|
{ |
|
"additional_special_tokens": [ |
|
{ |
|
"content": "</s_TRICARE CHAMPUS>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_YY>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_13. INSURED OR AUTHORIZED PERSON'S SIGNATURE>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_d. IS THERE ANOTHER HEALTH BENEFIT PLAN>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_$ CHARGES1>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_MM>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_DATE>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_1a. INSURED'S I.D. NUMBER>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_meta>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_GROUP HEALTH PLAN>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_10. PATIENT CONDITION>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_AUTO ACCIDENT>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_CPT/HCPCS2>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_ZIP CODE>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_7. INSURED'S ADDRESS>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_28. TOTAL CHARGE>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_TRICARE CHAMPUS>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_2. PATIENT'S NAME>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_23. PRIOR AUTHORIZATION NUMBER>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_4. INSURED'S NAME>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_E. DIAGNOSIS>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_GROUP HEALTH PLAN>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_STATE>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_27. ACCEPT ASSIGNMENT>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_3. PATIENT's BIRTH DATE>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_1a. INSURED'S I.D. NUMBER>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_CITY>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_MM1>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_F.>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_DATE>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_21. DIAGNOSIS OR NATURE OF ILLNESS>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_MEDICAID>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_32. SERVICE FACILITY LOCATION>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_6. PATIENT RELATIONSHIP>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_YY1>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_formnumber>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_1. MEDICARE>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_24. DATE OF SERVICE>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_13. INSURED OR AUTHORIZED PERSON'S SIGNATURE>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_DAYS OR UNITS>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_6. PATIENT RELATIONSHIP>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_8. PATIENT STATUS>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_4. INSURED'S NAME>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_MEDICAL PROVIDER INFORMATION>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_DD>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_FECA>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_CHAMPVA>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_STATE>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_SEX>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_d. INSURANCE PLAN NAME>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_formtype>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_YY>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_CHAMPVA>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_10. PATIENT CONDITION>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_1.>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_DD1>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_9. OTHER INSURED'S NAME>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_7. INSURED'S ADDRESS>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_26. PATIENT'S ACCOUNT NUMBER>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_5. PATIENT'S ADDRESS>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_G.>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_2.>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_12. PATIENT'S OR AUTHORIZED PERSON'S SIGNATURE>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_D. PROCEDURES, SERVICES>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_27. ACCEPT ASSIGNMENT>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_$ CHARGES2>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_26. PATIENT'S ACCOUNT NUMBER>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_AUTO ACCIDENT>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_24. DATE OF SERVICE>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_3. PATIENT's BIRTH DATE>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_1. MEDICARE>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_POINTER1>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_$ CHARGES1>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_ZIP CODE>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_FECA>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_$ CHARGES2>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_OTHER ACCIDENT>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_DD1>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_32. SERVICE FACILITY LOCATION>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_11. INSURED'S POLICY GROUP ORFECA NUMBER>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_EMPLOYMENT>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_formtype>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_EMPLOYMENT>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_CPT/HCPCS2>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_OTHER>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_23. PRIOR AUTHORIZATION NUMBER>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_CPT/HCPCS1>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_MM>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_DAYS OR UNITS>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_YY1>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_MM1>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_28. TOTAL CHARGE>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_21. DIAGNOSIS OR NATURE OF ILLNESS>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_DD>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_OTHER ACCIDENT>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_1.>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_MEMBER AND PATIENT INFORMATION>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_2. PATIENT'S NAME>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_5. PATIENT'S ADDRESS>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_G.>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_SEX>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_OTHER>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_8. PATIENT STATUS>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_11. INSURED'S POLICY GROUP ORFECA NUMBER>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_d. IS THERE ANOTHER HEALTH BENEFIT PLAN>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_meta>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_E. DIAGNOSIS>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_POINTER1>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_CPT/HCPCS1>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_MEDICAL PROVIDER INFORMATION>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_F.>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_d. INSURANCE PLAN NAME>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_MEMBER AND PATIENT INFORMATION>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_2.>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_29. AMOUNT PAID>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_9. OTHER INSURED'S NAME>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_MEDICAID>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_CITY>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_D. PROCEDURES, SERVICES>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_12. PATIENT'S OR AUTHORIZED PERSON'S SIGNATURE>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "<s_formnumber>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
{ |
|
"content": "</s_29. AMOUNT PAID>", |
|
"lstrip": false, |
|
"normalized": false, |
|
"rstrip": false, |
|
"single_word": false |
|
} |
|
], |
|
"bos_token": "<s>", |
|
"cls_token": "<s>", |
|
"eos_token": "</s>", |
|
"mask_token": { |
|
"content": "<mask>", |
|
"lstrip": true, |
|
"normalized": true, |
|
"rstrip": false, |
|
"single_word": false |
|
}, |
|
"pad_token": "<pad>", |
|
"sep_token": "</s>", |
|
"unk_token": "<unk>" |
|
} |
|
|