Segment
X12 EDI Release 00303
To specify the claim service detail for a Health Care institution
Elements
  • SV201234Product/Service ID
    AN
    O可选(Optional)
    Min 1 / Max 30

    Identifying number for a product or service.

  • SV202235Product/Service ID Qualifier
    ID
    O可选(Optional)

    Code identifying the type/source of the descriptive number used in Product/Service ID (234).

    Codes (275)
  • SV203234Product/Service ID
    AN
    O可选(Optional)
    Min 1 / Max 30

    Identifying number for a product or service.

  • SV204782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 15

    Monetary amount.

  • SV205355Unit or Basis for Measurement Code
    ID
    O可选(Optional)

    Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken

    Codes (682)
  • SV206380Quantity
    R
    O可选(Optional)
    Min 1 / Max 15

    Numeric value of quantity.

  • SV2071339Procedure Modifier
    AN
    O可选(Optional)
    Min 2 / Max 2

    This identifies special circumstances related to the performance of the service, as defined by trading partners

  • SV2081339Procedure Modifier
    AN
    O可选(Optional)
    Min 2 / Max 2

    This identifies special circumstances related to the performance of the service, as defined by trading partners

  • SV2091339Procedure Modifier
    AN
    O可选(Optional)
    Min 2 / Max 2

    This identifies special circumstances related to the performance of the service, as defined by trading partners

  • SV2101371Unit Rate
    R
    O可选(Optional)
    Min 1 / Max 10

    The rate per unit of associate revenue for hospital accommodation

  • SV211352Description
    AN
    O可选(Optional)
    Min 1 / Max 80

    A free-form description to clarify the related data elements and their content.

  • SV212782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 15

    Monetary amount.

  • SV2131073Yes/No Condition or Response Code
    ID
    O可选(Optional)

    Code indicating a Yes or No condition or response.

    Codes (3)
  • SV2141345Nursing Home Residential Status Code
    ID
    O可选(Optional)

    Code specifying the status of a nursing home resident at the time of service

    Codes (9)
  • SV2151337Level of Care Code
    ID
    O可选(Optional)

    Code specifying the level of care provided by a nursing home facility

    Codes (7)