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Data
string | TRANS_Value
string | Group_name
string | Image_width
string | Image_height
string | Field_Name
string | x1
string | x2
string | y1
string | y2
string | Page
string | OCR_OMNI
string | OCR_IGEAR
string | OCR_AT
string | OCR_Optimizer
string | Comments
string | Key_file_name
string |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
103434682 | null | 1A_PriInsIDNumber | 1802 | 2205 | 1A_PriInsIDNumber | 1082 | 1220 | 283 | 304 | 1 | 103434682 | 103434682 | 103434682 | 103434682 | null | 1059C442AZ001_000_HCFA.KEY |
BRITTAIN CIARA | null | 2_PatFullName | 1802 | 2205 | 2_PatFullName | 78 | 302 | 349 | 371 | 1 | BRITTAIN CIARA | BRITTAIN CIARA | BRITTAIN CIARA | BRITTAIN CIARA | null | 1059C442AZ001_000_HCFA.KEY |
07052001 | null | 3_PatDOB | 1802 | 2205 | 3_PatDOB | 703 | 854 | 350 | 371 | 1 | 07052001 | 07052001 | 07052001 | 07052001 | null | 1059C442AZ001_000_HCFA.KEY |
null | null | PatGroup | 1802 | 2205 | 5_PatAddr1 | 78 | 317 | 410 | 432 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | PatGroup | 1802 | 2205 | 5_PatCity | 79 | 236 | 481 | 502 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | PatGroup | 1802 | 2205 | 5_PatState | 586 | 612 | 483 | 503 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | PatGroup | 1802 | 2205 | 5_PatPostCode | 77 | 155 | 551 | 572 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | PatGroup | 1802 | 2205 | 5_PatPhoneNumber | 156 | 542 | 551 | 574 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
BRITTAIN CIARA | null | 4_PriInsFullName | 1802 | 2205 | 4_PriInsFullName | 1081 | 1301 | 347 | 368 | 1 | BRITTAIN CIARA | BRITTAIN CIARA | BRITTAIN CIARA | BRITTAIN CIARA | null | 1059C442AZ001_000_HCFA.KEY |
73 N CONKLIN RD | null | PriGroup | 1802 | 2205 | 7_PriInsAddr1 | 1083 | 1317 | 409 | 429 | 1 | 73 N CONKLIN RD | 73 N CONKLIN RD | 73 N CONKLIN RD | 73 N CONKLIN RD | null | 1059C442AZ001_000_HCFA.KEY |
LAKE ORION | null | PriGroup | 1802 | 2205 | 7_PriInsCity | 1083 | 1236 | 479 | 500 | 1 | LAKE ORION | LAKE ORION | LAKE ORION | LAKE ORION | null | 1059C442AZ001_000_HCFA.KEY |
MI | null | PriGroup | 1802 | 2205 | 7_PriInsState | 1560 | 1587 | 481 | 501 | 1 | MI | MI | MI | MI | null | 1059C442AZ001_000_HCFA.KEY |
48362 | null | PriGroup | 1802 | 2205 | 7_PriInsPostCode | 1081 | 1156 | 549 | 569 | 1 | 48362 | 48362 | 48362 | 48362 | null | 1059C442AZ001_000_HCFA.KEY |
null | null | PriGroup | 1802 | 2205 | 7_PriInsPhoneNumber | 1157 | 1569 | 548 | 569 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 9_SecInsFullName | 1802 | 2205 | 9_SecInsFullName | 77 | 667 | 590 | 658 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 9A_SecInsPolGrpNumber | 1802 | 2205 | 9A_SecInsPolGrpNumber | 77 | 667 | 659 | 727 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 9B_SecInsDOB | 1802 | 2205 | 9B_SecInsDOB | 77 | 387 | 728 | 796 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 9D_SecInsPlanName | 1802 | 2205 | 9D_SecInsPlanName | 77 | 667 | 866 | 935 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 10B_PatAAState | 1802 | 2205 | 10B_PatAAState | 994 | 1034 | 735 | 802 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 10D_ClaimCodes | 1802 | 2205 | 10D_ClaimCodes | 703 | 930 | 875 | 930 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 11_PriInsPolGrpNumber | 1802 | 2205 | 11_PriInsPolGrpNumber | 1079 | 1739 | 590 | 658 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 11A_PriInsDOB | 1802 | 2205 | 11A_PriInsDOB | 1151 | 1302 | 686 | 706 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 11B_PriInsEmpName | 1802 | 2205 | 11B_PriInsEmpName | 1079 | 1739 | 728 | 796 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 11C_PriInsPlanName | 1802 | 2205 | 11C_PriInsPlanName | 1082 | 1551 | 812 | 833 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 11B_OtherClaimIdCodeQual | 1802 | 2205 | 11B_OtherClaimIdCodeQual | 1079 | 1739 | 728 | 796 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 11B_OtherClaimIdCode | 1802 | 2205 | 11B_OtherClaimIdCode | 1079 | 1739 | 728 | 796 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 12_PatSignonFile | 1802 | 2205 | 12_PatSignonFile | 188 | 469 | 1005 | 1025 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
