End of training
Browse files- README.md +55 -0
- added_tokens.json +270 -0
- generation_config.json +8 -0
- model.safetensors +1 -1
- preprocessor_config.json +26 -0
- runs/Mar09_11-00-45_c1f9f8bea4da/events.out.tfevents.1709982055.c1f9f8bea4da.2596.0 +2 -2
- sentencepiece.bpe.model +3 -0
- special_tokens_map.json +1537 -0
- tokenizer.json +0 -0
- tokenizer_config.json +2414 -0
README.md
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---
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license: mit
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base_model: naver-clova-ix/donut-base-finetuned-cord-v2
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tags:
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- generated_from_trainer
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datasets:
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- imagefolder
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model-index:
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- name: donut-base-cord-test5-CMStemp1
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results: []
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---
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<!-- This model card has been generated automatically according to the information the Trainer had access to. You
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should probably proofread and complete it, then remove this comment. -->
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# donut-base-cord-test5-CMStemp1
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This model is a fine-tuned version of [naver-clova-ix/donut-base-finetuned-cord-v2](https://huggingface.co/naver-clova-ix/donut-base-finetuned-cord-v2) on the imagefolder dataset.
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## Model description
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More information needed
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## Intended uses & limitations
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More information needed
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## Training and evaluation data
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More information needed
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## Training procedure
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### Training hyperparameters
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The following hyperparameters were used during training:
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- learning_rate: 2e-05
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- train_batch_size: 1
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- eval_batch_size: 8
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- seed: 42
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- optimizer: Adam with betas=(0.9,0.999) and epsilon=1e-08
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- lr_scheduler_type: linear
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- num_epochs: 20
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- mixed_precision_training: Native AMP
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### Training results
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### Framework versions
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- Transformers 4.38.2
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- Pytorch 2.1.0+cu121
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- Datasets 2.18.0
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- Tokenizers 0.15.2
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added_tokens.json
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{
|
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+
"</s_$CHARGES 1>": 57643,
|
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|
4 |
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5 |
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6 |
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7 |
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8 |
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|
9 |
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10 |
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11 |
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13 |
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|
14 |
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|
15 |
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16 |
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17 |
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18 |
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|
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20 |
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|
21 |
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|
22 |
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23 |
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|
24 |
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25 |
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|
26 |
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27 |
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28 |
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|
29 |
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|
30 |
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|
31 |
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|
32 |
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|
33 |
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34 |
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35 |
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|
36 |
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|
37 |
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|
38 |
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|
39 |
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|
40 |
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|
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|
56 |
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59 |
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60 |
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|
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|
63 |
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|
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|
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68 |
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|
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70 |
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|
71 |
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72 |
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|
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|
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|
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|
81 |
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82 |
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|
90 |
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|
91 |
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|
92 |
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|
93 |
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|
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|
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|
101 |
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|
102 |
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|
103 |
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104 |
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|
105 |
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|
106 |
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|
107 |
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|
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109 |
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|
110 |
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112 |
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|
113 |
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|
114 |
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|
115 |
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|
116 |
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|
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|
120 |
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|
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|
122 |
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|
123 |
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|
124 |
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|
125 |
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|
126 |
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|
127 |
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|
128 |
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|
129 |
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|
130 |
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|
131 |
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|
132 |
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|
133 |
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|
134 |
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|
135 |
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|
136 |
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137 |
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|
138 |
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|
139 |
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|
140 |
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|
141 |
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|
142 |
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|
143 |
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|
144 |
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|
145 |
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|
146 |
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|
147 |
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|
148 |
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|
149 |
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|
150 |
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|
151 |
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|
152 |
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|
153 |
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|
154 |
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|
155 |
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|
156 |
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"<s_23. PRIOR AUTHORIZATION NUMBER>": 57692,
|
157 |
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|
158 |
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|
159 |
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|
160 |
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|
161 |
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|
162 |
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|
163 |
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|
164 |
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|
165 |
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|
166 |
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|
167 |
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|
168 |
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|
169 |
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"<s_32. a. NPI NUMBER>": 57598,
|
170 |
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"<s_33. BILLING INFORMATION>": 57586,
|
171 |
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|
172 |
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|
173 |
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|
174 |
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|
175 |
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|
176 |
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|
177 |
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|
178 |
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|
179 |
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|
180 |
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|
181 |
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"<s_7. INSURED'S ADDRESS>": 57728,
|
182 |
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|
183 |
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|
184 |
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|
185 |
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"<s_7. INSURED'S TELEPHONE>": 57736,
|
186 |
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"<s_7. INSURED'S ZIP CODE>": 57734,
|
187 |
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"<s_9. OTHER INSURED'S NAME>": 57722,
|
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|
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generation_config.json
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|
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|
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|
model.safetensors
CHANGED
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preprocessor_config.json
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|
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|
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|
runs/Mar09_11-00-45_c1f9f8bea4da/events.out.tfevents.1709982055.c1f9f8bea4da.2596.0
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|
1 |
+
{
|
2 |
+
"additional_special_tokens": [
|
3 |
+
{
|
4 |
+
"content": "<s_meta>",
|
5 |
+
"lstrip": false,
|
6 |
+
"normalized": false,
|
7 |
+
"rstrip": false,
|
8 |
+
"single_word": false
|
9 |
+
},
|
10 |
+
{
|
11 |
+
"content": "</s_meta>",
|
12 |
+
"lstrip": false,
|
13 |
+
"normalized": false,
|
14 |
+
"rstrip": false,
|
15 |
+
"single_word": false
|
16 |
+
},
|
17 |
+
{
|
18 |
+
"content": "<s_formtype>",
|
19 |
+
"lstrip": false,
|
20 |
+
"normalized": false,
|
21 |
+
"rstrip": false,
|
22 |
+
"single_word": false
|
23 |
+
},
|
24 |
+
{
|
25 |
+
"content": "</s_formtype>",
|
26 |
+
"lstrip": false,
|
27 |
+
"normalized": false,
|
28 |
+
"rstrip": false,
|
29 |
+
"single_word": false
|
30 |
+
},
|
31 |
+
{
|
32 |
+
"content": "<s_PHYSICIAN OR MEDICAL PROVIDER INFORMATION>",
|
33 |
+
"lstrip": false,
|
34 |
+
"normalized": false,
|
35 |
+
"rstrip": false,
|
36 |
+
"single_word": false
|
37 |
+
},
|
38 |
+
{
|
39 |
+
"content": "</s_PHYSICIAN OR MEDICAL PROVIDER INFORMATION>",
|
40 |
+
"lstrip": false,
|
41 |
+
"normalized": false,
|
42 |
+
"rstrip": false,
|
43 |
+
"single_word": false
|
44 |
+
},
|
45 |
+
{
|
46 |
+
"content": "<s_33. BILLING INFORMATION>",
|
47 |
+
"lstrip": false,
|
48 |
+
"normalized": false,
|
49 |
+
"rstrip": false,
|
50 |
+
"single_word": false
|
51 |
+
},
|
52 |
+
{
|
53 |
+
"content": "</s_33. BILLING INFORMATION>",
|
54 |
+
"lstrip": false,
|
55 |
+
"normalized": false,
|
56 |
+
"rstrip": false,
|
57 |
+
"single_word": false
|
58 |
+
},
|
59 |
+
{
|
60 |
+
"content": "<s_33. BILLING PROVIDER PHONE>",
|
61 |
+
"lstrip": false,
|
62 |
+
"normalized": false,
|
63 |
+
"rstrip": false,
|
64 |
+
"single_word": false
|
65 |
+
},
|
66 |
+
{
|
67 |
+
"content": "</s_33. BILLING PROVIDER PHONE>",
|
68 |
+
"lstrip": false,
|
69 |
+
"normalized": false,
|
70 |
+
"rstrip": false,
|
71 |
+
"single_word": false
|
72 |
+
},
|
73 |
+
{
|
74 |
+
"content": "<s_33. BILLING PROVIDER LOCATION>",
|
75 |
+
"lstrip": false,
|
76 |
+
"normalized": false,
|
77 |
+
"rstrip": false,
|
78 |
+
"single_word": false
|
79 |
+
},
|
80 |
+
{
|
81 |
+
"content": "</s_33. BILLING PROVIDER LOCATION>",
|
82 |
+
"lstrip": false,
|
83 |
+
"normalized": false,
|
84 |
+
"rstrip": false,
|
85 |
+
"single_word": false
|
86 |
+
},
|
87 |
+
{
|
88 |
+
"content": "<s_33. a. NPI NUMBER>",
|
89 |
+
"lstrip": false,
|
90 |
+
"normalized": false,
|
91 |
+
"rstrip": false,
|
92 |
+
"single_word": false
|
93 |
+
},
|
94 |
+
{
|
95 |
+
"content": "</s_33. a. NPI NUMBER>",
|
96 |
+
"lstrip": false,
|
97 |
+
"normalized": false,
|
98 |
+
"rstrip": false,
|
99 |
+
"single_word": false
|
100 |
+
},
|
101 |
+
{
|
102 |
+
"content": "<s_32. SERVICE INFORMATION>",
|
103 |
+
"lstrip": false,
|
104 |
+
"normalized": false,
|
105 |
+
"rstrip": false,
|
106 |
+
"single_word": false
|
107 |
+
},
|
108 |
+
{
|
109 |
+
"content": "</s_32. SERVICE INFORMATION>",
|
110 |
+
"lstrip": false,
|
111 |
+
"normalized": false,
|
112 |
+
"rstrip": false,
|
113 |
+
"single_word": false
|
114 |
+
},
|
115 |
+
{
|
116 |
+
"content": "<s_32. SERVICE FACILITY LOCATION>",
|
117 |
+
"lstrip": false,
|
118 |
+
"normalized": false,
|
119 |
+
"rstrip": false,
|
120 |
+
"single_word": false
|
121 |
+
},
|
122 |
+
{
|
123 |
+
"content": "</s_32. SERVICE FACILITY LOCATION>",
|
124 |
+
"lstrip": false,
|
125 |
+
"normalized": false,
|
126 |
+
"rstrip": false,
|
127 |
+
"single_word": false
|
128 |
+
},
|
129 |
+
{
|
130 |
+
"content": "<s_32. a. NPI NUMBER>",
|
131 |
+
"lstrip": false,
|
132 |
+
"normalized": false,
|
133 |
+
"rstrip": false,
|
134 |
+
"single_word": false
|
135 |
+
},
|
136 |
+
{
|
137 |
+
"content": "</s_32. a. NPI NUMBER>",
|
138 |
+
"lstrip": false,
|
139 |
+
"normalized": false,
|
140 |
+
"rstrip": false,
|
141 |
+
"single_word": false
|
142 |
+
},
|
143 |
+
{
|
144 |
+
"content": "<s_31. PHYSICIAN OR SUPPLIER SIGNATURE>",
|
145 |
+
"lstrip": false,
|
146 |
+
"normalized": false,
|
147 |
+
"rstrip": false,
|
148 |
+
"single_word": false
|
149 |
+
},
|
150 |
+
{
|
151 |
+
"content": "</s_31. PHYSICIAN OR SUPPLIER SIGNATURE>",
|
152 |
+
"lstrip": false,
|
153 |
+
"normalized": false,
|
154 |
+
"rstrip": false,
|
155 |
+
"single_word": false
|
156 |
+
},
|
157 |
+
{
|
158 |
+
"content": "<s_SIGNED>",
|
159 |
+
"lstrip": false,
|
160 |
+
"normalized": false,
|
161 |
+
"rstrip": false,
|
162 |
+
"single_word": false
|
163 |
+
},
|
164 |
+
{
|
165 |
+
"content": "</s_SIGNED>",
|
166 |
+
"lstrip": false,
|
167 |
+
"normalized": false,
|
168 |
+
"rstrip": false,
|
169 |
+
"single_word": false
|
170 |
+
},
|
171 |
+
{
|
172 |
+
"content": "<s_DATE>",
|
173 |
+
"lstrip": false,
|
174 |
+
"normalized": false,
|
175 |
+
"rstrip": false,
|
176 |
+
"single_word": false
|
177 |
+
},
|
178 |
+
{
|
179 |
+
"content": "</s_DATE>",
|
180 |
+
"lstrip": false,
|
181 |
+
"normalized": false,
|
182 |
+
"rstrip": false,
|
183 |
+
"single_word": false
|
184 |
+
},
|
185 |
+
{
|
186 |
+
"content": "<s_29. AMOUNT PAID>",
|
187 |
+
"lstrip": false,
|
188 |
+
"normalized": false,
|
189 |
+
"rstrip": false,
|
190 |
+
"single_word": false
|
191 |
+
},
|
192 |
+
{
|
193 |
+
"content": "</s_29. AMOUNT PAID>",
|
194 |
+
"lstrip": false,
|
195 |
+
"normalized": false,
|
196 |
+
"rstrip": false,
|
197 |
+
"single_word": false
|
198 |
+
},
|
199 |
+
{
|
200 |
+
"content": "<s_28. TOTAL CHARGE>",
|
201 |
+
"lstrip": false,
|
202 |
+
"normalized": false,
|
203 |
+
"rstrip": false,
|
204 |
+
"single_word": false
|
205 |
+
},
|
206 |
+
{
|
207 |
+
"content": "</s_28. TOTAL CHARGE>",
|
208 |
+
"lstrip": false,
|
209 |
+
"normalized": false,
|
210 |
+
"rstrip": false,
|
211 |
+
"single_word": false
|
212 |
+
},
|
213 |
+
{
|
214 |
+
"content": "<s_27. ACCEPT ASSIGNMENT>",
|
215 |
+
"lstrip": false,
|
216 |
+
"normalized": false,
|
217 |
+
"rstrip": false,
|
218 |
+
"single_word": false
|
219 |
+
},
|
220 |
+
{
|
221 |
+
"content": "</s_27. ACCEPT ASSIGNMENT>",
|
222 |
+
"lstrip": false,
|
223 |
+
"normalized": false,
|
224 |
+
"rstrip": false,
|
225 |
+
"single_word": false
|
226 |
+
},
|
227 |
+
{
|
228 |
+
"content": "<s_26. PATIENT'S ACCOUNT NUMBER>",
|
229 |
+
"lstrip": false,
|
230 |
+
"normalized": false,
|
