,'275','00 06','00501 0X210','20 ','0006',' 02','SCN20 1712271656 55-12','20 160405',to _timestamp ('12-MAR-1 8 06.38.03 .640000000 PM','DD-M ON-RR HH.M I.SSXFF AM '),'1',nul l,null,602 ); | |
| 3661 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (6 09,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt',0, 'AZ','2805 80.pdf','P DF',null,' 1510139797 ','A','275 ','0007',' 005010X210 ','25','00 07','02',' SCN2017122 7165655-13 ','2016071 5',to_time stamp('12- MAR-18 06. 38.15.2780 00000 PM', 'DD-MON-RR HH.MI.SSX FF AM'),'2 ',null,nul l,603); | |
| 3662 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (6 10,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt',0, 'AZ','2805 82.pdf','P DF',null,' 1510139797 ','A','275 ','0007',' 005010X210 ','25','00 07','02',' SCN2017122 7165655-13 ','2016071 5',to_time stamp('12- MAR-18 06. 38.20.1450 00000 PM', 'DD-MON-RR HH.MI.SSX FF AM'),'2 ',null,nul l,604); | |
| 3663 | Insert int o ARS277_R EQUEST_TRA CKING.TRAN SACTIONS ( ATTACHMENT _ID,LOOP_I D,CLAIM_KE Y,BATCH_ID ,ATTACHMEN T_MOVED,RE PORT_CODE, ATTACHMENT _NAME,ATTA CHMENT_TYP E,EXTERNAL _CLAIM_ID, PAYER_CLAI M_CONTROL_ NUMBER,STA TUS,ST01,S T02,ST03,S E01,SE02,B GN01,BGN02 ,BGN03,TRA NS_TIMESTM P,LX01,PAT IENT_DOB,V A_FACILITY _CD,TRANSA CTIONS_ID) values (6 11,'2100B' ,null,'275 sCorrespon dingTo837P and837_TES T5.txt',0, 'AZ','2015 1030210832 78.pdf','P DF',null,' 1510139797 ','A','275 ','0008',' 005010X210 ','21','00 08','02',' SCN2017122 7165655-14 ','2015103 1',to_time stamp('12- MAR-18 06. 38.29.6610 00000 PM', 'DD-MON-RR HH.MI.SSX FF AM'),'1 ',null,nul l,605); | |
| 3664 | REM INSERT ING into A RS277_REQU EST_TRACKI NG.ZIPCODE | |
| 3665 | SET DEFINE OFF; | |
| 3666 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3667 | -- DDL fo r Index HC CS_CDV2_PK | |
| 3668 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3669 | ||
| 3670 | CREATE U NIQUE INDE X "ARS277_ REQUEST_TR ACKING"."H CCS_CDV2_P K" ON "ARS 277_REQUES T_TRACKING "."LOINC_M OD_CD" ("L OINC_MOD_I D") | |
| 3671 | PCTFREE 10 INITRAN S 2 MAXTRA NS 255 COM PUTE STATI STICS | |
| 3672 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 3673 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 3674 | TABLESPA CE "SYSTEM " ; | |
| 3675 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3676 | -- DDL fo r Index AR S_USER_ROL E_USAGES_U K01 | |
| 3677 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3678 | ||
| 3679 | CREATE U NIQUE INDE X "ARS277_ REQUEST_TR ACKING"."A RS_USER_RO LE_USAGES_ UK01" ON " ARS277_REQ UEST_TRACK ING"."ARS_ USER_ROLE_ USAGES" (" ARS_ROLE_I D", "ARS_U SER_ID") | |
| 3680 | PCTFREE 0 INITRANS 2 MAXTRAN S 255 COMP UTE STATIS TICS NOLOG GING | |
| 3681 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 3682 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 3683 | TABLESPA CE "SYSTEM " | |
| 3684 | PARALLEL 2 ; | |
| 3685 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3686 | -- DDL fo r Index AR S_ROLE_PK | |
| 3687 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3688 | ||
| 3689 | CREATE U NIQUE INDE X "ARS277_ REQUEST_TR ACKING"."A RS_ROLE_PK " ON "ARS2 77_REQUEST _TRACKING" ."ARS_ROLE " ("ARS_RO LE_ID") | |
| 3690 | PCTFREE 10 INITRAN S 2 MAXTRA NS 255 COM PUTE STATI STICS | |
| 3691 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 3692 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 3693 | TABLESPA CE "SYSTEM " ; | |
| 3694 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3695 | -- DDL fo r Index CL AIM_CONTAC T_PK | |
| 3696 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3697 | ||
| 3698 | CREATE U NIQUE INDE X "ARS277_ REQUEST_TR ACKING"."C LAIM_CONTA CT_PK" ON "ARS277_RE QUEST_TRAC KING"."CLA IM_CONTACT " ("CONTAC TUSERID") | |
| 3699 | PCTFREE 10 INITRAN S 2 MAXTRA NS 255 COM PUTE STATI STICS | |
| 3700 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 3701 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 3702 | TABLESPA CE "SYSTEM " ; | |
| 3703 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3704 | -- DDL fo r Index AR S_USER_UK1 | |
| 3705 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3706 | ||
| 3707 | CREATE U NIQUE INDE X "ARS277_ REQUEST_TR ACKING"."A RS_USER_UK 1" ON "ARS 277_REQUES T_TRACKING "."ARS_USE R" ("USER_ NAME") | |
| 3708 | PCTFREE 0 INITRANS 2 MAXTRAN S 255 COMP UTE STATIS TICS NOLOG GING | |
| 3709 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 3710 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 3711 | TABLESPA CE "SYSTEM " | |
| 3712 | PARALLEL 2 ; | |
| 3713 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3714 | -- DDL fo r Index PK _ARSAUDITL OG | |
| 3715 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3716 | ||
| 3717 | CREATE U NIQUE INDE X "ARS277_ REQUEST_TR ACKING"."P K_ARSAUDIT LOG" ON "A RS277_REQU EST_TRACKI NG"."ARSAU DITLOG" (" ID") | |
| 3718 | PCTFREE 10 INITRAN S 2 MAXTRA NS 255 COM PUTE STATI STICS | |
| 3719 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 3720 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 3721 | TABLESPA CE "SYSTEM " ; | |
| 3722 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3723 | -- DDL fo r Index TR ACE_NUMBER _PK | |
| 3724 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3725 | ||
| 3726 | CREATE U NIQUE INDE X "ARS277_ REQUEST_TR ACKING"."T RACE_NUMBE R_PK" ON " ARS277_REQ UEST_TRACK ING"."TRAC E_NUMBER" ("TRACENUM BERID") | |
| 3727 | PCTFREE 10 INITRAN S 2 MAXTRA NS 255 COM PUTE STATI STICS | |
| 3728 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 3729 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 3730 | TABLESPA CE "SYSTEM " ; | |
| 3731 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3732 | -- DDL fo r Index PK _CLAIMATTA CHMENTS | |
| 3733 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3734 | ||
| 3735 | CREATE U NIQUE INDE X "ARS277_ REQUEST_TR ACKING"."P K_CLAIMATT ACHMENTS" ON "ARS277 _REQUEST_T RACKING"." CLAIMATTAC HMENTS" (" ID") | |
| 3736 | PCTFREE 10 INITRAN S 2 MAXTRA NS 255 COM PUTE STATI STICS | |
| 3737 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 3738 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 3739 | TABLESPA CE "SYSTEM " ; | |
| 3740 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3741 | -- DDL fo r Index BI N275_PK | |
| 3742 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3743 | ||
| 3744 | CREATE U NIQUE INDE X "ARS277_ REQUEST_TR ACKING"."B IN275_PK" ON "ARS277 _REQUEST_T RACKING"." BINARY275" ("BINARY2 75ID") | |
| 3745 | PCTFREE 10 INITRAN S 2 MAXTRA NS 255 COM PUTE STATI STICS | |
| 3746 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 3747 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 3748 | TABLESPA CE "SYSTEM " ; | |
| 3749 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3750 | -- DDL fo r Index EM AIL_TEMPLA TE_PK | |
| 3751 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3752 | ||
| 3753 | CREATE U NIQUE INDE X "ARS277_ REQUEST_TR ACKING"."E MAIL_TEMPL ATE_PK" ON "ARS277_R EQUEST_TRA CKING"."EM AIL_TEMPLA TES" ("EMA IL_TEMPLAT E_ID") | |
| 3754 | PCTFREE 10 INITRAN S 2 MAXTRA NS 255 COM PUTE STATI STICS | |
| 3755 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 3756 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 3757 | TABLESPA CE "SYSTEM " ; | |
| 3758 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3759 | -- DDL fo r Index AR S_USER_PK | |
| 3760 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3761 | ||
| 3762 | CREATE U NIQUE INDE X "ARS277_ REQUEST_TR ACKING"."A RS_USER_PK " ON "ARS2 77_REQUEST _TRACKING" ."ARS_USER " ("ARS_US ER_ID") | |
| 3763 | PCTFREE 0 INITRANS 2 MAXTRAN S 255 COMP UTE STATIS TICS NOLOG GING | |
| 3764 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 3765 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 3766 | TABLESPA CE "SYSTEM " | |
