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ShekDass
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donut-base-cord-test1-CMS

Transformers
TensorBoard
Safetensors
vision-encoder-decoder
Generated from Trainer
Inference Endpoints
Model card Files Metrics Community
ShekDass commited on
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Files changed (10) hide show
  1. README.md +55 -0
  2. added_tokens.json +182 -0
  3. generation_config.json +8 -0
  4. model.safetensors +1 -1
  5. preprocessor_config.json +26 -0
  6. runs/Feb11_16-51-23_c4e50392437d/events.out.tfevents.1707670310.c4e50392437d.168.0 +2 -2
  7. sentencepiece.bpe.model +3 -0
  8. special_tokens_map.json +885 -0
  9. tokenizer.json +0 -0
  10. tokenizer_config.json +1622 -0
README.md ADDED
@@ -0,0 +1,55 @@
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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+ ---
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+ license: mit
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+ base_model: naver-clova-ix/donut-base-finetuned-cord-v2
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+ tags:
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+ - generated_from_trainer
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+ datasets:
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+ - imagefolder
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+ model-index:
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+ - name: donut-base-cord-test1-CMS
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+ results: []
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+ ---
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+
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+ <!-- This model card has been generated automatically according to the information the Trainer had access to. You
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+ should probably proofread and complete it, then remove this comment. -->
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+
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+ # donut-base-cord-test1-CMS
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+
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+ This model is a fine-tuned version of [naver-clova-ix/donut-base-finetuned-cord-v2](https://huggingface.co/naver-clova-ix/donut-base-finetuned-cord-v2) on the imagefolder dataset.
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+
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+ ## Model description
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+
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+ More information needed
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+
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+ ## Intended uses & limitations
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+
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+ More information needed
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+
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+ ## Training and evaluation data
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+
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+ More information needed
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+
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+ ## Training procedure
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+
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+ ### Training hyperparameters
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+
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+ The following hyperparameters were used during training:
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+ - learning_rate: 2e-05
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+ - train_batch_size: 1
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+ - eval_batch_size: 8
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+ - seed: 42
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+ - optimizer: Adam with betas=(0.9,0.999) and epsilon=1e-08
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+ - lr_scheduler_type: linear
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+ - num_epochs: 20
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+ - mixed_precision_training: Native AMP
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+
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+ ### Training results
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+
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+
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+
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+ ### Framework versions
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+
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+ - Transformers 4.35.2
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+ - Pytorch 2.1.0+cu121
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+ - Datasets 2.17.0
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+ - Tokenizers 0.15.1
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+ "rstrip": false,
141
+ "single_word": false
142
+ },
143
+ {
144