231 |
+
"rstrip": false,
|
232 |
+
"single_word": false
|
233 |
+
},
|
234 |
+
{
|
235 |
+
"content": "</s_26. PATIENT'S ACCOUNT NUMBER>",
|
236 |
+
"lstrip": false,
|
237 |
+
"normalized": false,
|
238 |
+
"rstrip": false,
|
239 |
+
"single_word": false
|
240 |
+
},
|
241 |
+
{
|
242 |
+
"content": "<s_25. FEDERAL TAX I.D. NUMBER>",
|
243 |
+
"lstrip": false,
|
244 |
+
"normalized": false,
|
245 |
+
"rstrip": false,
|
246 |
+
"single_word": false
|
247 |
+
},
|
248 |
+
{
|
249 |
+
"content": "</s_25. FEDERAL TAX I.D. NUMBER>",
|
250 |
+
"lstrip": false,
|
251 |
+
"normalized": false,
|
252 |
+
"rstrip": false,
|
253 |
+
"single_word": false
|
254 |
+
},
|
255 |
+
{
|
256 |
+
"content": "<s_25. FEDERAL IDENTIFICATION>",
|
257 |
+
"lstrip": false,
|
258 |
+
"normalized": false,
|
259 |
+
"rstrip": false,
|
260 |
+
"single_word": false
|
261 |
+
},
|
262 |
+
{
|
263 |
+
"content": "</s_25. FEDERAL IDENTIFICATION>",
|
264 |
+
"lstrip": false,
|
265 |
+
"normalized": false,
|
266 |
+
"rstrip": false,
|
267 |
+
"single_word": false
|
268 |
+
},
|
269 |
+
{
|
270 |
+
"content": "<s_24. SERVICES>",
|
271 |
+
"lstrip": false,
|
272 |
+
"normalized": false,
|
273 |
+
"rstrip": false,
|
274 |
+
"single_word": false
|
275 |
+
},
|
276 |
+
{
|
277 |
+
"content": "</s_24. SERVICES>",
|
278 |
+
"lstrip": false,
|
279 |
+
"normalized": false,
|
280 |
+
"rstrip": false,
|
281 |
+
"single_word": false
|
282 |
+
},
|
283 |
+
{
|
284 |
+
"content": "<s_YY 1>",
|
285 |
+
"lstrip": false,
|
286 |
+
"normalized": false,
|
287 |
+
"rstrip": false,
|
288 |
+
"single_word": false
|
289 |
+
},
|
290 |
+
{
|
291 |
+
"content": "</s_YY 1>",
|
292 |
+
"lstrip": false,
|
293 |
+
"normalized": false,
|
294 |
+
"rstrip": false,
|
295 |
+
"single_word": false
|
296 |
+
},
|
297 |
+
{
|
298 |
+
"content": "<s_UNITS 1>",
|
299 |
+
"lstrip": false,
|
300 |
+
"normalized": false,
|
301 |
+
"rstrip": false,
|
302 |
+
"single_word": false
|
303 |
+
},
|
304 |
+
{
|
305 |
+
"content": "</s_UNITS 1>",
|
306 |
+
"lstrip": false,
|
307 |
+
"normalized": false,
|
308 |
+
"rstrip": false,
|
309 |
+
"single_word": false
|
310 |
+
},
|
311 |
+
{
|
312 |
+
"content": "<s_PROVIDER ID 1>",
|
313 |
+
"lstrip": false,
|
314 |
+
"normalized": false,
|
315 |
+
"rstrip": false,
|
316 |
+
"single_word": false
|
317 |
+
},
|
318 |
+
{
|
319 |
+
"content": "</s_PROVIDER ID 1>",
|
320 |
+
"lstrip": false,
|
321 |
+
"normalized": false,
|
322 |
+
"rstrip": false,
|
323 |
+
"single_word": false
|
324 |
+
},
|
325 |
+
{
|
326 |
+
"content": "<s_PLACE OF SERVICE 1>",
|
327 |
+
"lstrip": false,
|
328 |
+
"normalized": false,
|
329 |
+
"rstrip": false,
|
330 |
+
"single_word": false
|
331 |
+
},
|
332 |
+
{
|
333 |
+
"content": "</s_PLACE OF SERVICE 1>",
|
334 |
+
"lstrip": false,
|
335 |
+
"normalized": false,
|
336 |
+
"rstrip": false,
|
337 |
+
"single_word": false
|
338 |
+
},
|
339 |
+
{
|
340 |
+
"content": "<s_MODIFIER 1>",
|
341 |
+
"lstrip": false,
|
342 |
+
"normalized": false,
|
343 |
+
"rstrip": false,
|
344 |
+
"single_word": false
|
345 |
+
},
|
346 |
+
{
|
347 |
+
"content": "</s_MODIFIER 1>",
|
348 |
+
"lstrip": false,
|
349 |
+
"normalized": false,
|
350 |
+
"rstrip": false,
|
351 |
+
"single_word": false
|
352 |
+
},
|
353 |
+
{
|
354 |
+
"content": "<s_MM 1>",
|
355 |
+
"lstrip": false,
|
356 |
+
"normalized": false,
|
357 |
+
"rstrip": false,
|
358 |
+
"single_word": false
|
359 |
+
},
|
360 |
+
{
|
361 |
+
"content": "</s_MM 1>",
|
362 |
+
"lstrip": false,
|
363 |
+
"normalized": false,
|
364 |
+
"rstrip": false,
|
365 |
+
"single_word": false
|
366 |
+
},
|
367 |
+
{
|
368 |
+
"content": "<s_Family Plan 1>",
|
369 |
+
"lstrip": false,
|
370 |
+
"normalized": false,
|
371 |
+
"rstrip": false,
|
372 |
+
"single_word": false
|
373 |
+
},
|
374 |
+
{
|
375 |
+
"content": "</s_Family Plan 1>",
|
376 |
+
"lstrip": false,
|
377 |
+
"normalized": false,
|
378 |
+
"rstrip": false,
|
379 |
+
"single_word": false
|
380 |
+
},
|
381 |
+
{
|
382 |
+
"content": "<s_EMG 1>",
|
383 |
+
"lstrip": false,
|
384 |
+
"normalized": false,
|
385 |
+
"rstrip": false,
|
386 |
+
"single_word": false
|
387 |
+
},
|
388 |
+
{
|
389 |
+
"content": "</s_EMG 1>",
|
390 |
+
"lstrip": false,
|
391 |
+
"normalized": false,
|
392 |
+
"rstrip": false,
|
393 |
+
"single_word": false
|
394 |
+
},
|
395 |
+
{
|
396 |
+
"content": "<s_DIAGNOSIS POINTER 1>",
|
397 |
+
"lstrip": false,
|
398 |
+
"normalized": false,
|
399 |
+
"rstrip": false,
|
400 |
+
"single_word": false
|
401 |
+
},
|
402 |
+
{
|
403 |
+
"content": "</s_DIAGNOSIS POINTER 1>",
|
404 |
+
"lstrip": false,
|
405 |
+
"normalized": false,
|
406 |
+
"rstrip": false,
|
407 |
+
"single_word": false
|
408 |
+
},
|
409 |
+
{
|
410 |
+
"content": "<s_DD 1>",
|
411 |
+
"lstrip": false,
|
412 |
+
"normalized": false,
|
413 |
+
"rstrip": false,
|
414 |
+
"single_word": false
|
415 |
+
},
|
416 |
+
{
|
417 |
+
"content": "</s_DD 1>",
|
418 |
+
"lstrip": false,
|
419 |
+
"normalized": false,
|
420 |
+
"rstrip": false,
|
421 |
+
"single_word": false
|
422 |
+
},
|
423 |
+
{
|
424 |
+
"content": "<s_CPT/HCPCS 1>",
|
425 |
+
"lstrip": false,
|
426 |
+
"normalized": false,
|
427 |
+
"rstrip": false,
|
428 |
+
"single_word": false
|
429 |
+
},
|
430 |
+
{
|
431 |
+
"content": "</s_CPT/HCPCS 1>",
|
432 |
+
"lstrip": false,
|
433 |
+
"normalized": false,
|
434 |
+
"rstrip": false,
|
435 |
+
"single_word": false
|
436 |
+
},
|
437 |
+
{
|
438 |
+
"content": "<s_$CHARGES 1>",
|
439 |
+
"lstrip": false,
|
440 |
+
"normalized": false,
|
441 |
+
"rstrip": false,
|
442 |
+
"single_word": false
|
443 |
+
},
|
444 |
+
{
|
445 |
+
"content": "</s_$CHARGES 1>",
|
446 |
+
"lstrip": false,
|
447 |
+
"normalized": false,
|
448 |
+
"rstrip": false,
|
449 |
+
"single_word": false
|
450 |
+
},
|
451 |
+
{
|
452 |
+
"content": "<s_YY 2>",
|
453 |
+
"lstrip": false,
|
454 |
+
"normalized": false,
|
455 |
+
"rstrip": false,
|
456 |
+
"single_word": false
|
457 |
+
},
|
458 |
+
{
|
459 |
+
"content": "</s_YY 2>",
|
460 |
+
"lstrip": false,
|
461 |
+
"normalized": false,
|
462 |
+
"rstrip": false,
|
463 |
+
"single_word": false
|
464 |
+
},
|
465 |
+
{
|
466 |
+
"content": "<s_UNITS 2>",
|
467 |
+
"lstrip": false,
|
468 |
+
"normalized": false,
|
469 |
+
"rstrip": false,
|
470 |
+
"single_word": false
|
471 |
+
},
|
472 |
+
{
|
473 |
+
"content": "</s_UNITS 2>",
|
474 |
+
"lstrip": false,
|
475 |
+
"normalized": false,
|
476 |
+
"rstrip": false,
|
477 |
+
"single_word": false
|
478 |
+
},
|
479 |
+
{
|
480 |
+
"content": "<s_PROVIDER ID 2>",
|
481 |
+
"lstrip": false,
|
482 |
+
"normalized": false,
|
483 |
+
"rstrip": false,
|
484 |
+
"single_word": false
|
485 |
+
},
|
486 |
+
{
|
487 |
+
"content": "</s_PROVIDER ID 2>",
|
488 |
+
"lstrip": false,
|
489 |
+
"normalized": false,
|
490 |
+
"rstrip": false,
|
491 |
+
"single_word": false
|
492 |
+
},
|
493 |
+
{
|
494 |
+
"content": "<s_PLACE OF SERVICE 2>",
|
495 |
+
"lstrip": false,
|
496 |
+
"normalized": false,
|
497 |
+
"rstrip": false,
|
498 |
+
"single_word": false
|
499 |
+
},
|
500 |
+
{
|
501 |
+
"content": "</s_PLACE OF SERVICE 2>",
|
502 |
+
"lstrip": false,
|
503 |
+
"normalized": false,
|
504 |
+
"rstrip": false,
|
505 |
+
"single_word": false
|
506 |
+
},
|
507 |
+
{
|
508 |
+
"content": "<s_MODIFIER 2>",
|
509 |
+
"lstrip": false,
|
510 |
+
"normalized": false,
|
511 |
+
"rstrip": false,
|
512 |
+
"single_word": false
|
513 |
+
},
|
514 |
+
{
|
515 |
+
"content": "</s_MODIFIER 2>",
|
516 |
+
"lstrip": false,
|
517 |
+
"normalized": false,
|
518 |
+
"rstrip": false,
|
519 |
+
"single_word": false
|
520 |
+
},
|
521 |
+
{
|
522 |
+
"content": "<s_MM 2>",
|
523 |
+
"lstrip": false,
|
524 |
+
"normalized": false,
|
525 |
+
"rstrip": false,
|
526 |
+
"single_word": false
|
527 |
+
},
|
528 |
+
{
|
529 |
+
"content": "</s_MM 2>",
|
530 |
+
"lstrip": false,
|
531 |
+
"normalized": false,
|
532 |
+
"rstrip": false,
|
533 |
+
"single_word": false
|
534 |
+
},
|
535 |
+
{
|
536 |
+
"content": "<s_Family Plan 2>",
|
537 |
+
"lstrip": false,
|
538 |
+
"normalized": false,
|
539 |
+
"rstrip": false,
|
540 |
+
"single_word": false
|
541 |
+
},
|
542 |
+
{
|
543 |
+
"content": "</s_Family Plan 2>",
|
544 |
+
"lstrip": false,
|
545 |
+
"normalized": false,
|
546 |
+
"rstrip": false,
|
547 |
+
"single_word": false
|
548 |
+
},
|
549 |
+
{
|
550 |
+
"content": "<s_EMG 2>",
|
551 |
+
"lstrip": false,
|
552 |
+
"normalized": false,
|
553 |
+
"rstrip": false,
|
554 |
+
"single_word": false
|
555 |
+
},
|
556 |
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{
|
557 |
+
"content": "</s_EMG 2>",
|
558 |
+
"lstrip": false,
|
559 |
+
"normalized": false,
|
560 |
+
"rstrip": false,
|
561 |
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"single_word": false
|
562 |
+
},
|
563 |
+
{
|
564 |
+
"content": "<s_DIAGNOSIS POINTER 2>",
|
565 |
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"lstrip": false,
|
566 |
+
"normalized": false,
|
567 |
+
"rstrip": false,
|
568 |
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"single_word": false
|
569 |
+
},
|
570 |
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{
|
571 |
+
"content": "</s_DIAGNOSIS POINTER 2>",
|
572 |
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"lstrip": false,
|
573 |
+
"normalized": false,
|
574 |
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"rstrip": false,
|
575 |
+
"single_word": false
|
576 |
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},
|
577 |
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{
|
578 |
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"content": "<s_DD 2>",
|
579 |
+
"lstrip": false,
|
580 |
+
"normalized": false,
|
581 |
+
"rstrip": false,
|
582 |
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"single_word": false
|
583 |
+
},
|
584 |
+
{
|
585 |
+
"content": "</s_DD 2>",
|
586 |
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"lstrip": false,
|
587 |
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"normalized": false,
|
588 |
+
"rstrip": false,
|
589 |
+
"single_word": false
|
590 |
+
},
|
591 |
+
{
|
592 |
+
"content": "<s_CPT/HCPCS 2>",
|
593 |
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"lstrip": false,
|
594 |
+
"normalized": false,
|
595 |
+
"rstrip": false,
|
596 |
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"single_word": false
|
597 |
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},
|
598 |
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{
|
599 |
+
"content": "</s_CPT/HCPCS 2>",
|
600 |
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"lstrip": false,
|
601 |
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"normalized": false,
|
602 |
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"rstrip": false,
|
603 |
+
"single_word": false
|
604 |
+
},
|
605 |
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{
|
606 |
+
"content": "<s_$CHARGES 2>",
|
607 |
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"lstrip": false,
|
608 |
+
"normalized": false,
|
609 |
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"rstrip": false,
|
610 |
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"single_word": false
|
611 |
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},
|
612 |
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{
|
613 |
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"content": "</s_$CHARGES 2>",
|
614 |
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|
615 |
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"normalized": false,
|
616 |
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|
617 |
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"single_word": false
|
618 |
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},
|
619 |
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{
|
620 |
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"content": "<s_YY 3>",
|
621 |
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"lstrip": false,
|
622 |
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"normalized": false,
|
623 |
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"rstrip": false,
|
624 |
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|
625 |
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},
|
626 |
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{
|
627 |
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"content": "</s_YY 3>",
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628 |
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"lstrip": false,
|
629 |
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"normalized": false,
|
630 |
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|
631 |
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"single_word": false
|
632 |
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},
|
633 |
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{
|
634 |
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"content": "<s_UNITS 3>",
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635 |
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|
636 |
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637 |
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|
638 |
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|
639 |
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},
|
640 |
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{
|
641 |
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"content": "</s_UNITS 3>",
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642 |
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"lstrip": false,
|
643 |
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"normalized": false,
|
644 |
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|
645 |
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646 |
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},
|
647 |
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{
|
648 |
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"content": "<s_PROVIDER ID 3>",
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649 |
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|
650 |
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|
651 |
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|
652 |
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|
653 |
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},
|
654 |
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{
|
655 |
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"content": "</s_PROVIDER ID 3>",
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656 |
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"lstrip": false,
|
657 |
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"normalized": false,
|
658 |
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|
659 |
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"single_word": false
|
660 |
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},
|
661 |
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{
|
662 |
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"content": "<s_PLACE OF SERVICE 3>",
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663 |
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"lstrip": false,
|
664 |
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"normalized": false,
|
665 |
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"rstrip": false,
|
666 |
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|
667 |
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},
|
668 |
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{
|
669 |
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"content": "</s_PLACE OF SERVICE 3>",
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670 |
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"lstrip": false,
|
671 |
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"normalized": false,
|
672 |
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"rstrip": false,
|
673 |
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"single_word": false
|
674 |
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},
|
675 |
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{
|
676 |
+
"content": "<s_MODIFIER 3>",
|
677 |
+
"lstrip": false,
|
678 |
+
"normalized": false,
|
679 |
+
"rstrip": false,
|
680 |
+
"single_word": false
|
681 |
+
},
|
682 |
+
{
|
683 |
+
"content": "</s_MODIFIER 3>",
|
684 |
+
"lstrip": false,
|
685 |
+
"normalized": false,
|
686 |
+
"rstrip": false,
|
687 |
+
"single_word": false
|
688 |
+
},
|
689 |
+
{
|
690 |
+
"content": "<s_MM 3>",
|
691 |
+
"lstrip": false,
|
692 |
+
"normalized": false,
|
693 |
+
"rstrip": false,
|
694 |
+
"single_word": false
|
695 |
+
},
|
696 |
+
{
|
697 |
+
"content": "</s_MM 3>",
|
698 |
+
"lstrip": false,
|
699 |
+
"normalized": false,
|
700 |
+
"rstrip": false,
|
701 |
+
"single_word": false
|
702 |
+
},
|
703 |
+
{
|
704 |
+
"content": "<s_Family Plan 3>",
|
705 |
+
"lstrip": false,
|
706 |
+
"normalized": false,
|
707 |
+
"rstrip": false,
|
708 |
+
"single_word": false
|
709 |
+
},
|
710 |
+
{
|
711 |
+
"content": "</s_Family Plan 3>",
|
712 |
+
"lstrip": false,
|
713 |
+
"normalized": false,
|
714 |
+
"rstrip": false,
|
715 |
+
"single_word": false
|
716 |
+
},
|
717 |
+
{
|
718 |
+
"content": "<s_EMG 3>",
|
719 |
+
"lstrip": false,
|
720 |
+
"normalized": false,
|
721 |
+
"rstrip": false,
|
722 |
+
"single_word": false
|
723 |
+
},
|
724 |
+
{
|
725 |
+
"content": "</s_EMG 3>",
|
726 |
+
"lstrip": false,
|
727 |
+
"normalized": false,
|
728 |
+
"rstrip": false,
|
729 |
+
"single_word": false
|
730 |
+
},
|
731 |
+
{
|
732 |
+
"content": "<s_DIAGNOSIS POINTER 3>",
|
733 |
+
"lstrip": false,
|
734 |
+
"normalized": false,
|
735 |
+
"rstrip": false,
|
736 |
+
"single_word": false
|
737 |
+
},
|
738 |
+
{
|
739 |
+
"content": "</s_DIAGNOSIS POINTER 3>",
|
740 |
+
"lstrip": false,
|
741 |
+
"normalized": false,
|
742 |
+
"rstrip": false,
|
743 |
+
"single_word": false
|
744 |
+
},
|
745 |
+
{
|
746 |
+
"content": "<s_DD 3>",
|
747 |
+
"lstrip": false,
|
748 |
+
"normalized": false,
|
749 |
+
"rstrip": false,
|
750 |
+
"single_word": false
|
751 |
+
},
|
752 |
+
{
|
753 |
+
"content": "</s_DD 3>",
|
754 |
+
"lstrip": false,
|
755 |
+
"normalized": false,
|
756 |
+
"rstrip": false,
|
757 |
+
"single_word": false
|
758 |
+
},
|
759 |
+
{
|
760 |
+
"content": "<s_CPT/HCPCS 3>",
|
761 |
+
"lstrip": false,
|
762 |
+
"normalized": false,
|
763 |
+
"rstrip": false,
|
764 |
+
"single_word": false
|
765 |
+
},
|
766 |
+
{
|
767 |
+
"content": "</s_CPT/HCPCS 3>",
|
768 |
+
"lstrip": false,
|
769 |
+
"normalized": false,
|
770 |
+
"rstrip": false,
|
771 |
+
"single_word": false
|
772 |
+
},
|
773 |
+
{
|
774 |
+
"content": "<s_$CHARGES 3>",
|
775 |
+
"lstrip": false,
|
776 |
+
"normalized": false,
|
777 |
+
"rstrip": false,
|
778 |
+
"single_word": false
|
779 |
+
},
|
780 |
+
{
|
781 |
+
"content": "</s_$CHARGES 3>",
|
782 |
+
"lstrip": false,
|
783 |
+
"normalized": false,
|
784 |
+
"rstrip": false,
|
785 |
+
"single_word": false
|
786 |
+
},
|
787 |
+
{
|
788 |
+
"content": "<s_23. PRIOR AUTHORIZATION NUMBER>",
|
789 |
+
"lstrip": false,
|
790 |
+
"normalized": false,
|
791 |
+
"rstrip": false,
|
792 |
+
"single_word": false
|
793 |
+
},
|
794 |
+
{
|
795 |
+
"content": "</s_23. PRIOR AUTHORIZATION NUMBER>",
|
796 |
+
"lstrip": false,
|
797 |
+
"normalized": false,
|
798 |
+
"rstrip": false,
|
799 |
+
"single_word": false
|
800 |
+
},
|
801 |
+
{
|
802 |
+
"content": "<s_22. RESUBMISSION CODE>",
|
803 |
+
"lstrip": false,
|
804 |
+
"normalized": false,
|
805 |
+
"rstrip": false,
|
806 |
+
"single_word": false
|
807 |
+
},