| 3767 | PARALLEL 2 ; | |
| 3768 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3769 | -- DDL fo r Index HC CS_CD_PK | |
| 3770 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3771 | ||
| 3772 | CREATE U NIQUE INDE X "ARS277_ REQUEST_TR ACKING"."H CCS_CD_PK" ON "ARS27 7_REQUEST_ TRACKING". "HCCS_CD" ("HCCS_ID" ) | |
| 3773 | PCTFREE 10 INITRAN S 2 MAXTRA NS 255 COM PUTE STATI STICS | |
| 3774 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 3775 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 3776 | TABLESPA CE "SYSTEM " ; | |
| 3777 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3778 | -- DDL fo r Index CL AIM_SUBMIS SION_PK | |
| 3779 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3780 | ||
| 3781 | CREATE U NIQUE INDE X "ARS277_ REQUEST_TR ACKING"."C LAIM_SUBMI SSION_PK" ON "ARS277 _REQUEST_T RACKING"." CLAIM_SUBM ISSION" (" SUBMISSION ID") | |
| 3782 | PCTFREE 10 INITRAN S 2 MAXTRA NS 255 COM PUTE STATI STICS | |
| 3783 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 3784 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 3785 | TABLESPA CE "SYSTEM " ; | |
| 3786 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3787 | -- DDL fo r Index CL AIM_SVC_LI NES_PK | |
| 3788 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3789 | ||
| 3790 | CREATE U NIQUE INDE X "ARS277_ REQUEST_TR ACKING"."C LAIM_SVC_L INES_PK" O N "ARS277_ REQUEST_TR ACKING"."C LAIM_SVC_L INES" ("SU BMISSIONSV CLINEID") | |
| 3791 | PCTFREE 10 INITRAN S 2 MAXTRA NS 255 COM PUTE STATI STICS | |
| 3792 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 3793 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 3794 | TABLESPA CE "SYSTEM " ; | |
| 3795 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3796 | -- DDL fo r Index PK _ARSREPORT TYPE | |
| 3797 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3798 | ||
| 3799 | CREATE U NIQUE INDE X "ARS277_ REQUEST_TR ACKING"."P K_ARSREPOR TTYPE" ON "ARS277_RE QUEST_TRAC KING"."ARS REPORTTYPE " ("CODE") | |
| 3800 | PCTFREE 10 INITRAN S 2 MAXTRA NS 255 COM PUTE STATI STICS | |
| 3801 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 3802 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 3803 | TABLESPA CE "SYSTEM " ; | |
| 3804 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3805 | -- DDL fo r Index HC CS_CDV1_PK | |
| 3806 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3807 | ||
| 3808 | CREATE U NIQUE INDE X "ARS277_ REQUEST_TR ACKING"."H CCS_CDV1_P K" ON "ARS 277_REQUES T_TRACKING "."LOINC_C D" ("LOINC _ID") | |
| 3809 | PCTFREE 10 INITRAN S 2 MAXTRA NS 255 COM PUTE STATI STICS | |
| 3810 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 3811 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 3812 | TABLESPA CE "SYSTEM " ; | |
| 3813 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3814 | -- DDL fo r Index CL AIM_SUBMIS SION_NOTE_ PK | |
| 3815 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3816 | ||
| 3817 | CREATE U NIQUE INDE X "ARS277_ REQUEST_TR ACKING"."C LAIM_SUBMI SSION_NOTE _PK" ON "A RS277_REQU EST_TRACKI NG"."CLAIM _SUBMISSIO N_NOTE" (" CLAIM_SUBM ISSION_NOT E_ID") | |
| 3818 | PCTFREE 10 INITRAN S 2 MAXTRA NS 255 COM PUTE STATI STICS | |
| 3819 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 3820 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 3821 | TABLESPA CE "SYSTEM " ; | |
| 3822 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3823 | -- DDL fo r Index AR S_SSO_PK_1 | |
| 3824 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3825 | ||
| 3826 | CREATE U NIQUE INDE X "ARS277_ REQUEST_TR ACKING"."A RS_SSO_PK_ 1" ON "ARS 277_REQUES T_TRACKING "."SSO_AUT HENTICATIO N" ("GUID" ) | |
| 3827 | PCTFREE 0 INITRANS 2 MAXTRAN S 255 COMP UTE STATIS TICS NOLOG GING | |
| 3828 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 3829 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 3830 | TABLESPA CE "SYSTEM " | |
| 3831 | PARALLEL 2 ; | |
| 3832 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3833 | -- DDL fo r Trigger ARS_ROLE_I D_TRG | |
| 3834 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3835 | ||
| 3836 | CREATE O R REPLACE TRIGGER "A RS277_REQU EST_TRACKI NG"."ARS_R OLE_ID_TRG " BEFORE | |
| 3837 | INSERT ON ars_ro le | |
| 3838 | FOR EA CH ROW | |
| 3839 | WHEN ( | |
| 3840 | new.ars_ro le_id IS N ULL | |
| 3841 | ) BE GIN | |
| 3842 | :new.a rs_role_id := ars_ro le_seq.nex tval; | |
| 3843 | END; | |
| 3844 | / | |
| 3845 | ALTER TRIG GER "ARS27 7_REQUEST_ TRACKING". "ARS_ROLE_ ID_TRG" EN ABLE; | |
| 3846 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3847 | -- DDL fo r Trigger ARS_ROLE_P ERMISSIONS _TRG | |
| 3848 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3849 | ||
| 3850 | CREATE O R REPLACE TRIGGER "A RS277_REQU EST_TRACKI NG"."ARS_R OLE_PERMIS SIONS_TRG" BEFORE | |
| 3851 | INSERT ON ARS_RO LE_PERMISS IONS | |
| 3852 | FOR EA CH ROW | |
| 3853 | WHEN ( | |
| 3854 | new.PERMIS SION_ID IS NULL | |
| 3855 | ) BE GIN | |
| 3856 | :new.P ERMISSION_ ID := ARS_ ROLE_PERMI SSIONS_SEQ .NEXTVAL; | |
| 3857 | END; | |
| 3858 | / | |
| 3859 | ALTER TRIG GER "ARS27 7_REQUEST_ TRACKING". "ARS_ROLE_ PERMISSION S_TRG" ENA BLE; | |
| 3860 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3861 | -- DDL fo r Trigger ARS_USER_I D_TRG | |
| 3862 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3863 | ||
| 3864 | CREATE O R REPLACE TRIGGER "A RS277_REQU EST_TRACKI NG"."ARS_U SER_ID_TRG " BEFORE | |
| 3865 | INSERT ON ars_us er | |
| 3866 | FOR EA CH ROW | |
| 3867 | WHEN ( | |
| 3868 | new.ars_us er_id IS N ULL | |
| 3869 | ) BE GIN | |
| 3870 | :new.a rs_user_id := ars_us er_seq.nex tval; | |
| 3871 | END; | |
| 3872 | / | |
| 3873 | ALTER TRIG GER "ARS27 7_REQUEST_ TRACKING". "ARS_USER_ ID_TRG" EN ABLE; | |
| 3874 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3875 | -- DDL fo r Trigger BINARY275_ TRG | |
| 3876 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3877 | ||
| 3878 | CREATE O R REPLACE TRIGGER "A RS277_REQU EST_TRACKI NG"."BINAR Y275_TRG" BEFORE | |
| 3879 | INSERT ON BINARY 275 | |
| 3880 | FOR EA CH ROW | |
| 3881 | BEGIN | |
| 3882 | :new.B INARY275ID := BINARY _275_SEQ.n extval; | |
| 3883 | END; | |
| 3884 | / | |
| 3885 | ALTER TRIG GER "ARS27 7_REQUEST_ TRACKING". "BINARY275 _TRG" ENAB LE; | |
| 3886 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3887 | -- DDL fo r Trigger CLAIM_DATE _TRG | |
| 3888 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3889 | ||
| 3890 | CREATE O R REPLACE TRIGGER "A RS277_REQU EST_TRACKI NG"."CLAIM _DATE_TRG" BEFORE | |
| 3891 | INSERT ON CLAIM_ DATE | |
| 3892 | FOR EA CH ROW | |
| 3893 | BEGIN | |
| 3894 | :new.C LAIM_DATE_ ID := CLAI M_DATE_SEQ .nextval; | |
| 3895 | END; | |
| 3896 | / | |
| 3897 | ALTER TRIG GER "ARS27 7_REQUEST_ TRACKING". "CLAIM_DAT E_TRG" ENA BLE; | |
| 3898 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3899 | -- DDL fo r Trigger CLAIM_STAT US_CHANGE_ TRIG | |
| 3900 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3901 | ||
| 3902 | CREATE O R REPLACE TRIGGER "A RS277_REQU EST_TRACKI NG"."CLAIM _STATUS_CH ANGE_TRIG" | |
| 3903 | AFTER UPDA TE | |
| 3904 | ON CLAIM_S UBMISSION | |
| 3905 | REFERENCIN G NEW AS N EW OLD AS OLD | |
| 3906 | FOR EACH R OW | |
| 3907 | DECLARE | |
| 3908 | PRAGMA AUTONOMOU S_TRANSACT ION; | |
| 3909 | ||
| 3910 | l_mailhost VARCHAR2(6 4) := ' DNS '; | |
| 3911 | l_from VARCHAR2(6 4) :=
|
|
| 3912 | l_to VAR CHAR2(64); | |
| 3913 | l_cc VARCHAR2(6 4) :=
|
|
| 3914 | l_subje ct VAR CHAR2(64) := 'A lert: Clai m Submissi on Status Change'; | |
| 3915 | l_mail_ conn UTL _SMTP.conn ection; | |
| 3916 | ||
| 3917 | BEGIN | |
| 3918 | ||
| 3919 | BEGIN | |
