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Text File  |  1996-01-22  |  11KB  |  536 lines
  1. "Format File Version 8"
  2. "Walkout Receipt Laser"
  3. 187
  4. ""
  5. 1,25,"ñ╒","XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX",2,3
  6. PRINTPRAC="Y" AND PRACDOC="P"
  7. PRNAME
  8. "#F⌐ñY╒»#D⌐ñP╒","#L"
  9. PRINTPRAC="Y" AND PRACDOC="D" AND BYATTEND="N"
  10. PNAME
  11. "#F⌐ñY╒»#D⌐ñD╒»#<⌐ñN╒","$>"
  12. PRINTPRAC="Y" AND PRACDOC="D" AND BYATTEND="Y"
  13. ANAME
  14. "#F⌐ñY╒»#D⌐ñD╒»#<⌐ñY╒","%_"
  15. ""
  16. 2,25,"ñ╒","XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX",2,3
  17. PRINTPRAC="Y" AND PRACDOC="P"
  18. PRSTREET
  19. "#F⌐ñY╒»#D⌐ñP╒","#M"
  20. PRINTPRAC="Y" AND PRACDOC="D" AND BYATTEND="N"
  21. PSTREET
  22. "#F⌐ñY╒»#D⌐ñD╒»#<⌐ñN╒","$?"
  23. PRINTPRAC="Y" AND PRACDOC="D" AND BYATTEND="Y"
  24. ASTREET
  25. "#F⌐ñY╒»#D⌐ñD╒»#<⌐ñY╒","%`"
  26. ""
  27. 3,22,"ñ╒","XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX",2,3
  28. PRINTPRAC="Y" AND PRACDOC="P"
  29. PRCITYLN
  30. "#F⌐ñY╒»#D⌐ñP╒","#N"
  31. PRINTPRAC="Y" AND PRACDOC="D" AND BYATTEND="N"
  32. PCITYLN
  33. "#F⌐ñY╒»#D⌐ñD╒»#<⌐ñN╒","$@"
  34. PRINTPRAC="Y" AND PRACDOC="D" AND BYATTEND="Y"
  35. ACITYLN
  36. "#F⌐ñY╒»#D⌐ñD╒»#<⌐ñY╒","%a"
  37. ""
  38. 4,33,"ñ╒","XXXXXXXXXXXXXX",2,3
  39. PRINTPRAC="Y" AND PRACDOC="P"
  40. PRPHONE
  41. "#F⌐ñY╒»#D⌐ñP╒","#R"
  42. PRINTPRAC="Y" AND PRACDOC="D" AND BYATTEND="N"
  43. PPHONE
  44. "#F⌐ñY╒»#D⌐ñD╒»#<⌐ñN╒","$D"
  45. PRINTPRAC="Y" AND PRACDOC="D" AND BYATTEND="Y"
  46. APHONE
  47. "#F⌐ñY╒»#D⌐ñD╒»#<⌐ñY╒","%e"
  48. SYSDATE
  49. 4,67,"#6","XX-XX-XX",0,0
  50. ""
  51. 5,27,"ñ╒","XXXXXXXXXXXXXXXXXXXXXXXXXXX",2,3
  52. PRINTPRAC="Y" AND PRACDOC="P"
  53. "Federal ID: "+PRFEDID
  54. "#F⌐ñY╒»#D⌐ñP╒","ñFederal ID: ╒ª#S"
  55. PRINTPRAC="Y" AND PRACDOC="D" AND BYATTEND="N"
  56. "License #: "+PLICENSE
  57. "#F⌐ñY╒»#D⌐ñD╒»#<⌐ñN╒","ñLicense #: ╒ª$G"
  58. PRINTPRAC="Y" AND PRACDOC="D" AND BYATTEND="Y"
  59. "License #: "+ALICENSE
  60. "#F⌐ñY╒»#D⌐ñD╒»#<⌐ñY╒","ñLicense #: ╒ª%h"
  61. ""
  62. 6,28,"ñ╒","XXXXXXXXXXXXXXXXXXXXXXXXX",2,3
  63. PRINTPRAC="Y" AND PRACDOC="P"
  64. ""
  65. "#F⌐ñY╒»#D⌐ñP╒","ñ╒"
  66. PRINTPRAC="Y" AND PRACDOC="D" AND BYATTEND="N"
  67. "PIN: "+PPIN
  68. "#F⌐ñY╒»#D⌐ñD╒»#<⌐ñN╒","ñPIN: ╒ª$J"
  69. PRINTPRAC="Y" AND PRACDOC="D" AND BYATTEND="Y"