|
808 |
+
{
|
809 |
+
"content": "</s_22. RESUBMISSION CODE>",
|
810 |
+
"lstrip": false,
|
811 |
+
"normalized": false,
|
812 |
+
"rstrip": false,
|
813 |
+
"single_word": false
|
814 |
+
},
|
815 |
+
{
|
816 |
+
"content": "<s_21. DIAGNOSIS OR NATURE OF ILLNESS>",
|
817 |
+
"lstrip": false,
|
818 |
+
"normalized": false,
|
819 |
+
"rstrip": false,
|
820 |
+
"single_word": false
|
821 |
+
},
|
822 |
+
{
|
823 |
+
"content": "</s_21. DIAGNOSIS OR NATURE OF ILLNESS>",
|
824 |
+
"lstrip": false,
|
825 |
+
"normalized": false,
|
826 |
+
"rstrip": false,
|
827 |
+
"single_word": false
|
828 |
+
},
|
829 |
+
{
|
830 |
+
"content": "<s_words>",
|
831 |
+
"lstrip": false,
|
832 |
+
"normalized": false,
|
833 |
+
"rstrip": false,
|
834 |
+
"single_word": false
|
835 |
+
},
|
836 |
+
{
|
837 |
+
"content": "</s_words>",
|
838 |
+
"lstrip": false,
|
839 |
+
"normalized": false,
|
840 |
+
"rstrip": false,
|
841 |
+
"single_word": false
|
842 |
+
},
|
843 |
+
{
|
844 |
+
"content": "<s_word>",
|
845 |
+
"lstrip": false,
|
846 |
+
"normalized": false,
|
847 |
+
"rstrip": false,
|
848 |
+
"single_word": false
|
849 |
+
},
|
850 |
+
{
|
851 |
+
"content": "</s_word>",
|
852 |
+
"lstrip": false,
|
853 |
+
"normalized": false,
|
854 |
+
"rstrip": false,
|
855 |
+
"single_word": false
|
856 |
+
},
|
857 |
+
{
|
858 |
+
"content": "<s_normalizedVertices>",
|
859 |
+
"lstrip": false,
|
860 |
+
"normalized": false,
|
861 |
+
"rstrip": false,
|
862 |
+
"single_word": false
|
863 |
+
},
|
864 |
+
{
|
865 |
+
"content": "</s_normalizedVertices>",
|
866 |
+
"lstrip": false,
|
867 |
+
"normalized": false,
|
868 |
+
"rstrip": false,
|
869 |
+
"single_word": false
|
870 |
+
},
|
871 |
+
{
|
872 |
+
"content": "<s_y>",
|
873 |
+
"lstrip": false,
|
874 |
+
"normalized": false,
|
875 |
+
"rstrip": false,
|
876 |
+
"single_word": false
|
877 |
+
},
|
878 |
+
{
|
879 |
+
"content": "</s_y>",
|
880 |
+
"lstrip": false,
|
881 |
+
"normalized": false,
|
882 |
+
"rstrip": false,
|
883 |
+
"single_word": false
|
884 |
+
},
|
885 |
+
{
|
886 |
+
"content": "<s_x>",
|
887 |
+
"lstrip": false,
|
888 |
+
"normalized": false,
|
889 |
+
"rstrip": false,
|
890 |
+
"single_word": false
|
891 |
+
},
|
892 |
+
{
|
893 |
+
"content": "</s_x>",
|
894 |
+
"lstrip": false,
|
895 |
+
"normalized": false,
|
896 |
+
"rstrip": false,
|
897 |
+
"single_word": false
|
898 |
+
},
|
899 |
+
{
|
900 |
+
"content": "<s_text>",
|
901 |
+
"lstrip": false,
|
902 |
+
"normalized": false,
|
903 |
+
"rstrip": false,
|
904 |
+
"single_word": false
|
905 |
+
},
|
906 |
+
{
|
907 |
+
"content": "</s_text>",
|
908 |
+
"lstrip": false,
|
909 |
+
"normalized": false,
|
910 |
+
"rstrip": false,
|
911 |
+
"single_word": false
|
912 |
+
},
|
913 |
+
{
|
914 |
+
"content": "<s_label>",
|
915 |
+
"lstrip": false,
|
916 |
+
"normalized": false,
|
917 |
+
"rstrip": false,
|
918 |
+
"single_word": false
|
919 |
+
},
|
920 |
+
{
|
921 |
+
"content": "</s_label>",
|
922 |
+
"lstrip": false,
|
923 |
+
"normalized": false,
|
924 |
+
"rstrip": false,
|
925 |
+
"single_word": false
|
926 |
+
},
|
927 |
+
{
|
928 |
+
"content": "<s_20. OUTSIDE LAB>",
|
929 |
+
"lstrip": false,
|
930 |
+
"normalized": false,
|
931 |
+
"rstrip": false,
|
932 |
+
"single_word": false
|
933 |
+
},
|
934 |
+
{
|
935 |
+
"content": "</s_20. OUTSIDE LAB>",
|
936 |
+
"lstrip": false,
|
937 |
+
"normalized": false,
|
938 |
+
"rstrip": false,
|
939 |
+
"single_word": false
|
940 |
+
},
|
941 |
+
{
|
942 |
+
"content": "<s_20. LAB $CHARGES>",
|
943 |
+
"lstrip": false,
|
944 |
+
"normalized": false,
|
945 |
+
"rstrip": false,
|
946 |
+
"single_word": false
|
947 |
+
},
|
948 |
+
{
|
949 |
+
"content": "</s_20. LAB $CHARGES>",
|
950 |
+
"lstrip": false,
|
951 |
+
"normalized": false,
|
952 |
+
"rstrip": false,
|
953 |
+
"single_word": false
|
954 |
+
},
|
955 |
+
{
|
956 |
+
"content": "<s_PATIENT AND INSURED INFORMATION>",
|
957 |
+
"lstrip": false,
|
958 |
+
"normalized": false,
|
959 |
+
"rstrip": false,
|
960 |
+
"single_word": false
|
961 |
+
},
|
962 |
+
{
|
963 |
+
"content": "</s_PATIENT AND INSURED INFORMATION>",
|
964 |
+
"lstrip": false,
|
965 |
+
"normalized": false,
|
966 |
+
"rstrip": false,
|
967 |
+
"single_word": false
|
968 |
+
},
|
969 |
+
{
|
970 |
+
"content": "<s_9d. INSURANCE PLAN NAME>",
|
971 |
+
"lstrip": false,
|
972 |
+
"normalized": false,
|
973 |
+
"rstrip": false,
|
974 |
+
"single_word": false
|
975 |
+
},
|
976 |
+
{
|
977 |
+
"content": "</s_9d. INSURANCE PLAN NAME>",
|
978 |
+
"lstrip": false,
|
979 |
+
"normalized": false,
|
980 |
+
"rstrip": false,
|
981 |
+
"single_word": false
|
982 |
+
},
|
983 |
+
{
|
984 |
+
"content": "<s_9a. OTHER INSURED'S POLICY OR GROUP>",
|
985 |
+
"lstrip": false,
|
986 |
+
"normalized": false,
|
987 |
+
"rstrip": false,
|
988 |
+
"single_word": false
|
989 |
+
},
|
990 |
+
{
|
991 |
+
"content": "</s_9a. OTHER INSURED'S POLICY OR GROUP>",
|
992 |
+
"lstrip": false,
|
993 |
+
"normalized": false,
|
994 |
+
"rstrip": false,
|
995 |
+
"single_word": false
|
996 |
+
},
|
997 |
+
{
|
998 |
+
"content": "<s_9. OTHER INSURED'S NAME>",
|
999 |
+
"lstrip": false,
|
1000 |
+
"normalized": false,
|
1001 |
+
"rstrip": false,
|
1002 |
+
"single_word": false
|
1003 |
+
},
|
1004 |
+
{
|
1005 |
+
"content": "</s_9. OTHER INSURED'S NAME>",
|
1006 |
+
"lstrip": false,
|
1007 |
+
"normalized": false,
|
1008 |
+
"rstrip": false,
|
1009 |
+
"single_word": false
|
1010 |
+
},
|
1011 |
+
{
|
1012 |
+
"content": "<s_7. INSURED'S INFO>",
|
1013 |
+
"lstrip": false,
|
1014 |
+
"normalized": false,
|
1015 |
+
"rstrip": false,
|
1016 |
+
"single_word": false
|
1017 |
+
},
|
1018 |
+
{
|
1019 |
+
"content": "</s_7. INSURED'S INFO>",
|
1020 |
+
"lstrip": false,
|
1021 |
+
"normalized": false,
|
1022 |
+
"rstrip": false,
|
1023 |
+
"single_word": false
|
1024 |
+
},
|
1025 |
+
{
|
1026 |
+
"content": "<s_4. INSURED'S NAME>",
|
1027 |
+
"lstrip": false,
|
1028 |
+
"normalized": false,
|
1029 |
+
"rstrip": false,
|
1030 |
+
"single_word": false
|
1031 |
+
},
|
1032 |
+
{
|
1033 |
+
"content": "</s_4. INSURED'S NAME>",
|
1034 |
+
"lstrip": false,
|
1035 |
+
"normalized": false,
|
1036 |
+
"rstrip": false,
|
1037 |
+
"single_word": false
|
1038 |
+
},
|
1039 |
+
{
|
1040 |
+
"content": "<s_7. INSURED'S ADDRESS>",
|
1041 |
+
"lstrip": false,
|
1042 |
+
"normalized": false,
|
1043 |
+
"rstrip": false,
|
1044 |
+
"single_word": false
|
1045 |
+
},
|
1046 |
+
{
|
1047 |
+
"content": "</s_7. INSURED'S ADDRESS>",
|
1048 |
+
"lstrip": false,
|
1049 |
+
"normalized": false,
|
1050 |
+
"rstrip": false,
|
1051 |
+
"single_word": false
|
1052 |
+
},
|
1053 |
+
{
|
1054 |
+
"content": "<s_7. INSURED'S STATE>",
|
1055 |
+
"lstrip": false,
|
1056 |
+
"normalized": false,
|
1057 |
+
"rstrip": false,
|
1058 |
+
"single_word": false
|
1059 |
+
},
|
1060 |
+
{
|
1061 |
+
"content": "</s_7. INSURED'S STATE>",
|
1062 |
+
"lstrip": false,
|
1063 |
+
"normalized": false,
|
1064 |
+
"rstrip": false,
|
1065 |
+
"single_word": false
|
1066 |
+
},
|
1067 |
+
{
|
1068 |
+
"content": "<s_7. INSURED'S CITY>",
|
1069 |
+
"lstrip": false,
|
1070 |
+
"normalized": false,
|
1071 |
+
"rstrip": false,
|
1072 |
+
"single_word": false
|
1073 |
+
},
|
1074 |
+
{
|
1075 |
+
"content": "</s_7. INSURED'S CITY>",
|
1076 |
+
"lstrip": false,
|
1077 |
+
"normalized": false,
|
1078 |
+
"rstrip": false,
|
1079 |
+
"single_word": false
|
1080 |
+
},
|
1081 |
+
{
|
1082 |
+
"content": "<s_7. INSURED'S ZIP CODE>",
|
1083 |
+
"lstrip": false,
|
1084 |
+
"normalized": false,
|
1085 |
+
"rstrip": false,
|
1086 |
+
"single_word": false
|
1087 |
+
},
|
1088 |
+
{
|
1089 |
+
"content": "</s_7. INSURED'S ZIP CODE>",
|
1090 |
+
"lstrip": false,
|
1091 |
+
"normalized": false,
|
1092 |
+
"rstrip": false,
|
1093 |
+
"single_word": false
|
1094 |
+
},
|
1095 |
+
{
|
1096 |
+
"content": "<s_7. INSURED'S TELEPHONE>",
|
1097 |
+
"lstrip": false,
|
1098 |
+
"normalized": false,
|
1099 |
+
"rstrip": false,
|
1100 |
+
"single_word": false
|
1101 |
+
},
|
1102 |
+
{
|
1103 |
+
"content": "</s_7. INSURED'S TELEPHONE>",
|
1104 |
+
"lstrip": false,
|
1105 |
+
"normalized": false,
|
1106 |
+
"rstrip": false,
|
1107 |
+
"single_word": false
|
1108 |
+
},
|
1109 |
+
{
|
1110 |
+
"content": "<s_6. PATIENT RELATIONSHIP>",
|
1111 |
+
"lstrip": false,
|
1112 |
+
"normalized": false,
|
1113 |
+
"rstrip": false,
|
1114 |
+
"single_word": false
|
1115 |
+
},
|
1116 |
+
{
|
1117 |
+
"content": "</s_6. PATIENT RELATIONSHIP>",
|
1118 |
+
"lstrip": false,
|
1119 |
+
"normalized": false,
|
1120 |
+
"rstrip": false,
|
1121 |
+
"single_word": false
|
1122 |
+
},
|
1123 |
+
{
|
1124 |
+
"content": "<s_5. PATIENT'S ZIP CODE>",
|
1125 |
+
"lstrip": false,
|
1126 |
+
"normalized": false,
|
1127 |
+
"rstrip": false,
|
1128 |
+
"single_word": false
|
1129 |
+
},
|
1130 |
+
{
|
1131 |
+
"content": "</s_5. PATIENT'S ZIP CODE>",
|
1132 |
+
"lstrip": false,
|
1133 |
+
"normalized": false,
|
1134 |
+
"rstrip": false,
|
1135 |
+
"single_word": false
|
1136 |
+
},
|
1137 |
+
{
|
1138 |
+
"content": "<s_5. PATIENT'S TELEPHONE>",
|
1139 |
+
"lstrip": false,
|
1140 |
+
"normalized": false,
|
1141 |
+
"rstrip": false,
|
1142 |
+
"single_word": false
|
1143 |
+
},
|
1144 |
+
{
|
1145 |
+
"content": "</s_5. PATIENT'S TELEPHONE>",
|
1146 |
+
"lstrip": false,
|
1147 |
+
"normalized": false,
|
1148 |
+
"rstrip": false,
|
1149 |
+
"single_word": false
|
1150 |
+
},
|
1151 |
+
{
|
1152 |
+
"content": "<s_5. PATIENT'S STATE>",
|
1153 |
+
"lstrip": false,
|
1154 |
+
"normalized": false,
|
1155 |
+
"rstrip": false,
|
1156 |
+
"single_word": false
|
1157 |
+
},
|
1158 |
+
{
|
1159 |
+
"content": "</s_5. PATIENT'S STATE>",
|
1160 |
+
"lstrip": false,
|
1161 |
+
"normalized": false,
|
1162 |
+
"rstrip": false,
|
1163 |
+
"single_word": false
|
1164 |
+
},
|
1165 |
+
{
|
1166 |
+
"content": "<s_5. PATIENT'S CITY>",
|
1167 |
+
"lstrip": false,
|
1168 |
+
"normalized": false,
|
1169 |
+
"rstrip": false,
|
1170 |
+
"single_word": false
|
1171 |
+
},
|
1172 |
+
{
|
1173 |
+
"content": "</s_5. PATIENT'S CITY>",
|
1174 |
+
"lstrip": false,
|
1175 |
+
"normalized": false,
|
1176 |
+
"rstrip": false,
|
1177 |
+
"single_word": false
|
1178 |
+
},
|
1179 |
+
{
|
1180 |
+
"content": "<s_5. PATIENT'S ADDRESS>",
|
1181 |
+
"lstrip": false,
|
1182 |
+
"normalized": false,
|
1183 |
+
"rstrip": false,
|
1184 |
+
"single_word": false
|
1185 |
+
},
|
1186 |
+
{
|
1187 |
+
"content": "</s_5. PATIENT'S ADDRESS>",
|
1188 |
+
"lstrip": false,
|
1189 |
+
"normalized": false,
|
1190 |
+
"rstrip": false,
|
1191 |
+
"single_word": false
|
1192 |
+
},
|
1193 |
+
{
|
1194 |
+
"content": "<s_3. PATIENT'S SEX>",
|
1195 |
+
"lstrip": false,
|
1196 |
+
"normalized": false,
|
1197 |
+
"rstrip": false,
|
1198 |
+
"single_word": false
|
1199 |
+
},
|
1200 |
+
{
|
1201 |
+
"content": "</s_3. PATIENT'S SEX>",
|
1202 |
+
"lstrip": false,
|
1203 |
+
"normalized": false,
|
1204 |
+
"rstrip": false,
|
1205 |
+
"single_word": false
|
1206 |
+
},
|
1207 |
+
{
|
1208 |
+
"content": "<s_3. PATIENT'S DATE OF BIRTH>",
|
1209 |
+
"lstrip": false,
|
1210 |
+
"normalized": false,
|
1211 |
+
"rstrip": false,
|
1212 |
+
"single_word": false
|
1213 |
+
},
|
1214 |
+
{
|
1215 |
+
"content": "</s_3. PATIENT'S DATE OF BIRTH>",
|
1216 |
+
"lstrip": false,
|
1217 |
+
"normalized": false,
|
1218 |
+
"rstrip": false,
|
1219 |
+
"single_word": false
|
1220 |
+
},
|
1221 |
+
{
|
1222 |
+
"content": "<s_YY>",
|
1223 |
+
"lstrip": false,
|
1224 |
+
"normalized": false,
|
1225 |
+
"rstrip": false,
|
1226 |
+
"single_word": false
|
1227 |
+
},
|
1228 |
+
{
|
1229 |
+
"content": "</s_YY>",
|
1230 |
+
"lstrip": false,
|
1231 |
+
"normalized": false,
|
1232 |
+
"rstrip": false,
|
1233 |
+
"single_word": false
|
1234 |
+
},
|
1235 |
+
{
|
1236 |
+
"content": "<s_MM>",
|
1237 |
+
"lstrip": false,
|
1238 |
+
"normalized": false,
|
1239 |
+
"rstrip": false,
|
1240 |
+
"single_word": false
|
1241 |
+
},
|
1242 |
+
{
|
1243 |
+
"content": "</s_MM>",
|
1244 |
+
"lstrip": false,
|
1245 |
+
"normalized": false,
|
1246 |
+
"rstrip": false,
|
1247 |
+
"single_word": false
|
1248 |
+
},
|
1249 |
+
{
|
1250 |
+
"content": "<s_DD>",
|
1251 |
+
"lstrip": false,
|
1252 |
+
"normalized": false,
|
1253 |
+
"rstrip": false,
|
1254 |
+
"single_word": false
|
1255 |
+
},
|
1256 |
+
{
|
1257 |
+
"content": "</s_DD>",
|
1258 |
+
"lstrip": false,
|
1259 |
+
"normalized": false,
|
1260 |
+
"rstrip": false,
|
1261 |
+
"single_word": false
|
1262 |
+
},
|
1263 |
+
{
|
1264 |
+
"content": "<s_2. PATIENT'S NAME>",
|
1265 |
+
"lstrip": false,
|
1266 |
+
"normalized": false,
|
1267 |
+
"rstrip": false,
|
1268 |
+
"single_word": false
|
1269 |
+
},
|
1270 |
+
{
|
1271 |
+
"content": "</s_2. PATIENT'S NAME>",
|
1272 |
+
"lstrip": false,
|
1273 |
+
"normalized": false,
|
1274 |
+
"rstrip": false,
|
1275 |
+
"single_word": false
|
1276 |
+
},
|
1277 |
+
{
|
1278 |
+
"content": "<s_1a. INSURED'S I.D. NUMBER>",
|
1279 |
+
"lstrip": false,
|
1280 |
+
"normalized": false,
|
1281 |
+
"rstrip": false,
|
1282 |
+
"single_word": false
|
1283 |
+
},
|
1284 |
+
{
|
1285 |
+
"content": "</s_1a. INSURED'S I.D. NUMBER>",
|
1286 |
+
"lstrip": false,
|
1287 |
+
"normalized": false,
|
1288 |
+
"rstrip": false,
|
1289 |
+
"single_word": false
|
1290 |
+
},
|
1291 |
+
{
|
1292 |
+
"content": "<s_13. INSURED OR AUTHORIZED PERSON'S SIGNATURE>",
|
1293 |
+
"lstrip": false,
|
1294 |
+
"normalized": false,
|
1295 |
+
"rstrip": false,
|
1296 |
+
"single_word": false
|
1297 |
+
},
|
1298 |
+
{
|
1299 |
+
"content": "</s_13. INSURED OR AUTHORIZED PERSON'S SIGNATURE>",
|
1300 |
+
"lstrip": false,
|
1301 |
+
"normalized": false,
|
1302 |
+
"rstrip": false,
|
1303 |
+
"single_word": false
|
1304 |
+
},
|
1305 |
+
{
|
1306 |
+
"content": "<s_12. PATIENT'S OR AUTHORIZED PERSON'S SIGNATURE>",
|
1307 |
+
"lstrip": false,
|
1308 |
+
"normalized": false,
|
1309 |
+
"rstrip": false,
|
1310 |
+
"single_word": false
|
1311 |
+
},
|
1312 |
+
{
|
1313 |
+
"content": "</s_12. PATIENT'S OR AUTHORIZED PERSON'S SIGNATURE>",
|
1314 |
+
"lstrip": false,
|
1315 |
+
"normalized": false,
|
1316 |
+
"rstrip": false,
|
1317 |
+
"single_word": false
|
1318 |
+
},
|
1319 |
+
{
|
1320 |
+
"content": "<s_11d. IS THERE ANOTHER HEALTH BENEFIT PLAN>",
|
1321 |
+
"lstrip": false,
|
1322 |
+
"normalized": false,
|
1323 |
+
"rstrip": false,
|
1324 |
+
"single_word": false
|
1325 |
+
},
|
1326 |
+
{
|
1327 |
+
"content": "</s_11d. IS THERE ANOTHER HEALTH BENEFIT PLAN>",
|
1328 |
+
"lstrip": false,
|
1329 |
+
"normalized": false,
|
1330 |
+
"rstrip": false,
|
1331 |
+
"single_word": false
|
1332 |
+
},
|
1333 |
+
{
|
1334 |
+
"content": "<s_11c. INSURANCE PLAN NAME>",
|
1335 |
+
"lstrip": false,
|
1336 |
+
"normalized": false,
|
1337 |
+
"rstrip": false,
|
1338 |
+
"single_word": false
|
1339 |
+
},
|
1340 |
+
{
|
1341 |
+
"content": "</s_11c. INSURANCE PLAN NAME>",
|
1342 |
+
"lstrip": false,
|
1343 |
+
"normalized": false,
|
1344 |
+
"rstrip": false,
|
1345 |
+
"single_word": false
|
1346 |
+
},
|
1347 |
+
{
|
1348 |
+
"content": "<s_11a. INSURED'S SEX>",
|
1349 |
+
"lstrip": false,
|
1350 |
+
"normalized": false,
|
1351 |
+
"rstrip": false,
|
1352 |
+
"single_word": false
|
1353 |
+
},
|
1354 |
+
{
|
1355 |
+
"content": "</s_11a. INSURED'S SEX>",
|
1356 |
+
"lstrip": false,
|
1357 |
+
"normalized": false,
|
1358 |
+
"rstrip": false,
|
1359 |
+
"single_word": false
|
1360 |
+
},
|
1361 |
+
{
|
1362 |
+
"content": "<s_11. INSURED'S POLICY GROUP OR FECA NUMBER>",
|
1363 |
+
"lstrip": false,
|
1364 |
+
"normalized": false,
|
1365 |
+
"rstrip": false,
|
1366 |
+
"single_word": false
|
1367 |
+
},
|
1368 |
+
{
|
1369 |
+
"content": "</s_11. INSURED'S POLICY GROUP OR FECA NUMBER>",
|
1370 |
+
"lstrip": false,
|
1371 |
+
"normalized": false,
|
1372 |
+
"rstrip": false,
|
1373 |
+
"single_word": false
|
1374 |
+
},
|
1375 |
+
{
|
1376 |
+
"content": "<s_10. PATIENT'S CONDITION>",
|
1377 |
+
"lstrip": false,
|
1378 |
+
"normalized": false,
|
1379 |
+
"rstrip": false,
|
1380 |
+
"single_word": false
|
1381 |
+
},
|
1382 |
+
{
|
1383 |
+
"content": "</s_10. PATIENT'S CONDITION>",
|
1384 |
+
"lstrip": false,
|
1385 |
+
"normalized": false,
|
1386 |
+
"rstrip": false,
|
1387 |
+
"single_word": false
|
1388 |
+
},
|
1389 |
+
{
|
1390 |
+
"content": "<s_10a. EMPLOYMENT>",
|
1391 |
+
"lstrip": false,
|
1392 |
+
"normalized": false,
|
1393 |
+
"rstrip": false,
|
1394 |
+
"single_word": false
|
1395 |
+
},
|
1396 |
+
{
|
1397 |
+
"content": "</s_10a. EMPLOYMENT>",
|
1398 |
+
"lstrip": false,
|
1399 |
+
"normalized": false,
|
1400 |
+
"rstrip": false,
|
1401 |
+
"single_word": false
|
1402 |
+
},
|
1403 |
+
{
|
1404 |
+
"content": "<s_10b. AUTO ACCIDENT>",
|
1405 |
+
"lstrip": false,
|
1406 |
+
"normalized": false,
|
1407 |
+
"rstrip": false,
|
1408 |
+
"single_word": false
|
1409 |
+
},
|
1410 |
+
{
|
1411 |
+
"content": "</s_10b. AUTO ACCIDENT>",
|
1412 |
+
"lstrip": false,
|
1413 |
+
"normalized": false,
|
1414 |
+
"rstrip": false,
|
1415 |
+
"single_word": false
|
1416 |
+
},
|
1417 |
+
{
|
1418 |
+
"content": "<s_10c. OTHER ACCIDENT>",
|
1419 |
+
"lstrip": false,
|
1420 |
+
"normalized": false,
|
1421 |
+
"rstrip": false,
|
1422 |
+
"single_word": false
|
1423 |
+
},
|
1424 |
+
{
|
1425 |
+
"content": "</s_10c. OTHER ACCIDENT>",
|
1426 |
+
"lstrip": false,
|
1427 |
+
"normalized": false,
|
1428 |
+
"rstrip": false,
|
1429 |
+
"single_word": false
|
1430 |
+
},
|
1431 |
+
{
|
1432 |
+
"content": "<s_1.INSURED PLAN>",
|
1433 |
+
"lstrip": false,
|
1434 |
+
"normalized": false,
|
1435 |
+
"rstrip": false,
|
1436 |
+
"single_word": false
|
1437 |
+
},
|
1438 |
+
{
|
1439 |
+
"content": "</s_1.INSURED PLAN>",
|
1440 |
+
"lstrip": false,
|
1441 |
+
"normalized": false,
|
1442 |
+
"rstrip": false,
|
1443 |
+
"single_word": false
|
1444 |
+
},
|
1445 |
+
{
|
1446 |
+
"content": "<s_1. INSURED PLAN>",
|
1447 |
+
"lstrip": false,
|
1448 |
+
"normalized": false,
|
1449 |
+
"rstrip": false,
|
1450 |
+
"single_word": false
|
1451 |
+
},
|
1452 |
+
{
|
1453 |
+
"content": "</s_1. INSURED PLAN>",
|
1454 |
+
"lstrip": false,
|
1455 |
+
"normalized": false,
|
1456 |
+
"rstrip": false,
|
1457 |
+
"single_word": false
|
1458 |
+
},
|
1459 |
+
{
|
1460 |
+
"content": "<s_17>",
|
1461 |
+
"lstrip": false,
|
1462 |
+
"normalized": false,
|
1463 |
+
"rstrip": false,
|
1464 |
+
"single_word": false
|
1465 |
+
},
|
1466 |
+
{
|
1467 |
+
"content": "</s_17>",
|
1468 |
+
"lstrip": false,
|
1469 |
+
"normalized": false,
|
1470 |
+
"rstrip": false,
|
1471 |
+
"single_word": false
|
1472 |
+
},
|
1473 |
+
{
|
1474 |
+
"content": "<s>",
|
1475 |
+
"lstrip": false,
|
1476 |
+
"normalized": false,
|
1477 |
+
"rstrip": false,
|
1478 |
+
"single_word": false
|
1479 |
+
},
|
1480 |
+
{
|
1481 |
+
"content": "</s>",
|
1482 |
+
"lstrip": false,
|
1483 |
+
"normalized": false,
|
1484 |
+
"rstrip": false,
|
1485 |
+
"single_word": false
|
1486 |
+
}
|
1487 |
+
],
|
1488 |
+
"bos_token": {
|
1489 |
+
"content": "<s>",
|
1490 |
+
"lstrip": false,
|
1491 |
+
"normalized": false,
|
1492 |
+
"rstrip": false,
|
1493 |
+
"single_word": false
|
1494 |
+
},
|
1495 |
+
"cls_token": {
|
1496 |
+
"content": "<s>",
|
1497 |
+
"lstrip": false,
|
1498 |
+
"normalized": false,
|
1499 |
+
"rstrip": false,
|
1500 |
+
"single_word": false
|
1501 |
+
},
|
1502 |
+
"eos_token": {
|
1503 |
+
"content": "</s>",
|
1504 |
+
"lstrip": false,
|
1505 |
+
"normalized": false,
|
1506 |
+
"rstrip": false,
|
1507 |
+
"single_word": false
|
1508 |
+
},
|
1509 |
+
"mask_token": {
|
1510 |
+
"content": "<mask>",
|
1511 |
+
"lstrip": true,
|
1512 |
+
"normalized": true,
|
1513 |
+
"rstrip": false,
|
1514 |
+
"single_word": false
|
1515 |
+
},
|
1516 |
+