| 3920 | SELECT CC. CONTACTEMA IL | |
| 3921 | INTO l_t o | |
| 3922 | FROM CLA IM_CONTACT CC, CLAIM _SUBMISSIO N CS | |
| 3923 | WHERE CS. SUBMISSION ID = :new. submission id | |
| 3924 | AND CS. CONTACTUSE RID = CC.C ONTACTUSER ID; | |
| 3925 | ||
| 3926 | EXCEPTION | |
| 3927 | ||
| 3928 | WHEN NO_DA TA_FOUND T HEN | |
| 3929 | --l_to := PII '; | |
| 3930 | RAISE_AP PLICATION_ ERROR(-200 00, 'NO EM AIL ADDRES S FOUND IN DATABASE' ); | |
| 3931 | ||
| 3932 | WHEN OTHER S THEN | |
| 3933 | --l_to := PII '; | |
| 3934 | RAISE_AP PLICATION_ ERROR(-200 01, 'ORACL E EXCEPTIO N THROWN : ' || SUBST R(SQLERRM, 1, 200)); | |
| 3935 | ||
| 3936 | END; | |
| 3937 | ||
| 3938 | IF :old.su bmission_s tatus != : new.submis sion_statu s | |
| 3939 | THEN | |
| 3940 | l_mail_c onn := UTL _SMTP.open _connectio n(l_mailho st, 25); | |
| 3941 | UTL_SMTP .helo(l_ma il_conn, l _mailhost) ; | |
| 3942 | UTL_SMTP .mail(l_ma il_conn, l _from); | |
| 3943 | UTL_SMTP .rcpt(l_ma il_conn, l _to); | |
| 3944 | UTL_SMTP .rcpt(l_ma il_conn, l _cc); | |
| 3945 | ||
| 3946 | UTL_SMTP .open_data (l_mail_co nn); | |
| 3947 | ||
| 3948 | UTL_SMTP .write_dat a(l_mail_c onn, 'From : ' || l_f rom || Chr (13)); | |
| 3949 | UTL_SMTP .write_dat a(l_mail_c onn, 'Subj ect: ' || l_subject || Chr(13) ); | |
| 3950 | UTL_SMTP .write_dat a(l_mail_c onn, 'To: ' || l_to || Chr(13) ); | |
| 3951 | UTL_SMTP .write_dat a(l_mail_c onn, '' || Chr(13)); | |
| 3952 | ||
| 3953 | UTL_SMTP .write_dat a(l_mail_c onn, 'Clai m Submissi on Status has change d for subm ssion id ' || :new.s ubmissioni d || Chr(1 3)); | |
| 3954 | UTL_SMTP .write_dat a(l_mail_c onn, '' || Chr(13)); | |
| 3955 | UTL_SMTP .write_dat a(l_mail_c onn, 'Aler t: Claim S ubmission Status has changed f rom ' || : old.submis sion_statu s || ' to ' || :new. submission _status || Chr(13)); | |
| 3956 | UTL_SMTP .write_dat a(l_mail_c onn, '' || Chr(13)); | |
| 3957 | UTL_SMTP .write_dat a(l_mail_c onn, '' || Chr(13)); | |
| 3958 | ||
| 3959 | UTL_SMTP .close_dat a(l_mail_c onn); | |
| 3960 | UTL_SMTP .quit(l_ma il_conn); | |
| 3961 | ||
| 3962 | END IF; | |
| 3963 | ||
| 3964 | END; | |
| 3965 | / | |
| 3966 | ALTER TRIG GER "ARS27 7_REQUEST_ TRACKING". "CLAIM_STA TUS_CHANGE _TRIG" ENA BLE; | |
| 3967 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3968 | -- DDL fo r Trigger CLAIM_SUBM ISSION_NOT E_TRG | |
| 3969 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3970 | ||
| 3971 | CREATE O R REPLACE TRIGGER "A RS277_REQU EST_TRACKI NG"."CLAIM _SUBMISSIO N_NOTE_TRG " | |
| 3972 | BEFORE INS ERT ON CLA IM_SUBMISS ION_NOTE | |
| 3973 | FOR EACH R OW | |
| 3974 | BEGIN | |
| 3975 | <<COLUMN _SEQUENCES >> | |
| 3976 | BEGIN | |
| 3977 | IF INS ERTING AND :NEW.CLAI M_SUBMISSI ON_NOTE_ID IS NULL T HEN | |
| 3978 | SELE CT CLAIM_S UBMISSION_ NOTE_SEQ.N EXTVAL INT O :NEW.CLA IM_SUBMISS ION_NOTE_I D FROM SYS .DUAL; | |
| 3979 | END IF ; | |
| 3980 | END COLU MN_SEQUENC ES; | |
| 3981 | END; | |
| 3982 | / | |
| 3983 | ALTER TRIG GER "ARS27 7_REQUEST_ TRACKING". "CLAIM_SUB MISSION_NO TE_TRG" EN ABLE; | |
| 3984 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3985 | -- DDL fo r Trigger CLAIM_SUBM ISSION_SUB MISSIONID | |
| 3986 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3987 | ||
| 3988 | CREATE O R REPLACE TRIGGER "A RS277_REQU EST_TRACKI NG"."CLAIM _SUBMISSIO N_SUBMISSI ONID" BEFO RE | |
| 3989 | INSERT ON claim_ submission | |
| 3990 | FOR EA CH ROW | |
| 3991 | WHEN ( new.subm issionid I S NULL ) B EGIN | |
| 3992 | :new.s ubmissioni d := claim _submissio n_submissi onid.nextv al; | |
| 3993 | END; | |
| 3994 | ||
| 3995 | / | |
| 3996 | ALTER TRIG GER "ARS27 7_REQUEST_ TRACKING". "CLAIM_SUB MISSION_SU BMISSIONID " ENABLE; | |
| 3997 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 3998 | -- DDL fo r Trigger CLAIM_SUBM ISSION_TRG | |
| 3999 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4000 | ||
| 4001 | CREATE O R REPLACE TRIGGER "A RS277_REQU EST_TRACKI NG"."CLAIM _SUBMISSIO N_TRG" | |
| 4002 | BEFORE INS ERT ON CLA IM_SUBMISS ION | |
| 4003 | FOR EACH R OW | |
| 4004 | BEGIN | |
| 4005 | <<COLUMN _SEQUENCES >> | |
| 4006 | BEGIN | |
| 4007 | IF INS ERTING AND :NEW.SUBM ISSIONID I S NULL THE N | |
| 4008 | SELE CT CLAIM_S UBMISSION_ SEQ.NEXTVA L INTO :NE W.SUBMISSI ONID FROM SYS.DUAL; | |
| 4009 | END IF ; | |
| 4010 | END COLU MN_SEQUENC ES; | |
| 4011 | END; | |
| 4012 | / | |
| 4013 | ALTER TRIG GER "ARS27 7_REQUEST_ TRACKING". "CLAIM_SUB MISSION_TR G" ENABLE; | |
| 4014 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4015 | -- DDL fo r Trigger CLAIM_SVC_ LINES_SUBM ISSIONSVCL | |
| 4016 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4017 | ||
| 4018 | CREATE O R REPLACE TRIGGER "A RS277_REQU EST_TRACKI NG"."CLAIM _SVC_LINES _SUBMISSIO NSVCL" BEF ORE | |
| 4019 | INSERT ON claim_ svc_lines | |
| 4020 | FOR EA CH ROW | |
| 4021 | WHEN ( new.subm issionsvcl ineid IS N ULL ) BEGI N | |
| 4022 | :new.s ubmissions vclineid : = claim_sv c_lines_su bmissionsv cl.nextval ; | |
| 4023 | END; | |
| 4024 | ||
| 4025 | / | |
| 4026 | ALTER TRIG GER "ARS27 7_REQUEST_ TRACKING". "CLAIM_SVC _LINES_SUB MISSIONSVC L" ENABLE; | |
| 4027 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4028 | -- DDL fo r Trigger CONTACT_TR G | |
| 4029 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4030 | ||
| 4031 | CREATE O R REPLACE TRIGGER "A RS277_REQU EST_TRACKI NG"."CONTA CT_TRG" BE FORE | |
| 4032 | INSERT ON CONTAC T | |
| 4033 | FOR EA CH ROW | |
| 4034 | BEGIN | |
| 4035 | :new.C ONTACT_ID := CONTACT _SEQ.nextv al; | |
| 4036 | END; | |
| 4037 | / | |
| 4038 | ALTER TRIG GER "ARS27 7_REQUEST_ TRACKING". "CONTACT_T RG" ENABLE ; | |
| 4039 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4040 | -- DDL fo r Trigger DOCUMENT_C ATEGORY_TR G | |
| 4041 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4042 | ||
| 4043 | CREATE O R REPLACE TRIGGER "A RS277_REQU EST_TRACKI NG"."DOCUM ENT_CATEGO RY_TRG" BE FORE | |
| 4044 | INSERT ON DOCUME NT_CATEGOR Y | |
| 4045 | FOR EA CH ROW | |
| 4046 | BEGIN | |
| 4047 | :new.D OCUMENT_CA TEGORYID : = DOCUMENT _CATEGORY_ SEQ.NEXTVA L; | |
| 4048 | END; | |
| 4049 | / | |
| 4050 | ALTER TRIG GER "ARS27 7_REQUEST_ TRACKING". "DOCUMENT_ CATEGORY_T RG" ENABLE ; | |
| 4051 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4052 | -- DDL fo r Trigger ENTITYADDR ESS_TRG | |
| 4053 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4054 | ||
| 4055 | CREATE O R REPLACE TRIGGER "A RS277_REQU EST_TRACKI NG"."ENTIT YADDRESS_T RG" BEFORE | |
| 4056 | INSERT ON ENTITY ADDRESS | |
| 4057 | FOR EA CH ROW | |
| 4058 | BEGIN | |
| 4059 | :new.E NTITYADDRE SSID := EN TITY_ADDRE SS_SEQ.NEX TVAL; | |
| 4060 | END; | |
| 4061 | / | |
| 4062 | ALTER TRIG GER "ARS27 7_REQUEST_ TRACKING". "ENTITYADD RESS_TRG" ENABLE; | |
| 4063 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4064 | -- DDL fo r Trigger ENTITYNAME _TRG | |
| 4065 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4066 | ||
| 4067 | CREATE O R REPLACE TRIGGER "A RS277_REQU EST_TRACKI NG"."ENTIT YNAME_TRG" BEFORE | |
| 4068 | INSERT ON ENTITY NAME | |
| 4069 | FOR EA CH ROW | |
| 4070 | BEGIN | |
| 4071 | :new.E NTITYNAMEI D := ENTIT Y_NAME_SEQ .NEXTVAL; | |
| 4072 | END; | |
| 4073 | / | |
| 4074 | ALTER TRIG GER "ARS27 7_REQUEST_ TRACKING". "ENTITYNAM E_TRG" ENA BLE; | |
| 4075 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4076 | -- DDL fo r Trigger EREPOSDATA _TRG | |
| 4077 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4078 | ||
| 4079 | CREATE O R REPLACE TRIGGER "A RS277_REQU EST_TRACKI NG"."EREPO SDATA_TRG" BEFORE | |
| 4080 | INSERT ON erepos data | |
| 4081 | FOR EA CH ROW | |
| 4082 | BEGIN | |
| 4083 | :new.e reposdata_ id := erep osdata_seq .nextval; | |
