Segment
X12 EDI Release 00404
To supply information related to the delivery of health care
Elements
  • HI01C022Health Care Code InformationM必须(Mandatory)
    127012711250125178238079912711073
    • HI01011270Code List Qualifier Code
      ID
      M必须(Mandatory)

      Code identifying a specific industry code list

      Codes (873)
    • HI01021271Industry Code
      AN
      M必须(Mandatory)
      Min 0 / Max 30

      Code indicating a code from a specific industry code list

    • HI01031250Date Time Period Format Qualifier
      ID
      O可选(Optional)

      Code indicating the date format, time format, or date and time format

      Codes (41)
    • HI01041251Date Time Period
      AN
      O可选(Optional)
      Min 1 / Max 35

      Expression of a date, a time, or range of dates, times or dates and times

    • HI0105782Monetary Amount
      R
      O可选(Optional)
      Min 1 / Max 18

      Monetary amount

    • HI0106380Quantity
      R
      O可选(Optional)
      Min 1 / Max 15

      Numeric value of quantity

    • HI0107799Version Identifier
      AN
      O可选(Optional)
      Min 1 / Max 30

      Revision level of a particular format, program, technique or algorithm

    • HI01081271Industry Code
      AN
      O可选(Optional)
      Min 1 / Max 30

      Code indicating a code from a specific industry code list

    • HI01091073Yes/No Condition or Response Code
      ID
      O可选(Optional)

      Code indicating a Yes or No condition or response

      Codes (4)
  • HI02C022Health Care Code InformationO可选(Optional)
    127012711250125178238079912711073
    • HI02011270Code List Qualifier Code
      ID
      M必须(Mandatory)

      Code identifying a specific industry code list

      Codes (873)
    • HI02021271Industry Code
      AN
      M必须(Mandatory)
      Min 0 / Max 30

      Code indicating a code from a specific industry code list

    • HI02031250Date Time Period Format Qualifier
      ID
      O可选(Optional)

      Code indicating the date format, time format, or date and time format

      Codes (41)
    • HI02041251Date Time Period
      AN
      O可选(Optional)
      Min 1 / Max 35

      Expression of a date, a time, or range of dates, times or dates and times

    • HI0205782Monetary Amount
      R
      O可选(Optional)
      Min 1 / Max 18

      Monetary amount

    • HI0206380Quantity
      R
      O可选(Optional)
      Min 1 / Max 15

      Numeric value of quantity

    • HI0207799Version Identifier
      AN
      O可选(Optional)
      Min 1 / Max 30

      Revision level of a particular format, program, technique or algorithm

    • HI02081271Industry Code
      AN
      O可选(Optional)
      Min 1 / Max 30

      Code indicating a code from a specific industry code list

    • HI02091073Yes/No Condition or Response Code
      ID
      O可选(Optional)

      Code indicating a Yes or No condition or response

      Codes (4)
  • HI03C022Health Care Code InformationO可选(Optional)
    127012711250125178238079912711073
    • HI03011270Code List Qualifier Code
      ID
      M必须(Mandatory)

      Code identifying a specific industry code list

      Codes (873)
    • HI03021271Industry Code
      AN
      M必须(Mandatory)
      Min 0 / Max 30

      Code indicating a code from a specific industry code list

    • HI03031250Date Time Period Format Qualifier
      ID
      O可选(Optional)

      Code indicating the date format, time format, or date and time format

      Codes (41)
    • HI03041251Date Time Period
      AN
      O可选(Optional)
      Min 1 / Max 35

      Expression of a date, a time, or range of dates, times or dates and times

    • HI0305782Monetary Amount
      R
      O可选(Optional)
      Min 1 / Max 18

      Monetary amount

    • HI0306380Quantity
      R
      O可选(Optional)
      Min 1 / Max 15

      Numeric value of quantity

    • HI0307799Version Identifier
      AN
      O可选(Optional)
      Min 1 / Max 30

      Revision level of a particular format, program, technique or algorithm

    • HI03081271Industry Code
      AN
      O可选(Optional)
      Min 1 / Max 30

      Code indicating a code from a specific industry code list

    • HI03091073Yes/No Condition or Response Code
      ID
      O可选(Optional)