"pad_token": {
|
1517 |
+
"content": "<pad>",
|
1518 |
+
"lstrip": false,
|
1519 |
+
"normalized": false,
|
1520 |
+
"rstrip": false,
|
1521 |
+
"single_word": false
|
1522 |
+
},
|
1523 |
+
"sep_token": {
|
1524 |
+
"content": "</s>",
|
1525 |
+
"lstrip": false,
|
1526 |
+
"normalized": false,
|
1527 |
+
"rstrip": false,
|
1528 |
+
"single_word": false
|
1529 |
+
},
|
1530 |
+
"unk_token": {
|
1531 |
+
"content": "<unk>",
|
1532 |
+
"lstrip": false,
|
1533 |
+
"normalized": false,
|
1534 |
+
"rstrip": false,
|
1535 |
+
"single_word": false
|
1536 |
+
}
|
1537 |
+
}
|
tokenizer.json
ADDED
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|
tokenizer_config.json
ADDED
@@ -0,0 +1,2414 @@
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|
1 |
+
{
|
2 |
+
"added_tokens_decoder": {
|
3 |
+
"0": {
|
4 |
+
"content": "<s>",
|
5 |
+
"lstrip": false,
|
6 |
+
"normalized": false,
|
7 |
+
"rstrip": false,
|
8 |
+
"single_word": false,
|
9 |
+
"special": true
|
10 |
+
},
|
11 |
+
"1": {
|
12 |
+
"content": "<pad>",
|
13 |
+
"lstrip": false,
|
14 |
+
"normalized": false,
|
15 |
+
"rstrip": false,
|
16 |
+
"single_word": false,
|
17 |
+
"special": true
|
18 |
+
},
|
19 |
+
"2": {
|
20 |
+
"content": "</s>",
|
21 |
+
"lstrip": false,
|
22 |
+
"normalized": false,
|
23 |
+
"rstrip": false,
|
24 |
+
"single_word": false,
|
25 |
+
"special": true
|
26 |
+
},
|
27 |
+
"3": {
|
28 |
+
"content": "<unk>",
|
29 |
+
"lstrip": false,
|
30 |
+
"normalized": false,
|
31 |
+
"rstrip": false,
|
32 |
+
"single_word": false,
|
33 |
+
"special": true
|
34 |
+
},
|
35 |
+
"57521": {
|
36 |
+
"content": "<mask>",
|
37 |
+
"lstrip": true,
|
38 |
+
"normalized": true,
|
39 |
+
"rstrip": false,
|
40 |
+
"single_word": false,
|
41 |
+
"special": true
|
42 |
+
},
|
43 |
+
"57522": {
|
44 |
+
"content": "<sep/>",
|
45 |
+
"lstrip": false,
|
46 |
+
"normalized": true,
|
47 |
+
"rstrip": false,
|
48 |
+
"single_word": false,
|
49 |
+
"special": false
|
50 |
+
},
|
51 |
+
"57523": {
|
52 |
+
"content": "<s_iitcdip>",
|
53 |
+
"lstrip": false,
|
54 |
+
"normalized": true,
|
55 |
+
"rstrip": false,
|
56 |
+
"single_word": false,
|
57 |
+
"special": false
|
58 |
+
},
|
59 |
+
"57524": {
|
60 |
+
"content": "<s_synthdog>",
|
61 |
+
"lstrip": false,
|
62 |
+
"normalized": true,
|
63 |
+
"rstrip": false,
|
64 |
+
"single_word": false,
|
65 |
+
"special": false
|
66 |
+
},
|
67 |
+
"57525": {
|
68 |
+
"content": "</s_menu>",
|
69 |
+
"lstrip": false,
|
70 |
+
"normalized": true,
|
71 |
+
"rstrip": false,
|
72 |
+
"single_word": false,
|
73 |
+
"special": false
|
74 |
+
},
|
75 |
+
"57526": {
|
76 |
+
"content": "<s_menu>",
|
77 |
+
"lstrip": false,
|
78 |
+
"normalized": true,
|
79 |
+
"rstrip": false,
|
80 |
+
"single_word": false,
|
81 |
+
"special": false
|
82 |
+
},
|
83 |
+
"57527": {
|
84 |
+
"content": "</s_nm>",
|
85 |
+
"lstrip": false,
|
86 |
+
"normalized": true,
|
87 |
+
"rstrip": false,
|
88 |
+
"single_word": false,
|
89 |
+
"special": false
|
90 |
+
},
|
91 |
+
"57528": {
|
92 |
+
"content": "<s_nm>",
|
93 |
+
"lstrip": false,
|
94 |
+
"normalized": true,
|
95 |
+
"rstrip": false,
|
96 |
+
"single_word": false,
|
97 |
+
"special": false
|
98 |
+
},
|
99 |
+
"57529": {
|
100 |
+
"content": "</s_cnt>",
|
101 |
+
"lstrip": false,
|
102 |
+
"normalized": true,
|
103 |
+
"rstrip": false,
|
104 |
+
"single_word": false,
|
105 |
+
"special": false
|
106 |
+
},
|
107 |
+
"57530": {
|
108 |
+
"content": "<s_cnt>",
|
109 |
+
"lstrip": false,
|
110 |
+
"normalized": true,
|
111 |
+
"rstrip": false,
|
112 |
+
"single_word": false,
|
113 |
+
"special": false
|
114 |
+
},
|
115 |
+
"57531": {
|
116 |
+
"content": "</s_price>",
|
117 |
+
"lstrip": false,
|
118 |
+
"normalized": true,
|
119 |
+
"rstrip": false,
|
120 |
+
"single_word": false,
|
121 |
+
"special": false
|
122 |
+
},
|
123 |
+
"57532": {
|
124 |
+
"content": "<s_price>",
|
125 |
+
"lstrip": false,
|
126 |
+
"normalized": true,
|
127 |
+
"rstrip": false,
|
128 |
+
"single_word": false,
|
129 |
+
"special": false
|
130 |
+
},
|
131 |
+
"57533": {
|
132 |
+
"content": "</s_sub_total>",
|
133 |
+
"lstrip": false,
|
134 |
+
"normalized": true,
|
135 |
+
"rstrip": false,
|
136 |
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140 |
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141 |
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142 |
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143 |
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148 |
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182 |
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290 |
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292 |
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293 |
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294 |
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296 |
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336 |
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374 |
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389 |
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390 |
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392 |
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397 |
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398 |
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400 |
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414 |
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421 |
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422 |
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423 |
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433 |
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438 |
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446 |
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465 |
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466 |
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467 |
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468 |
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469 |
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470 |
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471 |
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472 |
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474 |
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478 |
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481 |
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482 |
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484 |
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486 |
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487 |
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488 |
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489 |
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490 |
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491 |
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492 |
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494 |
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497 |
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498 |
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502 |
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503 |
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510 |
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512 |
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518 |
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573 |
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574 |
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581 |
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582 |
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590 |
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598 |
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599 |
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600 |
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601 |
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602 |
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},
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603 |
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604 |
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"content": "<s_33. a. NPI NUMBER>",
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605 |
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606 |
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607 |
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608 |
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609 |
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610 |
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},
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611 |
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|
612 |
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"content": "</s_33. a. NPI NUMBER>",
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613 |
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614 |
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615 |
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616 |
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617 |
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618 |
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},
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619 |
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620 |
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"content": "<s_32. SERVICE INFORMATION>",
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621 |
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622 |
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623 |
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624 |
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625 |
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626 |
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},
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627 |
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|
628 |
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"content": "</s_32. SERVICE INFORMATION>",
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629 |
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630 |
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631 |
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632 |
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633 |
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634 |
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},
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635 |
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|
636 |
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"content": "<s_32. SERVICE FACILITY LOCATION>",
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637 |
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638 |
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639 |
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640 |
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641 |
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642 |
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},
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643 |
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|
644 |
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"content": "</s_32. SERVICE FACILITY LOCATION>",
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645 |
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646 |
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647 |
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648 |
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649 |
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650 |
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},
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651 |
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652 |
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"content": "<s_32. a. NPI NUMBER>",
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653 |
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654 |
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655 |
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656 |
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657 |
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658 |
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},
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659 |
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|
660 |
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"content": "</s_32. a. NPI NUMBER>",
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661 |
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662 |
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663 |
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664 |
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|
665 |
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666 |
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},
|
667 |
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|
668 |
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"content": "<s_31. PHYSICIAN OR SUPPLIER SIGNATURE>",
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669 |
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670 |
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671 |
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672 |
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673 |
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674 |
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},
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675 |
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|
676 |
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"content": "</s_31. PHYSICIAN OR SUPPLIER SIGNATURE>",
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677 |
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678 |
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|
679 |
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680 |
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|
681 |
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682 |
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},
|
683 |
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|
684 |
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"content": "<s_SIGNED>",
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685 |
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|
686 |
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687 |
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688 |
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|
689 |
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|
690 |
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},
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691 |
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|
692 |
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"content": "</s_SIGNED>",
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693 |
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|
694 |
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|
695 |
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|
696 |
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|
697 |
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698 |
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},
|
699 |
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|
700 |
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"content": "<s_DATE>",
|
701 |
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|
702 |
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|
703 |
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|
704 |
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|
705 |
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706 |
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},
|
707 |
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|
708 |
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"content": "</s_DATE>",
|
709 |
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|
710 |
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|
711 |
+
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|
712 |
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|
713 |
+
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|
714 |
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},
|
715 |
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|
716 |
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"content": "<s_29. AMOUNT PAID>",
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717 |
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|
718 |
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|
719 |
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|
720 |
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|
721 |
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|
722 |
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},
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723 |
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|
724 |
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"content": "</s_29. AMOUNT PAID>",
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725 |
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|
726 |
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|
727 |
+
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|
728 |
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|
729 |
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730 |
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},
|
731 |
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|
732 |
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"content": "<s_28. TOTAL CHARGE>",
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733 |
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|
734 |
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|
735 |
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|
736 |
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|
737 |
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|
738 |
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},
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739 |
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|
740 |
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"content": "</s_28. TOTAL CHARGE>",
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741 |
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|
742 |
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|
743 |
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|
744 |
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|
745 |
+
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|
746 |
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},
|
747 |
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|
748 |
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"content": "<s_27. ACCEPT ASSIGNMENT>",
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749 |
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|
750 |
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|
751 |
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|
752 |
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|
753 |
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754 |
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},
|
755 |
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|
756 |
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"content": "</s_27. ACCEPT ASSIGNMENT>",