| 4084 | END; | |
| 4085 | / | |
| 4086 | ALTER TRIG GER "ARS27 7_REQUEST_ TRACKING". "EREPOSDAT A_TRG" ENA BLE; | |
| 4087 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4088 | -- DDL fo r Trigger HCCS_CD_HC CS_ID_TRG | |
| 4089 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4090 | ||
| 4091 | CREATE O R REPLACE TRIGGER "A RS277_REQU EST_TRACKI NG"."HCCS_ CD_HCCS_ID _TRG" BEFO RE | |
| 4092 | INSERT ON hccs_c d | |
| 4093 | FOR EA CH ROW | |
| 4094 | WHEN ( new.hccs _id IS NUL L ) BEGIN | |
| 4095 | :new.h ccs_id := hccs_cd_hc cs_id_seq. nextval; | |
| 4096 | END; | |
| 4097 | ||
| 4098 | / | |
| 4099 | ALTER TRIG GER "ARS27 7_REQUEST_ TRACKING". "HCCS_CD_H CCS_ID_TRG " ENABLE; | |
| 4100 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4101 | -- DDL fo r Trigger LOINC_CD_L OINC_ID_TR G | |
| 4102 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4103 | ||
| 4104 | CREATE O R REPLACE TRIGGER "A RS277_REQU EST_TRACKI NG"."LOINC _CD_LOINC_ ID_TRG" BE FORE | |
| 4105 | INSERT ON loinc_ cd | |
| 4106 | FOR EA CH ROW | |
| 4107 | WHEN ( new.loin c_id IS NU LL ) BEGIN | |
| 4108 | :new.l oinc_id := loinc_cd_ loinc_id_s eq.nextval ; | |
| 4109 | END; | |
| 4110 | ||
| 4111 | / | |
| 4112 | ALTER TRIG GER "ARS27 7_REQUEST_ TRACKING". "LOINC_CD_ LOINC_ID_T RG" ENABLE ; | |
| 4113 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4114 | -- DDL fo r Trigger LOINC_MOD_ CD_LOINC_M OD_ID_TRG | |
| 4115 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4116 | ||
| 4117 | CREATE O R REPLACE TRIGGER "A RS277_REQU EST_TRACKI NG"."LOINC _MOD_CD_LO INC_MOD_ID _TRG" BEFO RE | |
| 4118 | INSERT ON loinc_ mod_cd | |
| 4119 | FOR EA CH ROW | |
| 4120 | WHEN ( new.loin c_mod_id I S NULL ) B EGIN | |
| 4121 | :new.l oinc_mod_i d := loinc _mod_cd_lo inc_mod_id _seq.nextv al; | |
| 4122 | END; | |
| 4123 | ||
| 4124 | / | |
| 4125 | ALTER TRIG GER "ARS27 7_REQUEST_ TRACKING". "LOINC_MOD _CD_LOINC_ MOD_ID_TRG " ENABLE; | |
| 4126 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4127 | -- DDL fo r Trigger PATH_TRG | |
| 4128 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4129 | ||
| 4130 | CREATE O R REPLACE TRIGGER "A RS277_REQU EST_TRACKI NG"."PATH_ TRG" BEFOR E | |
| 4131 | INSERT ON paths | |
| 4132 | FOR EA CH ROW | |
| 4133 | BEGIN | |
| 4134 | :new.p ath_id := path_seq.n extval; | |
| 4135 | END; | |
| 4136 | / | |
| 4137 | ALTER TRIG GER "ARS27 7_REQUEST_ TRACKING". "PATH_TRG" ENABLE; | |
| 4138 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4139 | -- DDL fo r Trigger REFERENCE_ IDENTIFICA TION_TRG | |
| 4140 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4141 | ||
| 4142 | CREATE O R REPLACE TRIGGER "A RS277_REQU EST_TRACKI NG"."REFER ENCE_IDENT IFICATION_ TRG" BEFOR E | |
| 4143 | INSERT ON REFERE NCE_IDENTI FICATION | |
| 4144 | FOR EA CH ROW | |
| 4145 | BEGIN | |
| 4146 | :new.R EFERENCE_I DENTIFICAT ION_ID := REFERENCE_ IDENTIFICA TION_SEQ.N EXTVAL; | |
| 4147 | END; | |
| 4148 | / | |
| 4149 | ALTER TRIG GER "ARS27 7_REQUEST_ TRACKING". "REFERENCE _IDENTIFIC ATION_TRG" ENABLE; | |
| 4150 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4151 | -- DDL fo r Trigger STATUS_INF ORMATION_T RG | |
| 4152 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4153 | ||
| 4154 | CREATE O R REPLACE TRIGGER "A RS277_REQU EST_TRACKI NG"."STATU S_INFORMAT ION_TRG" B EFORE | |
| 4155 | INSERT ON STATUS _INFORMATI ON | |
| 4156 | FOR EA CH ROW | |
| 4157 | BEGIN | |
| 4158 | :new.S TATUS_INFO RMATION_ID := STATUS _INFORMATI ON_SEQ.NEX TVAL; | |
| 4159 | END; | |
| 4160 | / | |
| 4161 | ALTER TRIG GER "ARS27 7_REQUEST_ TRACKING". "STATUS_IN FORMATION_ TRG" ENABL E; | |
| 4162 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4163 | -- DDL fo r Trigger TRACE_NUMB ER_TRG | |
| 4164 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4165 | ||
| 4166 | CREATE O R REPLACE TRIGGER "A RS277_REQU EST_TRACKI NG"."TRACE _NUMBER_TR G" BEFORE | |
| 4167 | INSERT ON TRACE_ NUMBER | |
| 4168 | FOR EA CH ROW | |
| 4169 | BEGIN | |
| 4170 | :new.T RACENUMBER ID := TRAC E_NUMBER_S EQ.NEXTVAL ; | |
| 4171 | END; | |
| 4172 | / | |
| 4173 | ALTER TRIG GER "ARS27 7_REQUEST_ TRACKING". "TRACE_NUM BER_TRG" E NABLE; | |
| 4174 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4175 | -- DDL fo r Trigger TRANSACTIO NS_TRG | |
| 4176 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4177 | ||
| 4178 | CREATE O R REPLACE TRIGGER "A RS277_REQU EST_TRACKI NG"."TRANS ACTIONS_TR G" BEFORE | |
| 4179 | INSERT ON TRANSA CTIONS | |
| 4180 | FOR EA CH ROW | |
| 4181 | BEGIN | |
| 4182 | :new.T RANSACTION S_ID := TR ANSACTIONS _SEQ.NEXTV AL; | |
| 4183 | END; | |
| 4184 | / | |
| 4185 | ALTER TRIG GER "ARS27 7_REQUEST_ TRACKING". "TRANSACTI ONS_TRG" E NABLE; | |
| 4186 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4187 | -- Constr aints for Table TRAC E_NUMBER | |
| 4188 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4189 | ||
| 4190 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "TRACE_NUM BER" ADD C ONSTRAINT "TRACE_NUM BER_PK" PR IMARY KEY ("TRACENUM BERID") | |
| 4191 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4192 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4193 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4194 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4195 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "TRACE_NUM BER" MODIF Y ("TRACEN UMBERID" N OT NULL EN ABLE); | |
| 4196 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "TRACE_NUM BER" MODIF Y ("ATTACH MENT_ID" N OT NULL EN ABLE); | |
| 4197 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4198 | -- Constr aints for Table TRAN SACTIONS | |
| 4199 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4200 | ||
| 4201 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "TRANSACTI ONS" ADD P RIMARY KEY ("TRANSAC TIONS_ID") | |
| 4202 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4203 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4204 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4205 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4206 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "TRANSACTI ONS" MODIF Y ("BGN01" NOT NULL ENABLE); | |
| 4207 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "TRANSACTI ONS" MODIF Y ("SE01" NOT NULL E NABLE); | |
| 4208 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "TRANSACTI ONS" MODIF Y ("ST01" NOT NULL E NABLE); | |
| 4209 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "TRANSACTI ONS" MODIF Y ("BATCH_ ID" NOT NU LL ENABLE) ; | |
| 4210 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "TRANSACTI ONS" MODIF Y ("LOOP_I D" NOT NUL L ENABLE); | |
| 4211 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "TRANSACTI ONS" MODIF Y ("ATTACH MENT_ID" N OT NULL EN ABLE); | |
| 4212 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "TRANSACTI ONS" MODIF Y ("TRANSA CTIONS_ID" NOT NULL ENABLE); | |
| 4213 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4214 | -- Constr aints for Table CLAI MATTACHMEN TS | |
| 4215 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4216 | ||
| 4217 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIMATTA CHMENTS" A DD CONSTRA INT "PK_CL AIMATTACHM ENTS" PRIM ARY KEY (" ID") | |
| 4218 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4219 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4220 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4221 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4222 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIMATTA CHMENTS" M ODIFY ("VE R" NOT NUL L ENABLE); | |
| 4223 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIMATTA CHMENTS" M ODIFY ("ST ATUS" NOT NULL ENABL E); | |