+ "content": "<s_E. DIAGNOSIS>",
145
+ "lstrip": false,
146
+ "normalized": false,
147
+ "rstrip": false,
148
+ "single_word": false
149
+ },
150
+ {
151
+ "content": "</s_GROUP HEALTH PLAN>",
152
+ "lstrip": false,
153
+ "normalized": false,
154
+ "rstrip": false,
155
+ "single_word": false
156
+ },
157
+ {
158
+ "content": "<s_STATE>",
159
+ "lstrip": false,
160
+ "normalized": false,
161
+ "rstrip": false,
162
+ "single_word": false
163
+ },
164
+ {
165
+ "content": "</s_27. ACCEPT ASSIGNMENT>",
166
+ "lstrip": false,
167
+ "normalized": false,
168
+ "rstrip": false,
169
+ "single_word": false
170
+ },
171
+ {
172
+ "content": "</s_3. PATIENT's BIRTH DATE>",
173
+ "lstrip": false,
174
+ "normalized": false,
175
+ "rstrip": false,
176
+ "single_word": false
177
+ },
178
+ {
179
+ "content": "<s_1a. INSURED'S I.D. NUMBER>",
180
+ "lstrip": false,
181
+ "normalized": false,
182
+ "rstrip": false,
183
+ "single_word": false
184
+ },
185
+ {
186
+ "content": "</s_CITY>",
187
+ "lstrip": false,
188
+ "normalized": false,
189
+ "rstrip": false,
190
+ "single_word": false
191
+ },
192
+ {
193
+ "content": "</s_MM1>",
194
+ "lstrip": false,
195
+ "normalized": false,
196
+ "rstrip": false,
197
+ "single_word": false
198
+ },
199
+ {
200
+ "content": "<s_F.>",
201
+ "lstrip": false,
202
+ "normalized": false,
203
+ "rstrip": false,
204
+ "single_word": false
205
+ },
206
+ {
207
+ "content": "</s_DATE>",
208
+ "lstrip": false,
209
+ "normalized": false,
210
+ "rstrip": false,
211
+ "single_word": false
212
+ },
213
+ {
214
+ "content": "<s_21. DIAGNOSIS OR NATURE OF ILLNESS>",
215
+ "lstrip": false,
216
+ "normalized": false,
217
+ "rstrip": false,
218
+ "single_word": false
219
+ },
220
+ {
221
+ "content": "<s_MEDICAID>",
222
+ "lstrip": false,
223
+ "normalized": false,
224
+ "rstrip": false,
225
+ "single_word": false
226
+ },
227
+ {
228
+ "content": "</s_32. SERVICE FACILITY LOCATION>",
229
+ "lstrip": false,
230
+ "normalized": false,
231
+ "rstrip": false,
232
+ "single_word": false
233
+ },
234
+ {
235
+ "content": "<s_6. PATIENT RELATIONSHIP>",
236
+ "lstrip": false,
237
+ "normalized": false,
238
+ "rstrip": false,
239
+ "single_word": false
240
+ },
241
+ {
242
+ "content": "</s_YY1>",
243
+ "lstrip": false,
244
+ "normalized": false,
245
+ "rstrip": false,
246
+ "single_word": false
247
+ },
248
+ {
249
+ "content": "</s_formnumber>",
250
+ "lstrip": false,
251
+ "normalized": false,
252
+ "rstrip": false,
253
+ "single_word": false
254
+ },
255
+ {
256
+ "content": "<s_1. MEDICARE>",
257
+ "lstrip": false,
258
+ "normalized": false,
259
+ "rstrip": false,
260
+ "single_word": false
261
+ },
262
+ {
263
+ "content": "<s_24. DATE OF SERVICE>",
264
+ "lstrip": false,
265
+ "normalized": false,
266
+ "rstrip": false,
267
+ "single_word": false
268
+ },
269
+ {
270
+ "content": "</s_13. INSURED OR AUTHORIZED PERSON'S SIGNATURE>",
271
+ "lstrip": false,
272
+ "normalized": false,
273
+ "rstrip": false,
274
+ "single_word": false
275
+ },
276
+ {
277
+ "content": "</s_DAYS OR UNITS>",
278
+ "lstrip": false,
279
+ "normalized": false,
280
+ "rstrip": false,
281
+ "single_word": false
282
+ },
283
+ {
284
+ "content": "</s_6. PATIENT RELATIONSHIP>",
285
+ "lstrip": false,
286
+ "normalized": false,
287
+ "rstrip": false,
288
+ "single_word": false
289
+ },
290
+ {
291
+ "content": "</s_8. PATIENT STATUS>",
292
+ "lstrip": false,
293
+ "normalized": false,
294
+ "rstrip": false,
295
+ "single_word": false
296
+ },
297
+ {
298
+ "content": "</s_4. INSURED'S NAME>",
299
+ "lstrip": false,
300
+ "normalized": false,
301
+ "rstrip": false,
302
+ "single_word": false
303
+ },
304
+ {
305
+ "content": "<s_MEDICAL PROVIDER INFORMATION>",
306
+ "lstrip": false,
307
+ "normalized": false,
308
+ "rstrip": false,
309
+ "single_word": false
310
+ },
311
+ {
312
+ "content": "</s_DD>",
313
+ "lstrip": false,
314
+ "normalized": false,
315
+ "rstrip": false,
316
+ "single_word": false
317
+ },
318
+ {
319
+ "content": "<s_FECA>",
320
+ "lstrip": false,
321
+ "normalized": false,
322
+ "rstrip": false,
323
+ "single_word": false
324
+ },
325
+ {
326
+ "content": "</s_CHAMPVA>",
327
+ "lstrip": false,
328
+ "normalized": false,
329
+ "rstrip": false,
330
+ "single_word": false
331
+ },
332
+ {
333
+ "content": "</s_STATE>",
334
+ "lstrip": false,
335
+ "normalized": false,
336
+ "rstrip": false,
337
+ "single_word": false
338
+ },
339
+ {
340
+ "content": "</s_SEX>",
341
+ "lstrip": false,
342
+ "normalized": false,
343
+ "rstrip": false,
344
+ "single_word": false
345
+ },
346
+ {
347
+ "content": "<s_d. INSURANCE PLAN NAME>",
348
+ "lstrip": false,
349
+ "normalized": false,
350
+ "rstrip": false,
351
+ "single_word": false
352
+ },
353
+ {
354
+ "content": "</s>",
355
+ "lstrip": false,
356
+ "normalized": false,
357
+ "rstrip": false,
358
+ "single_word": false
359
+ },
360
+ {
361
+ "content": "<s_formtype>",
362
+ "lstrip": false,
363
+ "normalized": false,
364
+ "rstrip": false,
365
+ "single_word": false
366
+ },
367
+ {
368
+ "content": "<s_YY>",
369
+ "lstrip": false,
370
+ "normalized": false,
371
+ "rstrip": false,
372
+ "single_word": false
373
+ },
374
+ {
375
+ "content": "<s_CHAMPVA>",
376
+ "lstrip": false,