SIGNATURE ON FILE | null | 13_PriSignonFileList | 1802 | 2205 | 13_PriSignonFileList | 1205 | 1469 | 1000 | 1021 | 1 | SIGNATURE ON FILE | SIGNATURE ON FILE | SIGNATURE ON FILE | SIGNATURE ON FILE | null | 1059C442AZ001_000_HCFA.KEY |
05312022 | null | 14_PatCurrentDate | 1802 | 2205 | 14_PatCurrentDate | 101 | 260 | 1083 | 1104 | 1 | 05312022 | 05312022 | 05312022 | 05312022 | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 14_PatCurrentDateQual | 1802 | 2205 | 14_PatCurrentDateQual | 261 | 420 | 1083 | 1103 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 15_PatFirstDateOfIll | 1802 | 2205 | 15_PatFirstDateOfIll | 640 | 1024 | 1062 | 1114 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 15_PatFirstDateOfIllQual | 1802 | 2205 | 15_PatFirstDateOfIllQual | 640 | 1024 | 1062 | 1114 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | Box16Group | 1802 | 2205 | 16_PatUTWFromDate | 1079 | 1690 | 1052 | 1129 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | Box16Group | 1802 | 2205 | 16_PatUTWToDate | 1079 | 1690 | 1052 | 1129 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | Box18Group | 1802 | 2205 | 18_PatHospFromDate | 1079 | 1690 | 1150 | 1200 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | Box18Group | 1802 | 2205 | 18_PatHospToDate | 1079 | 1690 | 1150 | 1200 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
DN | null | Box17Group | 1802 | 2205 | 17_RefProvFullNameQual | 81 | 110 | 1150 | 1171 | 1 | DN | DN | DN | DN | null | 1059C442AZ001_000_HCFA.KEY |
ELIZABETH MIKULICH NP | null | Box17Group | 1802 | 2205 | 17_RefProvFullName | 128 | 461 | 1150 | 1171 | 1 | ELIZABETH MIKULICH NP | ELIZABETH MIKULICH NP | ELIZABETH MIKULICH NP | ELIZABETH MIKULICH NP | null | 1059C442AZ001_000_HCFA.KEY |
null | null | Box17Group | 1802 | 2205 | 17_RefProvOrgName | 77 | 590 | 1115 | 1190 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | Box17Group | 1802 | 2205 | 17A_RefProvOtherIdQual | 653 | 713 | 1095 | 1143 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | Box17Group | 1802 | 2205 | 17A_RefProvOtherId | 703 | 999 | 1095 | 1143 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
1740533736 | null | Box17Group | 1802 | 2205 | 17B_RefProvNPI | 724 | 892 | 1142 | 1165 | 1 | 1740533736 | 1740533736 | 1740533736 | 1740533736 | null | 1059C442AZ001_000_HCFA.KEY |
null | null | Box20Group | 1802 | 2205 | 20_OSLabCharges | 1277 | 1650 | 1210 | 1265 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
0 | null | 21_ICDInd | 1802 | 2205 | 21_ICDInd | 926 | 939 | 1255 | 1275 | 1 | 0 | 0 | 0 | 0 | null | 1059C442AZ001_000_HCFA.KEY |
Z20822 | null | 21_DiagCode | 1802 | 2205 | 21_DiagCode | 120 | 214 | 1278 | 1299 | 1 | Z20822 | Z20822 | 220822 | ?20822 | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 21_DiagDescription | 1802 | 2205 | 21_DiagDescription | 120 | 214 | 1278 | 1299 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | MedPriorGroup | 1802 | 2205 | 22_MedicaidCode | 1079 | 1670 | 1275 | 1417 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | MedPriorGroup | 1802 | 2205 | 22_MedicaidRefNum | 1079 | 1670 | 1275 | 1417 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
23D2058953 | null | 23_PriorAuthNum | 1802 | 2205 | 23_PriorAuthNum | 1082 | 1236 | 1344 | 1365 | 1 | 23D2058953 | 2302058953 | 23D2058953 | 23D2058953 | null | 1059C442AZ001_000_HCFA.KEY |
05312022 | null | 24A_FromDate | 1802 | 2205 | 24A_FromDate | 83 | 209 | 1477 | 1497 | 1 | 05312022 | 05312022 | 05312022 | 05312022 | null | 1059C442AZ001_000_HCFA.KEY |