| 4224 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIMATTA CHMENTS" M ODIFY ("AT TACHMENT_T YPE" NOT N ULL ENABLE ); | |
| 4225 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIMATTA CHMENTS" M ODIFY ("ID " NOT NULL ENABLE); | |
| 4226 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4227 | -- Constr aints for Table ARS_ ROLE | |
| 4228 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4229 | ||
| 4230 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_ROLE" ADD CONST RAINT "ARS _ROLE_PK" PRIMARY KE Y ("ARS_RO LE_ID") | |
| 4231 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4232 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4233 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4234 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4235 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_ROLE" MODIFY (" DATE_CREAT ED" NOT NU LL ENABLE) ; | |
| 4236 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_ROLE" MODIFY (" CREATED_BY " NOT NULL ENABLE); | |
| 4237 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_ROLE" MODIFY (" ROLE_NAME" NOT NULL ENABLE); | |
| 4238 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_ROLE" MODIFY (" ARS_ROLE_I D" NOT NUL L ENABLE); | |
| 4239 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4240 | -- Constr aints for Table ARSA UDITLOG | |
| 4241 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4242 | ||
| 4243 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARSAUDITL OG" ADD CO NSTRAINT " PK_ARSAUDI TLOG" PRIM ARY KEY (" ID") | |
| 4244 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4245 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4246 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4247 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4248 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARSAUDITL OG" MODIFY ("VER" NO T NULL ENA BLE); | |
| 4249 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARSAUDITL OG" MODIFY ("SUCCESS " NOT NULL ENABLE); | |
| 4250 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARSAUDITL OG" MODIFY ("ACTION" NOT NULL ENABLE); | |
| 4251 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARSAUDITL OG" MODIFY ("REQUEST ARGS" NOT NULL ENABL E); | |
| 4252 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARSAUDITL OG" MODIFY ("ACCESSD ATE" NOT N ULL ENABLE ); | |
| 4253 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARSAUDITL OG" MODIFY ("CLAIMAT TACHMENTID " NOT NULL ENABLE); | |
| 4254 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARSAUDITL OG" MODIFY ("USERID" NOT NULL ENABLE); | |
| 4255 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARSAUDITL OG" MODIFY ("METHODN AME" NOT N ULL ENABLE ); | |
| 4256 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARSAUDITL OG" MODIFY ("ID" NOT NULL ENAB LE); | |
| 4257 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4258 | -- Constr aints for Table OAUT H_CLIENT_A UTHORITIES | |
| 4259 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4260 | ||
| 4261 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "OAUTH_CLI ENT_AUTHOR ITIES" MOD IFY ("AUTH ORITY" NOT NULL ENAB LE); | |
| 4262 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "OAUTH_CLI ENT_AUTHOR ITIES" MOD IFY ("USER NAME" NOT NULL ENABL E); | |
| 4263 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4264 | -- Constr aints for Table CLAI M_SUBMISSI ON_NOTE | |
| 4265 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4266 | ||
| 4267 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_SUB MISSION_NO TE" ADD CO NSTRAINT " CLAIM_SUBM ISSION_NOT E_PK" PRIM ARY KEY (" CLAIM_SUBM ISSION_NOT E_ID") | |
| 4268 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4269 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4270 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4271 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4272 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_SUB MISSION_NO TE" MODIFY ("DATE_CR EATED" NOT NULL ENAB LE); | |
| 4273 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_SUB MISSION_NO TE" MODIFY ("CLAIM_S UBMISSION_ ID" NOT NU LL ENABLE) ; | |
| 4274 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_SUB MISSION_NO TE" MODIFY ("CLAIM_S UBMISSION_ NOTE_ID" N OT NULL EN ABLE); | |
| 4275 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4276 | -- Constr aints for Table EMAI L_TEMPLATE S | |
| 4277 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4278 | ||
| 4279 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "EMAIL_TEM PLATES" AD D CONSTRAI NT "EMAIL_ TEMPLATE_P K" PRIMARY KEY ("EMA IL_TEMPLAT E_ID") | |
| 4280 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4281 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4282 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4283 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4284 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "EMAIL_TEM PLATES" MO DIFY ("EMA IL_TEMPLAT E_ID" NOT NULL ENABL E); | |
| 4285 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4286 | -- Constr aints for Table CLAI M_DATE | |
| 4287 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4288 | ||
| 4289 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_DAT E" ADD PRI MARY KEY ( "CLAIM_DAT E_ID") | |
| 4290 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4291 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4292 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4293 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4294 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_DAT E" MODIFY ("CLAIM_DA TE_ID" NOT NULL ENAB LE); | |
| 4295 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_DAT E" MODIFY ("REC_NUM" NOT NULL ENABLE); | |
| 4296 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_DAT E" MODIFY ("BATCH_ID " NOT NULL ENABLE); | |
| 4297 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_DAT E" MODIFY ("LOOP_ID" NOT NULL ENABLE); | |
| 4298 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_DAT E" MODIFY ("ATTACHME NT_ID" NOT NULL ENAB LE); | |
| 4299 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4300 | -- Constr aints for Table OAUT H_CLIENT_I NFO | |
| 4301 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4302 | ||
| 4303 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "OAUTH_CLI ENT_INFO" ADD PRIMAR Y KEY ("US ERNAME") | |
| 4304 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4305 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4306 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4307 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4308 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "OAUTH_CLI ENT_INFO" MODIFY ("D ATE_CREATE D" NOT NUL L ENABLE); | |
| 4309 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "OAUTH_CLI ENT_INFO" MODIFY ("C REATED_BY" NOT NULL ENABLE); | |
| 4310 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "OAUTH_CLI ENT_INFO" MODIFY ("E NABLED" NO T NULL ENA BLE); | |
| 4311 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "OAUTH_CLI ENT_INFO" MODIFY ("P ASSWORD" N OT NULL EN ABLE); | |
| 4312 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "OAUTH_CLI ENT_INFO" MODIFY ("U SERNAME" N OT NULL EN ABLE); | |
| 4313 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4314 | -- Constr aints for Table ENTI TYNAME | |
| 4315 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4316 | ||
| 4317 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ENTITYNAM E" ADD PRI MARY KEY ( "ENTITYNAM EID") | |
| 4318 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4319 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4320 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4321 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4322 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ENTITYNAM E" MODIFY ("BATCH_ID " NOT NULL ENABLE); | |