377
+ "normalized": false,
378
+ "rstrip": false,
379
+ "single_word": false
380
+ },
381
+ {
382
+ "content": "</s_10. PATIENT CONDITION>",
383
+ "lstrip": false,
384
+ "normalized": false,
385
+ "rstrip": false,
386
+ "single_word": false
387
+ },
388
+ {
389
+ "content": "<s_1.>",
390
+ "lstrip": false,
391
+ "normalized": false,
392
+ "rstrip": false,
393
+ "single_word": false
394
+ },
395
+ {
396
+ "content": "<s_DD1>",
397
+ "lstrip": false,
398
+ "normalized": false,
399
+ "rstrip": false,
400
+ "single_word": false
401
+ },
402
+ {
403
+ "content": "</s_9. OTHER INSURED'S NAME>",
404
+ "lstrip": false,
405
+ "normalized": false,
406
+ "rstrip": false,
407
+ "single_word": false
408
+ },
409
+ {
410
+ "content": "<s_7. INSURED'S ADDRESS>",
411
+ "lstrip": false,
412
+ "normalized": false,
413
+ "rstrip": false,
414
+ "single_word": false
415
+ },
416
+ {
417
+ "content": "<s_26. PATIENT'S ACCOUNT NUMBER>",
418
+ "lstrip": false,
419
+ "normalized": false,
420
+ "rstrip": false,
421
+ "single_word": false
422
+ },
423
+ {
424
+ "content": "<s_5. PATIENT'S ADDRESS>",
425
+ "lstrip": false,
426
+ "normalized": false,
427
+ "rstrip": false,
428
+ "single_word": false
429
+ },
430
+ {
431
+ "content": "<s_G.>",
432
+ "lstrip": false,
433
+ "normalized": false,
434
+ "rstrip": false,
435
+ "single_word": false
436
+ },
437
+ {
438
+ "content": "<s_2.>",
439
+ "lstrip": false,
440
+ "normalized": false,
441
+ "rstrip": false,
442
+ "single_word": false
443
+ },
444
+ {
445
+ "content": "</s_12. PATIENT'S OR AUTHORIZED PERSON'S SIGNATURE>",
446
+ "lstrip": false,
447
+ "normalized": false,
448
+ "rstrip": false,
449
+ "single_word": false
450
+ },
451
+ {
452
+ "content": "</s_D. PROCEDURES, SERVICES>",
453
+ "lstrip": false,
454
+ "normalized": false,
455
+ "rstrip": false,
456
+ "single_word": false
457
+ },
458
+ {
459
+ "content": "<s_27. ACCEPT ASSIGNMENT>",
460
+ "lstrip": false,
461
+ "normalized": false,
462
+ "rstrip": false,
463
+ "single_word": false
464
+ },
465
+ {
466
+ "content": "</s_$ CHARGES2>",
467
+ "lstrip": false,
468
+ "normalized": false,
469
+ "rstrip": false,
470
+ "single_word": false
471
+ },
472
+ {
473
+ "content": "</s_26. PATIENT'S ACCOUNT NUMBER>",
474
+ "lstrip": false,
475
+ "normalized": false,
476
+ "rstrip": false,
477
+ "single_word": false
478
+ },
479
+ {
480
+ "content": "</s_AUTO ACCIDENT>",
481
+ "lstrip": false,
482
+ "normalized": false,
483
+ "rstrip": false,
484
+ "single_word": false
485
+ },
486
+ {
487
+ "content": "</s_24. DATE OF SERVICE>",
488
+ "lstrip": false,
489
+ "normalized": false,
490
+ "rstrip": false,
491
+ "single_word": false
492
+ },
493
+ {
494
+ "content": "<s_3. PATIENT's BIRTH DATE>",
495
+ "lstrip": false,
496
+ "normalized": false,
497
+ "rstrip": false,
498
+ "single_word": false
499
+ },
500
+ {
501
+ "content": "</s_1. MEDICARE>",
502
+ "lstrip": false,
503
+ "normalized": false,
504
+ "rstrip": false,
505
+ "single_word": false
506
+ },
507
+ {
508
+ "content": "</s_POINTER1>",
509
+ "lstrip": false,
510
+ "normalized": false,
511
+ "rstrip": false,
512
+ "single_word": false
513
+ },
514
+ {
515
+ "content": "<s_$ CHARGES1>",
516
+ "lstrip": false,
517
+ "normalized": false,
518
+ "rstrip": false,
519
+ "single_word": false
520
+ },
521
+ {
522
+ "content": "<s_ZIP CODE>",
523
+ "lstrip": false,
524
+ "normalized": false,
525
+ "rstrip": false,
526
+ "single_word": false
527
+ },
528
+ {
529
+ "content": "</s_FECA>",
530
+ "lstrip": false,
531
+ "normalized": false,
532
+ "rstrip": false,
533
+ "single_word": false
534
+ },
535
+ {
536
+ "content": "<s_$ CHARGES2>",
537
+ "lstrip": false,
538
+ "normalized": false,
539
+ "rstrip": false,
540
+ "single_word": false
541
+ },
542
+ {
543
+ "content": "<s_OTHER ACCIDENT>",
544
+ "lstrip": false,
545
+ "normalized": false,
546
+ "rstrip": false,
547
+ "single_word": false
548
+ },
549
+ {
550
+ "content": "</s_DD1>",
551
+ "lstrip": false,
552
+ "normalized": false,
553
+ "rstrip": false,
554
+ "single_word": false
555
+ },
556
+ {
557
+ "content": "<s_32. SERVICE FACILITY LOCATION>",
558
+ "lstrip": false,
559
+ "normalized": false,
560
+ "rstrip": false,
561
+ "single_word": false
562
+ },
563
+ {
564
+ "content": "</s_11. INSURED'S POLICY GROUP ORFECA NUMBER>",
565
+ "lstrip": false,
566
+ "normalized": false,
567
+ "rstrip": false,
568
+ "single_word": false
569
+ },
570
+ {
571
+ "content": "</s_EMPLOYMENT>",
572
+ "lstrip": false,
573
+ "normalized": false,
574
+ "rstrip": false,
575
+ "single_word": false
576
+ },
577
+ {
578
+ "content": "</s_formtype>",
579
+ "lstrip": false,
580
+ "normalized": false,
581
+ "rstrip": false,
582
+ "single_word": false
583
+ },
584
+ {
585
+ "content": "<s_EMPLOYMENT>",
586
+ "lstrip": false,
587
+ "normalized": false,
588
+ "rstrip": false,
589
+ "single_word": false
590
+ },
591
+ {
592
+ "content": "</s_CPT/HCPCS2>",
593
+ "lstrip": false,
594
+ "normalized": false,
595
+ "rstrip": false,
596
+ "single_word": false
597
+ },
598
+ {
599
+ "content": "<s_OTHER>",
600
+ "lstrip": false,
601
+ "normalized": false,
602
+ "rstrip": false,
603
+ "single_word": false
604
+ },
605
+ {
606
+ "content": "</s_23. PRIOR AUTHORIZATION NUMBER>",