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757 |
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|
758 |
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|
759 |
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|
760 |
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|
761 |
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|
762 |
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},
|
763 |
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"57612": {
|
764 |
+
"content": "<s_26. PATIENT'S ACCOUNT NUMBER>",
|
765 |
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|
766 |
+
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|
767 |
+
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|
768 |
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|
769 |
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|
770 |
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},
|
771 |
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|
772 |
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"content": "</s_26. PATIENT'S ACCOUNT NUMBER>",
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773 |
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|
774 |
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|
775 |
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|
776 |
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|
777 |
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|
778 |
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},
|
779 |
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|
780 |
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"content": "<s_25. FEDERAL TAX I.D. NUMBER>",
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781 |
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|
782 |
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|
783 |
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|
784 |
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|
785 |
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|
786 |
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},
|
787 |
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|
788 |
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"content": "</s_25. FEDERAL TAX I.D. NUMBER>",
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789 |
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|
790 |
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|
791 |
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|
792 |
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|
793 |
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|
794 |
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},
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795 |
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|
796 |
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"content": "<s_25. FEDERAL IDENTIFICATION>",
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797 |
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|
798 |
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|
799 |
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|
800 |
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|
801 |
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802 |
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},
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803 |
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|
804 |
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"content": "</s_25. FEDERAL IDENTIFICATION>",
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805 |
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|
806 |
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|
807 |
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|
808 |
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|
809 |
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|
810 |
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},
|
811 |
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|
812 |
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"content": "<s_24. SERVICES>",
|
813 |
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|
814 |
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|
815 |
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|
816 |
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|
817 |
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|
818 |
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},
|
819 |
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|
820 |
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"content": "</s_24. SERVICES>",
|
821 |
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|
822 |
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|
823 |
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|
824 |
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|
825 |
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826 |
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},
|
827 |
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|
828 |
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"content": "<s_YY 1>",
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829 |
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|
830 |
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831 |
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|
832 |
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|
833 |
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834 |
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},
|
835 |
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|
836 |
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"content": "</s_YY 1>",
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837 |
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|
838 |
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|
839 |
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|
840 |
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|
841 |
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842 |
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},
|
843 |
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|
844 |
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"content": "<s_UNITS 1>",
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845 |
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|
846 |
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|
847 |
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848 |
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|
849 |
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850 |
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},
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851 |
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|
852 |
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"content": "</s_UNITS 1>",
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853 |
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|
854 |
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|
855 |
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|
856 |
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|
857 |
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858 |
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},
|
859 |
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|
860 |
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"content": "<s_PROVIDER ID 1>",
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861 |
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|
862 |
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|
863 |
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|
864 |
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|
865 |
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866 |
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},
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867 |
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|
868 |
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"content": "</s_PROVIDER ID 1>",
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869 |
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|
870 |
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|
871 |
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|
872 |
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|
873 |
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|
874 |
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},
|
875 |
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|
876 |
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"content": "<s_PLACE OF SERVICE 1>",
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877 |
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|
878 |
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|
879 |
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|
880 |
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|
881 |
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882 |
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},
|
883 |
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|
884 |
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"content": "</s_PLACE OF SERVICE 1>",
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885 |
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|
886 |
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|
887 |
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|
888 |
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|
889 |
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|
890 |
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},
|
891 |
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|
892 |
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"content": "<s_MODIFIER 1>",
|
893 |
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|
894 |
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|
895 |
+
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|
896 |
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|
897 |
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|
898 |
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},
|
899 |
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|
900 |
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"content": "</s_MODIFIER 1>",
|
901 |
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|
902 |
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|
903 |
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|
904 |
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|
905 |
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|
906 |
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},
|
907 |
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|
908 |
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"content": "<s_MM 1>",
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909 |
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|
910 |
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|
911 |
+
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|
912 |
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|
913 |
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|
914 |
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},
|
915 |
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|
916 |
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"content": "</s_MM 1>",
|
917 |
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|
918 |
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|
919 |
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|
920 |
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|
921 |
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"special": true
|
922 |
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},
|
923 |
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|
924 |
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"content": "<s_Family Plan 1>",
|
925 |
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|
926 |
+
"normalized": false,
|
927 |
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|
928 |
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|
929 |
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|
930 |
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},
|
931 |
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|
932 |
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"content": "</s_Family Plan 1>",
|
933 |
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|
934 |
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|
935 |
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|
936 |
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|
937 |
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|
938 |
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},
|
939 |
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|
940 |
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"content": "<s_EMG 1>",
|
941 |
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|
942 |
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"normalized": false,
|
943 |
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|
944 |
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|
945 |
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|
946 |
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},
|
947 |
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|
948 |
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"content": "</s_EMG 1>",
|
949 |
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|
950 |
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|
951 |
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|
952 |
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|
953 |
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|
954 |
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},
|
955 |
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|
956 |
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"content": "<s_DIAGNOSIS POINTER 1>",
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957 |
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"lstrip": false,
|
958 |
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"normalized": false,
|
959 |
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|
960 |
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|
961 |
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"special": true
|
962 |
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},
|
963 |
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|
964 |
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"content": "</s_DIAGNOSIS POINTER 1>",
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965 |
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|
966 |
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|
967 |
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|
968 |
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|
969 |
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|
970 |
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},
|
971 |
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|
972 |
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"content": "<s_DD 1>",
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973 |
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|
974 |
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|
975 |
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|
976 |
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|
977 |
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|
978 |
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},
|
979 |
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|
980 |
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"content": "</s_DD 1>",
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981 |
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|
982 |
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|
983 |
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|
984 |
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|
985 |
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|
986 |
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},
|
987 |
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|
988 |
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"content": "<s_CPT/HCPCS 1>",
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989 |
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|
990 |
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|
991 |
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|
992 |
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|
993 |
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|
994 |
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},
|
995 |
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|
996 |
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"content": "</s_CPT/HCPCS 1>",
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997 |
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|
998 |
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|
999 |
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|
1000 |
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|
1001 |
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|
1002 |
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},
|
1003 |
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"57642": {
|
1004 |
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"content": "<s_$CHARGES 1>",
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1005 |
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|
1006 |
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|
1007 |
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|
1008 |
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|
1009 |
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"special": true
|
1010 |
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},
|
1011 |
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|
1012 |
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"content": "</s_$CHARGES 1>",
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1013 |
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1014 |
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1015 |
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1016 |
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1017 |
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1018 |
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},
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1019 |
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|
1020 |
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"content": "<s_YY 2>",
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1021 |
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1022 |
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1023 |
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1024 |
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1025 |
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1026 |
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|
1027 |
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|
1028 |
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"content": "</s_YY 2>",
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1029 |
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1030 |
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1031 |
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1032 |
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1033 |