| 4323 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ENTITYNAM E" MODIFY ("LOOP_ID" NOT NULL ENABLE); | |
| 4324 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ENTITYNAM E" MODIFY ("ATTACHME NT_ID" NOT NULL ENAB LE); | |
| 4325 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ENTITYNAM E" MODIFY ("ENTITYNA MEID" NOT NULL ENABL E); | |
| 4326 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4327 | -- Constr aints for Table BINA RY275 | |
| 4328 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4329 | ||
| 4330 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "BINARY275 " ADD CONS TRAINT "BI N275_PK" P RIMARY KEY ("BINARY2 75ID") | |
| 4331 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4332 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4333 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4334 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4335 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "BINARY275 " MODIFY ( "BINARY275 ID" NOT NU LL ENABLE) ; | |
| 4336 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "BINARY275 " MODIFY ( "ATTACHMEN T_ID" NOT NULL ENABL E); | |
| 4337 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4338 | -- Constr aints for Table LOIN C_CD | |
| 4339 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4340 | ||
| 4341 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "LOINC_CD" ADD CONST RAINT "HCC S_CDV1_PK" PRIMARY K EY ("LOINC _ID") | |
| 4342 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4343 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4344 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4345 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4346 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "LOINC_CD" MODIFY (" LOINC_ID" CONSTRAINT "NNC_HCCS _CDV1_HCCS _ID" NOT N ULL ENABLE ); | |
| 4347 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4348 | -- Constr aints for Table REFE RENCE_IDEN TIFICATION | |
| 4349 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4350 | ||
| 4351 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "REFERENCE _IDENTIFIC ATION" ADD PRIMARY K EY ("REFER ENCE_IDENT IFICATION_ ID") | |
| 4352 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4353 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4354 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4355 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4356 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "REFERENCE _IDENTIFIC ATION" MOD IFY ("REFE RENCE_IDEN TIFICATION _ID" NOT N ULL ENABLE ); | |
| 4357 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "REFERENCE _IDENTIFIC ATION" MOD IFY ("BATC H_ID" NOT NULL ENABL E); | |
| 4358 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "REFERENCE _IDENTIFIC ATION" MOD IFY ("LOOP _ID" NOT N ULL ENABLE ); | |
| 4359 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "REFERENCE _IDENTIFIC ATION" MOD IFY ("ATTA CHMENT_ID" NOT NULL ENABLE); | |
| 4360 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4361 | -- Constr aints for Table LOIN C_MOD_CD | |
| 4362 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4363 | ||
| 4364 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "LOINC_MOD _CD" ADD C ONSTRAINT "HCCS_CDV2 _PK" PRIMA RY KEY ("L OINC_MOD_I D") | |
| 4365 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4366 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4367 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4368 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4369 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "LOINC_MOD _CD" MODIF Y ("LOINC_ MOD_ID" CO NSTRAINT " NNC_HCCS_C DV2_HCCS_I D" NOT NUL L ENABLE); | |
| 4370 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4371 | -- Constr aints for Table ARS_ USER_ROLE_ USAGES | |
| 4372 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4373 | ||
| 4374 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_USER_ ROLE_USAGE S" ADD CON STRAINT "A RS_USER_RO LE_USAGES_ UK01" UNIQ UE ("ARS_R OLE_ID", " ARS_USER_I D") | |
| 4375 | USING IN DEX PCTFRE E 0 INITRA NS 2 MAXTR ANS 255 CO MPUTE STAT ISTICS NOL OGGING | |
| 4376 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4377 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4378 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4379 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_USER_ ROLE_USAGE S" MODIFY ("DATE_CRE ATED" NOT NULL ENABL E); | |
| 4380 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_USER_ ROLE_USAGE S" MODIFY ("CREATED_ BY" NOT NU LL ENABLE) ; | |
| 4381 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_USER_ ROLE_USAGE S" MODIFY ("ARS_USER _ID" NOT N ULL ENABLE ); | |
| 4382 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_USER_ ROLE_USAGE S" MODIFY ("ARS_ROLE _ID" NOT N ULL ENABLE ); | |
| 4383 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4384 | -- Constr aints for Table EREP OSDATA | |
| 4385 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4386 | ||
| 4387 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "EREPOSDAT A" ADD PRI MARY KEY ( "EREPOSDAT A_ID") | |
| 4388 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4389 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4390 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4391 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4392 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "EREPOSDAT A" MODIFY ("EREPOSDA TA_ID" NOT NULL ENAB LE); | |
| 4393 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "EREPOSDAT A" MODIFY ("ATTACHME NT_ID" NOT NULL ENAB LE); | |
| 4394 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4395 | -- Constr aints for Table ZIPC ODE | |
| 4396 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4397 | ||
| 4398 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ZIPCODE" MODIFY ("D ATE_CREATE D" NOT NUL L ENABLE); | |
| 4399 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ZIPCODE" MODIFY ("C REATED_BY" NOT NULL ENABLE); | |
| 4400 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ZIPCODE" MODIFY ("V A_FACILITY _CD" NOT N ULL ENABLE ); | |
| 4401 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ZIPCODE" MODIFY ("A CTIVE_FLAG " NOT NULL ENABLE); | |
| 4402 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ZIPCODE" MODIFY ("Z IP_CODE" N OT NULL EN ABLE); | |
| 4403 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4404 | -- Constr aints for Table STAT US_INFORMA TION | |
| 4405 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4406 | ||
| 4407 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "STATUS_IN FORMATION" ADD PRIMA RY KEY ("S TATUS_INFO RMATION_ID ") | |
| 4408 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4409 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4410 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4411 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4412 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "STATUS_IN FORMATION" MODIFY (" STATUS_INF ORMATION_I D" NOT NUL L ENABLE); | |
| 4413 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "STATUS_IN FORMATION" MODIFY (" BATCH_ID" NOT NULL E NABLE); | |
| 4414 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "STATUS_IN FORMATION" MODIFY (" LOOP_ID" N OT NULL EN ABLE); | |
| 4415 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "STATUS_IN FORMATION" MODIFY (" ATTACHMENT _ID" NOT N ULL ENABLE ); | |
| 4416 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4417 | -- Constr aints for Table PATH S | |
| 4418 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4419 | ||
| 4420 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "PATHS" AD D PRIMARY KEY ("PATH _ID") | |