607
+ "lstrip": false,
608
+ "normalized": false,
609
+ "rstrip": false,
610
+ "single_word": false
611
+ },
612
+ {
613
+ "content": "</s_CPT/HCPCS1>",
614
+ "lstrip": false,
615
+ "normalized": false,
616
+ "rstrip": false,
617
+ "single_word": false
618
+ },
619
+ {
620
+ "content": "</s_MM>",
621
+ "lstrip": false,
622
+ "normalized": false,
623
+ "rstrip": false,
624
+ "single_word": false
625
+ },
626
+ {
627
+ "content": "<s_DAYS OR UNITS>",
628
+ "lstrip": false,
629
+ "normalized": false,
630
+ "rstrip": false,
631
+ "single_word": false
632
+ },
633
+ {
634
+ "content": "<s_YY1>",
635
+ "lstrip": false,
636
+ "normalized": false,
637
+ "rstrip": false,
638
+ "single_word": false
639
+ },
640
+ {
641
+ "content": "<s_MM1>",
642
+ "lstrip": false,
643
+ "normalized": false,
644
+ "rstrip": false,
645
+ "single_word": false
646
+ },
647
+ {
648
+ "content": "<s_28. TOTAL CHARGE>",
649
+ "lstrip": false,
650
+ "normalized": false,
651
+ "rstrip": false,
652
+ "single_word": false
653
+ },
654
+ {
655
+ "content": "</s_21. DIAGNOSIS OR NATURE OF ILLNESS>",
656
+ "lstrip": false,
657
+ "normalized": false,
658
+ "rstrip": false,
659
+ "single_word": false
660
+ },
661
+ {
662
+ "content": "<s_DD>",
663
+ "lstrip": false,
664
+ "normalized": false,
665
+ "rstrip": false,
666
+ "single_word": false
667
+ },
668
+ {
669
+ "content": "</s_OTHER ACCIDENT>",
670
+ "lstrip": false,
671
+ "normalized": false,
672
+ "rstrip": false,
673
+ "single_word": false
674
+ },
675
+ {
676
+ "content": "</s_1.>",
677
+ "lstrip": false,
678
+ "normalized": false,
679
+ "rstrip": false,
680
+ "single_word": false
681
+ },
682
+ {
683
+ "content": "</s_MEMBER AND PATIENT INFORMATION>",
684
+ "lstrip": false,
685
+ "normalized": false,
686
+ "rstrip": false,
687
+ "single_word": false
688
+ },
689
+ {
690
+ "content": "</s_2. PATIENT'S NAME>",
691
+ "lstrip": false,
692
+ "normalized": false,
693
+ "rstrip": false,
694
+ "single_word": false
695
+ },
696
+ {
697
+ "content": "</s_5. PATIENT'S ADDRESS>",
698
+ "lstrip": false,
699
+ "normalized": false,
700
+ "rstrip": false,
701
+ "single_word": false
702
+ },
703
+ {
704
+ "content": "</s_G.>",
705
+ "lstrip": false,
706
+ "normalized": false,
707
+ "rstrip": false,
708
+ "single_word": false
709
+ },
710
+ {
711
+ "content": "<s_SEX>",
712
+ "lstrip": false,
713
+ "normalized": false,
714
+ "rstrip": false,
715
+ "single_word": false
716
+ },
717
+ {
718
+ "content": "</s_OTHER>",
719
+ "lstrip": false,
720
+ "normalized": false,
721
+ "rstrip": false,
722
+ "single_word": false
723
+ },
724
+ {
725
+ "content": "<s_8. PATIENT STATUS>",
726
+ "lstrip": false,
727
+ "normalized": false,
728
+ "rstrip": false,
729
+ "single_word": false
730
+ },
731
+ {
732
+ "content": "<s_11. INSURED'S POLICY GROUP ORFECA NUMBER>",
733
+ "lstrip": false,
734
+ "normalized": false,
735
+ "rstrip": false,
736
+ "single_word": false
737
+ },
738
+ {
739
+ "content": "<s>",
740
+ "lstrip": false,
741
+ "normalized": false,
742
+ "rstrip": false,
743
+ "single_word": false
744
+ },
745
+ {
746
+ "content": "<s_d. IS THERE ANOTHER HEALTH BENEFIT PLAN>",
747
+ "lstrip": false,
748
+ "normalized": false,
749
+ "rstrip": false,
750
+ "single_word": false
751
+ },
752
+ {
753
+ "content": "</s_meta>",
754
+ "lstrip": false,
755
+ "normalized": false,
756
+ "rstrip": false,
757
+ "single_word": false
758
+ },
759
+ {
760
+ "content": "</s_E. DIAGNOSIS>",
761
+ "lstrip": false,
762
+ "normalized": false,
763
+ "rstrip": false,
764
+ "single_word": false
765
+ },
766
+ {
767
+ "content": "<s_POINTER1>",
768
+ "lstrip": false,
769
+ "normalized": false,
770
+ "rstrip": false,
771
+ "single_word": false
772
+ },
773
+ {
774
+ "content": "<s_CPT/HCPCS1>",
775
+ "lstrip": false,
776
+ "normalized": false,
777
+ "rstrip": false,
778
+ "single_word": false
779
+ },
780
+ {
781
+ "content": "</s_MEDICAL PROVIDER INFORMATION>",
782
+ "lstrip": false,
783
+ "normalized": false,
784
+ "rstrip": false,
785
+ "single_word": false
786
+ },
787
+ {
788
+ "content": "</s_F.>",
789
+ "lstrip": false,
790
+ "normalized": false,
791
+ "rstrip": false,
792
+ "single_word": false
793
+ },
794
+ {
795
+ "content": "</s_d. INSURANCE PLAN NAME>",
796
+ "lstrip": false,
797
+ "normalized": false,
798
+ "rstrip": false,
799
+ "single_word": false
800
+ },
801
+ {
802
+ "content": "<s_MEMBER AND PATIENT INFORMATION>",
803
+ "lstrip": false,
804
+ "normalized": false,
805
+ "rstrip": false,
806
+ "single_word": false
807
+ },
808
+ {
809
+ "content": "</s_2.>",
810
+ "lstrip": false,
811
+ "normalized": false,
812
+ "rstrip": false,
813
+ "single_word": false
814
+ },
815
+ {
816
+ "content": "<s_29. AMOUNT PAID>",
817
+ "lstrip": false,
818
+ "normalized": false,
819
+ "rstrip": false,
820
+ "single_word": false
821
+ },
822
+ {
823
+ "content": "<s_9. OTHER INSURED'S NAME>",
824
+ "lstrip": false,
825
+ "normalized": false,
826
+ "rstrip": false,
827
+ "single_word": false
828
+ },
829
+ {
830
+ "content": "</s_MEDICAID>",
831
+ "lstrip": false,
832
+ "normalized": false,
833
+ "rstrip": false,
834
+ "single_word": false
835
+ },
836
+ {
837
+ "content": "<s_CITY>",
838
+ "lstrip": false,
839
+ "normalized": false,