  70. "PIN: "+APIN
  71. "#F⌐ñY╒»#D⌐ñD╒»#<⌐ñY╒","ñPIN: ╒ª%k"
  72. ""
  73. 7,24,"ñ╒","XXXXXXXXXXXXXXXXXX",1,2
  74. AFTXIND="S"
  75. "Social Security #:"
  76. "%f⌐ñS╒","ñSocial Security #:╒"
  77. AFTXIND="E"
  78. "Federal Tax ID#:"
  79. "%f⌐ñE╒","ñFederal Tax ID#:╒"
  80. ""
  81. 7,43,"ñ╒","XXXXXXXXXXXX",0,2
  82. PRINTPRAC="Y" AND PRACDOC="D" AND BYATTEND="N"
  83. PSSN
  84. "#F⌐ñY╒»#D⌐ñD╒»#<⌐ñN╒","$F"
  85. PRINTPRAC="Y" AND PRACDOC="D" AND BYATTEND="Y"
  86. ASSN
  87. "#F⌐ñY╒»#D⌐ñD╒»#<⌐ñY╒","%g"
  88. "Patient:"
  89. 10,3,"ñPatient:╒","XXXXXXXX",0,0
  90. CHART
  91. 10,12,"#V","XXXXXXXX",0,0
  92. PHONE
  93. 10,22,"#a","XXXXXXXXXXXXXX",0,0
  94. "Diagnosis"
  95. 10,51,"ñDiagnosis╒","XXXXXXXXX",0,0
  96. "1."
  97. 11,40,"ñ1.╒","XX",0,0
  98. DIAGLINE
  99. 11,43,"%:","XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX",0,0
  100. NAME
  101. 12,6,"#W","XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX",0,0
  102. "2."
  103. 12,40,"ñ2.╒","XX",0,0
  104. DIAGLINE
  105. 12,43,"%:","XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX",0,0
  106. STREET
  107. 13,6,"#[","XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX",0,0
  108. "3."
  109. 13,40,"ñ3.╒","XX",0,0
  110. DIAGLINE
  111. 13,43,"%:","XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX",0,0
  112. CITYLN
  113. 14,6,"#\","XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX",0,0
  114. "4."
  115. 14,40,"ñ4.╒","XX",0,0
  116. DIAGLINE
  117. 14,43,"%:","XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX",0,0
  118.  
  119. 16,3,"","Instructions:  Complete the patient information portion of your own",0,0
  120.  
  121. 17,18,"","insurance claim form. Attach this bill, signed and dated,",0,0
  122.  
  123. 18,18,"","and all other bills pertaining to the claim. If you have a",0,0
  124.  
  125. 19,18,"","deductible policy, hold your claim forms until you have met",0,0
  126.  
  127. 20,18,"","your deductible. Mail directly to your insurance carrier.",0,0
  128.  
  129. 22,1,"","-------------------------------------------------------------------------------",0,0
  130.  
  131. 23,4,"","Date",0,0
  132.  
  133. 23,12,"","Description",0,0
  134.  
  135. 23,39,"","Procedure",0,0
  136.  
  137. 23,50,"","Modify",0,0
  138.  
  139. 23,59,"","DX",0,0
  140.  
  141. 23,63,"","Units    Charge",0,0
  142.  
