| Wed Oct 9 01:46 | PDF document, version .b | | Tue Oct 8 05:11 | PDF document, version 1.7 (Zip archive data, at least v4.5 to extract) | | Sun Oct 6 15:13 | PDF document, version J.ð | | Tue Sep 24 15:16 | Composite Document File V2 Document, Little Endian, Os: Windows, Version 4.0, Code page: 1252, Title: 1500 Claim Form, Keywords: HCFAs, Invoices, Invoice Line Items, Process/Print, Comments: v8.40+#0932 Click here to view sample report. Enabled for PDF-eXPLODE. Report data values (such as name or email) in the user-designated PDF-eXPLODE tag match the information in the first record on each page.Report is location sensitive to Invoice Header Location ID.This is the form CMS-1500 approved 08/05. If you need to submit the 1500 Health Insurance Claim Form for Workers' Comp or insurance billing this report can print the form on plain paper or pre-printed forms can be used if desired. If pre-printed forms are used and alignment is required, contact SYSTOC Technical Support. Invoice Type must be 'H' on invoice header for this report to print invoice. Invoices exported for electronic billing are not included during batch printing. An option is included to print an information sheet explaining where fields on report pull data from SYSTOC.If you enter a negative one (-1) for the Pr, Revision Number: 933, Total Editing Time: 10d+00:56:13, Last Printed: Mon May 10 19:36:03 2010, Last Saved Time/Date: Tue Sep 24 16:39:07 2024, Create Time/Date: Sun Oct 10 19:37:48 1999, Number of Pages: 1, Number of Words: 0, Number of Characters: 0, Name of Creating Application: Seagate Crystal Reports | | Sun Sep 22 05:26 | PDF document, version 1.4 (gzip compressed data, from Unix) | | Tue Sep 17 22:41 | PE32+ executable (GUI) x86-64, for MS Windows (gzip compressed data, was "New Order19352 PDF.exe", last modified: Tue Sep 17 08:29:46 2024, from FAT filesystem (MS-DOS, OS/2, NT)) | | Tue Sep 17 12:47 | PDF document, version 1.7 (gzip compressed data, max speed, from TOPS/20) | | Mon Sep 16 22:49 | PDF document, version ë.Y | | Thu Sep 12 06:28 | PDF document, version ‚. | | Sun Sep 8 10:03 | PDF document, version .F | Previous page | Next page |
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