| 4421 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4422 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4423 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4424 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4425 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "PATHS" MO DIFY ("ATT ACHMENT_ID " NOT NULL ENABLE); | |
| 4426 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "PATHS" MO DIFY ("PAT H_ID" NOT NULL ENABL E); | |
| 4427 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4428 | -- Constr aints for Table CONT ACT | |
| 4429 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4430 | ||
| 4431 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CONTACT" ADD PRIMAR Y KEY ("CO NTACT_ID") | |
| 4432 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4433 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4434 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4435 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4436 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CONTACT" MODIFY ("C ONTACT_ID" NOT NULL ENABLE); | |
| 4437 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CONTACT" MODIFY ("B ATCH_ID" N OT NULL EN ABLE); | |
| 4438 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CONTACT" MODIFY ("L OOP_ID" NO T NULL ENA BLE); | |
| 4439 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CONTACT" MODIFY ("A TTACHMENT_ ID" NOT NU LL ENABLE) ; | |
| 4440 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4441 | -- Constr aints for Table ENTI TYADDRESS | |
| 4442 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4443 | ||
| 4444 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ENTITYADD RESS" ADD PRIMARY KE Y ("ENTITY ADDRESSID" ) | |
| 4445 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4446 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4447 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4448 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4449 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ENTITYADD RESS" MODI FY ("ENTIT YADDRESSID " NOT NULL ENABLE); | |
| 4450 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ENTITYADD RESS" MODI FY ("BATCH _ID" NOT N ULL ENABLE ); | |
| 4451 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ENTITYADD RESS" MODI FY ("LOOP_ ID" NOT NU LL ENABLE) ; | |
| 4452 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ENTITYADD RESS" MODI FY ("ATTAC HMENT_ID" NOT NULL E NABLE); | |
| 4453 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4454 | -- Constr aints for Table SSO_ AUTHENTICA TION | |
| 4455 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4456 | ||
| 4457 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "SSO_AUTHE NTICATION" ADD CONST RAINT "ARS _SSO_PK_1" PRIMARY K EY ("GUID" ) | |
| 4458 | USING IN DEX PCTFRE E 0 INITRA NS 2 MAXTR ANS 255 CO MPUTE STAT ISTICS NOL OGGING | |
| 4459 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4460 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4461 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4462 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "SSO_AUTHE NTICATION" MODIFY (" GUID" NOT NULL ENABL E); | |
| 4463 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4464 | -- Constr aints for Table CLAI M_SVC_LINE S | |
| 4465 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4466 | ||
| 4467 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_SVC _LINES" AD D CONSTRAI NT "CLAIM_ SVC_LINES_ PK" PRIMAR Y KEY ("SU BMISSIONSV CLINEID") | |
| 4468 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4469 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4470 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4471 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4472 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_SVC _LINES" MO DIFY ("SUB MISSIONID" NOT NULL ENABLE); | |
| 4473 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_SVC _LINES" MO DIFY ("SUB MISSIONSVC LINEID" NO T NULL ENA BLE); | |
| 4474 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4475 | -- Constr aints for Table CLAI M_SUBMISSI ON | |
| 4476 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4477 | ||
| 4478 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_SUB MISSION" A DD CONSTRA INT "CLAIM _SUBMISSIO N_PK" PRIM ARY KEY (" SUBMISSION ID") | |
| 4479 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4480 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4481 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4482 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4483 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_SUB MISSION" M ODIFY ("LO INC_MOD_ID " NOT NULL ENABLE); | |
| 4484 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_SUB MISSION" M ODIFY ("LO INC_ID" NO T NULL ENA BLE); | |
| 4485 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_SUB MISSION" M ODIFY ("HC CS_ID" NOT NULL ENAB LE); | |
| 4486 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_SUB MISSION" M ODIFY ("CO NTACTUSERI D" NOT NUL L ENABLE); | |
| 4487 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_SUB MISSION" M ODIFY ("SU BMISSIONID " NOT NULL ENABLE); | |
| 4488 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4489 | -- Constr aints for Table DOCU MENT_CATEG ORY | |
| 4490 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4491 | ||
| 4492 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "DOCUMENT_ CATEGORY" ADD PRIMAR Y KEY ("DO CUMENT_CAT EGORYID") | |
| 4493 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4494 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4495 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4496 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4497 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "DOCUMENT_ CATEGORY" MODIFY ("D OCUMENT_CA TEGORYID" NOT NULL E NABLE); | |
| 4498 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "DOCUMENT_ CATEGORY" MODIFY ("E F101" NOT NULL ENABL E); | |
| 4499 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "DOCUMENT_ CATEGORY" MODIFY ("C AT02" NOT NULL ENABL E); | |
| 4500 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "DOCUMENT_ CATEGORY" MODIFY ("C AT01" NOT NULL ENABL E); | |
| 4501 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "DOCUMENT_ CATEGORY" MODIFY ("B ATCH_ID" N OT NULL EN ABLE); | |
| 4502 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "DOCUMENT_ CATEGORY" MODIFY ("L OOP_ID" NO T NULL ENA BLE); | |
| 4503 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "DOCUMENT_ CATEGORY" MODIFY ("A TTACHMENT_ ID" NOT NU LL ENABLE) ; | |
| 4504 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4505 | -- Constr aints for Table CLAI M_CONTACT | |
| 4506 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4507 | ||
| 4508 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_CON TACT" ADD CONSTRAINT "CLAIM_CO NTACT_PK" PRIMARY KE Y ("CONTAC TUSERID") | |
| 4509 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4510 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4511 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4512 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4513 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_CON TACT" MODI FY ("CONTA CTUSERID" NOT NULL E NABLE); | |
| 4514 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4515 | -- Constr aints for Table ARS_ USER | |
| 4516 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4517 | ||
| 4518 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_USER" ADD CONST RAINT "ARS _USER_PK" PRIMARY KE Y ("ARS_US ER_ID") | |
| 4519 | USING IN DEX PCTFRE E 0 INITRA NS 2 MAXTR ANS 255 CO MPUTE STAT ISTICS NOL OGGING | |