  143. 24,1,"","-------------------------------------------------------------------------------",0,0
  144. DATE
  145. 25,3,"%;","XX-XX-XX",0,0
  146. DESC
  147. 25,12,"%K","XXXXXXXXXXXXXXXXXXXXXXXXXX",0,0
  148. CODEONLY
  149. 25,39,"%@","XXXXXXXXXX",0,0
  150. MODIF
  151. 25,50,"%A","XXXXXX",0,0
  152. DIAGPTR
  153. 25,58,"%O","XXXX",0,0
  154. UNITS
  155. 25,64,"%P","XXX",0,0
  156. AMOUNT
  157. 25,69,"%R","XXXXXX.XX",1,0
  158. DATE
  159. 26,3,"%;","XX-XX-XX",0,0
  160. DESC
  161. 26,12,"%K","XXXXXXXXXXXXXXXXXXXXXXXXXX",0,0
  162. CODEONLY
  163. 26,39,"%@","XXXXXXXXXX",0,0
  164. MODIF
  165. 26,50,"%A","XXXXXX",0,0
  166. DIAGPTR
  167. 26,58,"%O","XXXX",0,0
  168. UNITS
  169. 26,64,"%P","XXX",0,0
  170. AMOUNT
  171. 26,69,"%R","XXXXXX.XX",1,0
  172. DATE
  173. 27,3,"%;","XX-XX-XX",0,0
  174. DESC
  175. 27,12,"%K","XXXXXXXXXXXXXXXXXXXXXXXXXX",0,0
  176. CODEONLY
  177. 27,39,"%@","XXXXXXXXXX",0,0
  178. MODIF
  179. 27,50,"%A","XXXXXX",0,0
  180. DIAGPTR
  181. 27,58,"%O","XXXX",0,0
  182. UNITS
  183. 27,64,"%P","XXX",0,0
  184. AMOUNT
  185. 27,69,"%R","XXXXXX.XX",1,0
  186. DATE
  187. 28,3,"%;","XX-XX-XX",0,0
  188. DESC
  189. 28,12,"%K","XXXXXXXXXXXXXXXXXXXXXXXXXX",0,0
  190. CODEONLY
  191. 28,39,"%@","XXXXXXXXXX",0,0
  192. MODIF
  193. 28,50,"%A","XXXXXX",0,0
  194. DIAGPTR
  195. 28,58,"%O","XXXX",0,0
  196. UNITS
  197. 28,64,"%P","XXX",0,0
  198. AMOUNT
  199. 28,69,"%R","XXXXXX.XX",1,0
  200. DATE
  201. 29,3,"%;","XX-XX-XX",0,0
  202. DESC
  203. 29,12,"%K","XXXXXXXXXXXXXXXXXXXXXXXXXX",0,0
  204. CODEONLY
  205. 29,39,"%@","XXXXXXXXXX",0,0
  206. MODIF
  207. 29,50,"%A","XXXXXX",0,0
  208. DIAGPTR
  209. 29,58,"%O","XXXX",0,0
  210. UNITS
  211. 29,64,"%P","XXX",0,0
  212. AMOUNT
  213. 29,69,"%R","XXXXXX.XX",1,0
  214. DATE
  215. 30,3,"%;","XX-XX-XX",0,0
  216. DESC
  217. 30,12,"%K","XXXXXXXXXXXXXXXXXXXXXXXXXX",0,0
  218. CODEONLY
  219. 30,39,"%@","XXXXXXXXXX",0,0
  220. MODIF
  221. 30,50,"%A","XXXXXX",0,0
  222. DIAGPTR
  223. 30,58,"%O","XXXX",0,0
  224. UNITS
  225. 30,64,"%P","XXX",0,0
  226. AMOUNT
  227. 30,69,"%R","XXXXXX.XX",1,0
  228. DATE
  229. 31,3,"%;","XX-XX-XX",0,0
  230. DESC
  231. 31,12,"%K","XXXXXXXXXXXXXXXXXXXXXXXXXX",0,0
  232. CODEONLY
  233. 31,39,"%@","XXXXXXXXXX",0,0
  234. MODIF