05312022 | null | 24A_ToDate | 1802 | 2205 | 24A_ToDate | 274 | 397 | 1479 | 1499 | 1 | 05312022 | 05312022 | 05312022 | 05312022 | null | 1059C442AZ001_000_HCFA.KEY |
11 | null | 24B_POS | 1802 | 2205 | 24B_POS | 439 | 463 | 1476 | 1496 | 1 | 11 | 11 | 11 | 11 | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 24C_EMG | 1802 | 2205 | 24C_EMG | 462 | 487 | 1479 | 1497 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
G2023 | null | 24D_ProcCode | 1802 | 2205 | 24D_ProcCode | 591 | 666 | 1476 | 1496 | 1 | G2023 | G2023 | G2023 | G2023 | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 24D_Modifier | 1802 | 2205 | 24D_Modifier | 665 | 690 | 1479 | 1496 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
A | null | 24E_DiagPtr | 1802 | 2205 | 24E_DiagPtr | 1027 | 1042 | 1475 | 1495 | 1 | A | A | A | A | null | 1059C442AZ001_000_HCFA.KEY |
3900 | null | 24F_LineCharges | 1802 | 2205 | 24F_LineCharges | 1161 | 1238 | 1475 | 1495 | 1 | 3900 | 3900 | 3900 | 3900 | null | 1059C442AZ001_000_HCFA.KEY |
1 | null | 24G_Units | 1802 | 2205 | 24G_Units | 1311 | 1318 | 1475 | 1494 | 1 | 1 | 1 | 1 | 1 | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 24H_EPSDT | 1802 | 2205 | 24H_EPSDT | 1317 | 1342 | 1479 | 1495 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 24J_RenProvOtherIdQual | 1802 | 2205 | 24J_RenProvOtherIdQual | 1302 | 1327 | 1479 | 1495 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 24J_RenProvOtherId | 1802 | 2205 | 24J_RenProvOtherId | 1317 | 1342 | 1479 | 1495 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 24J_RenProvFullName | 1802 | 2205 | 24J_RenProvFullName | 1317 | 1342 | 1479 | 1495 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
1740533736 | null | 24J_RenProvNPIId | 1802 | 2205 | 24J_RenProvNPIId | 1434 | 1585 | 1474 | 1494 | 1 | 1740533736 | 1740533736 | 1740533736 | 1740533736 | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 24_ProcDesc | 1802 | 2205 | 24_ProcDesc | 1586 | 1611 | 1479 | 1494 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 24_NDCQualifier | 1802 | 2205 | 24_NDCQualifier | 83 | 1585 | 1479 | 1494 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 24_NDC | 1802 | 2205 | 24_NDC | 83 | 1585 | 1479 | 1494 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 24_NDCUnitsQual | 1802 | 2205 | 24_NDCUnitsQual | 83 | 1585 | 1479 | 1494 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 24_NDCUnits | 1802 | 2205 | 24_NDCUnits | 83 | 1585 | 1479 | 1494 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 24_NDCCharges | 1802 | 2205 | 24_NDCCharges | 83 | 1585 | 1479 | 1494 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | 24_HCT | 1802 | 2205 | 24_HCT | 1586 | 1611 | 1479 | 1494 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
204269269 | null | 25_BillProvFedIdCode | 1802 | 2205 | 25_BillProvFedIdCode | 85 | 226 | 1880 | 1900 | 1 | 204269269 | 204269269 | 204269269 | 204269269 | null | 1059C442AZ001_000_HCFA.KEY |
2722358V1658 | null | 26_PatAcctNo | 1802 | 2205 | 26_PatAcctNo | 537 | 721 | 1879 | 1900 | 1 | 2722358V1658 | 2722358V1658 | 2722358V1658 | ???????????? | null | 1059C442AZ001_000_HCFA.KEY |
3900 | null | Box28To30Grp | 1802 | 2205 | 28_TotalCharges | 1202 | 1277 | 1879 | 1898 | 1 | 3900 | 3900 | 3900 | 3900 | null | 1059C442AZ001_000_HCFA.KEY |
000 | null | Box28To30Grp | 1802 | 2205 | 29_AmountPaid | 1418 | 1461 | 1878 | 1898 | 1 | 000 | 000 | 000 | 000 | null | 1059C442AZ001_000_HCFA.KEY |
3900 | null | Box28To30Grp | 1802 | 2205 | 30_BalanceDue | 1588 | 1664 | 1878 | 1898 | 1 | 3900 | 3900 | 3900 | 3900 | null | 1059C442AZ001_000_HCFA.KEY |