840
+ "rstrip": false,
841
+ "single_word": false
842
+ },
843
+ {
844
+ "content": "<s_D. PROCEDURES, SERVICES>",
845
+ "lstrip": false,
846
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847
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+ "content": "<s_13. INSURED OR AUTHORIZED PERSON'S SIGNATURE>",
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+ "lstrip": false,
526
+ "normalized": false,
527
+ "rstrip": false,
528
+ "single_word": false,
529
+ "special": true
530
+ },
531
+ "57583": {
532
+ "content": "</s_d. IS THERE ANOTHER HEALTH BENEFIT PLAN>",
533
+ "lstrip": false,
534
+ "normalized": false,
535
+ "rstrip": false,
536
+ "single_word": false,
537
+ "special": true
538
+ },
539
+ "57584": {
540
+ "content": "</s_$ CHARGES1>",
541
+ "lstrip": false,
542
+ "normalized": false,
543
+ "rstrip": false,
544
+ "single_word": false,
545
+ "special": true
546
+ },
547
+ "57585": {
548
+ "content": "<s_MM>",
549
+ "lstrip": false,
550
+ "normalized": false,
551
+ "rstrip": false,
552
+ "single_word": false,
553
+ "special": true
554
+ },
555
+ "57586": {
556
+ "content": "<s_DATE>",
557
+ "lstrip": false,
558
+ "normalized": false,
559
+ "rstrip": false,
560
+ "single_word": false,
561
+ "special": true
562
+ },
563
+ "57587": {
564
+ "content": "</s_1a. INSURED'S I.D. NUMBER>",
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+ "lstrip": false,
566
+ "normalized": false,
567
+ "rstrip": false,
568
+ "single_word": false,
569
+ "special": true
570
+ },
571
+ "57588": {
572
+ "content": "<s_meta>",
573
+ "lstrip": false,
574
+ "normalized": false,
575
+ "rstrip": false,
576
+ "single_word": false,
577
+ "special": true
578
+ },
579
+ "57589": {
580
+ "content": "<s_GROUP HEALTH PLAN>",
581
+ "lstrip": false,
582
+ "normalized": false,
583
+ "rstrip": false,
584
+ "single_word": false,
585
+ "special": true
586
+ },
587
+ "57590": {
588
+ "content": "<s_10. PATIENT CONDITION>",
589
+ "lstrip": false,
590
+ "normalized": false,
591
+ "rstrip": false,
592
+ "single_word": false,
593
+ "special": true
594
+ },
595
+ "57591": {
596
+ "content": "<s_AUTO ACCIDENT>",
597
+ "lstrip": false,
598
+ "normalized": false,
599
+ "rstrip": false,
600
+ "single_word": false,
601
+ "special": true
602
+ },
603
+ "57592": {
604
+ "content": "<s_CPT/HCPCS2>",
605
+ "lstrip": false,
606
+ "normalized": false,
607
+ "rstrip": false,
608
+ "single_word": false,
609
+ "special": true
610
+ },
611
+ "57593": {
612
+ "content": "</s_ZIP CODE>",
613
+ "lstrip": false,
614
+ "normalized": false,
615
+ "rstrip": false,
616
+ "single_word": false,
617
+ "special": true
618
+ },
619
+ "57594": {
620
+ "content": "</s_7. INSURED'S ADDRESS>",
621
+ "lstrip": false,
622
+ "normalized": false,
623
+ "rstrip": false,
624
+ "single_word": false,
625
+ "special": true
626
+ },
627
+ "57595": {
628
+ "content": "</s_28. TOTAL CHARGE>",
629
+ "lstrip": false,
630
+ "normalized": false,
631
+ "rstrip": false,
632
+ "single_word": false,
633
+ "special": true
634
+ },
635
+ "57596": {
636
+ "content": "<s_TRICARE CHAMPUS>",
637
+ "lstrip": false,
638
+ "normalized": false,
639
+ "rstrip": false,
640
+ "single_word": false,
641
+ "special": true
642
+ },
643
+ "57597": {
644
+ "content": "<s_2. PATIENT'S NAME>",
645
+ "lstrip": false,
646
+ "normalized": false,
647
+ "rstrip": false,
648
+ "single_word": false,
649
+ "special": true
650
+ },
651
+ "57598": {
652
+ "content": "<s_23. PRIOR AUTHORIZATION NUMBER>",
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+ "lstrip": false,
654
+ "normalized": false,
655
+ "rstrip": false,
656
+ "single_word": false,
657
+ "special": true
658
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659
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660
+ "content": "<s_4. INSURED'S NAME>",
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+ "lstrip": false,
662
+ "normalized": false,
663
+ "rstrip": false,
664
+ "single_word": false,
665
+ "special": true
666
+ },
667
+ "57600": {
668
+ "content": "<s_E. DIAGNOSIS>",
669
+ "lstrip": false,
670
+ "normalized": false,
671
+ "rstrip": false,
672
+ "single_word": false,
673
+ "special": true
674
+ },
675
+ "57601": {
676
+ "content": "</s_GROUP HEALTH PLAN>",
677
+ "lstrip": false,
678
+ "normalized": false,
679
+ "rstrip": false,
680
+ "single_word": false,
681
+ "special": true
682
+ },
683
+ "57602": {
684
+ "content": "<s_STATE>",
685
+ "lstrip": false,
686
+ "normalized": false,
687
+ "rstrip": false,
688
+ "single_word": false,
689
+ "special": true
690
+ },
691
+ "57603": {
692
+ "content": "</s_27. ACCEPT ASSIGNMENT>",
693
+ "lstrip": false,
694
+ "normalized": false,
695
+ "rstrip": false,
696
+ "single_word": false,
697
+ "special": true
698
+ },
699
+ "57604": {
700
+ "content": "</s_3. PATIENT's BIRTH DATE>",
701
+ "lstrip": false,
702
+ "normalized": false,
703
+ "rstrip": false,
704
+ "single_word": false,
705
+ "special": true
706
+ },
707
+ "57605": {
708
+ "content": "<s_1a. INSURED'S I.D. NUMBER>",
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+ "lstrip": false,
710
+ "normalized": false,
711
+ "rstrip": false,
712
+ "single_word": false,
713
+ "special": true
714
+ },
715
+ "57606": {
716