  235. 31,50,"%A","XXXXXX",0,0
  236. DIAGPTR
  237. 31,58,"%O","XXXX",0,0
  238. UNITS
  239. 31,64,"%P","XXX",0,0
  240. AMOUNT
  241. 31,69,"%R","XXXXXX.XX",1,0
  242. DATE
  243. 32,3,"%;","XX-XX-XX",0,0
  244. DESC
  245. 32,12,"%K","XXXXXXXXXXXXXXXXXXXXXXXXXX",0,0
  246. CODEONLY
  247. 32,39,"%@","XXXXXXXXXX",0,0
  248. MODIF
  249. 32,50,"%A","XXXXXX",0,0
  250. DIAGPTR
  251. 32,58,"%O","XXXX",0,0
  252. UNITS
  253. 32,64,"%P","XXX",0,0
  254. AMOUNT
  255. 32,69,"%R","XXXXXX.XX",1,0
  256. DATE
  257. 33,3,"%;","XX-XX-XX",0,0
  258. DESC
  259. 33,12,"%K","XXXXXXXXXXXXXXXXXXXXXXXXXX",0,0
  260. CODEONLY
  261. 33,39,"%@","XXXXXXXXXX",0,0
  262. MODIF
  263. 33,50,"%A","XXXXXX",0,0
  264. DIAGPTR
  265. 33,58,"%O","XXXX",0,0
  266. UNITS
  267. 33,64,"%P","XXX",0,0
  268. AMOUNT
  269. 33,69,"%R","XXXXXX.XX",1,0
  270. DATE
  271. 34,3,"%;","XX-XX-XX",0,0
  272. DESC
  273. 34,12,"%K","XXXXXXXXXXXXXXXXXXXXXXXXXX",0,0
  274. CODEONLY
  275. 34,39,"%@","XXXXXXXXXX",0,0
  276. MODIF
  277. 34,50,"%A","XXXXXX",0,0
  278. DIAGPTR
  279. 34,58,"%O","XXXX",0,0
  280. UNITS
  281. 34,64,"%P","XXX",0,0
  282. AMOUNT
  283. 34,69,"%R","XXXXXX.XX",1,0
  284. DATE
  285. 35,3,"%;","XX-XX-XX",0,0
  286. DESC
  287. 35,12,"%K","XXXXXXXXXXXXXXXXXXXXXXXXXX",0,0
  288. CODEONLY
  289. 35,39,"%@","XXXXXXXXXX",0,0
  290. MODIF
  291. 35,50,"%A","XXXXXX",0,0
  292. DIAGPTR
  293. 35,58,"%O","XXXX",0,0
  294. UNITS
  295. 35,64,"%P","XXX",0,0
  296. AMOUNT
  297. 35,69,"%R","XXXXXX.XX",1,0
  298. DATE
  299. 36,3,"%;","XX-XX-XX",0,0
  300. DESC
  301. 36,12,"%K","XXXXXXXXXXXXXXXXXXXXXXXXXX",0,0
  302. CODEONLY
  303. 36,39,"%@","XXXXXXXXXX",0,0
  304. MODIF
  305. 36,50,"%A","XXXXXX",0,0
  306. DIAGPTR
  307. 36,58,"%O","XXXX",0,0
  308. UNITS
  309. 36,64,"%P","XXX",0,0
  310. AMOUNT
  311. 36,69,"%R","XXXXXX.XX",1,0
  312. DATE
  313. 37,3,"%;","XX-XX-XX",0,0
  314. DESC
  315. 37,12,"%K","XXXXXXXXXXXXXXXXXXXXXXXXXX",0,0
  316. CODEONLY
  317. 37,39,"%@","XXXXXXXXXX",0,0
  318. MODIF
  319. 37,50,"%A","XXXXXX",0,0
  320. DIAGPTR
  321. 37,58,"%O","XXXX",0,0
  322. UNITS
  323. 37,64,"%P","XXX",0,0
  324. AMOUNT
  325. 37,69,"%R","XXXXXX.XX",1,0
  326. DATE
  327. 38,3,"%;","XX-XX-XX",0,0
  328. DESC
  329. 38,12,"%K","XXXXXXXXXXXXXXXXXXXXXXXXXX",0,0
  330. CODEONLY
