Segment
X12 EDI Release 00304
To specify the claim service detail for drug services that have been adjudicated
Elements
  • SV701127Reference Number
    AN
    O可选(Optional)
    Min 1 / Max 30

    Reference number or identification number as defined for a particular Transaction Set, or as specified by the Reference Number Qualifier.

  • SV702127Reference Number
    AN
    O可选(Optional)
    Min 1 / Max 30

    Reference number or identification number as defined for a particular Transaction Set, or as specified by the Reference Number Qualifier.

  • SV7031355Prescription Denial Override Code
    ID
    O可选(Optional)

    Code indicating that a pharmacist has overridden the denial of a prescription

    Codes (8)