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1034 |
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},
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1035 |
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|
1036 |
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"content": "<s_UNITS 2>",
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1037 |
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1038 |
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1039 |
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1040 |
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1041 |
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|
1042 |
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},
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1043 |
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|
1044 |
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"content": "</s_UNITS 2>",
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1045 |
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"lstrip": false,
|
1046 |
+
"normalized": false,
|
1047 |
+
"rstrip": false,
|
1048 |
+
"single_word": false,
|
1049 |
+
"special": true
|
1050 |
+
},
|
1051 |
+
"57648": {
|
1052 |
+
"content": "<s_PROVIDER ID 2>",
|
1053 |
+
"lstrip": false,
|
1054 |
+
"normalized": false,
|
1055 |
+
"rstrip": false,
|
1056 |
+
"single_word": false,
|
1057 |
+
"special": true
|
1058 |
+
},
|
1059 |
+
"57649": {
|
1060 |
+
"content": "</s_PROVIDER ID 2>",
|
1061 |
+
"lstrip": false,
|
1062 |
+
"normalized": false,
|
1063 |
+
"rstrip": false,
|
1064 |
+
"single_word": false,
|
1065 |
+
"special": true
|
1066 |
+
},
|
1067 |
+
"57650": {
|
1068 |
+
"content": "<s_PLACE OF SERVICE 2>",
|
1069 |
+
"lstrip": false,
|
1070 |
+
"normalized": false,
|
1071 |
+
"rstrip": false,
|
1072 |
+
"single_word": false,
|
1073 |
+
"special": true
|
1074 |
+
},
|
1075 |
+
"57651": {
|
1076 |
+
"content": "</s_PLACE OF SERVICE 2>",
|
1077 |
+
"lstrip": false,
|
1078 |
+
"normalized": false,
|
1079 |
+
"rstrip": false,
|
1080 |
+
"single_word": false,
|
1081 |
+
"special": true
|
1082 |
+
},
|
1083 |
+
"57652": {
|
1084 |
+
"content": "<s_MODIFIER 2>",
|
1085 |
+
"lstrip": false,
|
1086 |
+
"normalized": false,
|
1087 |
+
"rstrip": false,
|
1088 |
+
"single_word": false,
|
1089 |
+
"special": true
|
1090 |
+
},
|
1091 |
+
"57653": {
|
1092 |
+
"content": "</s_MODIFIER 2>",
|
1093 |
+
"lstrip": false,
|
1094 |
+
"normalized": false,
|
1095 |
+
"rstrip": false,
|
1096 |
+
"single_word": false,
|
1097 |
+
"special": true
|
1098 |
+
},
|
1099 |
+
"57654": {
|
1100 |
+
"content": "<s_MM 2>",
|
1101 |
+
"lstrip": false,
|
1102 |
+
"normalized": false,
|
1103 |
+
"rstrip": false,
|
1104 |
+
"single_word": false,
|
1105 |
+
"special": true
|
1106 |
+
},
|
1107 |
+
"57655": {
|
1108 |
+
"content": "</s_MM 2>",
|
1109 |
+
"lstrip": false,
|
1110 |
+
"normalized": false,
|
1111 |
+
"rstrip": false,
|
1112 |
+
"single_word": false,
|
1113 |
+
"special": true
|
1114 |
+
},
|
1115 |
+
"57656": {
|
1116 |
+
"content": "<s_Family Plan 2>",
|
1117 |
+
"lstrip": false,
|
1118 |
+
"normalized": false,
|
1119 |
+
"rstrip": false,
|
1120 |
+
"single_word": false,
|
1121 |
+
"special": true
|
1122 |
+
},
|
1123 |
+
"57657": {
|
1124 |
+
"content": "</s_Family Plan 2>",
|
1125 |
+
"lstrip": false,
|
1126 |
+
"normalized": false,
|
1127 |
+
"rstrip": false,
|
1128 |
+
"single_word": false,
|
1129 |
+
"special": true
|
1130 |
+
},
|
1131 |
+
"57658": {
|
1132 |
+
"content": "<s_EMG 2>",
|
1133 |
+
"lstrip": false,
|
1134 |
+
"normalized": false,
|
1135 |
+
"rstrip": false,
|
1136 |
+
"single_word": false,
|
1137 |
+
"special": true
|
1138 |
+
},
|
1139 |
+
"57659": {
|
1140 |
+
"content": "</s_EMG 2>",
|
1141 |
+
"lstrip": false,
|
1142 |
+
"normalized": false,
|
1143 |
+
"rstrip": false,
|
1144 |
+
"single_word": false,
|
1145 |
+
"special": true
|
1146 |
+
},
|
1147 |
+
"57660": {
|
1148 |
+
"content": "<s_DIAGNOSIS POINTER 2>",
|
1149 |
+
"lstrip": false,
|
1150 |
+
"normalized": false,
|
1151 |
+
"rstrip": false,
|
1152 |
+
"single_word": false,
|
1153 |
+
"special": true
|
1154 |
+
},
|
1155 |
+
"57661": {
|
1156 |
+
"content": "</s_DIAGNOSIS POINTER 2>",
|
1157 |
+
"lstrip": false,
|
1158 |
+
"normalized": false,
|
1159 |
+
"rstrip": false,
|
1160 |
+
"single_word": false,
|
1161 |
+
"special": true
|
1162 |
+
},
|
1163 |
+
"57662": {
|
1164 |
+
"content": "<s_DD 2>",
|
1165 |
+
"lstrip": false,
|
1166 |
+
"normalized": false,
|
1167 |
+
"rstrip": false,
|
1168 |
+
"single_word": false,
|
1169 |
+
"special": true
|
1170 |
+
},
|
1171 |
+
"57663": {
|
1172 |
+
"content": "</s_DD 2>",
|
1173 |
+
"lstrip": false,
|
1174 |
+
"normalized": false,
|
1175 |
+
"rstrip": false,
|
1176 |
+
"single_word": false,
|
1177 |
+
"special": true
|
1178 |
+
},
|
1179 |
+
"57664": {
|
1180 |
+
"content": "<s_CPT/HCPCS 2>",
|
1181 |
+
"lstrip": false,
|
1182 |
+
"normalized": false,
|
1183 |
+
"rstrip": false,
|
1184 |
+
"single_word": false,
|
1185 |
+
"special": true
|
1186 |
+
},
|
1187 |
+
"57665": {
|
1188 |
+
"content": "</s_CPT/HCPCS 2>",
|
1189 |
+
"lstrip": false,
|
1190 |
+
"normalized": false,
|
1191 |
+
"rstrip": false,
|
1192 |
+
"single_word": false,
|
1193 |
+
"special": true
|
1194 |
+
},
|
1195 |
+
"57666": {
|
1196 |
+
"content": "<s_$CHARGES 2>",
|
1197 |
+
"lstrip": false,
|
1198 |
+
"normalized": false,
|
1199 |
+
"rstrip": false,
|
1200 |
+
"single_word": false,
|
1201 |
+
"special": true
|
1202 |
+
},
|
1203 |
+
"57667": {
|
1204 |
+
"content": "</s_$CHARGES 2>",
|
1205 |
+
"lstrip": false,
|
1206 |
+
"normalized": false,
|
1207 |
+
"rstrip": false,
|
1208 |
+
"single_word": false,
|
1209 |
+
"special": true
|
1210 |
+
},
|
1211 |
+
"57668": {
|
1212 |
+
"content": "<s_YY 3>",
|
1213 |
+
"lstrip": false,
|
1214 |
+
"normalized": false,
|
1215 |
+
"rstrip": false,
|
1216 |
+
"single_word": false,
|
1217 |
+
"special": true
|
1218 |
+
},
|
1219 |
+
"57669": {
|
1220 |
+
"content": "</s_YY 3>",
|
1221 |
+
"lstrip": false,
|
1222 |
+
"normalized": false,
|
1223 |
+
"rstrip": false,
|
1224 |
+
"single_word": false,
|
1225 |
+
"special": true
|
1226 |
+
},
|
1227 |
+
"57670": {
|
1228 |
+
"content": "<s_UNITS 3>",
|
1229 |
+
"lstrip": false,
|
1230 |
+
"normalized": false,
|
1231 |
+
"rstrip": false,
|
1232 |
+
"single_word": false,
|
1233 |
+
"special": true
|
1234 |
+
},
|
1235 |
+
"57671": {
|
1236 |
+
"content": "</s_UNITS 3>",
|
1237 |
+
"lstrip": false,
|
1238 |
+
"normalized": false,
|
1239 |
+
"rstrip": false,
|
1240 |
+
"single_word": false,
|
1241 |
+
"special": true
|
1242 |
+
},
|
1243 |
+
"57672": {
|
1244 |
+
"content": "<s_PROVIDER ID 3>",
|
1245 |
+
"lstrip": false,
|
1246 |
+
"normalized": false,
|
1247 |
+
"rstrip": false,
|
1248 |
+
"single_word": false,
|
1249 |
+
"special": true
|
1250 |
+
},
|
1251 |
+
"57673": {
|
1252 |
+
"content": "</s_PROVIDER ID 3>",
|
1253 |
+
"lstrip": false,
|
1254 |
+
"normalized": false,
|
1255 |
+
"rstrip": false,
|
1256 |
+
"single_word": false,
|
1257 |
+
"special": true
|
1258 |
+
},
|
1259 |
+
"57674": {
|
1260 |
+
"content": "<s_PLACE OF SERVICE 3>",
|
1261 |
+
"lstrip": false,
|
1262 |
+
"normalized": false,
|
1263 |
+
"rstrip": false,
|
1264 |
+
"single_word": false,
|
1265 |
+
"special": true
|
1266 |
+
},
|
1267 |
+
"57675": {
|
1268 |
+
"content": "</s_PLACE OF SERVICE 3>",
|
1269 |
+
"lstrip": false,
|
1270 |
+
"normalized": false,
|
1271 |
+
"rstrip": false,
|
1272 |
+
"single_word": false,
|
1273 |
+
"special": true
|
1274 |
+
},
|
1275 |
+
"57676": {
|
1276 |
+
"content": "<s_MODIFIER 3>",
|
1277 |
+
"lstrip": false,
|
1278 |
+
"normalized": false,
|
1279 |
+
"rstrip": false,
|
1280 |
+
"single_word": false,
|
1281 |
+
"special": true
|
1282 |
+
},
|
1283 |
+
"57677": {
|
1284 |
+
"content": "</s_MODIFIER 3>",
|
1285 |
+
"lstrip": false,
|
1286 |
+
"normalized": false,
|
1287 |
+
"rstrip": false,
|
1288 |
+
"single_word": false,
|
1289 |
+
"special": true
|
1290 |
+
},
|
1291 |
+
"57678": {
|
1292 |
+
"content": "<s_MM 3>",
|
1293 |
+
"lstrip": false,
|
1294 |
+
"normalized": false,
|
1295 |
+
"rstrip": false,
|
1296 |
+
"single_word": false,
|
1297 |
+
"special": true
|
1298 |
+
},
|
1299 |
+
"57679": {
|
1300 |
+
"content": "</s_MM 3>",
|
1301 |
+
"lstrip": false,
|
1302 |
+
"normalized": false,
|
1303 |
+
"rstrip": false,
|
1304 |
+
"single_word": false,
|
1305 |
+
"special": true
|
1306 |
+
},
|
1307 |
+
"57680": {
|
1308 |
+
"content": "<s_Family Plan 3>",
|
1309 |
+
"lstrip": false,
|
1310 |
+
"normalized": false,
|
1311 |
+
"rstrip": false,
|
1312 |
+
"single_word": false,
|
1313 |
+
"special": true
|
1314 |
+
},
|
1315 |
+
"57681": {
|
1316 |
+
"content": "</s_Family Plan 3>",
|
1317 |
+
"lstrip": false,
|
1318 |
+
"normalized": false,
|
1319 |
+
"rstrip": false,
|
1320 |
+
"single_word": false,
|
1321 |
+
"special": true
|
1322 |
+
},
|
1323 |
+
"57682": {
|
1324 |
+
"content": "<s_EMG 3>",
|
1325 |
+
"lstrip": false,
|
1326 |
+
"normalized": false,
|
1327 |
+
"rstrip": false,
|
1328 |
+
"single_word": false,
|
1329 |
+
"special": true
|
1330 |
+
},
|
1331 |
+
"57683": {
|
1332 |
+
"content": "</s_EMG 3>",
|
1333 |
+
"lstrip": false,
|
1334 |
+
"normalized": false,
|
1335 |
+
"rstrip": false,
|
1336 |
+
"single_word": false,
|
1337 |
+
"special": true
|
1338 |
+
},
|
1339 |
+
"57684": {
|
1340 |
+
"content": "<s_DIAGNOSIS POINTER 3>",
|
1341 |
+
"lstrip": false,
|
1342 |
+
"normalized": false,
|
1343 |
+
"rstrip": false,
|
1344 |
+
"single_word": false,
|
1345 |
+
"special": true
|
1346 |
+
},
|
1347 |
+
"57685": {
|
1348 |
+
"content": "</s_DIAGNOSIS POINTER 3>",
|
1349 |
+
"lstrip": false,
|
1350 |
+
"normalized": false,
|
1351 |
+
"rstrip": false,
|
1352 |
+
"single_word": false,
|
1353 |
+
"special": true
|
1354 |
+
},
|
1355 |
+
"57686": {
|
1356 |
+
"content": "<s_DD 3>",
|
1357 |
+
"lstrip": false,
|
1358 |
+
"normalized": false,
|
1359 |
+
"rstrip": false,
|
1360 |
+
"single_word": false,
|
1361 |
+
"special": true
|
1362 |
+
},
|
1363 |
+
"57687": {
|
1364 |
+
"content": "</s_DD 3>",
|
1365 |
+
"lstrip": false,
|
1366 |
+
"normalized": false,
|
1367 |
+
"rstrip": false,
|
1368 |
+
"single_word": false,
|
1369 |
+
"special": true
|
1370 |
+
},
|
1371 |
+
"57688": {
|
1372 |
+
"content": "<s_CPT/HCPCS 3>",
|
1373 |
+
"lstrip": false,
|
1374 |
+
"normalized": false,
|
1375 |
+
"rstrip": false,
|
1376 |
+
"single_word": false,
|
1377 |
+
"special": true
|
1378 |
+
},
|
1379 |
+
"57689": {
|
1380 |
+
"content": "</s_CPT/HCPCS 3>",
|
1381 |
+
"lstrip": false,
|
1382 |
+
"normalized": false,
|
1383 |
+
"rstrip": false,
|
1384 |
+
"single_word": false,
|
1385 |
+
"special": true
|
1386 |
+
},
|
1387 |
+
"57690": {
|
1388 |
+
"content": "<s_$CHARGES 3>",
|
1389 |
+
"lstrip": false,
|
1390 |
+
"normalized": false,
|
1391 |
+
"rstrip": false,
|
1392 |
+
"single_word": false,
|
1393 |
+
"special": true
|
1394 |
+
},
|
1395 |
+
"57691": {
|
1396 |
+
"content": "</s_$CHARGES 3>",
|
1397 |
+
"lstrip": false,
|
1398 |
+
"normalized": false,
|
1399 |
+
"rstrip": false,
|
1400 |
+
"single_word": false,
|
1401 |
+
"special": true
|
1402 |
+
},
|
1403 |
+
"57692": {
|
1404 |
+
"content": "<s_23. PRIOR AUTHORIZATION NUMBER>",
|
1405 |
+
"lstrip": false,
|
1406 |
+
"normalized": false,
|
1407 |
+
"rstrip": false,
|
1408 |
+
"single_word": false,
|
1409 |
+
"special": true
|
1410 |
+
},
|
1411 |
+
"57693": {
|
1412 |
+
"content": "</s_23. PRIOR AUTHORIZATION NUMBER>",
|
1413 |
+
"lstrip": false,
|
1414 |
+
"normalized": false,
|
1415 |
+
"rstrip": false,
|
1416 |
+
"single_word": false,
|
1417 |
+
"special": true
|
1418 |
+
},
|
1419 |
+
"57694": {
|
1420 |
+
"content": "<s_22. RESUBMISSION CODE>",
|
1421 |
+
"lstrip": false,
|
1422 |
+
"normalized": false,
|
1423 |
+
"rstrip": false,
|
1424 |
+
"single_word": false,
|
1425 |
+
"special": true
|
1426 |
+
},
|
1427 |
+
"57695": {
|
1428 |
+
"content": "</s_22. RESUBMISSION CODE>",
|
1429 |
+
"lstrip": false,
|
1430 |
+
"normalized": false,
|
1431 |
+
"rstrip": false,
|
1432 |
+
"single_word": false,
|
1433 |
+
"special": true
|
1434 |
+
},
|
1435 |
+
"57696": {
|
1436 |
+
"content": "<s_21. DIAGNOSIS OR NATURE OF ILLNESS>",
|
1437 |
+
"lstrip": false,
|
1438 |
+
"normalized": false,
|
1439 |
+
"rstrip": false,
|
1440 |
+
"single_word": false,
|
1441 |
+
"special": true
|
1442 |
+
},
|
1443 |
+
"57697": {
|
1444 |
+
"content": "</s_21. DIAGNOSIS OR NATURE OF ILLNESS>",
|
1445 |
+
"lstrip": false,
|
1446 |
+
"normalized": false,
|
1447 |
+
"rstrip": false,
|
1448 |
+
"single_word": false,
|
1449 |
+
"special": true
|
1450 |
+
},
|
1451 |
+
"57698": {
|
1452 |
+
"content": "<s_words>",
|
1453 |
+
"lstrip": false,
|
1454 |
+
"normalized": false,
|
1455 |
+
"rstrip": false,
|
1456 |
+
"single_word": false,
|
1457 |
+
"special": true
|
1458 |
+
},
|
1459 |
+
"57699": {
|
1460 |
+
"content": "</s_words>",
|
1461 |
+
"lstrip": false,
|
1462 |
+
"normalized": false,
|
1463 |
+
"rstrip": false,
|
1464 |
+
"single_word": false,
|
1465 |
+
"special": true
|
1466 |
+
},
|
1467 |
+
"57700": {
|
1468 |
+
"content": "<s_word>",
|
1469 |
+
"lstrip": false,
|
1470 |
+
"normalized": false,
|
1471 |
+
"rstrip": false,
|
1472 |
+
"single_word": false,
|
1473 |
+
"special": true
|
1474 |
+
},
|
1475 |
+
"57701": {
|
1476 |
+
"content": "</s_word>",
|
1477 |
+
"lstrip": false,
|
1478 |
+
"normalized": false,
|
1479 |
+
"rstrip": false,
|
1480 |
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1481 |
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1482 |
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1483 |
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1484 |
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1486 |
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1487 |
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1489 |
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1490 |
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1492 |
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1493 |
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1494 |
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1500 |
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1501 |
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1508 |
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1509 |
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1510 |
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1511 |
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1512 |
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1513 |
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1514 |
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1515 |
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1516 |
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1517 |
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1518 |
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1519 |
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1520 |
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1521 |
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1522 |
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1523 |
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1524 |
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1525 |
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1526 |
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1527 |
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1528 |
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1529 |
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1530 |
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1531 |
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1532 |
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1533 |
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1534 |
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1535 |
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1536 |
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1537 |
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1538 |
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1539 |
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1540 |
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1541 |
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|
1542 |
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|
1543 |
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|
1544 |
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1545 |
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1546 |
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1547 |
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1548 |
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1549 |
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1550 |
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1551 |
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1552 |
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1553 |
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1554 |
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1555 |
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1556 |
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1557 |
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1558 |
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1559 |
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1560 |
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1561 |
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1562 |
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1563 |
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1564 |
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1566 |
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1567 |
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1568 |
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1569 |
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1570 |
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1571 |
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|
1572 |
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1573 |
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|
1574 |
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|
1575 |
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|
1576 |
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|
1577 |
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1578 |
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1579 |
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|
1580 |
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"content": "<s_20. LAB $CHARGES>",
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1581 |
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|
1582 |
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1583 |
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|
1584 |
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|
1585 |
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1586 |
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1587 |
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|
1588 |
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1589 |
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|
1590 |
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|
1591 |
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|
1592 |
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|
1593 |
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|
1594 |
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},
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1595 |
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"57716": {