  331. 38,39,"%@","XXXXXXXXXX",0,0
  332. MODIF
  333. 38,50,"%A","XXXXXX",0,0
  334. DIAGPTR
  335. 38,58,"%O","XXXX",0,0
  336. UNITS
  337. 38,64,"%P","XXX",0,0
  338. AMOUNT
  339. 38,69,"%R","XXXXXX.XX",1,0
  340. DATE
  341. 39,3,"%;","XX-XX-XX",0,0
  342. DESC
  343. 39,12,"%K","XXXXXXXXXXXXXXXXXXXXXXXXXX",0,0
  344. CODEONLY
  345. 39,39,"%@","XXXXXXXXXX",0,0
  346. MODIF
  347. 39,50,"%A","XXXXXX",0,0
  348. DIAGPTR
  349. 39,58,"%O","XXXX",0,0
  350. UNITS
  351. 39,64,"%P","XXX",0,0
  352. AMOUNT
  353. 39,69,"%R","XXXXXX.XX",1,0
  354. DATE
  355. 40,3,"%;","XX-XX-XX",0,0
  356. DESC
  357. 40,12,"%K","XXXXXXXXXXXXXXXXXXXXXXXXXX",0,0
  358. CODEONLY
  359. 40,39,"%@","XXXXXXXXXX",0,0
  360. MODIF
  361. 40,50,"%A","XXXXXX",0,0
  362. DIAGPTR
  363. 40,58,"%O","XXXX",0,0
  364. UNITS
  365. 40,64,"%P","XXX",0,0
  366. AMOUNT
  367. 40,69,"%R","XXXXXX.XX",1,0
  368. DATE
  369. 41,3,"%;","XX-XX-XX",0,0
  370. DESC
  371. 41,12,"%K","XXXXXXXXXXXXXXXXXXXXXXXXXX",0,0
  372. CODEONLY
  373. 41,39,"%@","XXXXXXXXXX",0,0
  374. MODIF
  375. 41,50,"%A","XXXXXX",0,0
  376. DIAGPTR
  377. 41,58,"%O","XXXX",0,0
  378. UNITS
  379. 41,64,"%P","XXX",0,0
  380. AMOUNT
  381. 41,69,"%R","XXXXXX.XX",1,0
  382. DATE
  383. 42,3,"%;","XX-XX-XX",0,0
  384. DESC
  385. 42,12,"%K","XXXXXXXXXXXXXXXXXXXXXXXXXX",0,0
  386. CODEONLY
  387. 42,39,"%@","XXXXXXXXXX",0,0
  388. MODIF
  389. 42,50,"%A","XXXXXX",0,0
  390. DIAGPTR
  391. 42,58,"%O","XXXX",0,0
  392. UNITS
  393. 42,64,"%P","XXX",0,0
  394. AMOUNT
  395. 42,69,"%R","XXXXXX.XX",1,0
  396.  
  397. 44,50,"","Total Charges:",0,0
  398. CHARGES
  399. 44,65,"#-","XXXXXXXXX.XX",1,0
  400.  
  401. 45,50,"","Total Credits:",0,0
  402. PAYMENTS
  403. 45,65,"#.","XXXXXXXXX.XX",1,0
  404.  
  405. 46,60,"","Tax: ",0,0
  406. TAX
  407. 46,65,"#/","XXXXXXXXX.XX",1,0
  408.  
  409. 47,43,"","Total Due This Visit:",0,0
  410. DUE
  411. 47,65,"#0","XXXXXXXXX.XX",1,0
  412.  
  413. 49,43,"","Prior",0,0
  414.  
  415. 49,48,""," F",0,0
  416.  
  417. 49,50,"","amily Balance: ",0,0
  418. BALANCE
  419. 49,65,"#,","XXXXXXXXX.XX",1,0
  420.  
  421. 50,45,"","Family Balance Due:",0,0
  422. SUM(DUE,BALANCE)
  423. 50,65,"╝#0º#,¿","XXXXXXXXX.XX",1,1
  424. SUM(DUE,BALANCE)=0
  425. "000"
  426. "╝#0º#,¿⌐Ñ0╒","ñ000╒"
  427.  
