Insured name

Full name of the person insured

string

Insured Birthdate

Birthdate of the person insured

date

Insured NISZ

National insurance number of the person insured

string

Addressee House number

House number of the person insured

string

Addressee Zip code

Postal code of the person insured

integer

Invoice Type

Type of the invoice: invoice/ambulant/other

tag

Credit Note

Credit note: yes/no

tag

Invoice id

Unique identification of the invoice

string

Invoice date

The date when the invoice was issued

date

Hospital id

Unique identification of the hospital invoice

string

Date in

The date when the treatment period of the person insured starts

date

Date out

The date when the treatment period of the person insured ends

date

Gross amount

Gross amount of the hospital invoice

float

Tax amount

Tax amount of the hospital invoice

float

SUM CHECK SUP

EQUAL(

ADD($Frais du Séjour / Verblijfskosten.SUP amount$1:$Frais du Séjour / Verblijfskosten.SUP amount$$, $Montants forfaitaires / Forfaitaire kosten.SUP amount$1:$Montants forfaitaires / Forfaitaire kosten.SUP amount$$, $Pharmacie / Apotheek.SUP amount$1:$Pharmacie / Apotheek.SUP amount$$, $Honoraires / Honoraria.SUP amount$1:$Honoraires / Honoraria.SUP amount$$),

ADD($Totals.SUP amount$1:$Totals.SUP amount$$)

)

SUM CHECK MUT

EQUAL(

ADD($Frais du Séjour / Verblijfskosten.MUT amount$1:$Frais du Séjour / Verblijfskosten.MUT amount$$, $Montants forfaitaires / Forfaitaire kosten.MUT amount$1:$Montants forfaitaires / Forfaitaire kosten.MUT amount$$, $Pharmacie / Apotheek.MUT amount$1:$Pharmacie / Apotheek.MUT amount$$, $Honoraires / Honoraria.MUT amount$1:$Honoraires / Honoraria.MUT amount$$, $Autres fournitures / Andere leveringen.MUT amount$1:$Autres fournitures / Andere leveringen.MUT amount$$, $Transport / Ziekenvervoer.MUT amount$1:$Transport / Ziekenvervoer.MUT amount$$),

ADD($Totals.MUT amount$1:$Totals.MUT amount$$)

)

SUM CHECK PA

EQUAL(

ADD($Frais du Séjour / Verblijfskosten.PA amount$1:$Frais du Séjour / Verblijfskosten.PA amount$$, $Montants forfaitaires / Forfaitaire kosten.PA amount$1:$Montants forfaitaires / Forfaitaire kosten.PA amount$$, $Pharmacie / Apotheek.PA amount$1:$Pharmacie / Apotheek.PA amount$$, $Honoraires / Honoraria.PA amount$1:$Honoraires / Honoraria.PA amount$$, $Autres fournitures / Andere leveringen.PA amount$1:$Autres fournitures / Andere leveringen.PA amount$$, $Transport / Ziekenvervoer.PA amount$1:$Transport / Ziekenvervoer.PA amount$$, $Frais Divers / Diverse kosten.PA amount$1:$Frais Divers / Diverse kosten.PA amount$$),

ADD($Totals.PA amount$1:$Totals.PA amount$$)

)