|
1596 |
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"content": "<s_PATIENT AND INSURED INFORMATION>",
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1597 |
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1598 |
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1599 |
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|
1600 |
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|
1601 |
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|
1602 |
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},
|
1603 |
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|
1604 |
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"content": "</s_PATIENT AND INSURED INFORMATION>",
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1605 |
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|
1606 |
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|
1607 |
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|
1608 |
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|
1609 |
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"special": true
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1610 |
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},
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1611 |
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|
1612 |
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"content": "<s_9d. INSURANCE PLAN NAME>",
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1613 |
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1614 |
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1615 |
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|
1616 |
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|
1617 |
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1618 |
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1619 |
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|
1620 |
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"content": "</s_9d. INSURANCE PLAN NAME>",
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1621 |
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|
1622 |
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1623 |
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1624 |
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|
1625 |
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1626 |
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1627 |
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|
1628 |
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"content": "<s_9a. OTHER INSURED'S POLICY OR GROUP>",
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1629 |
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|
1630 |
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1631 |
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|
1632 |
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|
1633 |
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1634 |
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1635 |
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|
1636 |
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"content": "</s_9a. OTHER INSURED'S POLICY OR GROUP>",
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1637 |
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|
1638 |
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|
1639 |
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1640 |
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|
1641 |
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1642 |
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1643 |
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|
1644 |
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"content": "<s_9. OTHER INSURED'S NAME>",
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1645 |
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|
1646 |
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|
1647 |
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|
1648 |
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|
1649 |
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1650 |
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1651 |
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|
1652 |
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"content": "</s_9. OTHER INSURED'S NAME>",
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1653 |
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|
1654 |
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|
1655 |
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|
1656 |
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|
1657 |
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|
1658 |
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1659 |
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|
1660 |
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"content": "<s_7. INSURED'S INFO>",
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1661 |
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|
1662 |
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|
1663 |
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|
1664 |
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|
1665 |
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|
1666 |
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|
1667 |
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|
1668 |
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"content": "</s_7. INSURED'S INFO>",
|
1669 |
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|
1670 |
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|
1671 |
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|
1672 |
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|
1673 |
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1674 |
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1675 |
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|
1676 |
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"content": "<s_4. INSURED'S NAME>",
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1677 |
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|
1678 |
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1679 |
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1680 |
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|
1681 |
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1682 |
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1683 |
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|
1684 |
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1685 |
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1686 |
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|
1687 |
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1688 |
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|
1689 |
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1690 |
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1691 |
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|
1692 |
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1693 |
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|
1694 |
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|
1695 |
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|
1696 |
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|
1697 |
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1698 |
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1699 |
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|
1700 |
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"content": "</s_7. INSURED'S ADDRESS>",
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1701 |
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|
1702 |
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1703 |
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|
1704 |
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|
1705 |
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1706 |
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1707 |
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1708 |
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"content": "<s_7. INSURED'S STATE>",
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1709 |
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1710 |
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1711 |
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1712 |
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1713 |
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1714 |
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1715 |
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1716 |
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1717 |
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1718 |
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1719 |
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1720 |
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1721 |
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1722 |
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1723 |
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1724 |
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"content": "<s_7. INSURED'S CITY>",
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1725 |
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|
1726 |
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1727 |
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1728 |
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1729 |
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1730 |
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1731 |
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1732 |
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"content": "</s_7. INSURED'S CITY>",
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1733 |
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|
1734 |
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1735 |
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1736 |
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1737 |
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1738 |
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1739 |
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1740 |
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"content": "<s_7. INSURED'S ZIP CODE>",
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1741 |
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|
1742 |
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1743 |
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1744 |
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1745 |
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1746 |
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1747 |
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1748 |
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"content": "</s_7. INSURED'S ZIP CODE>",
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1749 |
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|
1750 |
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1751 |
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|
1752 |
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|
1753 |
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1754 |
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1755 |
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1756 |
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"content": "<s_7. INSURED'S TELEPHONE>",
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1757 |
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|
1758 |
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|
1759 |
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|
1760 |
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|
1761 |
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"special": true
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1762 |
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1763 |
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1764 |
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"content": "</s_7. INSURED'S TELEPHONE>",
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1765 |
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|
1766 |
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|
1767 |
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|
1768 |
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|
1769 |
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"special": true
|
1770 |
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},
|
1771 |
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"57738": {
|
1772 |
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"content": "<s_6. PATIENT RELATIONSHIP>",
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1773 |
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|
1774 |
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|
1775 |
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|
1776 |
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|
1777 |
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"special": true
|
1778 |
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1779 |
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"57739": {
|
1780 |
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"content": "</s_6. PATIENT RELATIONSHIP>",
|
1781 |
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|
1782 |
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|
1783 |
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|
1784 |
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|
1785 |
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"special": true
|
1786 |
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},
|
1787 |
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"57740": {
|
1788 |
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"content": "<s_5. PATIENT'S ZIP CODE>",
|
1789 |
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|
1790 |
+
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|
1791 |
+
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|
1792 |
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|
1793 |
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"special": true
|
1794 |
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},
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1795 |
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|
1796 |
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"content": "</s_5. PATIENT'S ZIP CODE>",
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1797 |
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|
1798 |
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|
1799 |
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|
1800 |
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|
1801 |
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1802 |
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},
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1803 |
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|
1804 |
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"content": "<s_5. PATIENT'S TELEPHONE>",
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1805 |
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|
1806 |
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|
1807 |
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|
1808 |
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|
1809 |
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1810 |
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1811 |
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|
1812 |
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"content": "</s_5. PATIENT'S TELEPHONE>",
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1813 |
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|
1814 |
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|
1815 |
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|
1816 |
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|
1817 |
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"special": true
|
1818 |
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},
|
1819 |
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"57744": {
|
1820 |
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"content": "<s_5. PATIENT'S STATE>",
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1821 |
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|
1822 |
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|
1823 |
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|
1824 |
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|
1825 |
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"special": true
|
1826 |
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1827 |
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"57745": {
|
1828 |
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"content": "</s_5. PATIENT'S STATE>",
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1829 |
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|
1830 |
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|
1831 |
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|
1832 |
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|
1833 |
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"special": true
|
1834 |
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},
|
1835 |
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"57746": {
|
1836 |
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"content": "<s_5. PATIENT'S CITY>",
|
1837 |
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"lstrip": false,
|
1838 |
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|
1839 |
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|
1840 |
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|
1841 |
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"special": true
|
1842 |
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},
|
1843 |
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"57747": {
|
1844 |
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"content": "</s_5. PATIENT'S CITY>",
|
1845 |
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|
1846 |
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|
1847 |
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|
1848 |
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|
1849 |
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"special": true
|
1850 |
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},
|
1851 |
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"57748": {
|
1852 |
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"content": "<s_5. PATIENT'S ADDRESS>",
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1853 |
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|
1854 |
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|
1855 |
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|
1856 |
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|
1857 |
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"special": true
|
1858 |
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},
|
1859 |
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"57749": {
|
1860 |
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"content": "</s_5. PATIENT'S ADDRESS>",
|
1861 |
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|
1862 |
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|
1863 |