  428. 51,1,"","===============================================================================",0,0
  429. ""
  430. 52,3,"ñ╒","XXXXXXXXXXXXXXXXXXX",0,1
  431. ACCASSIGN="Y" OR ACASSIGNB="Y" OR ACASSIGNC="Y"
  432. "Assign and Release:"
  433. "$1⌐ñY╒░$2⌐ñY╒░$3⌐ñY╒","ñAssign and Release:╒"
  434. ""
  435. 52,23,"ñ╒","XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX",0,1
  436. ACCASSIGN="Y" OR ACASSIGNB="Y" OR ACASSIGNC="Y"
  437. "I hereby authorize payment of medical benefits to this"
  438. "$1⌐ñY╒░$2⌐ñY╒░$3⌐ñY╒","ñI hereby authorize payment of medical benefits to this╒"
  439. ""
  440. 53,23,"ñ╒","XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX",0,1
  441. ACCASSIGN="Y" OR ACASSIGNB="Y" OR ACASSIGNC="Y"
  442. "physician for the services described above.  I also"
  443. "$1⌐ñY╒░$2⌐ñY╒░$3⌐ñY╒","ñphysician for the services described above.  I also╒"
  444. ""
  445. 54,23,"ñ╒","XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX",0,1
  446. ACCASSIGN="Y" OR ACASSIGNB="Y" OR ACASSIGNC="Y"
  447. "authorize the release of any information necessary to"
  448. "$1⌐ñY╒░$2⌐ñY╒░$3⌐ñY╒","ñauthorize the release of any information necessary to╒"
  449. ""
  450. 55,23,"ñ╒","XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX",0,1
  451. ACCASSIGN="Y" OR ACASSIGNB="Y" OR ACASSIGNC="Y"
  452. "process this claim."
  453. "$1⌐ñY╒░$2⌐ñY╒░$3⌐ñY╒","ñprocess this claim.╒"
  454. ""
  455. 57,3,"ñ╒","XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX",0,1
  456. ACCASSIGN="Y" OR ACASSIGNB="Y" OR ACASSIGNC="Y"
  457. "Patient Signature: __________________________________"
  458. "$1⌐ñY╒░$2⌐ñY╒░$3⌐ñY╒","ñPatient Signature: __________________________________╒"
  459. ""
  460. 57,61,"ñ╒","XXXXXXXXXXXXXXX",0,1
  461. ACCASSIGN="Y" OR ACASSIGNB="Y" OR ACASSIGNC="Y"
  462. "Date: _________"
  463. "$1⌐ñY╒░$2⌐ñY╒░$3⌐ñY╒","ñDate: _________╒"
  464. ""
  465. 59,1,"ñ╒","XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX",0,1
  466. ACCASSIGN="Y" OR ACASSIGNB="Y" OR ACASSIGNC="Y"
  467. "==============================================================="
  468. "$1⌐ñY╒░$2⌐ñY╒░$3⌐ñY╒","ñ===============================================================╒"
  469. ""
  470. 59,64,"ñ╒","XXXXXXXXXXXXXXXX",0,1
  471. ACCASSIGN="Y" OR ACASSIGNB="Y" OR ACASSIGNC="Y"
  472. "================"
  473. "$1⌐ñY╒░$2⌐ñY╒░$3⌐ñY╒","ñ================╒"
  474. 18
  475. 4
  476. 20
  477. 60
  478. "60"
  479. 79
  480. "79"
  481. -1
  482. "-1"
  483.  
  484. ""
  485. DATE,DOC
  486. "%^%;%="
  487.  
  488. ""
  489.  
  490. "%^"
  491.  
  492. ""
  493.  
  494. ""
  495. Y
  496. "Y"
  497. N
  498. "N"
  499. N
  500. "N"
  501. N
  502. "N"
  503. Y
  504. "Y"
  505. N
  506. "N"
  507. Y
  508. "Y"
  509. D
  510. "D"
  511. Y
  512. "Y"
  513. Y
  514. "Y"
  515. TAX
  516. "TAX"
  517. 18
  518. "","Y"
  519. "","Y"
  520. "","Y"
  521. "","Y"
  522. "","Y"
  523. "","Y"
  524. "","Y"
  525. "","Y"
  526. "","Y"
  527. "","Y"
  528. "","Y"
  529. "N","Y"
  530. "","Y"
  531. "","N"
  532. "","N"
  533. "","N"
  534. "","N"
  535. "","Y"
  536.