+ "content": "</s_CITY>",
717
+ "lstrip": false,
718
+ "normalized": false,
719
+ "rstrip": false,
720
+ "single_word": false,
721
+ "special": true
722
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723
+ "57607": {
724
+ "content": "</s_MM1>",
725
+ "lstrip": false,
726
+ "normalized": false,
727
+ "rstrip": false,
728
+ "single_word": false,
729
+ "special": true
730
+ },
731
+ "57608": {
732
+ "content": "<s_F.>",
733
+ "lstrip": false,
734
+ "normalized": false,
735
+ "rstrip": false,
736
+ "single_word": false,
737
+ "special": true
738
+ },
739
+ "57609": {
740
+ "content": "</s_DATE>",
741
+ "lstrip": false,
742
+ "normalized": false,
743
+ "rstrip": false,
744
+ "single_word": false,
745
+ "special": true
746
+ },
747
+ "57610": {
748
+ "content": "<s_21. DIAGNOSIS OR NATURE OF ILLNESS>",
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+ "lstrip": false,
750
+ "normalized": false,
751
+ "rstrip": false,
752
+ "single_word": false,
753
+ "special": true
754
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756
+ "content": "<s_MEDICAID>",
757
+ "lstrip": false,
758
+ "normalized": false,
759
+ "rstrip": false,
760
+ "single_word": false,
761
+ "special": true
762
+ },
763
+ "57612": {
764
+ "content": "</s_32. SERVICE FACILITY LOCATION>",
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+ "lstrip": false,
766
+ "normalized": false,
767
+ "rstrip": false,
768
+ "single_word": false,
769
+ "special": true
770
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771
+ "57613": {
772
+ "content": "<s_6. PATIENT RELATIONSHIP>",
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+ "lstrip": false,
774
+ "normalized": false,
775
+ "rstrip": false,
776
+ "single_word": false,
777
+ "special": true
778
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779
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780
+ "content": "</s_YY1>",
781
+ "lstrip": false,
782
+ "normalized": false,
783
+ "rstrip": false,
784
+ "single_word": false,
785
+ "special": true
786
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787
+ "57615": {
788
+ "content": "</s_formnumber>",
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+ "lstrip": false,
790
+ "normalized": false,
791
+ "rstrip": false,
792
+ "single_word": false,
793
+ "special": true
794
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795
+ "57616": {
796
+ "content": "<s_1. MEDICARE>",
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+ "lstrip": false,
798
+ "normalized": false,
799
+ "rstrip": false,
800
+ "single_word": false,
801
+ "special": true
802
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803
+ "57617": {
804
+ "content": "<s_24. DATE OF SERVICE>",
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806
+ "normalized": false,
807
+ "rstrip": false,
808
+ "single_word": false,
809
+ "special": true
810
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811
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812
+ "content": "</s_13. INSURED OR AUTHORIZED PERSON'S SIGNATURE>",
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814
+ "normalized": false,
815
+ "rstrip": false,
816
+ "single_word": false,
817
+ "special": true
818
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819
+ "57619": {
820
+ "content": "</s_DAYS OR UNITS>",
821
+ "lstrip": false,
822
+ "normalized": false,
823
+ "rstrip": false,
824
+ "single_word": false,
825
+ "special": true
826
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827
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828
+ "content": "</s_6. PATIENT RELATIONSHIP>",
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+ "lstrip": false,
830
+ "normalized": false,
831
+ "rstrip": false,
832
+ "single_word": false,
833
+ "special": true
834
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835
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836
+ "content": "</s_8. PATIENT STATUS>",
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838
+ "normalized": false,
839
+ "rstrip": false,
840
+ "single_word": false,
841
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846
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847
+ "rstrip": false,
848
+ "single_word": false,
849
+ "special": true
850
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851
+ "57623": {
852
+ "content": "<s_MEDICAL PROVIDER INFORMATION>",
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+ "lstrip": false,
854
+ "normalized": false,
855
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856
+ "single_word": false,
857
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858
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859
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860
+ "content": "</s_DD>",
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+ "lstrip": false,
862
+ "normalized": false,
863
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864
+ "single_word": false,
865
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868
+ "content": "<s_FECA>",
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+ "lstrip": false,
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+ "normalized": false,
871
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872