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|
1864 |
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|
1865 |
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"special": true
|
1866 |
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},
|
1867 |
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"57750": {
|
1868 |
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"content": "<s_3. PATIENT'S SEX>",
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1869 |
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"lstrip": false,
|
1870 |
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"normalized": false,
|
1871 |
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"rstrip": false,
|
1872 |
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|
1873 |
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"special": true
|
1874 |
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},
|
1875 |
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"57751": {
|
1876 |
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"content": "</s_3. PATIENT'S SEX>",
|
1877 |
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"lstrip": false,
|
1878 |
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|
1879 |
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|
1880 |
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|
1881 |
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"special": true
|
1882 |
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},
|
1883 |
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"57752": {
|
1884 |
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"content": "<s_3. PATIENT'S DATE OF BIRTH>",
|
1885 |
+
"lstrip": false,
|
1886 |
+
"normalized": false,
|
1887 |
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"rstrip": false,
|
1888 |
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"single_word": false,
|
1889 |
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"special": true
|
1890 |
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},
|
1891 |
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"57753": {
|
1892 |
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"content": "</s_3. PATIENT'S DATE OF BIRTH>",
|
1893 |
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"lstrip": false,
|
1894 |
+
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|
1895 |
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|
1896 |
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|
1897 |
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"special": true
|
1898 |
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},
|
1899 |
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"57754": {
|
1900 |
+
"content": "<s_YY>",
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1901 |
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"lstrip": false,
|
1902 |
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"normalized": false,
|
1903 |
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"rstrip": false,
|
1904 |
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|
1905 |
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"special": true
|
1906 |
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|
1907 |
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"57755": {
|
1908 |
+
"content": "</s_YY>",
|
1909 |
+
"lstrip": false,
|
1910 |
+
"normalized": false,
|
1911 |
+
"rstrip": false,
|
1912 |
+
"single_word": false,
|
1913 |
+
"special": true
|
1914 |
+
},
|
1915 |
+
"57756": {
|
1916 |
+
"content": "<s_MM>",
|
1917 |
+
"lstrip": false,
|
1918 |
+
"normalized": false,
|
1919 |
+
"rstrip": false,
|
1920 |
+
"single_word": false,
|
1921 |
+
"special": true
|
1922 |
+
},
|
1923 |
+
"57757": {
|
1924 |
+
"content": "</s_MM>",
|
1925 |
+
"lstrip": false,
|
1926 |
+
"normalized": false,
|
1927 |
+
"rstrip": false,
|
1928 |
+
"single_word": false,
|
1929 |
+
"special": true
|
1930 |
+
},
|
1931 |
+
"57758": {
|
1932 |
+
"content": "<s_DD>",
|
1933 |
+
"lstrip": false,
|
1934 |
+
"normalized": false,
|
1935 |
+
"rstrip": false,
|
1936 |
+
"single_word": false,
|
1937 |
+
"special": true
|
1938 |
+
},
|
1939 |
+
"57759": {
|
1940 |
+
"content": "</s_DD>",
|
1941 |
+
"lstrip": false,
|
1942 |
+
"normalized": false,
|
1943 |
+
"rstrip": false,
|
1944 |
+
"single_word": false,
|
1945 |
+
"special": true
|
1946 |
+
},
|
1947 |
+
"57760": {
|
1948 |
+
"content": "<s_2. PATIENT'S NAME>",
|
1949 |
+
"lstrip": false,
|
1950 |
+
"normalized": false,
|
1951 |
+
"rstrip": false,
|
1952 |
+
"single_word": false,
|
1953 |
+
"special": true
|
1954 |
+
},
|
1955 |
+
"57761": {
|
1956 |
+
"content": "</s_2. PATIENT'S NAME>",
|
1957 |
+
"lstrip": false,
|
1958 |
+
"normalized": false,
|
1959 |
+
"rstrip": false,
|
1960 |
+
"single_word": false,
|
1961 |
+
"special": true
|
1962 |
+
},
|
1963 |
+
"57762": {
|
1964 |
+
"content": "<s_1a. INSURED'S I.D. NUMBER>",
|
1965 |
+
"lstrip": false,
|
1966 |
+
"normalized": false,
|
1967 |
+
"rstrip": false,
|
1968 |
+
"single_word": false,
|
1969 |
+
"special": true
|
1970 |
+
},
|
1971 |
+
"57763": {
|
1972 |
+
"content": "</s_1a. INSURED'S I.D. NUMBER>",
|
1973 |
+
"lstrip": false,
|
1974 |
+
"normalized": false,
|
1975 |
+
"rstrip": false,
|
1976 |
+
"single_word": false,
|
1977 |
+
"special": true
|
1978 |
+
},
|
1979 |
+
"57764": {
|
1980 |
+
"content": "<s_13. INSURED OR AUTHORIZED PERSON'S SIGNATURE>",
|
1981 |
+
"lstrip": false,
|
1982 |
+
"normalized": false,
|
1983 |
+
"rstrip": false,
|
1984 |
+
"single_word": false,
|
1985 |
+
"special": true
|
1986 |
+
},
|
1987 |
+
"57765": {
|
1988 |
+
"content": "</s_13. INSURED OR AUTHORIZED PERSON'S SIGNATURE>",
|
1989 |
+
"lstrip": false,
|
1990 |
+
"normalized": false,
|
1991 |
+
"rstrip": false,
|
1992 |
+
"single_word": false,
|
1993 |
+
"special": true
|
1994 |
+
},
|
1995 |
+
"57766": {
|
1996 |
+
"content": "<s_12. PATIENT'S OR AUTHORIZED PERSON'S SIGNATURE>",
|
1997 |
+
"lstrip": false,
|
1998 |
+
"normalized": false,
|
1999 |
+
"rstrip": false,
|
2000 |
+
"single_word": false,
|
2001 |
+
"special": true
|
2002 |
+
},
|
2003 |
+
"57767": {
|
2004 |
+
"content": "</s_12. PATIENT'S OR AUTHORIZED PERSON'S SIGNATURE>",
|
2005 |
+
"lstrip": false,
|
2006 |
+
"normalized": false,
|
2007 |
+
"rstrip": false,
|
2008 |
+
"single_word": false,
|
2009 |
+
"special": true
|
2010 |
+
},
|
2011 |
+
"57768": {
|
2012 |
+
"content": "<s_11d. IS THERE ANOTHER HEALTH BENEFIT PLAN>",
|
2013 |
+
"lstrip": false,
|
2014 |
+
"normalized": false,
|
2015 |
+
"rstrip": false,
|
2016 |
+
"single_word": false,
|
2017 |
+
"special": true
|
2018 |
+
},
|
2019 |
+
"57769": {
|
2020 |
+
"content": "</s_11d. IS THERE ANOTHER HEALTH BENEFIT PLAN>",
|
2021 |
+
"lstrip": false,
|
2022 |
+
"normalized": false,
|
2023 |
+
"rstrip": false,
|
2024 |
+
"single_word": false,
|
2025 |
+
"special": true
|
2026 |
+
},
|
2027 |
+
"57770": {
|
2028 |
+
"content": "<s_11c. INSURANCE PLAN NAME>",
|
2029 |
+
"lstrip": false,
|
2030 |
+
"normalized": false,
|
2031 |
+
"rstrip": false,
|
2032 |
+
"single_word": false,
|
2033 |
+
"special": true
|
2034 |
+
},
|
2035 |
+
"57771": {
|
2036 |
+
"content": "</s_11c. INSURANCE PLAN NAME>",
|
2037 |
+
"lstrip": false,
|
2038 |
+
"normalized": false,
|
2039 |
+
"rstrip": false,
|
2040 |
+
"single_word": false,
|
2041 |
+
"special": true
|
2042 |
+
},
|
2043 |
+
"57772": {
|
2044 |
+
"content": "<s_11a. INSURED'S SEX>",
|
2045 |
+
"lstrip": false,
|
2046 |
+
"normalized": false,
|
2047 |
+
"rstrip": false,
|
2048 |
+
"single_word": false,
|
2049 |
+
"special": true
|
2050 |
+
},
|
2051 |
+
"57773": {
|
2052 |
+
"content": "</s_11a. INSURED'S SEX>",
|
2053 |
+
"lstrip": false,
|
2054 |
+
"normalized": false,
|
2055 |
+
"rstrip": false,
|
2056 |
+
"single_word": false,
|
2057 |
+
"special": true
|
2058 |
+
},
|
2059 |
+
"57774": {
|
2060 |
+
"content": "<s_11. INSURED'S POLICY GROUP OR FECA NUMBER>",
|
2061 |
+
"lstrip": false,
|
2062 |
+
"normalized": false,
|
2063 |
+
"rstrip": false,
|
2064 |
+
"single_word": false,
|
2065 |
+
"special": true
|
2066 |
+
},
|
2067 |
+
"57775": {
|
2068 |
+
"content": "</s_11. INSURED'S POLICY GROUP OR FECA NUMBER>",
|
2069 |
+
"lstrip": false,
|
2070 |
+
"normalized": false,
|
2071 |
+
"rstrip": false,
|
2072 |
+
"single_word": false,
|
2073 |
+
"special": true
|
2074 |
+
},
|
2075 |
+
"57776": {
|
2076 |
+
"content": "<s_10. PATIENT'S CONDITION>",
|
2077 |
+
"lstrip": false,
|
2078 |
+
"normalized": false,
|
2079 |
+
"rstrip": false,
|
2080 |
+
"single_word": false,
|
2081 |
+
"special": true
|
2082 |
+
},
|
2083 |
+
"57777": {
|
2084 |
+
"content": "</s_10. PATIENT'S CONDITION>",
|
2085 |
+
"lstrip": false,
|
2086 |
+
"normalized": false,
|
2087 |
+
"rstrip": false,
|
2088 |
+
"single_word": false,
|
2089 |
+
"special": true
|
2090 |
+
},
|
2091 |
+
"57778": {
|
2092 |
+
"content": "<s_10a. EMPLOYMENT>",
|
2093 |
+
"lstrip": false,
|
2094 |
+
"normalized": false,
|
2095 |
+
"rstrip": false,
|
2096 |
+
"single_word": false,
|
2097 |
+
"special": true
|
2098 |
+
},
|
2099 |
+
"57779": {
|
2100 |
+
"content": "</s_10a. EMPLOYMENT>",
|
2101 |
+
"lstrip": false,
|
2102 |
+
"normalized": false,
|
2103 |
+
"rstrip": false,
|
2104 |
+
"single_word": false,
|
2105 |
+
"special": true
|
2106 |
+
},
|
2107 |
+
"57780": {
|
2108 |
+
"content": "<s_10b. AUTO ACCIDENT>",
|
2109 |
+
"lstrip": false,
|
2110 |
+
"normalized": false,
|
2111 |
+
"rstrip": false,
|
2112 |
+
"single_word": false,
|
2113 |
+
"special": true
|
2114 |
+
},
|
2115 |
+
"57781": {
|
2116 |
+
"content": "</s_10b. AUTO ACCIDENT>",
|
2117 |
+
"lstrip": false,
|
2118 |
+
"normalized": false,
|
2119 |
+
"rstrip": false,
|
2120 |
+
"single_word": false,
|
2121 |
+
"special": true
|
2122 |
+
},
|
2123 |
+
"57782": {
|
2124 |
+
"content": "<s_10c. OTHER ACCIDENT>",
|
2125 |
+
"lstrip": false,
|
2126 |
+
"normalized": false,
|
2127 |
+
"rstrip": false,
|
2128 |
+
"single_word": false,
|
2129 |
+
"special": true
|
2130 |
+
},
|
2131 |
+
"57783": {
|
2132 |
+
"content": "</s_10c. OTHER ACCIDENT>",
|
2133 |
+
"lstrip": false,
|
2134 |
+
"normalized": false,
|
2135 |
+
"rstrip": false,
|
2136 |
+
"single_word": false,
|
2137 |
+
"special": true
|
2138 |
+
},
|
2139 |
+
"57784": {
|
2140 |
+
"content": "<s_1.INSURED PLAN>",
|
2141 |
+
"lstrip": false,
|
2142 |
+
"normalized": false,
|
2143 |
+
"rstrip": false,
|
2144 |
+
"single_word": false,
|
2145 |
+
"special": true
|
2146 |
+
},
|
2147 |
+
"57785": {
|
2148 |
+
"content": "</s_1.INSURED PLAN>",
|
2149 |
+
"lstrip": false,
|
2150 |
+
"normalized": false,
|
2151 |
+
"rstrip": false,
|
2152 |
+
"single_word": false,
|
2153 |
+
"special": true
|
2154 |
+
},
|
2155 |
+
"57786": {
|
2156 |
+
"content": "<s_1. INSURED PLAN>",
|
2157 |
+
"lstrip": false,
|
2158 |
+
"normalized": false,
|
2159 |
+
"rstrip": false,
|
2160 |
+
"single_word": false,
|
2161 |
+
"special": true
|
2162 |
+
},
|
2163 |
+
"57787": {
|
2164 |
+
"content": "</s_1. INSURED PLAN>",
|
2165 |
+
"lstrip": false,
|
2166 |
+
"normalized": false,
|
2167 |
+
"rstrip": false,
|
2168 |
+
"single_word": false,
|
2169 |
+
"special": true
|
2170 |
+
},
|
2171 |
+
"57788": {
|
2172 |
+
"content": "<s_17>",
|
2173 |
+
"lstrip": false,
|
2174 |
+
"normalized": false,
|
2175 |
+
"rstrip": false,
|
2176 |
+
"single_word": false,
|
2177 |
+
"special": true
|
2178 |
+
},
|
2179 |
+
"57789": {
|
2180 |
+
"content": "</s_17>",
|
2181 |
+
"lstrip": false,
|
2182 |
+
"normalized": false,
|
2183 |
+
"rstrip": false,
|
2184 |
+
"single_word": false,
|
2185 |
+
"special": true
|
2186 |
+
}
|
2187 |
+
},
|
2188 |
+
"additional_special_tokens": [
|
2189 |
+
"<s_meta>",
|
2190 |
+
"</s_meta>",
|
2191 |
+
"<s_formtype>",
|
2192 |
+
"</s_formtype>",
|
2193 |
+
"<s_PHYSICIAN OR MEDICAL PROVIDER INFORMATION>",
|
2194 |
+
"</s_PHYSICIAN OR MEDICAL PROVIDER INFORMATION>",
|
2195 |
+
"<s_33. BILLING INFORMATION>",
|
2196 |
+
"</s_33. BILLING INFORMATION>",
|
2197 |
+
"<s_33. BILLING PROVIDER PHONE>",
|
2198 |
+
"</s_33. BILLING PROVIDER PHONE>",
|
2199 |
+
"<s_33. BILLING PROVIDER LOCATION>",
|
2200 |
+
"</s_33. BILLING PROVIDER LOCATION>",
|
2201 |
+
"<s_33. a. NPI NUMBER>",
|
2202 |
+
"</s_33. a. NPI NUMBER>",
|
2203 |
+
"<s_32. SERVICE INFORMATION>",
|
2204 |
+
"</s_32. SERVICE INFORMATION>",
|
2205 |
+
"<s_32. SERVICE FACILITY LOCATION>",
|
2206 |
+
"</s_32. SERVICE FACILITY LOCATION>",
|
2207 |
+
"<s_32. a. NPI NUMBER>",
|
2208 |
+
"</s_32. a. NPI NUMBER>",
|
2209 |
+
"<s_31. PHYSICIAN OR SUPPLIER SIGNATURE>",
|
2210 |
+
"</s_31. PHYSICIAN OR SUPPLIER SIGNATURE>",
|
2211 |
+
"<s_SIGNED>",
|
2212 |
+
"</s_SIGNED>",
|
2213 |
+
"<s_DATE>",
|
2214 |
+
"</s_DATE>",
|
2215 |
+
"<s_29. AMOUNT PAID>",
|
2216 |
+
"</s_29. AMOUNT PAID>",
|
2217 |
+
"<s_28. TOTAL CHARGE>",
|
2218 |
+
"</s_28. TOTAL CHARGE>",
|
2219 |
+
"<s_27. ACCEPT ASSIGNMENT>",
|
2220 |
+
"</s_27. ACCEPT ASSIGNMENT>",
|
2221 |
+
"<s_26. PATIENT'S ACCOUNT NUMBER>",
|
2222 |
+
"</s_26. PATIENT'S ACCOUNT NUMBER>",
|
2223 |
+
"<s_25. FEDERAL TAX I.D. NUMBER>",
|
2224 |
+
"</s_25. FEDERAL TAX I.D. NUMBER>",
|
2225 |
+
"<s_25. FEDERAL IDENTIFICATION>",
|
2226 |
+
"</s_25. FEDERAL IDENTIFICATION>",
|
2227 |
+
"<s_24. SERVICES>",
|
2228 |
+
"</s_24. SERVICES>",
|
2229 |
+
"<s_YY 1>",
|
2230 |
+
"</s_YY 1>",
|
2231 |
+
"<s_UNITS 1>",
|
2232 |
+
"</s_UNITS 1>",
|
2233 |
+
"<s_PROVIDER ID 1>",
|
2234 |
+
"</s_PROVIDER ID 1>",
|
2235 |
+
"<s_PLACE OF SERVICE 1>",
|
2236 |
+
"</s_PLACE OF SERVICE 1>",
|
2237 |
+
"<s_MODIFIER 1>",
|
2238 |
+
"</s_MODIFIER 1>",
|
2239 |
+
"<s_MM 1>",
|
2240 |
+
"</s_MM 1>",
|
2241 |
+
"<s_Family Plan 1>",
|
2242 |
+
"</s_Family Plan 1>",
|
2243 |
+
"<s_EMG 1>",
|
2244 |
+
"</s_EMG 1>",
|
2245 |
+
"<s_DIAGNOSIS POINTER 1>",
|
2246 |
+
"</s_DIAGNOSIS POINTER 1>",
|
2247 |
+
"<s_DD 1>",
|
2248 |
+
"</s_DD 1>",
|
2249 |
+
"<s_CPT/HCPCS 1>",
|
2250 |
+
"</s_CPT/HCPCS 1>",
|
2251 |
+
"<s_$CHARGES 1>",
|
2252 |
+
"</s_$CHARGES 1>",
|
2253 |
+
"<s_YY 2>",
|
2254 |
+
"</s_YY 2>",
|
2255 |
+
"<s_UNITS 2>",
|
2256 |
+
"</s_UNITS 2>",
|
2257 |
+
"<s_PROVIDER ID 2>",
|
2258 |
+
"</s_PROVIDER ID 2>",
|
2259 |
+
"<s_PLACE OF SERVICE 2>",
|
2260 |
+
"</s_PLACE OF SERVICE 2>",
|
2261 |
+
"<s_MODIFIER 2>",
|
2262 |
+
"</s_MODIFIER 2>",
|
2263 |
+
"<s_MM 2>",
|
2264 |
+
"</s_MM 2>",
|
2265 |
+
"<s_Family Plan 2>",
|
2266 |
+
"</s_Family Plan 2>",
|
2267 |
+
"<s_EMG 2>",
|
2268 |
+
"</s_EMG 2>",
|
2269 |
+
"<s_DIAGNOSIS POINTER 2>",
|
2270 |
+
"</s_DIAGNOSIS POINTER 2>",
|
2271 |
+
"<s_DD 2>",
|
2272 |
+
"</s_DD 2>",
|
2273 |
+
"<s_CPT/HCPCS 2>",
|
2274 |
+
"</s_CPT/HCPCS 2>",
|
2275 |
+
"<s_$CHARGES 2>",
|
2276 |
+
"</s_$CHARGES 2>",
|
2277 |
+
"<s_YY 3>",
|
2278 |
+
"</s_YY 3>",
|
2279 |
+
"<s_UNITS 3>",
|
2280 |
+
"</s_UNITS 3>",
|
2281 |
+
"<s_PROVIDER ID 3>",
|
2282 |
+
"</s_PROVIDER ID 3>",
|
2283 |
+
"<s_PLACE OF SERVICE 3>",
|
2284 |
+
"</s_PLACE OF SERVICE 3>",
|
2285 |
+
"<s_MODIFIER 3>",
|
2286 |
+
"</s_MODIFIER 3>",
|
2287 |
+
"<s_MM 3>",
|
2288 |
+
"</s_MM 3>",
|
2289 |
+
"<s_Family Plan 3>",
|
2290 |
+
"</s_Family Plan 3>",
|
2291 |
+
"<s_EMG 3>",
|
2292 |
+
"</s_EMG 3>",
|
2293 |
+
"<s_DIAGNOSIS POINTER 3>",
|
2294 |
+
"</s_DIAGNOSIS POINTER 3>",
|
2295 |
+
"<s_DD 3>",
|
2296 |
+
"</s_DD 3>",
|
2297 |
+
"<s_CPT/HCPCS 3>",
|
2298 |
+
"</s_CPT/HCPCS 3>",
|
2299 |
+
"<s_$CHARGES 3>",
|
2300 |
+
"</s_$CHARGES 3>",
|
2301 |
+
"<s_23. PRIOR AUTHORIZATION NUMBER>",
|
2302 |
+
"</s_23. PRIOR AUTHORIZATION NUMBER>",
|
2303 |
+
"<s_22. RESUBMISSION CODE>",
|
2304 |
+
"</s_22. RESUBMISSION CODE>",
|
2305 |
+
"<s_21. DIAGNOSIS OR NATURE OF ILLNESS>",
|
2306 |
+
"</s_21. DIAGNOSIS OR NATURE OF ILLNESS>",
|
2307 |
+
"<s_words>",
|
2308 |
+
"</s_words>",
|
2309 |
+
"<s_word>",
|
2310 |
+
"</s_word>",
|
2311 |
+
"<s_normalizedVertices>",
|
2312 |
+
"</s_normalizedVertices>",
|
2313 |
+
"<s_y>",
|
2314 |
+
"</s_y>",
|
2315 |
+
"<s_x>",
|
2316 |
+
"</s_x>",
|
2317 |
+
"<s_text>",
|
2318 |
+
"</s_text>",
|
2319 |
+
"<s_label>",
|
2320 |
+
"</s_label>",
|
2321 |
+
"<s_20. OUTSIDE LAB>",
|
2322 |
+
"</s_20. OUTSIDE LAB>",
|
2323 |
+
"<s_20. LAB $CHARGES>",
|
2324 |
+
"</s_20. LAB $CHARGES>",
|
2325 |
+
"<s_PATIENT AND INSURED INFORMATION>",
|
2326 |
+
"</s_PATIENT AND INSURED INFORMATION>",
|
2327 |
+
"<s_9d. INSURANCE PLAN NAME>",
|
2328 |
+
"</s_9d. INSURANCE PLAN NAME>",
|
2329 |
+
"<s_9a. OTHER INSURED'S POLICY OR GROUP>",
|
2330 |
+
"</s_9a. OTHER INSURED'S POLICY OR GROUP>",
|
2331 |
+
"<s_9. OTHER INSURED'S NAME>",
|
2332 |
+
"</s_9. OTHER INSURED'S NAME>",
|
2333 |
+
"<s_7. INSURED'S INFO>",
|
2334 |
+
"</s_7. INSURED'S INFO>",
|
2335 |
+
"<s_4. INSURED'S NAME>",
|
2336 |
+
"</s_4. INSURED'S NAME>",
|
2337 |
+
"<s_7. INSURED'S ADDRESS>",
|
2338 |
+
"</s_7. INSURED'S ADDRESS>",
|
2339 |
+
"<s_7. INSURED'S STATE>",
|
2340 |
+
"</s_7. INSURED'S STATE>",
|
2341 |
+
"<s_7. INSURED'S CITY>",
|
2342 |
+
"</s_7. INSURED'S CITY>",
|
2343 |
+
"<s_7. INSURED'S ZIP CODE>",
|
2344 |
+
"</s_7. INSURED'S ZIP CODE>",
|
2345 |
+
"<s_7. INSURED'S TELEPHONE>",
|
2346 |
+
"</s_7. INSURED'S TELEPHONE>",
|
2347 |
+
"<s_6. PATIENT RELATIONSHIP>",
|
2348 |
+
"</s_6. PATIENT RELATIONSHIP>",
|
2349 |
+
"<s_5. PATIENT'S ZIP CODE>",
|
2350 |
+
"</s_5. PATIENT'S ZIP CODE>",
|
2351 |
+
"<s_5. PATIENT'S TELEPHONE>",
|
2352 |
+
"</s_5. PATIENT'S TELEPHONE>",
|
2353 |
+
"<s_5. PATIENT'S STATE>",
|
2354 |
+
"</s_5. PATIENT'S STATE>",
|
2355 |
+
"<s_5. PATIENT'S CITY>",
|
2356 |
+
"</s_5. PATIENT'S CITY>",
|
2357 |
+
"<s_5. PATIENT'S ADDRESS>",
|
2358 |
+
"</s_5. PATIENT'S ADDRESS>",
|
2359 |
+
"<s_3. PATIENT'S SEX>",
|
2360 |
+
"</s_3. PATIENT'S SEX>",
|
2361 |
+
"<s_3. PATIENT'S DATE OF BIRTH>",
|
2362 |
+
"</s_3. PATIENT'S DATE OF BIRTH>",
|
2363 |
+
"<s_YY>",
|
2364 |
+
"</s_YY>",
|
2365 |
+
"<s_MM>",
|
2366 |
+
"</s_MM>",
|
2367 |
+
"<s_DD>",
|
2368 |
+
"</s_DD>",
|
2369 |
+
"<s_2. PATIENT'S NAME>",
|
2370 |
+
"</s_2. PATIENT'S NAME>",
|
2371 |
+
"<s_1a. INSURED'S I.D. NUMBER>",
|
2372 |
+
"</s_1a. INSURED'S I.D. NUMBER>",
|
2373 |
+
"<s_13. INSURED OR AUTHORIZED PERSON'S SIGNATURE>",
|
2374 |
+
"</s_13. INSURED OR AUTHORIZED PERSON'S SIGNATURE>",
|
2375 |
+
"<s_12. PATIENT'S OR AUTHORIZED PERSON'S SIGNATURE>",
|
2376 |
+
"</s_12. PATIENT'S OR AUTHORIZED PERSON'S SIGNATURE>",
|
2377 |
+
"<s_11d. IS THERE ANOTHER HEALTH BENEFIT PLAN>",
|
2378 |
+
"</s_11d. IS THERE ANOTHER HEALTH BENEFIT PLAN>",
|
2379 |
+
"<s_11c. INSURANCE PLAN NAME>",
|
2380 |
+
"</s_11c. INSURANCE PLAN NAME>",
|
2381 |
+
"<s_11a. INSURED'S SEX>",
|
2382 |
+
"</s_11a. INSURED'S SEX>",
|
2383 |
+
"<s_11. INSURED'S POLICY GROUP OR FECA NUMBER>",
|
2384 |
+
"</s_11. INSURED'S POLICY GROUP OR FECA NUMBER>",
|
2385 |
+
"<s_10. PATIENT'S CONDITION>",
|
2386 |
+
"</s_10. PATIENT'S CONDITION>",
|
2387 |
+
"<s_10a. EMPLOYMENT>",
|
2388 |
+
"</s_10a. EMPLOYMENT>",
|
2389 |
+
"<s_10b. AUTO ACCIDENT>",
|
2390 |
+
"</s_10b. AUTO ACCIDENT>",
|
2391 |
+
"<s_10c. OTHER ACCIDENT>",
|
2392 |
+
"</s_10c. OTHER ACCIDENT>",
|
2393 |
+
"<s_1.INSURED PLAN>",
|
2394 |
+
"</s_1.INSURED PLAN>",
|
2395 |
+
"<s_1. INSURED PLAN>",
|
2396 |
+
"</s_1. INSURED PLAN>",
|
2397 |
+
"<s_17>",
|
2398 |
+
"</s_17>",
|
2399 |
+
"<s>",
|
2400 |
+
"</s>"
|
2401 |
+
],
|
2402 |
+
"bos_token": "<s>",
|
2403 |
+
"clean_up_tokenization_spaces": true,
|
2404 |
+
"cls_token": "<s>",
|
2405 |
+
"eos_token": "</s>",
|
2406 |
+
"mask_token": "<mask>",
|
2407 |
+
"model_max_length": 1000000000000000019884624838656,
|
2408 |
+
"pad_token": "<pad>",
|
2409 |
+
"processor_class": "DonutProcessor",
|
2410 |
+
"sep_token": "</s>",
|
2411 |
+
"sp_model_kwargs": {},
|
2412 |
+
"tokenizer_class": "XLMRobertaTokenizer",
|
2413 |
+
"unk_token": "<unk>"
|
2414 |
+
}
|