      Code indicating a Yes or No condition or response

      Codes (4)
  • HI04C022Health Care Code InformationO可选(Optional)
    127012711250125178238079912711073
    • HI04011270Code List Qualifier Code
      ID
      M必须(Mandatory)

      Code identifying a specific industry code list

      Codes (873)
    • HI04021271Industry Code
      AN
      M必须(Mandatory)
      Min 0 / Max 30

      Code indicating a code from a specific industry code list

    • HI04031250Date Time Period Format Qualifier
      ID
      O可选(Optional)

      Code indicating the date format, time format, or date and time format

      Codes (41)
    • HI04041251Date Time Period
      AN
      O可选(Optional)
      Min 1 / Max 35

      Expression of a date, a time, or range of dates, times or dates and times

    • HI0405782Monetary Amount
      R
      O可选(Optional)
      Min 1 / Max 18

      Monetary amount

    • HI0406380Quantity
      R
      O可选(Optional)
      Min 1 / Max 15

      Numeric value of quantity

    • HI0407799Version Identifier
      AN
      O可选(Optional)
      Min 1 / Max 30

      Revision level of a particular format, program, technique or algorithm

    • HI04081271Industry Code
      AN
      O可选(Optional)
      Min 1 / Max 30

      Code indicating a code from a specific industry code list

    • HI04091073Yes/No Condition or Response Code
      ID
      O可选(Optional)

      Code indicating a Yes or No condition or response

      Codes (4)
  • HI05C022Health Care Code InformationO可选(Optional)
    127012711250125178238079912711073
    • HI05011270Code List Qualifier Code
      ID
      M必须(Mandatory)

      Code identifying a specific industry code list

      Codes (873)
    • HI05021271Industry Code
      AN
      M必须(Mandatory)
      Min 0 / Max 30

      Code indicating a code from a specific industry code list

    • HI05031250Date Time Period Format Qualifier
      ID
      O可选(Optional)

      Code indicating the date format, time format, or date and time format

      Codes (41)
    • HI05041251Date Time Period
      AN
      O可选(Optional)
      Min 1 / Max 35

      Expression of a date, a time, or range of dates, times or dates and times

    • HI0505782Monetary Amount
      R
      O可选(Optional)
      Min 1 / Max 18

      Monetary amount

    • HI0506380Quantity
      R
      O可选(Optional)
      Min 1 / Max 15

      Numeric value of quantity

    • HI0507799Version Identifier
      AN
      O可选(Optional)
      Min 1 / Max 30

      Revision level of a particular format, program, technique or algorithm

    • HI05081271Industry Code
      AN
      O可选(Optional)
      Min 1 / Max 30

      Code indicating a code from a specific industry code list

    • HI05091073Yes/No Condition or Response Code
      ID
      O可选(Optional)

      Code indicating a Yes or No condition or response

      Codes (4)
  • HI06C022Health Care Code InformationO可选(Optional)
    127012711250125178238079912711073
    • HI06011270Code List Qualifier Code
      ID
      M必须(Mandatory)

      Code identifying a specific industry code list

      Codes (873)
    • HI06021271Industry Code
      AN
      M必须(Mandatory)
      Min 0 / Max 30

      Code indicating a code from a specific industry code list

    • HI06031250Date Time Period Format Qualifier
      ID
      O可选(Optional)

      Code indicating the date format, time format, or date and time format

      Codes (41)
    • HI06041251Date Time Period
      AN
      O可选(Optional)
      Min 1 / Max 35

      Expression of a date, a time, or range of dates, times or dates and times

    • HI0605782Monetary Amount
      R
      O可选(Optional)
      Min 1 / Max 18

      Monetary amount

    • HI0606380Quantity
      R
      O可选(Optional)
      Min 1 / Max 15

      Numeric value of quantity

    • HI0607799Version Identifier
      AN
      O可选(Optional)
      Min 1 / Max 30

      Revision level of a particular format, program, technique or algorithm

    • HI06081271Industry Code
      AN
      O可选(Optional)
      Min 1 / Max 30

      Code indicating a code from a specific industry code list

    • HI06091073Yes/No Condition or Response Code
      ID
      O可选(Optional)

