$发票号码$       $医疗机构类型$          $ZYBAH$        $ZYNO$
     $入年$  $入月$  $入日$      $出年$  $出月$  $出日$         $ZYTS$
      $XM$     $XB$       $医保类型$         $社保卡$
$费用类别1$  $金额1$ $费用类别2$  $金额2$
$费用类别3$  $金额3$ $费用类别4$  $金额4$
$费用类别5$  $金额5$ $费用类别6$  $金额6$
$费用类别7$  $金额7$ $费用类别8$  $金额8$
$费用类别9$  $金额9$ $费用类别10$  $金额10$
$费用类别11$  $金额11$ $费用类别12$  $金额12$
          $医疗费总额大写$    $医疗费总额$
      $预交款$     $补收款$     $退款$
      $COMPANYID$   $结算年$$结算月$$结算日$

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