+ "single_word": false,
873
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+ "content": "</s_CHAMPVA>",
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878
+ "normalized": false,
879
+ "rstrip": false,
880
+ "single_word": false,
881
+ "special": true
882
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883
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884
+ "content": "</s_STATE>",
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886
+ "normalized": false,
887
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888
+ "single_word": false,
889
+ "special": true
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+ "content": "</s_SEX>",
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894
+ "normalized": false,
895
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896
+ "single_word": false,
897
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898
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+ "content": "<s_d. INSURANCE PLAN NAME>",
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902
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903
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904
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905
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912
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914
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916
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921
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922
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923
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924
+ "content": "<s_CHAMPVA>",
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926
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927
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931
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932
+ "content": "</s_10. PATIENT CONDITION>",
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934
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935
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936
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940
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942
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943
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944
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945
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951
+ "rstrip": false,
952
+ "single_word": false,
953
+ "special": true
954
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955
+ "57636": {
956
+ "content": "</s_9. OTHER INSURED'S NAME>",
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+ "lstrip": false,
958
+ "normalized": false,
959
+ "rstrip": false,
960
+ "single_word": false,
961
+ "special": true
962
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963
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964
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966
+ "normalized": false,
967
+ "rstrip": false,
968
+ "single_word": false,
969
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971
+ "57638": {
972
+ "content": "<s_26. PATIENT'S ACCOUNT NUMBER>",
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974
+ "normalized": false,
975
+ "rstrip": false,
976
+ "single_word": false,
977
+ "special": true
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980
+ "content": "<s_5. PATIENT'S ADDRESS>",
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982
+ "normalized": false,
983
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984
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985
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986
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988
+ "content": "<s_G.>",
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+ "lstrip": false,
990
+ "normalized": false,
991
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992
+ "single_word": false,
993
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994
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995
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996
+ "content": "<s_2.>",
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998
+ "normalized": false,
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+ "rstrip": false,
1000
+ "single_word": false,
1001
+ "special": true
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+ "57642": {
1004
+ "content": "</s_12. PATIENT'S OR AUTHORIZED PERSON'S SIGNATURE>",
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+ "lstrip": false,
1006
+ "normalized": false,
1007
+ "rstrip": false,
1008
+ "single_word": false,
1009
+ "special": true
1010
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1011
+ "57643": {
1012
+ "content": "</s_D. PROCEDURES, SERVICES>",
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+ "lstrip": false,
1014
+ "normalized": false,
1015
+ "rstrip": false,
1016
+ "single_word": false,
1017
+ "special": true
1018
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1019
+ "57644": {
1020
+ "content": "<s_27. ACCEPT ASSIGNMENT>",
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+ "lstrip": false,
1022