      Code indicating a Yes or No condition or response

      Codes (4)
  • HI07C022Health Care Code InformationO可选(Optional)
    127012711250125178238079912711073
    • HI07011270Code List Qualifier Code
      ID
      M必须(Mandatory)

      Code identifying a specific industry code list

      Codes (873)
    • HI07021271Industry Code
      AN
      M必须(Mandatory)
      Min 0 / Max 30

      Code indicating a code from a specific industry code list

    • HI07031250Date Time Period Format Qualifier
      ID
      O可选(Optional)

      Code indicating the date format, time format, or date and time format

      Codes (41)
    • HI07041251Date Time Period
      AN
      O可选(Optional)
      Min 1 / Max 35

      Expression of a date, a time, or range of dates, times or dates and times

    • HI0705782Monetary Amount
      R
      O可选(Optional)
      Min 1 / Max 18

      Monetary amount

    • HI0706380Quantity
      R
      O可选(Optional)
      Min 1 / Max 15

      Numeric value of quantity

    • HI0707799Version Identifier
      AN
      O可选(Optional)
      Min 1 / Max 30

      Revision level of a particular format, program, technique or algorithm

    • HI07081271Industry Code
      AN
      O可选(Optional)
      Min 1 / Max 30

      Code indicating a code from a specific industry code list

    • HI07091073Yes/No Condition or Response Code
      ID
      O可选(Optional)

      Code indicating a Yes or No condition or response

      Codes (4)
  • HI08C022Health Care Code InformationO可选(Optional)
    127012711250125178238079912711073
    • HI08011270Code List Qualifier Code
      ID
      M必须(Mandatory)

      Code identifying a specific industry code list

      Codes (873)
    • HI08021271Industry Code
      AN
      M必须(Mandatory)
      Min 0 / Max 30

      Code indicating a code from a specific industry code list

    • HI08031250Date Time Period Format Qualifier
      ID
      O可选(Optional)

      Code indicating the date format, time format, or date and time format

      Codes (41)
    • HI08041251Date Time Period
      AN
      O可选(Optional)
      Min 1 / Max 35

      Expression of a date, a time, or range of dates, times or dates and times

    • HI0805782Monetary Amount
      R
      O可选(Optional)
      Min 1 / Max 18

      Monetary amount

    • HI0806380Quantity
      R
      O可选(Optional)
      Min 1 / Max 15

      Numeric value of quantity

    • HI0807799Version Identifier
      AN
      O可选(Optional)
      Min 1 / Max 30

      Revision level of a particular format, program, technique or algorithm

    • HI08081271Industry Code
      AN
      O可选(Optional)
      Min 1 / Max 30

      Code indicating a code from a specific industry code list

    • HI08091073Yes/No Condition or Response Code
      ID
      O可选(Optional)

      Code indicating a Yes or No condition or response

      Codes (4)
  • HI09C022Health Care Code InformationO可选(Optional)
    127012711250125178238079912711073
    • HI09011270Code List Qualifier Code
      ID
      M必须(Mandatory)

      Code identifying a specific industry code list

      Codes (873)
    • HI09021271Industry Code
      AN
      M必须(Mandatory)
      Min 0 / Max 30

      Code indicating a code from a specific industry code list

    • HI09031250Date Time Period Format Qualifier
      ID
      O可选(Optional)

      Code indicating the date format, time format, or date and time format

      Codes (41)
    • HI09041251Date Time Period
      AN
      O可选(Optional)
      Min 1 / Max 35

      Expression of a date, a time, or range of dates, times or dates and times

    • HI0905782Monetary Amount
      R
      O可选(Optional)
      Min 1 / Max 18

      Monetary amount

    • HI0906380Quantity
      R
      O可选(Optional)
      Min 1 / Max 15

      Numeric value of quantity

    • HI0907799Version Identifier
      AN
      O可选(Optional)
      Min 1 / Max 30

      Revision level of a particular format, program, technique or algorithm

    • HI09081271Industry Code
      AN
      O可选(Optional)
      Min 1 / Max 30

      Code indicating a code from a specific industry code list

    • HI09091073Yes/No Condition or Response Code
      ID
      O可选(Optional)

