Prompt | Response | Req | Len |
---|---|---|---|
Procedure Code | 10 | ||
Date of Service | 10 | ||
Diagnosis | 10 | ||
Original Amount | 10 | ||
Unpaid Amount | 10 | ||
Check Number | 20 | ||
Reversal Reason | 40 | ||
Reverse All Transactions for this Accounting Date | Enter 'Y' if you want to reverse all transactions for this accounting date. | 1 |