| 4520 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4521 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4522 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4523 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_USER" MODIFY (" DATE_CREAT ED" NOT NU LL ENABLE) ; | |
| 4524 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_USER" MODIFY (" CREATED_BY " NOT NULL ENABLE); | |
| 4525 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_USER" MODIFY (" ENABLED" N OT NULL EN ABLE); | |
| 4526 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_USER" MODIFY (" USER_NAME" NOT NULL ENABLE); | |
| 4527 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_USER" MODIFY (" ARS_USER_I D" NOT NUL L ENABLE); | |
| 4528 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4529 | -- Constr aints for Table ARS_ ROLE_PERMI SSIONS | |
| 4530 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4531 | ||
| 4532 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_ROLE_ PERMISSION S" ADD PRI MARY KEY ( "PERMISSIO N_ID") | |
| 4533 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4534 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4535 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4536 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4537 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_ROLE_ PERMISSION S" MODIFY ("DATE_CRE ATED" NOT NULL ENABL E); | |
| 4538 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_ROLE_ PERMISSION S" MODIFY ("CREATED_ BY" NOT NU LL ENABLE) ; | |
| 4539 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_ROLE_ PERMISSION S" MODIFY ("ENABLED" NOT NULL ENABLE); | |
| 4540 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_ROLE_ PERMISSION S" MODIFY ("ARS_ROLE _ID" NOT N ULL ENABLE ); | |
| 4541 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_ROLE_ PERMISSION S" MODIFY ("PERMISSI ON_NAME" N OT NULL EN ABLE); | |
| 4542 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_ROLE_ PERMISSION S" MODIFY ("PAGE_NAM E" NOT NUL L ENABLE); | |
| 4543 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_ROLE_ PERMISSION S" MODIFY ("PERMISSI ON_ID" NOT NULL ENAB LE); | |
| 4544 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4545 | -- Constr aints for Table HCCS _CD | |
| 4546 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4547 | ||
| 4548 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "HCCS_CD" ADD CONSTR AINT "HCCS _CD_PK" PR IMARY KEY ("HCCS_ID" ) | |
| 4549 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4550 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4551 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4552 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4553 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "HCCS_CD" MODIFY ("H CCS_ID" NO T NULL ENA BLE); | |
| 4554 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4555 | -- Constr aints for Table ARSR EPORTTYPE | |
| 4556 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4557 | ||
| 4558 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARSREPORT TYPE" ADD CONSTRAINT "PK_ARSRE PORTTYPE" PRIMARY KE Y ("CODE") | |
| 4559 | USING IN DEX PCTFRE E 10 INITR ANS 2 MAXT RANS 255 C OMPUTE STA TISTICS | |
| 4560 | STORAGE( INITIAL 65 536 NEXT 1 048576 MIN EXTENTS 1 MAXEXTENTS 214748364 5 | |
| 4561 | PCTINCRE ASE 0 FREE LISTS 1 FR EELIST GRO UPS 1 BUFF ER_POOL DE FAULT FLAS H_CACHE DE FAULT CELL _FLASH_CAC HE DEFAULT ) | |
| 4562 | TABLESPA CE "SYSTEM " ENABLE; | |
| 4563 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARSREPORT TYPE" MODI FY ("DEFIN ITION" NOT NULL ENAB LE); | |
| 4564 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARSREPORT TYPE" MODI FY ("CODE" NOT NULL ENABLE); | |
| 4565 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4566 | -- Ref Co nstraints for Table ARS_ROLE_P ERMISSIONS | |
| 4567 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4568 | ||
| 4569 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_ROLE_ PERMISSION S" ADD FOR EIGN KEY ( "ARS_ROLE_ ID") | |
| 4570 | REFERENCES "ARS277_R EQUEST_TRA CKING"."AR S_ROLE" (" ARS_ROLE_I D") ENABLE ; | |
| 4571 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4572 | -- Ref Co nstraints for Table ARS_USER_R OLE_USAGES | |
| 4573 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4574 | ||
| 4575 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_USER_ ROLE_USAGE S" ADD CON STRAINT "A RS_USER_RO LE_USAGES_ FK01" FORE IGN KEY (" ARS_ROLE_I D") | |
| 4576 | REFERENCES "ARS277_R EQUEST_TRA CKING"."AR S_ROLE" (" ARS_ROLE_I D") ENABLE ; | |
| 4577 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "ARS_USER_ ROLE_USAGE S" ADD CON STRAINT "A RS_USER_RO LE_USAGES_ FK02" FORE IGN KEY (" ARS_USER_I D") | |
| 4578 | REFERENCES "ARS277_R EQUEST_TRA CKING"."AR S_USER" (" ARS_USER_I D") ENABLE ; | |
| 4579 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4580 | -- Ref Co nstraints for Table CLAIMATTAC HMENTS | |
| 4581 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4582 | ||
| 4583 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIMATTA CHMENTS" A DD CONSTRA INT "FK_RE PORTTYPE" FOREIGN KE Y ("REPORT _CODE") | |
| 4584 | REFERENCES "ARS277_R EQUEST_TRA CKING"."AR SREPORTTYP E" ("CODE" ) ENABLE; | |
| 4585 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4586 | -- Ref Co nstraints for Table CLAIM_SUBM ISSION | |
| 4587 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4588 | ||
| 4589 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_SUB MISSION" A DD CONSTRA INT "CLAIM _CONTACT_F K" FOREIGN KEY ("CON TACTUSERID ") | |
| 4590 | REFERENCES "ARS277_R EQUEST_TRA CKING"."CL AIM_CONTAC T" ("CONTA CTUSERID") ENABLE; | |
| 4591 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_SUB MISSION" A DD CONSTRA INT "HCCS_ CD_FK" FOR EIGN KEY ( "HCCS_ID") | |
| 4592 | REFERENCES "ARS277_R EQUEST_TRA CKING"."HC CS_CD" ("H CCS_ID") E NABLE; | |
| 4593 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_SUB MISSION" A DD CONSTRA INT "LOINC _CD_FK" FO REIGN KEY ("LOINC_ID ") | |
| 4594 | REFERENCES "ARS277_R EQUEST_TRA CKING"."LO INC_CD" (" LOINC_ID") ENABLE; | |
| 4595 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_SUB MISSION" A DD CONSTRA INT "LOINC _MOD_CD_FK " FOREIGN KEY ("LOIN C_MOD_ID") | |
| 4596 | REFERENCES "ARS277_R EQUEST_TRA CKING"."LO INC_MOD_CD " ("LOINC_ MOD_ID") E NABLE; | |
| 4597 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4598 | -- Ref Co nstraints for Table CLAIM_SUBM ISSION_NOT E | |
| 4599 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4600 | ||
| 4601 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_SUB MISSION_NO TE" ADD CO NSTRAINT " CLAIM_SUB_ NOTE_CLAIM _SUB_FK" F OREIGN KEY ("CLAIM_S UBMISSION_ ID") | |
| 4602 | REFERENCES "ARS277_R EQUEST_TRA CKING"."CL AIM_SUBMIS SION" ("SU BMISSIONID ") ON DELE TE CASCADE ENABLE; | |
| 4603 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4604 | -- Ref Co nstraints for Table CLAIM_SVC_ LINES | |
| 4605 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4606 | ||
| 4607 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "CLAIM_SVC _LINES" AD D CONSTRAI NT "CLAIM_ SVC_CLAIM_ FK" FOREIG N KEY ("SU BMISSIONID ") | |
| 4608 | REFERENCES "ARS277_R EQUEST_TRA CKING"."CL AIM_SUBMIS SION" ("SU BMISSIONID ") ENABLE; | |
| 4609 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4610 | -- Ref Co nstraints for Table OAUTH_CLIE NT_AUTHORI TIES | |
| 4611 | ---------- ---------- ---------- ---------- ---------- ------ | |
| 4612 | ||
| 4613 | ALTER TA BLE "ARS27 7_REQUEST_ TRACKING". "OAUTH_CLI ENT_AUTHOR ITIES" ADD CONSTRAIN T "FK_AUTH ORITIES_CL IENTS" FOR EIGN KEY ( "USERNAME" ) | |
| 4614 | REFERENCES "ARS277_R EQUEST_TRA CKING"."OA UTH_CLIENT _INFO" ("U SERNAME") ENABLE; |
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