      Code indicating a Yes or No condition or response

      Codes (4)
  • HI10C022Health Care Code InformationO可选(Optional)
    127012711250125178238079912711073
    • HI10011270Code List Qualifier Code
      ID
      M必须(Mandatory)

      Code identifying a specific industry code list

      Codes (873)
    • HI10021271Industry Code
      AN
      M必须(Mandatory)
      Min 0 / Max 30

      Code indicating a code from a specific industry code list

    • HI10031250Date Time Period Format Qualifier
      ID
      O可选(Optional)

      Code indicating the date format, time format, or date and time format

      Codes (41)
    • HI10041251Date Time Period
      AN
      O可选(Optional)
      Min 1 / Max 35

      Expression of a date, a time, or range of dates, times or dates and times

    • HI1005782Monetary Amount
      R
      O可选(Optional)
      Min 1 / Max 18

      Monetary amount

    • HI1006380Quantity
      R
      O可选(Optional)
      Min 1 / Max 15

      Numeric value of quantity

    • HI1007799Version Identifier
      AN
      O可选(Optional)
      Min 1 / Max 30

      Revision level of a particular format, program, technique or algorithm

    • HI10081271Industry Code
      AN
      O可选(Optional)
      Min 1 / Max 30

      Code indicating a code from a specific industry code list

    • HI10091073Yes/No Condition or Response Code
      ID
      O可选(Optional)

      Code indicating a Yes or No condition or response

      Codes (4)
  • HI11C022Health Care Code InformationO可选(Optional)
    127012711250125178238079912711073
    • HI11011270Code List Qualifier Code
      ID
      M必须(Mandatory)

      Code identifying a specific industry code list

      Codes (873)
    • HI11021271Industry Code
      AN
      M必须(Mandatory)
      Min 0 / Max 30

      Code indicating a code from a specific industry code list

    • HI11031250Date Time Period Format Qualifier
      ID
      O可选(Optional)

      Code indicating the date format, time format, or date and time format

      Codes (41)
    • HI11041251Date Time Period
      AN
      O可选(Optional)
      Min 1 / Max 35

      Expression of a date, a time, or range of dates, times or dates and times

    • HI1105782Monetary Amount
      R
      O可选(Optional)
      Min 1 / Max 18

      Monetary amount

    • HI1106380Quantity
      R
      O可选(Optional)
      Min 1 / Max 15

      Numeric value of quantity

    • HI1107799Version Identifier
      AN
      O可选(Optional)
      Min 1 / Max 30

      Revision level of a particular format, program, technique or algorithm

    • HI11081271Industry Code
      AN
      O可选(Optional)
      Min 1 / Max 30

      Code indicating a code from a specific industry code list

    • HI11091073Yes/No Condition or Response Code
      ID
      O可选(Optional)

      Code indicating a Yes or No condition or response

      Codes (4)
  • HI12C022Health Care Code InformationO可选(Optional)
    127012711250125178238079912711073
    • HI12011270Code List Qualifier Code
      ID
      M必须(Mandatory)

      Code identifying a specific industry code list

      Codes (873)
    • HI12021271Industry Code
      AN
      M必须(Mandatory)
      Min 0 / Max 30

      Code indicating a code from a specific industry code list

    • HI12031250Date Time Period Format Qualifier
      ID
      O可选(Optional)

      Code indicating the date format, time format, or date and time format

      Codes (41)
    • HI12041251Date Time Period
      AN
      O可选(Optional)
      Min 1 / Max 35

      Expression of a date, a time, or range of dates, times or dates and times

    • HI1205782Monetary Amount
      R
      O可选(Optional)
      Min 1 / Max 18

      Monetary amount

    • HI1206380Quantity
      R
      O可选(Optional)
      Min 1 / Max 15

      Numeric value of quantity

    • HI1207799Version Identifier
      AN
      O可选(Optional)
      Min 1 / Max 30

      Revision level of a particular format, program, technique or algorithm

    • HI12081271Industry Code
      AN
      O可选(Optional)
      Min 1 / Max 30

      Code indicating a code from a specific industry code list

    • HI12091073Yes/No Condition or Response Code
      ID
      O可选(Optional)

      Code indicating a Yes or No condition or response

      Codes (4)