null | null | Box24AmtGroup | 1802 | 2205 | 24_ClmDiscountAmount | 77 | 1690 | 1434 | 1874 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | Box24AmtGroup | 1802 | 2205 | 24_ClmTaxAmount | 77 | 1690 | 1434 | 1874 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | Box24AmtGroup | 1802 | 2205 | 24_ClmNYSurChargeAmount | 77 | 1690 | 1434 | 1874 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | Box31Group | 1802 | 2205 | 31_PrnRenProvFullName | 85 | 248 | 1992 | 2009 | 1 | MINUTECLINIC | MINUTECLINIC | MINUTECLINIC | MINUTECLINIC | The field is Mandatory, the value is empty | 1059C442AZ001_000_HCFA.KEY |
null | null | Box31Group | 1802 | 2205 | 31_RenProvOrgName | 77 | 521 | 1908 | 2068 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | Box31Group | 1802 | 2205 | 31_RenProvTaxonomyCode | 77 | 521 | 1908 | 2068 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | Box32Group | 1802 | 2205 | 32_FacProvOrgName | 531 | 1079 | 1928 | 2125 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
MINUTECLINIC | null | Box32Group | 1802 | 2205 | 32_FacProvFullName | 528 | 672 | 1961 | 1978 | 1 | MINUTECLINIC | MINUTECLINIC | MINUTECLINIC | MINUTECLINIC | ClassifyAndCorrectName: Field (32_FacProvFullName) does not have any word breaks | 1059C442AZ001_000_HCFA.KEY |
209 SOUTH STATE STREET | null | Box32Group | 1802 | 2205 | 32_FacProvAddr1 | 529 | 787 | 1985 | 2002 | 1 | 209 SOUTH STATE STREET | 209 SOUTH STATE STREET | 209 SOUTH STATE STREET | 209 SOUTH STATE STREET | null | 1059C442AZ001_000_HCFA.KEY |
ANN ARBOR | null | Box32Group | 1802 | 2205 | 32_FacProvCity | 527 | 634 | 2011 | 2027 | 1 | ANN ARBOR | ANN ARBOR | ANN ARBOR | ANN ARBOR | null | 1059C442AZ001_000_HCFA.KEY |
MI | null | Box32Group | 1802 | 2205 | 32_FacProvState | 643 | 664 | 2011 | 2027 | 1 | MI | MI | MI | MI | null | 1059C442AZ001_000_HCFA.KEY |
481032005 | null | Box32Group | 1802 | 2205 | 32_FacProvPostCode | 678 | 788 | 2010 | 2027 | 1 | 481032005 | 481032005 | 481032005 | 481032005 | null | 1059C442AZ001_000_HCFA.KEY |
1902848617 | null | Box32Group | 1802 | 2205 | 32_FacProvNPIId | 541 | 693 | 2040 | 2061 | 1 | 1902848617 | 1902848617 | 1902848617 | 1902848617 | null | 1059C442AZ001_000_HCFA.KEY |
null | null | Box32Group | 1802 | 2205 | 32_FacProvOtherIdFull | 743 | 753 | 2040 | 2061 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | Box32_AmbToGroup | 1802 | 2205 | 32_AmbToFacProvOrgName | 531 | 1079 | 1928 | 2125 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | Box32_AmbToGroup | 1802 | 2205 | 32_AmbToFacProvFullName | 531 | 1079 | 1928 | 2125 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | Box32_AmbToGroup | 1802 | 2205 | 32_AmbToFacProvAddr1 | 531 | 1079 | 1928 | 2125 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | Box32_AmbToGroup | 1802 | 2205 | 32_AmbToFacProvCity | 531 | 1079 | 1928 | 2125 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | Box32_AmbToGroup | 1802 | 2205 | 32_AmbToFacProvState | 531 | 1079 | 1928 | 2125 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | Box32_AmbToGroup | 1802 | 2205 | 32_AmbToFacProvPostCode | 531 | 1079 | 1928 | 2125 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | Box32_AmbToGroup | 1802 | 2205 | 32_AmbToFacProvPostCodeExt | 531 | 1079 | 1928 | 2125 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | Box32_AmbToGroup | 1802 | 2205 | 32_AmbToFacProvNPIId | 531 | 1079 | 1928 | 2125 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
null | null | Box32_AmbToGroup | 1802 | 2205 | 32_AmbToFacProvOtherIdFull | 531 | 1079 | 1928 | 2125 | 1 | null | null | null | null | null | 1059C442AZ001_000_HCFA.KEY |
MINUTECLINIC DIAGNOSTIC OF MICHIGAN PC | null | Box33Group | 1802 | 2205 | 33_BillProvOrgName | 1081 | 1522 | 1944 | 1961 | 1 | MINUTECLINICDIAGNOSTIC OF MICHIGAN PC | null | null | ????????????????????????????????????? | null | 1059C442AZ001_000_HCFA.KEY |
null | null | Box33Group | 1802 | 2205 | 33_BillProvFullName | 1084 | 1690 | 1908 | 1960 | 1 | ? | MINUTECLINICDIAGNOSTICOF MICHIGANF1? | 866 389-2727 | ???????????????????????? ??????????? | null | 1059C442AZ001_000_HCFA.KEY |
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