+ "normalized": false,
1023
+ "rstrip": false,
1024
+ "single_word": false,
1025
+ "special": true
1026
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1027
+ "57645": {
1028
+ "content": "</s_$ CHARGES2>",
1029
+ "lstrip": false,
1030
+ "normalized": false,
1031
+ "rstrip": false,
1032
+ "single_word": false,
1033
+ "special": true
1034
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1035
+ "57646": {
1036
+ "content": "</s_26. PATIENT'S ACCOUNT NUMBER>",
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+ "lstrip": false,
1038
+ "normalized": false,
1039
+ "rstrip": false,
1040
+ "single_word": false,
1041
+ "special": true
1042
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1043
+ "57647": {
1044
+ "content": "</s_AUTO ACCIDENT>",
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+ "lstrip": false,
1046
+ "normalized": false,
1047
+ "rstrip": false,
1048
+ "single_word": false,
1049
+ "special": true
1050
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1051
+ "57648": {
1052
+ "content": "</s_24. DATE OF SERVICE>",
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+ "lstrip": false,
1054
+ "normalized": false,
1055
+ "rstrip": false,
1056
+ "single_word": false,
1057
+ "special": true
1058
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1059
+ "57649": {
1060
+ "content": "<s_3. PATIENT's BIRTH DATE>",
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+ "lstrip": false,
1062
+ "normalized": false,
1063
+ "rstrip": false,
1064
+ "single_word": false,
1065
+ "special": true
1066
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1067
+ "57650": {
1068
+ "content": "</s_1. MEDICARE>",
1069
+ "lstrip": false,
1070
+ "normalized": false,
1071
+ "rstrip": false,
1072
+ "single_word": false,
1073
+ "special": true
1074
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1075
+ "57651": {
1076
+ "content": "</s_POINTER1>",
1077
+ "lstrip": false,
1078
+ "normalized": false,
1079
+ "rstrip": false,
1080
+ "single_word": false,
1081
+ "special": true
1082
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1083
+ "57652": {
1084
+ "content": "<s_$ CHARGES1>",
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+ "lstrip": false,
1086
+ "normalized": false,
1087
+ "rstrip": false,
1088
+ "single_word": false,
1089
+ "special": true
1090
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1091
+ "57653": {
1092
+ "content": "<s_ZIP CODE>",
1093
+ "lstrip": false,
1094
+ "normalized": false,
1095
+ "rstrip": false,
1096
+ "single_word": false,
1097
+ "special": true
1098
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1099
+ "57654": {
1100
+ "content": "</s_FECA>",
1101
+ "lstrip": false,
1102
+ "normalized": false,
1103
+ "rstrip": false,
1104
+ "single_word": false,
1105
+ "special": true
1106
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1107
+ "57655": {
1108
+ "content": "<s_$ CHARGES2>",
1109
+ "lstrip": false,
1110
+ "normalized": false,
1111
+ "rstrip": false,
1112
+ "single_word": false,
1113
+ "special": true
1114
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1115
+ "57656": {
1116
+ "content": "<s_OTHER ACCIDENT>",
1117
+ "lstrip": false,
1118
+ "normalized": false,
1119
+ "rstrip": false,
1120
+ "single_word": false,
1121
+ "special": true
1122
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1123
+ "57657": {
1124
+ "content": "</s_DD1>",
1125
+ "lstrip": false,
1126
+ "normalized": false,
1127
+ "rstrip": false,
1128
+ "single_word": false,
1129
+ "special": true
1130
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1131
+ "57658": {
1132
+ "content": "<s_32. SERVICE FACILITY LOCATION>",
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+ "lstrip": false,
1134
+ "normalized": false,
1135
+ "rstrip": false,
1136
+ "single_word": false,
1137
+ "special": true
1138
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1139
+ "57659": {
1140
+ "content": "</s_11. INSURED'S POLICY GROUP ORFECA NUMBER>",
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+ "lstrip": false,
1142
+ "normalized": false,
1143
+ "rstrip": false,
1144
+ "single_word": false,
1145
+ "special": true
1146
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1147
+ "57660": {
1148
+ "content": "</s_EMPLOYMENT>",
1149
+ "lstrip": false,
1150
+ "normalized": false,
1151
+ "rstrip": false,
1152
+ "single_word": false,
1153
+ "special": true
1154
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1155
+ "57661": {
1156
+ "content": "</s_formtype>",
1157
+ "lstrip": false,
1158
+ "normalized": false,
1159
+ "rstrip": false,
1160
+ "single_word": false,
1161
+ "special": true
1162
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1163
+ "57662": {
1164
+ "content": "<s_EMPLOYMENT>",
1165
+ "lstrip": false,
1166
+ "normalized": false,
1167
+ "rstrip": false,
1168
+ "single_word": false,
1169
+ "special": true
1170
+ },
1171
+ "57663": {
1172
+ "content": "</s_CPT/HCPCS2>",
1173
+ "lstrip": false,
1174
+ "normalized": false,
1175
+ "rstrip": false,
1176
+ "single_word": false,
1177
+ "special": true
1178
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1179
+ "57664": {
1180
+ "content": "<s_OTHER>",
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